n SA Journal of Radiology - Histological underestimation of a 9-gauge stereotactic vacuum-assisted breast biopsy system compared with surgical excision at a tertiary hospital in South Africa : original research

Volume 20 Number 1
  • ISSN : 1027-202X
  • E-ISSN: 2078-6778



Breast cancer is a major cause of morbidity and mortality worldwide. Certain lesions encountered on mammography require histological assessment of biopsy samples to identify benign versus malignant disease. Stereotactic vacuum-assisted breast biopsy (SVAB) is a useful technique, especially for non-palpable microcalcific lesions, and was introduced at our institution in 2011.

To determine whether the histological underestimation from 9-gauge SVABs performed at our institution is within acceptable limits.
In this cross-sectional study, 9-gauge stereotactic biopsy histology results and breast imaging and reporting data system (BI-RADS) findings of 158 lesions (from 153 patients) were analysed and the histological findings compared with surgical excision histology results (54 lesions) to determine histological underestimation (upgrade rates).
One out of eight cases of ductal carcinoma (DCIS) was underestimated, yielding a DCIS underestimation rate of 12.5%.
The DCIS underestimation obtained from the present study in our institution was on a par with other authors' findings and was therefore within acceptable limits. Atypical ductal hyperplasia underestimation could not be reliably obtained with the small study population.

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