Underestimation of high-risk breast lesions undergoing vacuum-assisted biopsy

The aim of our study is to analyze the results of US guided vacuum assisted breast biopsy (VABB) applied to patients with breast lesions between March 2011 and March 2014, to determine the underestimation rate patients with high-risk lesions and intraductal carcinoma. We conducted this study retrospectivly and after permission of our ethic committee (Number:70904504/738, Board Code: 2012-KAEK-20 / Date: 21.10.2020). From our PACS and hospital information systems (MEDI_HASTA 16.43 1997-2014, MİA-MED 1.0.1.3726, SECTRA PACD IDS7 21.2..9.6220), we found 97 patients underwent US guided VABB between March 2011 and March 2014. We excluded the patients who are not completing or participating to our protocol. Seventy five patients who had completed at least two years of follow-up and whose surgical operation and pathological diagnosis were obtained were included in our study. US-guided vacuum-assisted breast biopsy with 10 gauge device was performed in 76 lesions in 75 women (age range: 19-67, mean age:46.5). Histopathological diagnosis and the malignancy rate of the lesions with VABB were analyzed. Follow-up findings of the lesions were evaluated. Pathological diagnosis of VABB were compared with surgical diagnosis and revealed false negative rate, underestimation rate. Sample sufficient for histopathological examination were obtained from all lesions (100%). Of all 76 lesions, 51 (67%) were diagnosed as benign, 13 (17%) were diagnosed as high risk lesions and 12 (16%) were diagnosed as malignant lesions. There is no false negative lesions. The underestimation rate of high risk lesions and intraductal carcinoma were higher than expected underestimation rate. Stability or regression of the lesions were observed in at least 2 years of follow up performed by ultrasonography. Us- guided VABB is a method with high diagnostic sensitivity, alternative to surgical treatment, low complication rate, easy tolerance by patients but limited availability due to its high cost. Key Words: Breast, Vacuum-Assisted Breast Biopsy