Vergleich des Zugangs mit versus ohne lateralen Arm bei der stereotaktischen Vakuumbiopsie

Purpose: Due to the better visualisation of microcalcifications during stereotactic vacuum-assisted biopsy (VB) with a lateral approach, its technical efficacy was compared to that of the frontal approach. Material and Methods: Prospectively, 50 patients with suspicious microcalcifications had a VB (Mammotome, Ethicon, 11G needle). Patients had VB either with a lateral arm (lateral approach; n=27) or without a lateral arm (frontal approach; n=23). We compared the duration of the localization procedure, of the biopsy itself and of the entire procedure, the degree (in vertical and horizontal planes) and distance (in needle direction) of lesion displacement on prefire and postfire images in relation to the initial stereo images, the relative amount of remnant microcalcifications, the need and number of needle corrections (during the localization procedure) as well as of direct re-biopsies, and the visualization of the lesion during the entire procedure for both patient groups. Statistics were performed using Χ 2 - and t-tests. Results: Lesion characteristics did not differ significantly between patient groups. Using the lateral approach, the distance of lesion displacement in the needle direction was significantly greater (p 0.05) and the relative amount of remnant microcalcifications (p > 0.05) did not differ. Conclusion: To avoid unnecessary displacement of microcalcifications, we generally prefer the frontal approach. If not possible (mostly because of the narrowness of the margin), the lateral approach can be used. With the latter, however, approach-specific aspects must be taken into consideration.