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Biomedical subjects

F Burbank

Publications and source records attributed to F Burbank.

At least 19 recordsLinked to original sources
PubMed2001

Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates.

PURPOSE: To measure the effect of biopsy device, probe size, mammographic lesion type, lesion size, and number of samples obtained per lesion on the ductal carcinoma in situ (DCIS) underestimation rate. MATERIALS AND METHODS: Nonpalpable breast lesions at 16 institutions received a histologic diagnosis of DCIS after 14-gauge automated large-core biopsy in 373 lesions and after 14- or 11-gauge directional vacuum-assisted biopsy in 953 lesions. The presence of histopathologic invasive carcinoma was noted at subsequent surgical biopsy. RESULTS: By performing the chi(2) test, independent significant DCIS underestimation rates by biopsy device were 20.4% (76 of 373) of lesions diagnosed at large-core biopsy and 11.2% (107 of 953) of lesions diagnosed at vacuum-assisted biopsy (P <.001); by lesion type, 24.3% (35 of 144) of masses and 12.5% (148 of 1,182) of microcalcifications (P <.001); and by number of specimens per lesion, 17.5% (88 of 502) with 10 or fewer specimens and 11.5% (92 of 799) with greater than 10 (P <.02). DCIS underestimations increased with lesion size. CONCLUSION: DCIS underestimations were 1.9 times more frequent with masses than with calcifications, 1.8 times more frequent with large-core biopsy than with vacuum-assisted biopsy, and 1.5 times more frequent with 10 or fewer specimens per lesion than with more than 10 specimens per lesion.

Axilla↗
PubMed1997

Stereotactic breast biopsy of atypical ductal hyperplasia and ductal carcinoma in situ lesions: improved accuracy with directional, vacuum-assisted biopsy.

PURPOSE: To evaluate stereotactic, percutaneous, directional, vacuum-assisted breast biopsy of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). MATERIALS AND METHODS: Percutaneous biopsy was followed by surgical excision in 113 ADH and DCIS lesions in 101 patients (mean age, 55.5 years). Fourteen-gauge, automated needle biopsy was performed in 73 of these 113 lesions; 14-gauge, directional, vacuum-assisted breast biopsy was performed in 40 lesions. RESULTS: Eight of 18 lesions diagnosed with automated needle biopsy as ADH were determined at surgery to be breast cancer (DCIS or infiltrating ductal carcinoma). None of the eight ADH lesions diagnosed with directional, vacuum-assisted biopsy was determined at surgery to be breast cancer (P = .03, Fisher exact test). Nine of 55 lesions diagnosed with automated needle biopsy as DCIS were diagnosed as infiltrating ductal carcinoma at surgery. None of the 32 DCIS lesions diagnosed with directional, vacuum-assisted biopsy was diagnosed as infiltrating ductal carcinoma at surgery (P = .02, Fisher exact test). CONCLUSION: Directional, vacuum-assisted biopsy resulted in statistically significantly fewer cases of ADH or DCIS underestimation of disease without clinical complications or the creation of postbiopsy mammographic lesions.

Biopsy, Needle↗
PubMed1997

Mammographic findings after 14-gauge automated needle and 14-gauge directional, vacuum-assisted stereotactic breast biopsies.

PURPOSE: To compare findings from first imaging follow-up mammography for breast lesions shown to be benign at stereotactic biopsy with 14-gauge automated needles or 14-gauge directional, vacuum-assisted probes. MATERIALS AND METHODS: In 495 stereotactic breast biopsies, the mammographic appearance of the biopsy site or target lesion was evaluated at first imaging follow-up with a four-point scale (1 = progression of lesion or suspicious interval change [repeat biopsy], 2 = no clinically relevant change, 3 = interval decrease in size of lesion or number of microcalcifications, and 4 = no residual mammographic lesion). An automated needle was used in 363 biopsies and a directional, vacuum-assisted probe was used in 132 biopsies. Patient and lesion variables and time to first imaging follow-up were compared for the two techniques. RESULTS: No biopsy site or target lesion was assigned a score of 1 at first imaging follow-up with either technique. No lesion was referred for repeat biopsy because of the mammographic appearance at first imaging follow-up. First imaging follow-up was performed an average of 6.6 months for the directional, vacuum-assisted biopsies and 8.6 months for the automated needle biopsies (P < .0001). This difference reflected a difference in scheduling methods. CONCLUSION: Directional, vacuum-assisted and automated needle breast biopsies produced no distortion or suspicious interval change at the biopsy site at the first follow-up mammographic examination.

