Pain and complications of directional vacuum-assisted stereotactic biopsy: Comparison of the Mammotome and Vacora techniques

Salem, C.; Sakr, R.; Chopier, J.; Antoine, M.; Uzan, S.; Daraï, E.

doi:10.1016/j.ejrad.2008.07.015

« Previous Next »European Journal of Radiology
Volume 72, Issue 2 , Pages 295-299, November 2009

Pain and complications of directional vacuum-assisted stereotactic biopsy: Comparison of the Mammotome and Vacora techniques

C. Salem
- Department of Radiology, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France
R. Sakr
- Department of Gynecology and Breast Cancer, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France
- Corresponding author at: Hôpital Tenon, Service de gynécologie-obstétrique, 4 rue de la Chine, 75020 Paris, France. Tel.: +33 1 56 01 60 07; fax: +33 1 56 01 73 17.
J. Chopier
- Department of Radiology, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France
M. Antoine
- Department of Pathology, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France
S. Uzan
- Department of Gynecology and Breast Cancer, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France
E. Daraï
- Department of Gynecology and Breast Cancer, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, CancerEst, AP-HP, France

Received 28 May 2008; received in revised form 7 July 2008; accepted 18 July 2008.

Abstract

Objective

The aim of our study is to compare the Mammotome and Vacora methods of stereotactic directional vacuum-assisted biopsy in terms of pain and complications.

Materials and methods

From June 2001 to May 2005, 1114 consecutive patients underwent directional stereotactic vacuum-assisted breast biopsy (DVAB) for nonpalpable mammographically detected breast lesions (BI-RADS 3, 4 or 5). Respectively 967 and 147 patients underwent the Mammotome and Vacora procedures. Pain was evaluated with a visual analog scale. Immediate and late complications were recorded.

Results

The mean±S.D. (range) pain scores in the Mammotome and Vacora groups were 1.7±1.8 (0–9) and 2.9±2.3 (0–10), respectively (p<0.001). Patient age and operator experience were the main determinants of pain. Immediate complications were significantly more frequent in the Mammotome group (p=0.003), and so were late hematomas (p=0.04). Moderate and severe complications occurred exclusively in the Mammotome group.

Conclusion

The Mammotome technique is associated with a higher risk of immediate and late complications, while the Vacora technique is associated with more frequent severe pain. Patient age was the major factor influencing pain. Further prospective studies are needed to clarify factors incriminated in pain or complications after DVAB procedures.

Keywords: Stereotactic vacuum-assisted biopsy, Mammotome, Vacora, Pain, Complications