Comparison of sitting versus prone position for stereotactic large-core breast biopsy in surgically proven lesions.

Abstract

Our purpose was to compare the two different body positions for stereotactic large-core breast biopsy with regard to sensitivity, specificity, and accuracy, as well as complication rate. Two hundred patients had large-core breast biopsy performed either in the prone (n = 100) or in the sitting (n = 100) position and subsequently underwent surgical resection. The histopathologic findings of large-core breast biopsy and surgery of all 200 patients were compared; sensitivity, specificity, and accuracy were calculated for both groups. Biopsy-associated complications were prospectively recorded for immediate and delayed events and for technical failures in both groups. Sensitivity (96%), specificity (100%), and accuracy (98%) were the same for both groups with two false-negative findings in each group. The two false-negative results in the sitting group were caused by vasovagal reactions, whereas those in the prone group were caused by technical failure and uncomfortable biopsy position. More statistically significant complications (seven vs four, p < 0.001) and vasovagal reactions (seven vs two, p < 0.0001) were seen in the sitting group. For performance of large-core breast biopsy, both the prone and sitting positions are reliable and accurate methods. However, vasovagal reactions that could potentially complicate biopsy were seen significantly more often in the sitting position.