Aftercare↗
PubMed1997

Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy.

PURPOSE: To compare histologic findings of atypical ductal hyperplasia (ADH) at 14-gauge, directional, vacuum-assisted breast biopsy (hereafter, vacuum-assisted biopsy) and at 14-gauge, automated, large-core breast biopsy (hereafter, large-core biopsy) with findings at histologic examination after surgical biopsy. MATERIALS AND METHODS: Nonpalpable breast lesions were diagnosed as ADH at histologic examination after vacuum-assisted biopsy in 88 lesions in seven institutions and after large-core biopsy in 55 previously reported lesions. Histologic findings at subsequent surgical biopsy were compared for the presence of carcinoma. RESULTS: On the basis of histologic findings of carcinoma at surgical biopsy, the diagnosis of ADH was not correct in 26 (48%) of 54 lesions sampled at large-core biopsy and in 13 (18%) of 74 lesions sampled at vacuum-assisted biopsy (Fisher exact test, P < .0004). More tissue specimens were obtained at vacuum-assisted biopsy (mean, 15.8 specimens) than at large-core biopsy (mean, 9.7 specimens). Individual specimens were twice as large at vacuum-assisted biopsy (mean, 34 mg) as at large-core biopsy (mean, 17 mg) (previously reported). CONCLUSION: ADH was diagnosed 2.7 times more reliably at vacuum-assisted biopsy than at large-core biopsy (with no increase in complications) with most of the improvement as a result of acquisition of more than 10 specimens per lesion, but carcinoma was sufficiently underestimated with both methods to necessitate surgical biopsy.

Biopsy, Needle↗
PubMed1997

Tissue marking clip for stereotactic breast biopsy: initial placement accuracy, long-term stability, and usefulness as a guide for wire localization.

PURPOSE: To determine initial placement accuracy, long-term stability, and usefulness as a guide for wire localization for metallic marker clips placed percutaneously after stereotactic breast biopsy. MATERIALS AND METHODS: One hundred forty-nine marker clips were placed percutaneously with a straight-needle or through-probe method, and clip positions were measured. The locations of 31 marker clips were followed up from deployment to first follow-up mammography. Thirty-six biopsy sites with marker clips were excised surgically and examined; 18 of these marker clips were targets for wire localization. The locations of 22 benign lesions were measured over time to calibrate the measurement system. RESULTS: Baseline variability was 8 mm. Initial marker clip deployment averaged 5 mm above baseline from the center of the target lesion (P < or = .01). Compared with baseline variability, marker clips remained in place from initial deployment to first imaging follow-up (mean, 8.6 months). Potentially clinically meaningful misplacement rates (deployment > 24 mm from target lesion center) were 7% for the through-probe method and 11% for the straight-needle method (not significantly different; P = .33). CONCLUSION: The marker clips appear to be useful targets for wire localization when the entire target lesion is removed at directional, vacuum-assisted breast biopsy. Upright, two-view mammography is recommended after deployment of the marker clip to document location.

Adult↗
PubMed1997

Stereotactic breast biopsy: comparison of 14- and 11-gauge Mammotome probe performance and complication rates.

The purpose of this study was to compare specimen weights, tissue acquisition times, and complication rates for 14- and 11-gauge Mammotome probes during stereotactic breast biopsy. Three hundred forty stereotactic Mammotome breast biopsies were reviewed for complications; 269 (79%) of these biopsies were performed with the 14-gauge Mammotome probe, and 71 (21%) with the 11-gauge probe. Aggregate specimen weights and tissue acquisition times were measured in 248 out of 340 stereotactic Mammotome breast biopsies. Of these 248 lesions, 186 (75%) were performed with the 14-gauge probe, and 62 (25%) with the 11-gauge probe. Complication rates were essentially the same for each probe: 1.1 per cent for the 14-gauge probe and 1.4 per cent for the 11-gauge probe (not significant). More total aggregate breast tissue was obtained during the biopsies performed with the 11-gauge Mammotome probes than with the 14-gauge probes (1730 versus 1067 mg; P < or = 0.0001). The number of specimens acquired was smaller during the 11-gauge biopsy sessions (18 versus 27; P < or = 0.0001). The average per-specimen weight was significantly higher with the 11-gauge probe: 96 versus 40 mg per specimen (P < or = 0.0001). The average tissue harvesting time was approximately the same with each probe size, 15.6 minutes for the 11-gauge probe and 15.4 for the 14-gauge probe (not significant). Consequently, the harvesting rate (mg of tissue obtained per minute) was 111 mg/minute with the 11-gauge probe versus 69 with the 14-gauge probe (P < or = 0.0001). The per-specimen breast tissue yield, using the 11-gauge probe, was more than two times greater than the yield using the 14-gauge probe. There was no increase in procedure time, and there were no additional complications.

