Stereotactic directional vacuum-assisted breast biopsy using lateral approach.

ABSTRACT

BACKGROUND: In recent years, stereotactic vacuum-assisted breast biopsy [so-called Mammotome® biopsy (ST-MMT)] has been established as a reliable method for diagnosis of nonpalpable and mammographically detected lesions with microcalcification. However, there are few reports regarding the lateral approach. We performed ST-MMT using the lateral approach. The purpose of this study was to determine the usefulness of the lateral approach. MATERIALS AND METHODS: 124 women with microcalcifications underwent stereotactic vacuum-assisted breast biopsy (median age, 52.5 years). All underwent stereotactic biopsy using the lateral approach. We compared our data with those of other institutes using the vertical approach. RESULTS: We removed microcalcifications and used an 11-gauge vacuum-assisted probe in all cases. The range of breast thickness was 10-45 mm. 12 patients had vasovagal reactions, however they quickly recovered without drug intervention. No patients had major complications. Of 124 cases, cancer was diagnosed in 37 patients. In other institutes using the vertical approach, it was impossible to use 11G probes in some cases due to the breast being too thin. In our study, minimum breast thickness was 10 mm (7 cases) and we were able to use 11G probes in all 7 cases with only polyethylene foam. CONCLUSION: With the lateral approach, it is possible to use 11G probes if the breast is thin (in our study minimum thickness was 10 mm) with only polyethylene foam. We believe this to be an advantage of the lateral approach. This advantage is very important in stereotactic biopsy, especially in Japan, as Japanese women's breasts are generally thinner than most Western women's.