Huang Xu Chen, Hu Xu Hua, Wang Xiao Ran, Zhou Chao Xi, Wang Fei Fei, Yang Shan, Wang Gui Ying
Department of Thyroid and Breast Surgery, Jiangsu Taizhou People's Hospital, Taizhou, China.
The Second Department of General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, No. 12 Jiankang Road, Shijiazhuang, China.
Ir J Med Sci. 2018 Nov;187(4):999-1008. doi: 10.1007/s11845-018-1781-6. Epub 2018 Mar 16.
Core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) are both popularly used breast percutaneous biopsies. Both of them have become reliable alternatives to open surgical biopsy (OSB) for breast microcalcification (BM).
It is controversial that which biopsy method is more accurate and safer for BM. Hence, we conducted this meta-analysis to compare the diagnostic performance between CNB and VAB for BM, aiming to find out the better method.
Articles according with including and excluding criteria were collected from the databases, PubMed, Embase, and the Cochrane Library. Preset outcomes were abstracted and pooled to find out the potential advantages in CNB or VAB.
Seven studies were identified and entered final meta-analysis from initially found 138 studies. The rate of ductal carcinoma in situ (DCIS) underestimation was significantly lower in VAB than CNB group [risk ratio (RR) = 1.83, 95% confidence interval (CI) 1.40 to 2.40, p < 0.001]. The microcalcification retrieval rate was significantly higher in VAB than CNB group (RR = 0.89, 95% CI 0.81 to 0.98, p = 0.02), while CNB owned a significantly lower complication rate than VAB (RR = 0.18, 95% CI 0.03 to 0.93, p = 0.04). The atypical ductal hyperplasia (ADH) underestimation rates were not compared for the limited number of studies reporting this outcome.
Compared with CNB, VAB shows better diagnostic performance in DCIS underestimation rate and microcalcification retrieval rate. However, CNB shows a significantly lower complication rate. More studies are needed to verify these findings.
粗针活检（CNB）和真空辅助活检（VAB）都是常用的乳腺经皮活检方法。对于乳腺微钙化（BM），它们都已成为开放性手术活检（OSB）的可靠替代方法。
对于BM，哪种活检方法更准确、更安全存在争议。因此，我们进行了这项荟萃分析，以比较CNB和VAB对BM的诊断性能，旨在找出更好的方法。
从PubMed、Embase和Cochrane图书馆数据库中收集符合纳入和排除标准的文章。提取并汇总预设结果，以找出CNB或VAB的潜在优势。
从最初找到的138项研究中确定了7项研究并纳入最终的荟萃分析。VAB组原位导管癌（DCIS）低估率显著低于CNB组[风险比（RR）=1.83，95%置信区间（CI）1.40至2.40，p<0.001]。VAB组微钙化取出率显著高于CNB组（RR=0.89，95%CI 0.81至0.98，p=0.02），而CNB的并发症发生率显著低于VAB（RR=0.18，95%CI 0.03至0.93，p=0.04）。由于报告该结果的研究数量有限，未对非典型导管增生（ADH）低估率进行比较。
与CNB相比，VAB在DCIS低估率和微钙化取出率方面显示出更好的诊断性能。然而，CNB的并发症发生率显著更低。需要更多研究来验证这些发现。