Biopsy, Needle↗
PubMed1996

A practical approach to minimally invasive breast biopsy.

With the development of stereotactic or ultrasound-guided, large-core percutaneous breast biopsy and the evolution of mammotomy, radiologists are now able to render definitive diagnoses of breast lesions. To ensure success, however, there must be a commitment at the outset to put into place the required personnel and equipment. The radiologists involved must conscientiously adhere to standardized technique and be willing to assume clinical responsibility, including comprehensive follow-up methods. With these commitments, radiologists can substantially increase their contribution to the care of patients with a breast abnormality.

Biopsy, Needle↗
PubMed1996

Stereotactic breast biopsy: improved tissue harvesting with the Mammotome.

The current study was performed to determine whether the Mammotome, a new breast biopsy instrument, is better at harvesting breast tissue percutaneously than an automated Tru-Cut (ATC) device. A total of 345 stereotactic breast biopsies were performed with the Mammotome. The Mammotome specimens were clinically evaluated on a five-point specimen scale that reflected the quality and quantity of the specimens and the rapidity of collection. In selected cases, specimen weights from both techniques were measured. In addition, by examining the lesion site post-biopsy, biopsies were categorized as incisional or excisional. Specimens obtained with the Mammotome were two times heavier than when obtained with the Biopty gun (34.3 mg vs. 17.2 mg, P < or = 0.0002). When aggregate Mammotome specimen weights were regressed against number of specimens submitted, average weight per specimen was 31.9 mg (P < or = 0.0001). When compared with the ATC device on the specimen scale, the Mammotome specimens were rated "Average" in 2.1 percent, "Good" in 13 percent, and "Very Good" in 84.9 percent. Also, 51.9 percent of the biopsies with the Mammotome were judged to be incisional; 48.1 percent, excisional. Three minor complications were encountered. The Mammotome more quickly harvests more breast tissue compared with ATC technology.

Adult↗
PubMed1994

Image-guided automated core biopsies of the breast, chest, abdomen, and pelvis.

PURPOSE: A prospective study was undertaken to measure success at obtaining definitive histologic diagnoses with an automated biopsy gun technique. MATERIALS AND METHODS: Image-directed biopsies (n = 300) were performed between November 1989 and June 1992 in 288 patients. Biopsy specimens of breast lesions were obtained with ultrasound (US) or stereotaxic mammographic guidance. Biopsy samples of lesions from other areas of the body were obtained with computed tomographic or US guidance. Clinical follow-up and surgical biopsy were used to measure diagnostic accuracy. RESULTS: Overall, a definitive diagnosis was reached with core specimen biopsy techniques in 95.3% of cases (286 of 300), and all 286 definitive findings were accurate. CONCLUSION: Because of the success of this approach, the adoption of an automated biopsy gun technique that includes histologic examination of a core specimen should be considered by all radiologists who perform image-guided biopsies.

Abdomen↗
PubMed1994

Percutaneous large-core breast biopsy: a multi-institutional study.

PURPOSE: To assess the reliability and reproducibility of automated large-core breast biopsy. MATERIALS AND METHODS: A consortium of 20 institutions reported, in a standardized fashion, their core breast biopsy data. All biopsies were performed with "long-throw" (2.3-cm) automated core biopsy devices fitted with 14-gauge needles. Needle guidance was accomplished by means of either a dedicated, stereotaxic device, in which the patient lies in the prone position, or high-frequency electronically focused ultrasound equipment. RESULTS: The data in 6,152 lesions were gathered. Clinical or surgical follow-up was available in 3,765 lesions; 1,363 of these lesions were subsequently surgically excised, and the core histologic study showed cancer in 910 lesions, mammary intraepithelial neoplasia in 173 lesions, and benign disease in 280 lesions. In these 280 lesions, there were 15 false-negative core biopsies. CONCLUSION: The data show that percutaneous large-core breast biopsy is a reproducible and reliable alternative to surgical biopsy.

Biopsy, Needle↗