Nonpalpable breast cancer: Percutaneous diagnosis with 11-and 8-gauge stereotactic vacuum-assisted biopsy devices

PURPOSE: To compare the accuracy of diagnosis of invasive breast cancer wit h 11- and 8-gauge stereotactic vacuum-assisted biopsy (SVAB) devices and to correlate lesion diameter and accuracy of breast cancer diagnosis at SVAB. MATERIALS AND METHODS: During a 22-month period, 489 SVAB procedures were p erformed with an 11-gauge probe and 305 with an 8-gauge probe. SVAB and sur gical pathologic results of 104 breast carcinomas were reviewed and correla ted with lesion size, number of specimens obtained, and type of SVAB probe used. RESULTS: Four of 38 ductal carcinoma in situ (DCIS) lesions diagnosed with 11-gauge SVAB demonstrated invasion at surgery, whereas one of 23 DCIS lesi ons diagnosed with 8-gauge SVAB demonstrated invasion at surgery (P = .6). A mean of 12 specimens per lesion were obtained in each group. In lesions 3 0 mm or larger, the underestimation rate for DCIS was 43% (three of seven) with 11-gauge SVAB and 17% (one of six) with 8-gauge SVAB (P = .6). Overall , the rate of underestimation for DCIS was significantly higher in lesions 30 mm or larger (four of 13)than in smaller lesions tone of 48, P = .006). CONCLUSION: This study demonstrated no difference in breast cancer diagnosi s with the 8- and 11-gauge SVAB systems, but the accuracy of breast cancer diagnosis was greater in lesions smaller than 30 mm than in larger lesions.