Evaluation of mammographic and clinical follow-up after 755 stereotactic vacuum-assisted breast biopsies

Purpose: Stereotactic vacuum-assisted breast biopsy is a new method that promises high accuracy and reliability. In order to avoid surgery in cases with benign histology the examination must be quality assured and the accuracy should be well established. We present follow-up data of 755 VBs with benign results. Methods: In all, 984 of 1268 consecutive VBs proved histopathologically benign (lobular carcinoma in situ and atypical ductal hyperplasia not included). Follow-up data are available for 755 of 984 (77%) lesions and constitute the basis of this evaluation. Follow-up mammograms were performed of 728 lesions at 6 to 67 months (mean 24, median 17.8) after VB. Results: Seven technically unsuccessful cases underwent immediate rebiopsy; 3 unsuccessful cases were diagnosed otherwise. No false negative occurred among the 752 followed-up, eventually successful VBs. On follow-up mammography 444 of 728 (61%) benign lesions proved radiologically completely removed, 284 (39%) partially. In 6 cases (0.8%) a surgical biopsy was performed again during the follow-up time confirming the benign result. No scar was seen in 96%, a slight scar in 3.8%, and a small stellate scar with possible diagnostic interference in 0.3%. Conclusions: A benign diagnosis of quality assured VB is very reliable and leads to no or minimal scarring (C) 2003 Excerpta Medica, Inc. All rights reserved.