Prone stereotactic (PS) vacuum-assisted breast biopsy (VABB) has replaced surgical excision for diagnosing findings identified at mammography, but it also has some significant limitations. Does digital breast tomosynthesis (DBT)-guided VABB provide specialists with a better alternative?
“With upright DBT-guided VABB, an attachment is applied to a DBT unit so that it can function both as a standard mammography unit and as a unit to guide biopsy of lesions, including those visible only with DBT,” wrote Manisha Bahl, MD, department of radiology at Massachusetts General Hospital in Boston, and colleagues. “Although this technology is promising, there is limited research on the clinical performance of upright DBT-guided VABB; the largest study to date included only 51 procedures.”
The authors reviewed data from 439 consecutive patients who underwent PS VABB from August 2014 to December 2015, and 706 consecutive patients who underwent DBT-guided VABB from February 2016 to June 2017. The mean age of PS VABB patients was 56.5 years, and the mean age of DBT-guided VABB patients was 57.9 years.
Overall, technical success was achieved for 99.3 percent of lesions when DBT-guided VABB was used. For PS VABB, that umber was 95.1 percent. DBT-guided VABB also had a mean procedure time that was 15 fewer minutes than PS VABB. No “major complications” occurred in either group of patients, the authors reported.
“Our results suggest that upright DBT-guided VABB can replace PS VABB for routine use in patients with findings suspicious for cancer identified at DBT alone and on digital two-dimensional mammograms,” Bahl and colleagues wrote.
The authors added that DBT-guided VABB provides patients with more comfort. They are asked to sit in an upright chair for DBT-guided VABB instead of lying down, “which allows for patients with limited mobility or with weight limitations to undergo biopsy."