Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros
The increase in the incidence of breast cancer has prompted the development of new interventional and therapeutic techniques, replacing traditional surgical biopsy with image-guided percutaneous biopsy techniques. In 1994, Parker et al developed percutaneous large core breast biopsy –core needle pun...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42635 |
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I10-R327-article-42635 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
breast; puncture; suros; interventionism; microcalcifications breast puncture suros intervensionism microcalcifications mama punción suros intervencionismo microcalcificaciones . |
| spellingShingle |
breast; puncture; suros; interventionism; microcalcifications breast puncture suros intervensionism microcalcifications mama punción suros intervencionismo microcalcificaciones . Alcain , WL Garcia Chiple , ME Canals , NV Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| topic_facet |
breast; puncture; suros; interventionism; microcalcifications breast puncture suros intervensionism microcalcifications mama punción suros intervencionismo microcalcificaciones . |
| author |
Alcain , WL Garcia Chiple , ME Canals , NV |
| author_facet |
Alcain , WL Garcia Chiple , ME Canals , NV |
| author_sort |
Alcain , WL |
| title |
Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| title_short |
Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| title_full |
Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| title_fullStr |
Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| title_full_unstemmed |
Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros |
| title_sort |
utility of vacuum-assisted breast biopsy puncture (vab): mammotome and suros |
| description |
The increase in the incidence of breast cancer has prompted the development of new interventional and therapeutic techniques, replacing traditional surgical biopsy with image-guided percutaneous biopsy techniques. In 1994, Parker et al developed percutaneous large core breast biopsy –core needle puncture- and, in 2000, Vacuum Assisted Biopsy (VAB) for the study of non-palpable lesions and microcalcifications seeking to manage lesions of uncertain malignant potential. These techniques were protocolized in the Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) held in 2019, and we consider this conference our main / primary bibliographic reference. The aim of the present work is to compare anatomo-pathological results of punctures obtained by VAB with the respective surgical specimens and to demonstrate the benefits of this interventional procedure.
We conducted an observational, retrospective, cross-sectional, using non-probabilistic convenience sampling. We selected patients with BIRADS 4-5 mammography results who underwent VAB and were diagnosed with atypical precursor lesions or early breast carcinoma. The study included surgical specimens obtained between January 2019 and July 2023 at Instituto Oulton in Córdoba, Argentina. The cylinders obtained with 9/11 gauge needle were fixed in 10% formalin, processed using a Leica automatic processor, and cut into 4 micron sections and stained with hematoxylin-eosin. The data were analyzed using descriptive statistics, including frequency distribution analysis and the calculation of percentages.
Out of a total of 504 AVBs, only 53 were operated on at our institution, resulting in a 100% concordance rate. Histologic underestimation ranged from 18% to 21% varying according to ultrasound or mammographic images of microcalcifications, distortion, or nodules). This rate aligns with findings reported in other studies, which typically indicate underestimation rates between 10% and 25%.
We can conclude that the VAB technique is considered today as the gold standard when faced with the mammographic finding of microcalcifications BIRADS 4-5 given its moderate to high positive predictive value for cancer, according to recommendations and international guidelines: National Inter-Society Consensus on Breast Cancer (2019), SAMAS (2018, American Society of Clinical Oncology (ASCO), American Joint Committee on Cancer (AJCC), and College of American Pathologists (CAP). |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42635 |
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2024-09-03T21:04:39Z |
