Purpose: To evaluate a digital, stereotactically controlled vacuum punch biopsy method.
Material and method: In 60/61 female patients a vacuum punch biopsy (14 G) was performed under digital stereotactic control; by means of a single biopsy 1-2 cm3 of tissue was obtained. In one patient the examination could not be carried out because of insufficient microcalcification. Excision biopsies were performed because of doubtful microcalcification (24), focal lesions (35) or abnormal tissue architecture (1).
Results: 48 of the biopsies proved benign, 2 showed dysplasias, 5 in situ and 5 invasive carcinomas. In all cases the histological and radiological diagnoses were in agreement. The possibility of a non-presentative biopsy could be excluded with a high degree of certainty because of the accurate localisation and the coherent tissue samples; this produced significant increase in diagnostic certainty. Subsequent haematomas seen mammographically (58/60) are smaller (1-1.5 cm) than for conventional percutaneous punch biopsies because of the effect of suction. The examination was well tolerated (there were no significant haematomas and no infection). Problems consisted of one case of bleeding (due to little experience) and one incorrect localisation which was immediately recognised.
Discussion: If the high degree of accuracy, which is expected, can be confirmed, the procedure would appear suitable for replacing diagnostic operative biopsies of non-characteristic mammographic finding.