Safety and efficacy of tomosynthesis-guided breast biopsies in the prone position: monocentric study and review of the literature

Purpose: The purpose of this study is to describe the safety and efficacy of 9G needle biopsy under tomosynthesis guidance with the patient in the prone position.

Materials and methods: This is a retrospective observational study conducted on patients with non-palpable breast mass exclusively detectable through tomosynthesis, performed from the 1st January 2018 to the 1st August 2020. The procedures were performed by taking 12 tissue samples from each mass. The evaluated technical success was considered as a conclusive sample for histological diagnosis. We performed a comparison between the procedural data of interventions in patients who have a lesion < or = 10 mm and > 10 mm and between high-contrast and low-contrast masses. The histological data of the samples were analyzed.

Results: Five hundred biopsies of the total 1500 performed from the 1st January 2018 to the 1st August 2020 were included in the study; repetitions for inadequate withdrawal occurred 0.4% (3/500). No major complications have ever been observed. Two cases (0.2%) of minor bleeding were observed with self-limited bleeding from the skin breach at 90 min without clinical sequelae in an asymptomatic patient. The biopsy samples showed carcinoma in 55.2% (276/500).

Conclusion: Our study suggests that the 9G needle sampling biopsy procedure through tomosynthesis guide with prone patient is a safe and effective procedure for the characterization of indeterminate breast mass.