Yadav Sanjay Kumar, Carpenter Ashutosh, Rai Roshni, Jha Chandan Kumar, Sharma Dhananjaya
Department of Surgery, NSCB Medical College, Jabalpur, India.
Endocrine Surgery, AIIMS, Patna, India.
World J Surg. 2022 Jun;46(6):1445-1450. doi: 10.1007/s00268-022-06475-3. Epub 2022 Feb 15.
Core biopsy has replaced fine needle aspiration cytology in the assessment of breast lumps to diagnose malignancy and is now standard of care in developed countries. Unfortunately, cost of core biopsy system is a major limitation in low-and middle-income countries (LMICs). This prompted us to devise and appraise a low-cost technique of core biopsy using negative pressure.
We devised and prospectively evaluated a simple model of core biopsy (vacuum assisted core needle biopsy-VACNB) using a 50 ml syringe, a 10 ml syringe and a 14G needle.
57 consecutive women (median age 42.66 years) with breast lumps (median diameter 5.2 cm) underwent VACNB. The sensitivity for diagnosing malignancy was 92%, specificity was 100%, and diagnostic accuracy was 92.98%. The positive predictive value of this technique was 100%, and negative predictive value was 63.64%. The cost (~ 5.5 USD) of the system was significantly less than the cost of core biopsy needle (~ 41.00 USD) and vacuum assisted breast biopsy needle (~ 341.00 USD) in India.
Frugal innovations are needed to overcome cost constraints in LMICs. Our low-cost VACNB technique is easy to use and accurate.
在乳腺肿块评估中，核心活检已取代细针穿刺细胞学检查来诊断恶性肿瘤，目前在发达国家已成为标准的诊疗方法。不幸的是，核心活检系统的成本是低收入和中等收入国家（LMICs）的一个主要限制因素。这促使我们设计并评估一种使用负压的低成本核心活检技术。
我们设计并前瞻性评估了一种使用50毫升注射器、10毫升注射器和14G针头的简单核心活检模型（真空辅助核心针活检-VACNB）。
57名连续的患有乳腺肿块（中位直径5.2厘米）的女性（中位年龄42.66岁）接受了VACNB。诊断恶性肿瘤的敏感性为92%，特异性为100%，诊断准确性为92.98%。该技术的阳性预测值为100%，阴性预测值为63.64%。在印度，该系统的成本（约5.5美元）明显低于核心活检针（约41.00美元）和真空辅助乳腺活检针（约341.00美元）的成本。
需要进行节俭创新以克服LMICs中的成本限制。我们的低成本VACNB技术易于使用且准确。
