Prone Versus Upright Digital Tomosynthesis-Guided Biopsy

Area of Science:

• Radiology
• Medical Imaging
• Breast Cancer Diagnostics

Background:

• Digital breast tomosynthesis (DBT) is an advanced imaging technique for breast cancer detection.
• Both prone and upright positions are utilized for DBT-guided breast biopsies.
• Comparative performance data between these positioning methods is crucial for optimizing biopsy procedures.

Purpose of the Study:

• To compare the clinical performance of digital breast tomosynthesis (DBT)-guided prone versus upright breast biopsies.
• To identify differences in key procedural metrics and outcomes between the two biopsy techniques.

Main Methods:

• Retrospective review of 282 consecutive DBT-guided breast biopsies performed between May 2018 and July 2019.
• Data collected included patient demographics, biopsy details, procedural metrics (samples, exposures, time), complications, and histopathology.
• Statistical comparison using chi-square and Wilcoxon rank sum tests to evaluate differences between prone and upright methods.

Main Results:

• All 282 biopsies (215 prone, 67 upright) were technically successful.
• Upright DBT-guided biopsies required significantly fewer mean exposures compared to prone biopsies (p < 0.001).
• No significant differences were observed in mean samples acquired, procedure time, calcification removal, or complication rates.

Conclusions:

• Prone and upright DBT-guided breast biopsies demonstrate comparable clinical performance regarding diagnostic yield and safety.
• The number of exposures is a key differentiator, with upright biopsies being more efficient in this regard.
• Selection between prone and upright positioning should incorporate factors beyond technical performance, such as room utilization and patient comfort.