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Preferential Use of Sonographically Guided Biopsy to Minimize Patient Discomfort and Procedure Time in a Percutaneous Image-Guided Breast Biopsy Program

Departments of Diagnostic Imaging (M.B.M., W.S., C.C., B.S.) and Community Health and the Center for Statistical Sciences (I.F.G.), Brown Medical School, Rhode Island Hospital, Providence, Rhode Island; and RAND, Santa Monica, California (C.E.B.).

Address correspondence and reprint requests to Martha B. Mainiero, MD, Department of Diagnostic Imaging, Brown Medical School, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.

Objective. To determine whether preferential use of sonographic guidance for percutaneous biopsy of breast masses results in a subset of patients with a shorter procedure time and less discomfort compared with patients undergoing stereotactic biopsy. Methods. A prospective observational study was performed on 193 women undergoing percutaneous image-guided breast biopsy between 1997 and 1999. Data were collected on room time, physician time, and patient comfort levels for 122 stereotactic and 71 sonographically guided biopsies. Differences between stereotactic and sonographically guided biopsy for all lesions and for masses were analyzed for statistical significance. Results. Mean room times were 62.2 minutes for stereotactic biopsy and 39.4 minutes for sonographically guided biopsy (P < .0001). Mean physician times were 23.0 minutes for stereotactic biopsy and 15.8 minutes for sonographically guided biopsy (P < .0001). When we limited our analyses to women undergoing biopsy for masses, the difference in physician time largely disappeared, but the difference in room time remained (P < .0001). Women undergoing stereotactic biopsy were more likely to report discomfort due to body positioning than were women undergoing sonographically guided biopsy (P < .001). These differences existed whether we included all lesions or restricted our analyses to masses. Conclusions. Preferential use of sonographically guided breast biopsy for masses results in shorter procedure times and less patient discomfort compared with prone stereotactic biopsy.

Abbreviations: VAB, vacuum-assisted biopsy

Key Words: breast biopsy • breast cancer diagnosis • breast sonography

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