Feasibility of Vacuum-Assisted Breast Cone-Beam CT-Guided Biopsy and Comparison With Prone Stereotactic Biopsy

The feasibility of breast vacuum-assisted biopsy (VAB) guided by cone-beam CT (CBCT) was assessed. The initial clinical performance of CT-guided breast VAB was compared with that of established prone stereotactic VAB.

In this retrospective clinical trial, VABs were performed for women with mammographically suspicious breast lesions using a dedicated breast CBCT protocol. The technical success rate, total intervention time, and complications were documented and compared with examinations performed by prone stereotactic VAB.

Between June 2015 and March 2016, 65 patients with 68 target lesions underwent image-guided VAB. CT-guided VAB was performed for 29 patients with 31 lesions. Thirty-six patients with 37 lesions underwent prone stereotactic VAB. The type of lesion was not different between the two groups (p = 0.135). Technical success rate was achieved in 31 of 33 lesions (93.9%) with CT-guided VAB versus 37 of 38 lesions (97.4%) with prone stereotactic VAB. The mean (± SD) total intervention time was 22.7 ± 8.4 minutes for CT-guided VAB versus 28.8 ± 9.4 minutes for prone stereotactic VAB (p < 0.05). Reidentifying and targeting lesions took about the same time for both systems (p = 0.362). The time for tissue sampling was significantly faster with CT-guided VAB (p < 0.05). No major complications were observed with either system.

CT-guided VAB is safe and feasible using the currently available breast CBCT protocol. The mean total intervention time to complete VAB and the time for tissue sampling was significantly faster using CT-guided VAB in comparison with prone stereotactic VAB.