Radiation doses during stereotactic guided vacuum-assisted breast biopsy for calcified breast lesions
Yoshihiro KozawaRitsuko FujimitsuMikiko ShimakuraKaori TominagaMami NishikawaTokitaka UenoMinoru TanakaKengo Yoshimitsu
0
Citation
3
Reference
10
Related Paper
Abstract:
ステレオガイド下吸引式乳房組織生検（以下ST―VAB）のUP―right 式による入射角度は，vertical 法やcranial 法があり，手技によって撮影回数が増え，患者の被ばく線量が多くなると考えられる。しかしST―VAB による被ばく線量を示した報告はない。本研究ではUP―right 式側臥位生検（以下側臥位法）での確定的影響の評価を目的として，入射角度vertical 法とcranial 法それぞれの入射皮膚線量と水晶体線量の測定を行い検討した。 乳房部にPMMA ファントム（１０mm×４枚）を用い，人体ファントムを側臥位で固定した。PMMA 入射表面と水晶体部にガラス線量計を配置した。線量測定は，ステレオ撮影も含め自験例全体の平均撮影回数１３回で行った。vertical 法，cranial 法の入射皮膚線量は，８１．９５mGy，８５．２４mGy，水晶体線量は０．０１３mGy，０．０２８mGy であった。入射皮膚線量においては，cranial 法で軽度増加を認めたが，水晶体線量では入射口が近くなるcranial法での線量が約２倍であった。以上より，UP―right 式側臥位法でのST―VAB は，確定的影響のない低線量領域内で行われていることが明らかとなった。しかし，被ばく線量を抑える意味で入射角度は，vertical 法で行うことが望ましく，撮影回数を減らす工夫が今後の検討課題である。Keywords:
Stereotactic biopsy
Breast biopsy
One hundred three patients underwent stereotactic breast biopsy with an 18-, 16-, or 14-gauge cutting needle and a biopsy gun. After biopsy, a localization wire was placed and surgical biopsy performed. There was agreement of the histologic results in 89 cases (87%) including 14 of 16 cancers (87%) (kappa = 0.806). The gun biopsy yielded the correct diagnosis in four cases involving a lesion (including one cancer) that was missed at the surgical biopsy. Nine cases in which the lesion was missed at gun biopsy can be related to insufficient needle size, the greater difficulty in using one of the two stereotactic devices, and early inexperience with the technique. A 14-gauge needle was used in the last 29 biopsies, the results of which agreed with the surgical pathologic findings in 28 cases (97%). With greater experience, stereotactic-guided large-gauge automated percutaneous biopsy may prove to be an acceptable alternative to surgical biopsy in women with breast masses suspected at mammography.
Stereotactic biopsy
Breast biopsy
Cite
Citations (364)
To evaluate three biopsy methods which are currently used in stereotactic breast biopsy.A total of 361 cases of stereotactic breast biopsies were carried out since 2000, including 73 cases of true cut core needle biopsies (ST-CNB), 74 cases of vacuum assisted biopsies (ST-VAB) and 214 cases of excisional biopsies. After medium follow-up time of 18 months (6 to 66 months), the accuracy as well as the clinical benefits of the three stereotactic biopsy procedures were analyzed retrospectively.The cancer miss rate of stereotactic wire localized excisional biopsy, ST-CNB and ST-VAB is 0, 2.7% and 0 respectively. Under-estimate rate of minimal invasive biopsy was 33% in atypical ductal hyperplasia (ADH) and 53% in ductal carcinoma in situ (DCIS). The minimal invasive procedure is superior to surgical procedure in terms of operation time, breast cosmetic outcome and complications, etc. Furthermore, 69% of the surgeries for suspicious lesion were waived.Stereotactic minimal invasive breast biopsy, especially ST-VAB, is an accurate, safty and convenient diagnosis technique and could be considered as the first line choice for mammographic moderate suspicious breast lesions (BIRADS-4). However, further excisional biopsy is recommended for atypical hyperplasia. Stereotactic excisional biopsy could be directly used for diagnosis of mammographic highly suspicious breast lesions (BIRADS-5).
Stereotactic biopsy
Breast biopsy
Atypical Hyperplasia
Cite
Citations (0)
Cost-Effectiveness of Stereotactic 11-Gauge Directional Vacuum-Assisted Breast BiopsyLaura Liberman1 and Michelle P. SamaAudio Available | Share
Stereotactic biopsy
Breast biopsy
Cite
Citations (109)
A 49-year-old woman underwent 11-gauge vacuum-assisted stereotactic biopsy of a cluster of indeterminate calcifications in the left breast. A clip was deployed accurately at the biopsy site as confirmed on mammograms obtained immediately after biopsy. The patient returned 8 days later for additional stereotactic biopsies of the left breast. Repeat mammograms revealed that the clip deployed at the original biopsy site had migrated 5 cm inferiorly. © RSNA, 2003
Stereotactic biopsy
Breast biopsy
Cite
Citations (21)
One hundred two patients with mammographically suspicious, nonpalpable lesions underwent stereotactic breast biopsy with a biopsy gun and an automated 14-gauge cutting needle. After biopsy, a localization wire was placed and surgical biopsy performed. There was agreement of the histologic results from the gun biopsy and the surgical biopsy specimens in 98 cases (96%), including 22 of 23 carcinomas (96%) (kappa = 0.936). The gun biopsy yielded findings that led to the correct diagnosis in two cases involving lesions that were missed at surgical biopsy; two lesions found at surgery were missed at gun biopsy. The results of this study suggest that the use of 14-gauge needles improves agreement between surgical and needle core biopsy findings and that stereotactic biopsy with an automated needle and gun can be an acceptable alternative to surgical biopsy in women with mammographically suspicious breast lesions.
Stereotactic biopsy
Core biopsy
Breast biopsy
Cite
Citations (379)
Non palpable breast lesion can be biopsied with the guiding under the B Ultrasound and stereotactic system.Fine Needle Aspiration (FNA) and Core needle biopsy (CNB) are currently two of the most comman needle biopsy methods for those lesion.Stereotactic core needle biopsy is utilized as screening for mammographic abnormalities because of high diagnostic sensitivity and avoidance of open biopsy for benign lesion.Furthermore, they also allow treatment planning before surgery.But for the histologic underestimation and some missed case,needle breast biopsy could not completely replace excisional biopsy.More attention should be paid to patient selection and rebiopsy indication.
Stereotactic biopsy
Breast biopsy
Core biopsy
Needle biopsy
Open biopsy
Cite
Citations (0)
Stereotactic biopsy
Breast biopsy
Open biopsy
Cite
Citations (27)
A 68-year-old woman underwent stereotactic biopsy of a small cluster of calcifications. The postbiopsy mammograms showed the biopsy-marking clip to be located correctly at the biopsy site. Follow-up mammograms 1 year later showed that the clip migrated to another quadrant of the breast. Findings in this case demonstrate that at long-term follow-up a biopsy-marking clip may not be accurately marking the biopsy site. © RSNA, 2002
Stereotactic biopsy
Cite
Citations (38)
Stereotactic biopsy
Breast biopsy
Punch Biopsy
Cite
Citations (1)
Stereotactic biopsy
Breast biopsy
Core biopsy
Cite
Citations (7)