True Lateral Mammography with Stereotactic VAB breast tissue is collected. The failure rate for stereotactic VAB is 3-10%, mostly due to a difficult procedure site or a compli- cation such as a lesion near the skin, muscle or axilla [2,4]. In our study, we did not encounter a case in which we could not use stereotactic VAB, and a surgical operation was added only for a malignant lesion. Because no further procedures were performed for the other 14 benign lesions, the sensitivity and specificity of stereotactic VAB could not be evaluated. A limitation of stereotactic VAB is that less breast tissue vol- ume is obtained than with ultrasound-guided VAB. The pro- cedure completion time for stereotactic VAB is usually not in- dicated in studies and no definite guideline exists. We termi- nated the procedure when microcalcifications were seen in more than two tissues obtained for specimen mammography or when the breast marker clip was accurately located at a breast lesion on post-procedure mammography. Because stereotactic VAB focuses on diagnosis and not treatment, additional pro- cedures are unnecessary. But, the rate of atypical ductal hyper- plasia (ADH, 20.9%) or DCIS (11.2%) can be underestimated [8]. Therefore, identifying an ADH or DCIS during stereotac- tic VAB warrants a further procedure or surgical excision. Although stereotactic VAB is definitely an innovative diag- nostic procedure, its disadvantages are that it is conducted in a prone position and that the unit is very large and expensive (approximately quadruple that of a regular unit). It is also dif- ficult to perform stereotactic VAB when the targeting site is close to the pectoralis muscle, axilla, or skin [6,13]. In contrast, stereotactic VAB in an upright position allows the breast lesion to be easily found with a scout image, which is almost same as the CC plane of original mammography. However, it is very difficult to maintain a stable position, because transient neck and back pain, as well as body numbness are common during the procedure, especially in the elderly. Moreover, patients can see the sharp devices, the wound and even blood, which cause anxiety, emotional stress, and possibly a vasovagal reaction, such as nausea, vertigo, or syncope [2,3,6]. To compensate for the disadvantages of the prone or up- right-positioning for stereotactic VAB, a one-side decubitus position was used, which is more comfortable and stable for the patients, even if it has not been generally used [7]. An ex- pensive prone table is unnecessary for lateral positioning dur- ing stereotactic VAB and it causes neither a vasovagal reaction nor neck, or back pain. But, it is more difficult to detect the breast lesion, because the lesions often moves, which is differ- ent from standard mammography. To alleviate this problem, we performed a true lateral mammography view before the procedure, which lengthened the procedure. Breast lesions could be easily identified on stereotactic mammography, be- cause the targeted site was nearly the same as the pre-proce- DOI: 10.4048/jbc.2011.14.1.64 67 dure true lateral view mammography. Our report has limitations such as the small number of cases with a short term follow-up and the absence of a comparison between stereotactic VAB and other diagnostic procedures. According to several studies, 6-27% of benign breast lesions remain after a VAB procedure, and it is difficult to distinguish between a post-procedural scar and residual lesion within 6 months [14,15]. Therefore, long term follow-up is necessary to evaluate for a residual breast lesion. 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