Liao Tingting, Yang Yuting, Lin Xiaohui, Lai Xiaohui, Dai Yi, Ma Jie
Department of Radiology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, China.
Department of Radiology, Luohu People's Hospital, Shenzhen, China.
Quant Imaging Med Surg. 2025 Mar 3;15(3):2042-2052. doi: 10.21037/qims-24-2114. Epub 2025 Feb 26.
Compared with traditional mammography, digital breast tomosynthesis (DBT) increases the detection of breast lesions by reducing the overlapping masking effect of glands through multi-angle exposures of a rotating X-ray tube. Breast biopsy under the guidance of mammography can effectively diagnose breast lesions. The main methods of mammography-guided biopsy include wire positioning, core needle biopsy (CNB), and vacuum-assisted breast biopsy (VABB). Currently, it is mainly guided by stereotactic or DBT-guided localization. In this study, we conducted a retrospective study to compare the clinical efficiency and performance of DBT-guided and prone stereotactic (PS)-guided breast lesion biopsies.
We performed a retrospective analysis of 406 patients who underwent mammogram-guided biopsies from three hospitals between August 2020 and August 2024. The cohort comprised 234 cases of DBT-guided biopsies and 172 cases of PS-guided biopsies. The DBT-guided biopsy methods included wire positioning, CNB, and VABB. The PS-guided biopsy methods included wire positioning and CNB. Statistical analyses utilized the Chi-squared or Mann-Whitney U tests to compare the effectiveness of biopsy methods acquired under DBT guidance and PS guidance.
In wire positioning and CNB, both the DBT-guided group and PS-guided group had higher biopsy success rates (100% 92.6%, 100% 96.2%), with no statistically significant difference (P=0.154 and P=0.127, respectively). Compared to the PS-guided group, the DBT-guided group had shorter total intervention (P<0.001) and lesion targeting time (P<0.001), less time to obtain the first effective positioning images (P<0.001), and fewer exposure times (P<0.001). The incidence of complications was lower in both DBT-guided and PS-guided groups, with no statistically significant difference (P=0.851 and 0.861, respectively). In addition, we successfully performed 69 cases of DBT-guided VABB. Compared with wire positioning and CNB under DBT guidance, this method also had shorter total intervention (19.49±4.75 minutes) and lesion targeting time (5.00, 7.00 minutes), and reduced exposure time (4.00, 5.00 exposures).
DBT-guided biopsies outperformed PS-guided biopsies in clinical efficiency, achieving quicker procedures and requiring fewer exposures while enabling the biopsy of a broader range of non-calcified breast lesions.
与传统乳腺钼靶摄影相比，数字乳腺断层合成（DBT）通过旋转X射线管的多角度曝光减少腺体的重叠掩盖效应，从而增加乳腺病变的检出率。钼靶摄影引导下的乳腺活检可有效诊断乳腺病变。钼靶摄影引导下活检的主要方法包括钢丝定位、粗针活检（CNB）和真空辅助乳腺活检（VABB）。目前，主要由立体定位或DBT引导定位。在本研究中，我们进行了一项回顾性研究，以比较DBT引导和俯卧位立体定位（PS）引导的乳腺病变活检的临床效率和性能。
我们对2020年8月至2024年8月期间在三家医院接受钼靶摄影引导活检的406例患者进行了回顾性分析。该队列包括234例DBT引导活检病例和172例PS引导活检病例。DBT引导活检方法包括钢丝定位、CNB和VABB。PS引导活检方法包括钢丝定位和CNB。统计分析采用卡方检验或曼-惠特尼U检验，比较DBT引导和PS引导下获得的活检方法的有效性。
在钢丝定位和CNB中，DBT引导组和PS引导组的活检成功率均较高（分别为100%对92.6%，100%对96.2%），差异无统计学意义（分别为P=0.154和P=0.127）。与PS引导组相比，DBT引导组的总干预时间（P<0.001）和病变靶向时间（P<0.001）更短，获得第一张有效定位图像的时间更少（P<0.001），曝光次数更少（P<0.001）。DBT引导组和PS引导组的并发症发生率均较低，差异无统计学意义（分别为P=0.851和0.861）。此外，我们成功进行了69例DBT引导的VABB。与DBT引导下的钢丝定位和CNB相比，该方法的总干预时间（19.49±4.75分钟）和病变靶向时间（5.00，7.00分钟）也更短，曝光时间减少（4.00，5.00次曝光）。
DBT引导活检在临床效率方面优于PS引导活检，手术过程更快，曝光次数更少，同时能够对更广泛的非钙化乳腺病变进行活检。
