Diagnostic accuracy of tomosynthesis-guided vacuum assisted breast biopsy of ultrasound occult lesions

This study aims to evaluate the diagnostic accuracy of digital breast tomosynthesis-guided vacuum assisted breast biopsy (DBT-VABB) of screening detected suspicious mammographic abnormalities comprising of calcifications, asymmetric densities, architectural distortions and spiculated masses. In this institutionally approved study, a total of 170 (n = 170) DBT-VABB were performed, 153 (90%) were for calcifications, 8 (4.7%) for spiculated mass, 5 (2.9%) for asymmetric density and 4 (2.4%) for architectural distortion. All these lesions were not detected on the corresponding ultrasound. Histopathology results revealed 140 (82.4%) benign, 9 (5.3%) borderline and 21 (12.4%) malignant lesions. The total upgrade rate at surgery was 40% for atypical ductal hyperplasia and 5.9% for ductal carcinoma in-situ. 3.6% discordant benign lesions showed no upgrade. DBT-VABB showed 100% specificity, 91.3% sensitivity and 100% positive predictive value (PPV) for detecting malignant lesions. The negative predictive value (NPV) was 80%. 2 (1.2%) patients had mild complications and 1 (0.6%) had severe pain. Our study showed that DBT-VABB was a safe and reliable method, with high sensitivity, specificity, PPV and NPV in the diagnosis of non-palpable benign and malignant breast lesions. Our data also confirmed the accuracy of DBT-VABB in detecting malignant lesions and we suggest further surgical excision in borderline lesions for a more accurate diagnostic evaluation.

The Effect of Group Counseling Using Ellis’s A-B-C Technique on Irrational Beliefs and Self-Efficacy About Breast Self-Awareness of Women Health Volunteers

Purpose: This preliminary pilot effort assessed the effect of group counseling using A-B-C technique on irrational beliefs and self-efficacy for women health volunteers (WHVs) in breast self-awareness. Design: In this randomized controlled trial, 40 WHVs from three health centers (Abhar, Iran) were randomly allocated into two groups. Method: Seven weekly group counseling sessions were held for the intervention group. Data about cancer fatalism belief, dissatisfaction of body, anxiety, and self-efficacy were collected through validated questionnaires 1 month before and 2 weeks after the intervention. Results: Mean scores of anxiety ( p = .036), body dissatisfaction ( p = .002), cancer fatalism belief ( p ≤ .0001), and self-efficacy ( p ≤ .0001) were improved in the intervention group compared with control group. Discussion/Conclusion: Group counseling using A-B-C technique was effective in improving irrational beliefs and self-efficacy of the WHVs about breast self-awareness. Implications for Practice: The findings may help in further development of strategies and cultural programs to improve health-related irrational beliefs.