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Ultrasound‐guided mammotome vacuum biopsy for the diagnosis of impalpable breast lesions
Author(s) -
Meloni G. B.,
Dessole S.,
Becchere M. P.,
Soro D.,
Capobianco G.,
Ambrosini G.,
Nardelli G. B.,
Canalis G. C.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.0960-7692.2001.00492.x
Subject(s) - mammotome , medicine , biopsy , malignancy , radiology , mammography , sampling (signal processing) , ultrasound , fine needle aspiration , breast cancer , pathology , cancer , filter (signal processing) , computer science , computer vision
Objectives To assess the diagnostic accuracy of ultrasound‐guided mammotome vacuum biopsy in impalpable breast lesions. Methods Seventy‐three patients who presented with impalpable breast lesions that were suspicious for malignancy at mammography and/or sonography were included in the study. In the first instance the women underwent ultrasound‐guided fine‐needle aspiration cytology, then, 3 days later, histological biopsy with an ultrasound‐guided mammotome device. The patients with both cytological and histological diagnoses of malignancy underwent surgery; those with a negative (for malignancy) cytological diagnosis, but with a histological diagnosis of atypical hyperplasia or sclerosing adenosis, underwent surgical biopsy. Results The diagnostic accuracy of fine‐needle aspiration cytology was 67.2%; the sensitivity was 86.7%, the specificity was 48.4%, the negative predictive value was 78.9% and the positive predictive value was 61.9%. In comparison, the diagnostic accuracy of histological sampling by mammotome vacuum biopsy was 97.3%; the sensitivity was 94.7%, the specificity was 100%, the negative predictive value was 94.6% and the positive predictive value was 100%. Thus there was a statistically significant difference in diagnostic accuracy between fine‐needle aspiration cytology and mammotome vacuum biopsy (67.2% vs. 97.3%; χ 2 test, P < 0.001). The 2.7% (2/73) failure rate of mammotome biopsy was likely to be due to an error in the positioning of the needle. The subsequent surgical biopsy proved that two cases, negative for malignancy by mammotome biopsy, were in fact malignant. Conclusions Our data confirm the value of sonography for the diagnosis of breast carcinoma in the preclinical phase and the efficacy of ultrasound sampling using a mammotome device to confirm the diagnosis in impalpable breast lesions. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology