False-negative results after stereotactically guided vacuum biopsy

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Stereotactically guided vacuum biopsy (VB) is a common method for diagnosing nonpalpable breast lesions.
• Assessing the accuracy of VB, specifically its false negative rate, is crucial for effective breast cancer screening and diagnosis.

Purpose of the Study:

• To determine the false negative rate of stereotactically guided vacuum biopsy (VB).
• To evaluate the diagnostic accuracy and limitations of VB in identifying breast lesions.

Main Methods:

• Retrospective analysis of patient data with benign lesions diagnosed via VB.
• Evaluation of follow-up data for a median period of 21 months post-biopsy.
• Assessment of reintervention rates and final diagnoses for lesions initially deemed benign.

Main Results:

• A total of 404 VB procedures were considered benign and recommended for follow-up.
• Follow-up data were available for 354 patients (87.6%).
• A false negative rate of 1.4% (5/354 cases) was identified, with four cases involving extensive microcalcifications or clusters where complete removal was challenging.

Conclusions:

• Stereotactically guided vacuum biopsy (VB) is an accurate diagnostic tool with a low cancer miss rate.
• The presence of disseminated microcalcifications or multiple clusters presents a limitation, potentially increasing the risk of false negatives.
• Close radiologic-pathologic correlation and strict follow-up are essential for benign lesions to prevent delayed cancer diagnosis.