Search strategy and evidence selection

Search strategy and evidence selection

Search strategy

The following search strategy was used to search Ovid MEDLINE (R) 1946 to July Week 2 2015:

1 exp breast/ or mammary glands, human/

2 Image‑Guided Biopsy/ or Biopsy/ or Biopsy, Needle/

3 vacuum/

4 1 and 2 and 3

5 ATEC.ti,ab.

6 4 or 5

7 (vacuum adj10 breast biopsy).ti,ab.

8 6 or 7

Similar search strategies were adapted for Medline in Process, Embase, Cochrane Library (all components), Pubmed, Scopus and Web of Science. The searches returned a total of 498 references after duplicate removal.

Evidence selection

Retrieved results were independently sifted by 2 researchers using the selection criteria below, and disagreements discussed and resolved.

  • Population/setting: people who need breast biopsies for suspected cancerous and benign lesions.

  • Intervention: vacuum‑assisted breast biopsy.

  • Comparator: other vacuum‑assisted breast biopsy devices (for example, Mammotome, Bard Encor), core needle biopsy, breast biopsy surgery.

  • Outcomes:

    • pain/discomfort

    • biopsy duration

    • number of total excisions

    • technical success rate

    • bleeding during intervention

    • haematoma post‑procedure

    • scarring

    • cancer detection

    • ductile carcinoma in situ.

After the first sift, 465 records were removed due to the following criteria:

  • non‑English language studies

  • not relevant to selection criteria

  • review articles and protocols.

Thirty-three references remained and full text articles were retrieved for these. Further studies were excluded due to the following criteria:

  • results for ATEC not separated from other results

  • no results presented

  • poster presentation.

Twenty-six studies remained after exclusion based on the above criteria. The literature was split into the 3 different imaging techniques (ultrasound, stereotactic and MRI) used to guide the biopsy procedure. Studies were selected with the following priority from highest to lowest: prospective comparative, prospective non‑comparative, retrospective comparative and retrospective non‑comparative. Finally, 7 studies were included in this briefing: 1 for ultrasound‑guided, 2 for MRI‑guided and 4 for stereotactic‑guided.