Complete removal of nonpalpable breast malignancies with a stereotactic percutaneous vacuum-assisted biopsy instrument

Background: Several devices have been developed for sampling nonpalpable ma mmographic breast lesions. Complete removal of malignancies with a stereota ctic percutaneous directional vacuum-assisted biopsy instrument has been re ported. Study Design: We reviewed our experience with the percutaneous vacuum-assis ted biopsy instrument to identify instances of complete excision of cancers : no residual carcinoma found at surgical excision for malignancies diagnos ed by the percutaneous vacuum-assisted biopsy instrument. The radiologic an d pathologic characteristics of malignancies completely removed by the perc utaneous vacuum-assisted biopsy instrument were compared with those of mali gnancies with residual carcinoma found at surgical excision. Results: Fifty-two malignancies were diagnosed by the percutaneous vacuum-a ssisted biopsy instrument: 16 infiltrating ductal carcinomas, 5 infiltratin g lobular carcinomas, and 31 ductal carcinomas in situ. No residual carcino ma was found at surgical excision in 9 (17%) of the 52 malignancies. Patien ts with complete removal of the malignant lesion were younger than patients with incomplete removal (52 versus 58 years; p=0.069). Completely removed malignancies were smaller on mammography (4 versus 17 mm; p = 0.213), and m ore specimens were removed (19 versus 15; p = 0.074). All nine completely r emoved malignancies presented with calcifications without a mass (p = 0.112 ), and all nine were ductal carcinoma in situ (p = 0.019). Conclusions: Complete removal of nonpalpable breast malignancies is possibl e with the stereotactic percutaneous directional vacuum-assisted biopsy dev ice. Complete removal is more likely with removal of a large number of spec imens from small areas of mammographic calcifications due to ductal carcino ma in situ. (J Am Cell Surg 1999;189:237-240. (C) 1999 by the American Coll ege of Surgeons).