Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun

OBJECTIVE. The 11-gauge vacuum suction probe is an alternative to the 14-ga uge needle and automatic gun for performing stereotactic core needle biopsi es. This study compares rebiopsy rates after stereotactic core needle biops ies that were performed with the two methods. The study also assesses the o utcomes of those repeat biopsies. MATERIALS AND METHODS. Five hundred ninety-two stereotactic core needle bio psies using a 14-gauge needle and automatic gun and 354 using an 11-gauge v acuum suction probe were performed consecutively. Excluding malignancies, t he number of cases requiring rebiopsy and the reasons for rebiopsy were det ermined for each group. The histologic diagnoses of the repeat biopsies wer e assessed. RESULTS. The rebiopsy rate was significantly lower with the 11-gauge vacuum suction probe (9.0%) than with the 14-gauge needle and automatic gun (14.9 %) (p =.013), Significant reductions were found in cases of insufficient sa mpling (probe, 1.7%; needle, 4.4%; p = .042) and mammographic-pathologic di screpancy (probe, 0.8%; needle, 3.4%; p =.026). The rebiopsy rate for masse s was 6.1% with the vacuum probe versus 10.7% with the 14-gauge needle (p = .12) and for calcifications was 11.6% with the vacuum probe versus 23.7% w ith the 11-gauge needle (p = .003). After rebiopsy, the percentage of cases in which malignancy was found was 18.5% with the vacuum probe versus 13.7% with the 14-gauge needle. On rebiopsy, the percentage of malignancies foun d in each category were atypical hyperplasia: probe 26.7%, needle 20.0%; in sufficient sample: probe 0%, needle 9.5%; pathologist recommendation: probe 50.0%, needle 12.5%; and lobular carcinoma in situ: probe 0%, needle 100%. CONCLUSION. Use of the 11-gauge vacuum-assisted device significantly decrea ses but does not eliminate the need for rebiopsy after stereotactic core ne edle biopsy. The rebiopsy rate for calcifications was significantly reduced by using the vacuum suction probe rather than the 14-gauge needle; however , the rate for masses was reduced only slightly. On rebiopsy, malignancies were found in both groups.