Cho Nariya, Moon Woo Kyung, Cha Joo Hee, Kim Sun Mi, Kim Seung Ja, Lee Sin Ho, Chung Hye Kyung, Cho Kyung Soo, Park In Ae, Noh Dong-Young
Department of Radiology, Seoul National University College of Medicine, The Institute of Radiation Medicine, SNUMRC, and The Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
Korean J Radiol. 2005 Apr-Jun;6(2):102-9. doi: 10.3348/kjr.2005.6.2.102.
To compare the outcomes of 14-gauge automated biopsy and 11-gauge vacuum-assisted biopsy for the sonographically guided core biopsies of breast lesions.
We retrospectively reviewed all sonographically guided core biopsies performed from January 2002 to February 2004. The sonographically guided core biopsies were performed with using a 14-gauge automated gun on 562 breast lesions or with using an 11-gauge vacuum-assisted device on 417 lesions. The histologic findings were compared with the surgical, imaging and follow-up findings. The histologic underestimation rate, the repeat biopsy rate and the false negative rates were compared between the two groups.
A repeat biopsy was performed on 49 benign lesions because of the core biopsy results of the high-risk lesions (n = 24), the imaging-histologic discordance (n = 5), and the imaging findings showing disease progression (n = 20). The total underestimation rates, according to the biopsy device, were 55% (12/22) for the 14-gauge automated gun biopsies and 36% (8/22) for the 11-gauge vacuum-assisted device (p = 0.226). The atypical ductal hyperplasia (ADH) underestimation (i.e., atypical ductal hyperplasia at core biopsy and carcinoma at surgery) was 58% (7/12) for the 14-gauge automated gun biopsies and 20% (1/5) for the 11-gauge vacuum-assisted biopsies. The ductal carcinoma in situ (DCIS) underestimation rate (i.e., ductal carcinoma in situ upon core biopsy and invasive carcinoma found at surgery) was 50% (5/10) for the 14-gauge automated gun biopsies and 41% (7/17) for the 11-gauge vacuum-assisted biopsies. The repeat biopsy rates were 6% (33/562) for the 14-gauge automated gun biopsies and 3.5% (16/417) for the 11-gauge vacuum-assisted biopsies. Only 5 (0.5%) of the 979 core biopsies were believed to have missed the malignant lesions. The false-negative rate was 3% (4 of 128 cancers) for the 14-gauge automated gun biopsies and 1% (1 of 69 cancers) for the 11-gauge vacuum-assisted biopsies.
The outcomes of the sonographically guided core biopsies performed with the 11-gauge vacuum-assisted device were better than those outcomes of the biopsies performed with the 14-gauge automated gun in terms of underestimation, rebiopsy and the false negative rate, although these differences were not statistically significant.
比较14G自动活检针与11G真空辅助活检针在超声引导下对乳腺病变进行粗针活检的结果。
回顾性分析2002年1月至2004年2月期间所有超声引导下的粗针活检病例。562例乳腺病变采用14G自动活检枪进行超声引导下粗针活检，417例病变采用11G真空辅助装置进行活检。将组织学检查结果与手术、影像学及随访结果进行比较。比较两组的组织学低估率、重复活检率及假阴性率。
49例良性病变因粗针活检结果为高危病变（n = 24）、影像学与组织学结果不一致（n = 5）及影像学显示疾病进展（n = 20）而进行了重复活检。根据活检装置，14G自动活检枪活检的总低估率为55%（12/22），11G真空辅助装置为36%（8/22）（p = 0.226）。14G自动活检枪活检的非典型导管增生（ADH）低估率（即粗针活检为非典型导管增生而手术为癌）为58%（7/12），11G真空辅助活检为20%（1/5）。14G自动活检枪活检的导管原位癌（DCIS）低估率（即粗针活检为导管原位癌而手术发现为浸润癌）为50%（5/10），11G真空辅助活检为41%（7/17）。14G自动活检枪活检的重复活检率为6%（33/562），11G真空辅助活检为3.5%（16/417）。979例粗针活检中仅5例（0.5%）被认为漏诊恶性病变。14G自动活检枪活检的假阴性率为3%（128例癌症中的4例），11G真空辅助活检为1%（69例癌症中的1例）。
尽管差异无统计学意义，但在低估率、重复活检率及假阴性率方面，11G真空辅助装置超声引导下粗针活检的结果优于14G自动活检枪活检的结果。
