Vacuum-assisted breast biopsy (VABB) guided by digital breast tomosynthesis (DBT) represents one of the best instruments to obtain a histological diagnosis of suspicious lesions with no ultrasound correlation or those which are visible only on DBT. After a review of the literature, we retrospectively analyzed the DBT-guided VABBs performed from 2019 to 2022 at our department. Descriptive statistics, Pearson’s correlation and χ2test were used to compare distributions of age, breast density (BD) and early performance measures including histopathology. We used kappa statistics to evaluate the agreement between histological assessment and diagnosis. Finally, we compared our experience to the literature to provide indications for clinical practice. We included 85 women aged 41–84 years old. We identified 37 breast cancers (BC), 26 stage 0 and 11 stage IA. 67.5% of BC was diagnosed in women with high BD. The agreement between VABB and surgery was 0.92 (k value, 95% CI: 0.76–1.08). We found a statistically significant inverse correlation between age and BD. The post-procedural clip was correctly positioned in 88.2%. The post-procedural hematoma rate was 14.1%. No infection or hemorrhage were recorded. When executed correctly, DBT-guided VABB represents a safe and minimally invasive technique with high histopathological concordance, for detecting nonpalpable lesions without ultrasound correlation.
数字乳腺断层摄影（DBT）引导下的真空辅助乳腺活检（VABB）是获取无超声关联或仅在DBT可见的可疑病灶组织学诊断的最佳工具之一。通过文献回顾，我们回顾性分析了2019年至2022年在本部门进行的DBT引导VABB病例。采用描述性统计、皮尔逊相关性和χ²检验比较年龄、乳腺密度（BD）及包括组织病理学在内的早期绩效指标的分布情况。使用kappa统计评估组织学评估与诊断结果的一致性。最后，我们将自身经验与文献对比，为临床实践提供参考依据。研究共纳入85名41-84岁女性患者，检出37例乳腺癌（BC），其中0期26例，IA期11例。67.5%的BC病例确诊于高乳腺密度女性。VABB与手术病理的一致性为0.92（kappa值，95% CI：0.76-1.08）。研究发现年龄与乳腺密度存在统计学显著负相关。术后标记夹正确放置率达88.2%，术后血肿发生率为14.1%，未记录感染或出血病例。规范操作下，DBT引导VABB对于检测无超声关联的不可触及病灶是一种安全、微创且具有高度组织病理学一致性的诊断技术。
Practical Challenges of DBT-Guided VABB: Harms and Benefits, from Literature to Clinical Experience
肿瘤(癌症)患者之家