Initial experience of tomosynthesis-guided vacuum-assisted biopsies of tomosynthesis-detected (2D mammography and ultrasound occult) architectural distortions

Bhavika K. Patel, Matthew Covington, Victor J. Pizzitola, Roxanne Lorans, Marina Giurescu, William Eversman, John Lewin

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

OBJECTIVE. As experience and aptitude in digital breast tomosynthesis (DBT) have increased, radiologists are seeing more areas of architectural distortion (AD) on DBT images compared with standard 2D mammograms. The purpose of this study is to report our experience using tomosynthesis-guided vacuum-assisted biopsies (VABs) for ADs that were occult at 2D mammography and ultrasound and to analyze the positive predictive value for malignancy. MATERIALS AND METHODS. We performed a retrospective review of 34 DBT-detected ADs that were occult at mammography and ultrasound. RESULTS. We found a positive predictive value of 26% (nine malignancies in 34 lesions). Eight of the malignancies were invasive and one was ductal carcinoma in situ. The invasive cancers were grade 1 (4/8; 50%), grade 2 (2/8; 25%), or grade 3 (1/8; 13%); information about one invasive cancer was not available. The mean size of the invasive cancers at pathologic examination was 7.5 mm (range, 6–30 mm). CONCLUSION. Tomosynthesis-guided VAB is a feasible method to sample ADs that are occult at 2D mammography and ultrasound. Tomosynthesis-guided VAB is a minimally invasive method that detected a significant number of carcinomas, most of which were grade 1 cancers. Further studies are needed.

Original languageEnglish
Pages (from-to)1395-1400
Number of pages6
JournalAmerican Journal of Roentgenology
Volume210
Issue number6
DOIs
StatePublished - Jun 2018

Keywords

  • Architectural distortion
  • Breast cancer
  • Digital breast tomosynthesis
  • Tomosynthesis-guided vacuum-assisted biopsy

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