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Gun needle device

Core needle biopsy, without vacuum assistance, can be done under ultrasound guidance, utilizing a variety of the gun needle devices. These devices are hand-held spring loaded 14-gauge devices. At least 5 passes are required for adequate sampling. Do not use a smaller device than 14-gauge as the accuracy for diagnosis of a carcinoma is significantly reduced with smaller devices (from 100%, 92% and 65% four 14, 16-gauge and 18-gauge respectively).

Advantage:
1. No expensive specialized equipment, only ultrasound required.
2. Quickest procedure.

Disadvantage:
1. Prone to sampling error, after first pass target often disappears into hematoma.
2. Needle must be withdrawn after each pass.
3. Much less tissue is obtained, consistent with 11-gauge vacuum core needle biopsy.
3. Long throw devices may cause pneumothorax if improperly positioned.
4. Difficult to biopsy microcalcifications (because of difficult localization with ultrasound).