Clinical benefits of tomosynthesis-guided vacuum assisted breast biopsy: A comparison with stereotactic vacuum assisted biopsy

Abstract

Abstract Background Tomosynthesis-guided vacuum assisted breast biopsy (3D-VAB) has been used increasingly and it is now replacing stereotactic vacuum assisted biopsy (2D-VAB). The aim of our study is to compare the clinical effectiveness of 3D-VAB and 2D-VAB on the number of tissue cores containing targeted calcifications and on the procedure time.Methods Consecutive 87 women who underwent biopsy at our hospital from April 2020 to March 2022 for calcifications mammographically suspicious of malignancy were included in this study: 57 patients with 3D-VAB and 30 patients with 2D-VAB. The procedure time was defined as the time between scout tomosynthesis for 3D-VAB and scout stereo images for 2D-VAB as a start and confirmation of targeted calcifications by specimen radiography as an end.Results Grouped or clustered calcified lesions were found in 39 and 21 patients among the 3D-VAB group and the 2D-VAB group, respectively. A mean long diameter and a mean area of the grouped or clustered calcified lesions of 39 patients were 9 mm and 50 mm2 from a MLO view. With the 21 cases of the 2D-VAB group, the corresponding figures were 10 mm and 78 mm2 from a MLO view. The mean number of tissue cores per biopsy containing targeted calcifications from the grouped or clustered calcified lesions was 3 and 2.3 specimens for 39 patients of the 3D-VAB group and for 21 patients of the 2D-VAB group, respectively. The mean procedure time for grouped or clustered calcifications was significantly shorter in the 3D-VAB group than in the 2D-VAB group (16.5 min vs. 27.4 min, P < 0.01). For all 87 patients, the mean procedure time was 18.1 minutes for 57 3D-VAB patients and 27.7 minutes for 30 2D-VAB patients, thus being significantly shorter with 3D-VAB than 2D-VAB (P < 0.01).Conclusion Our study demonstrated that the clinical performance of 3D-VAB is superior to that of 2D-VAB and that the significant reduction in examination time with 3D-VAB compared with 2D-VAB is expected to benefit patients.