Breast masses: Removal of all US evidence during biopsy by using a handheld vacuum-assisted device - Initial experience

被引:59
作者
March, DE
Coughlin, BF
Barham, RB
Goulart, RA
Klein, SV
Bur, ME
Frank, JL
Makari-Judson, G
机构
[1] Baystate Med Ctr, Dept Radiol, Springfield, MA 01199 USA
[2] Baystate Med Ctr, Baystate Comprehens Breast Ctr, Reg Canc Program, Springfield, MA 01199 USA
[3] Baystate Med Ctr, Dept Pathol, Springfield, MA 01199 USA
[4] Baystate Med Ctr, Dept Surg, Springfield, MA 01199 USA
[5] Baystate Med Ctr, Div Hematol & Oncol, Springfield, MA 01199 USA
关键词
breast; biopsy; breast neoplasms; localization; therapy; US; ultrasound; (US); guidance;
D O I
10.1148/radiol.2272020476
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To assess the effects of removal of all ultrasonographic (US) evidence of breast lesions by using a vacuum-assisted biopsy (VAB) device. MATERIALS AND METHODS: Thirty-four women with breast masses underwent US-guided biopsy with an 11 gauge VAB device, with which removal of all evidence of the lesion was attempted: Histologic findings were compared with results of ! surgery and follow-up imaging. Patient tolerance and perceptions of the procedure and the ability of the procedure to eliminate a palpable finding were evaluated with questionnaires and findings at follow-up physical examination. RESULTS: The biopsy protocol was completed in all cases. Twenty-six benign lesions (76%) and eight malignancies (24%) were diagnosed. After VAB, 10 patients (29%) underwent surgery on the basis of histologic findings of invasive carcinoma (n = 7), ductal carcinoma in situ (n = 1), lobular neoplasia (n = 1), or atypical ductal hyperplasia (n = 1). VAB resulted in complete excision of four of 10 lesions: two of eight malignancies and two of two benign lesions. Among 21 patients with benign I lesions who underwent 6-month follow-up imaging, eight (38%) had a definite residual mass. At 6-month follow-up examination, VAB was seen to have eliminated the palpable abnormality in seven (88%) of eight patients with initially palpable benign masses. Thirty-two patients (94%) described no or mild pain during biopsy, and 33 patients (97%) rated care as excellent. CONCLUSION: After removal of all US evidence of breast masses with a VAB device, there was a substantial probability that residual lesion that was not visualized during the procedure would later be found at surgery or follow-up imaging. A palpable mass (less than or equal to1.2 cm in mean diameter) was eliminated in 88% of cases, and patient tolerance and perceptions of the procedure were favorable.
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收藏
页码:549 / 555
页数:7
相关论文
共 30 条
[1]  
*AM COLL PATH, 1998, BREAST IM REP DAT SY
[2]   One hundred consecutive advanced breast biopsy instrumentation procedures: Complications, costs, and outcome [J].
Bloomston, M ;
D'Angelo, P ;
Galliano, D ;
Butler, J ;
Dean, R ;
Rosemurgy, AS .
ANNALS OF SURGICAL ONCOLOGY, 1999, 6 (02) :195-199
[3]   BREAST-TUMORS - COMPARATIVE ACCURACY OF MR-IMAGING RELATIVE TO MAMMOGRAPHY AND US FOR DEMONSTRATING EXTENT [J].
BOETES, C ;
MUS, RDM ;
HOLLAND, R ;
BARENTSZ, JO ;
STRIJK, SP ;
WOBBES, T ;
HENDRIKS, JHCL ;
RUYS, SHJ .
RADIOLOGY, 1995, 197 (03) :743-747
[4]  
Burbank F, 1996, AM SURGEON, V62, P738
[5]  
Burbank F, 1997, AM SURGEON, V63, P988
[6]  
Cady B, 1996, ARCH SURG-CHICAGO, V131, P301
[7]   Stereotactic breast biopsy: En bloc excision of microcalcifications with a large-bore cannula device [J].
Damascelli, B ;
Frigerio, LF ;
Patelli, G ;
Lanocita, R ;
Viganotti, G ;
Uslenghi, E ;
Ticha, V ;
Conti, A ;
Bohm, S ;
De Simone, T ;
Vespro, V .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1999, 173 (04) :895-900
[8]   Stereotactic excisional breast biopsies utilizing the advanced breast biopsy instrumentation system [J].
DAngelo, PC ;
Galliano, DE ;
Rosemurgy, AS .
AMERICAN JOURNAL OF SURGERY, 1997, 174 (03) :297-302
[9]   Stereotactically guided laser therapy of occult breast tumors -: Work-in-progress report [J].
Dowlatshahi, K ;
Fan, M ;
Gould, VE ;
Bloom, KJ ;
Ali, A .
ARCHIVES OF SURGERY, 2000, 135 (11) :1345-1352
[10]  
DUCHESNE N, 2001, AJR S, V176, P7