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I10-R327-article-426352023-10-19T21:20:32Z Utility of vacuum-assisted breast biopsy puncture (VAB): Mammotome and Suros Utilidad de la punción biopsia de mama asistida por vacío (BAV): mammotome/suros . Alcain , WL Garcia Chiple , ME Canals , NV breast; puncture; suros; interventionism; microcalcifications breast puncture suros intervensionism microcalcifications mama punción suros intervencionismo microcalcificaciones . The increase in the incidence of breast cancer has prompted the development of new interventional and therapeutic techniques, replacing traditional surgical biopsy with image-guided percutaneous biopsy techniques. In 1994, Parker et al developed percutaneous large core breast biopsy –core needle puncture- and, in 2000, Vacuum Assisted Biopsy (VAB) for the study of non-palpable lesions and microcalcifications seeking to manage lesions of uncertain malignant potential. These techniques were protocolized in the Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) held in 2019, and we consider this conference our main / primary bibliographic reference. The aim of the present work is to compare anatomo-pathological results of punctures obtained by VAB with the respective surgical specimens and to demonstrate the benefits of this interventional procedure. We conducted an observational, retrospective, cross-sectional, using non-probabilistic convenience sampling. We selected patients with BIRADS 4-5 mammography results who underwent VAB and were diagnosed with atypical precursor lesions or early breast carcinoma. The study included surgical specimens obtained between January 2019 and July 2023 at Instituto Oulton in Córdoba, Argentina. The cylinders obtained with 9/11 gauge needle were fixed in 10% formalin, processed using a Leica automatic processor, and cut into 4 micron sections and stained with hematoxylin-eosin. The data were analyzed using descriptive statistics, including frequency distribution analysis and the calculation of percentages. Out of a total of 504 AVBs, only 53 were operated on at our institution, resulting in a 100% concordance rate. Histologic underestimation ranged from 18% to 21% varying according to ultrasound or mammographic images of microcalcifications, distortion, or nodules). This rate aligns with findings reported in other studies, which typically indicate underestimation rates between 10% and 25%. We can conclude that the VAB technique is considered today as the gold standard when faced with the mammographic finding of microcalcifications BIRADS 4-5 given its moderate to high positive predictive value for cancer, according to recommendations and international guidelines: National Inter-Society Consensus on Breast Cancer (2019), SAMAS (2018, American Society of Clinical Oncology (ASCO), American Joint Committee on Cancer (AJCC), and College of American Pathologists (CAP). El incremento en la incidencia del cáncer de mama, ha impulsado a desarrollar nuevas técnicas intervencionistas y terapéuticas, desplazando la biopsia quirúrgica tradicional por técnicas de biopsias percutáneas guiadas por imágenes. En 1994, Parker, Burbank y col. desarrollaron la core biopsy (punción core o de aguja gruesa) y posteriormente (año 2000) la Biopsia Asistida por Vacío (BAV), para el estudio de lesiones no palpables y microcalcificaciones, buscando dar respuesta al manejo de lesiones de potencial maligno incierto, protocolizado en: Secund International Consensus Conference on lesions of uncertain malignnant potential in the breast (B3 lesions) (2019), el cual consideramos nuestro principal soporte bibliográfico. El objetivo del presente trabajo consiste en comparar resultados anatomopatológicos de punciones obtenidas por BAV con las respectivas piezas quirúrgicas y demostrar los beneficios de este procedimiento intervencionista. Se realizó un trabajo observacional, retrospectivo, transversal, con muestreo no probabilístico por conveniencia, donde se seleccionaron pacientes que cuentan con mamografía BIRADS 4-5, punzadas con BAV, con diagnóstico de lesiones atípicas precursoras/carcinoma temprano mamario y posterior pieza quirúrgica, realizadas entre enero del 2019 y julio del 2023 en Instituto Oulton (Córdoba). Los cilindros obtenidos con aguja 9/11 Gauge, fueron fijados en formol al 10%, procesados con Procesador automático Leica, con cortes de 4 micras y coloreados con Hematoxilina-eosina. Los datos se estudiaron mediante estadística descriptiva con análisis de distribución de frecuencias y cálculo de porcentajes. De un total de 504 BAV, sólo 53 fueron operadas en nuestra institución, con resultados concordantes en el 100% de los casos, habiendo subestimación histológica de entre 18-21% (diferenciado según imágenes ecográficas o mamográficas de microcalcificaciones, distorsión o nódulos), similar a lo publicado en otros trabajos (los cuales reportan entre 10-25% de subestimación). Se puede concluír que la técnica de BAV es considerada hoy como gold estándar ante el hallazgo mamográfico de microcalcificaciones BIRADS 4-5, dado el moderado a alto valor predictivo positivo para cáncer, según recomendaciones y Guias Internacionales: Consenso Nacional Intersociedades sobre Cáncer de Mama (2019), SAMAS (2018), American Society of Clinical Oncology (ASCO), American Joint Committe on Cancer (AJCC) y College of American Pathologists (CAP). . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://revistas.unc.edu.ar/index.php/med/article/view/42635 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |