Sonographically Guided Core Biopsy of the Breast: Comparison of 14-Gauge Automated Gun and 11-Gauge Directional Vacuum-Assisted Biopsy Methods

다국어 초록 (Multilingual Abstract)

Objective: To compare the outcomes of 14-gauge automated biopsy and 11-gauge vacuum-assisted biopsy for the sonographically guided core biopsies ofbreast lesions.
Materials and Methods: We retrospectively reviewed all sonographically guidedcore biopsies performed from January 2002 to February 2004. The sonographicallyguided core biopsies were performed with using a 14-gauge automatedgun on 562 breast lesions or with using an 11-gauge vacuum-assisted deviceon 417 lesions. The histologic findings were compared with the surgical, imagingand follow-up findings. The histologic underestimation rate, the repeat biopsy rateand the false negative rates were compared between the two groups.
Results: A repeat biopsy was performed on 49 benign lesions because of thecore biopsy results of the high-risk lesions (n = 24), the imaging-histologic discordance(n = 5), and the imaging findings showing disease progression (n = 20).
The total underestimation rates, according to the biopsy device, were 55%(12/22) for the 14-gauge automated gun biopsies and 36% (8/22) for the 11-gauge vacuum-assisted device (p = 0.226). The atypical ductal hyperplasia(ADH) underestimation (i.e., atypical ductal hyperplasia at core biopsy and carcinomaat surgery) was 58% (7/12) for the 14-gauge automated gun biopsies and20% (1/5) for the 11-gauge vacuum-assisted biopsies. The ductal carcinoma insitu (DCIS) underestimation rate (i.e., ductal carcinoma in situ upon core biopsyand invasive carcinoma found at surgery) was 50% (5/10) for the 14-gauge automatedgun biopsies and 41% (7/17) for the 11-gauge vacuum-assisted biopsies.
The repeat biopsy rates were 6% (33/562) for the 14-gauge automated gun biopsiesand 3.5% (16/417) for the 11-gauge vacuum-assisted biopsies. Only 5 (0.5%)of the 979 core biopsies were believed to have missed the malignant lesions. Thefalse-negative rate was 3% (4 of 128 cancers) for the 14-gauge automated gunbiopsies and 1% (1 of 69 cancers) for the 11-gauge vacuum-assisted biopsies.
Conclusion: The outcomes of the sonographically guided core biopsies performedwith the 11-gauge vacuum-assisted device were better than those outcomesof the biopsies performed with the 14-gauge automated gun in terms ofunderestimation, rebiopsy and the false negative rate, although these differenceswere not statistically significant.

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