Comparison of X-ray mammography and ultrasound in the diagnosis of suspected breast lesions / 中国辐射卫生

Objective To evaluate and compare the diagnostic efficiency of X-ray mammography and breast ultrasound for suspected breast lesions. Methods A total of 80 female patients with suspected breast lesions diagnosed by X-ray mammography or breast ultrasound were selected as the study subjects. The histopathological testresults served as the gold standard, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of X-ray mammography and breast ultrasound for the diagnosis of breast lesions were estimated and compared. Results Among the 80 female patients with suspected breast lesions, 57 patients were histopathologically diagnosed with breast cancer and 23 patients with benign breast lesions. The sensitivity, specificity, NPV, PPV, and accuracy of X-ray mammography for the diagnosis of suspected breast lesions in women were 63.16%, 73.91%, 44.74%, 85.71%, and 66.25%, respectively, and those of breast ultrasound were 78.95%, 21.74%, 29.41%, 71.43%, and 62.50%, respectively. There were no significant differences between X-ray mammography and breast ultrasound for the diagnosis of suspected breast lesions in women in terms of sensitivity (χ2 = 3.45, P > 0.05), NPV (χ2 = 1.15, P > 0.05), PPV (χ2 = 2.92, P > 0.05), and accuracy (χ2 = 0.25, P > 0.05). However, specificity showed a significant difference between X-ray mammography and breast ultrasound (χ2 = 12.55, P < 0.01). Conclusion A comparable accuracy of X-ray mammography and breast ultrasound is found for the diagnosis of suspected breast lesions in women. However, X-ray mammography presents a significantly higher specificity than breast ultrasound for the diagnosis of suspected breast lesions in women.

Application value of a new lesion positioning stickers in breast lesion surface localization / 中南大学学报(医学版)

OBJECTIVES@#Accurate breast lesion surface localization can guarantee accurate biopsy and local treatment. But there is no guideline to regular equipment and methods for the localization of breast lesions. The conventional non-invasive localization method is marker-based localization. The advantages of this method are simple and efficient. The disadvantages are that markers disappear easily under coupling agents; the positioning length of markers cannot last long on skin; and healthcare associated infection due to many patients using the same marker pen is potentially unavoidable. Breast lesion sticker (called sticker for short) is a new-type localization medical instrument in 2020. Our study aims to explore the clinical value of a new lesion stickers in breast lesion surface localization via comparison of the sticker and marker pen localization methods.@*METHODS@#This was a prospective cohort study. It was conducted in 67 patients who needed breast lesion surface localization before biopsy. The patients were randomly assigned into 2 groups. One group of patients used marker pen to mark breast lesion surface location by ultrasonography. The other group of patients used stickers. Patients labeled with markers on skin were swabbed agents before marking. Then the markers were checked by ultrasound scan. If the surface positions of breast lesion were not correct, the above procedure was repeated. In the sticker group, the stickers were released synchronously after the lesions were detected by ultrasound scan. Then locations were checked via scanning hole. If the surface positions of breast lesion were not correct, the above procedure was repeated. The accuracy of positioning, the length of positioning time and satisfaction of patients between the 2 groups were compared. The length of positioning time was calculated from the time when ultrasound detected the lesion to the time when the surface position of breast lesion was confirmed. The total score of patients' satisfaction was 5 points according to Service Quality Evaluation of SERVQUAL Scale, including sonographers' service attitude and their technical proficiency, other medical staffs' service attitude and their technical proficiency, hospital service procedures, positioning comfort, and positioning effects.@*RESULTS@#All 67 patients were females, aged 18-66 (39.73±13.10). There were 35 patients in the marker pen group and 32 patients in the sticker group. The time length of group used marker pen to localization was 22-88 (52.20±2.90) s, and the sticker group was 3-15 (9.22±0.58) s in length. The length of positioning time for the stickers was significantly shorter than that of the marker (P<0.01). Both methods were accurate in the surface localization of lesions before operation. The total scores of patients' satisfaction was 4-5 (4.92±0.02) in the stickers group, and 1-5 (3.35±0.10) in the marker pen group. The patients' satisfaction scores with the sticker were significantly higher than those with the marker pen (P<0.01). The length of positioning time and patients' satisfication scores for sonographer with 20 years' working experience were shorter and higher than those of sonographer with 10 years' working experience, respectively (both P<0.05).@*CONCLUSIONS@#The new breast lesion positioning stickers have more advantages than the marker pen in localization efficiency. It could reduce the workload of medical workers and increase patients' satisfaction to some extent. The stickers can be used not only in the breast lesions surface localization, but also in the skin location of pleural effusion and ascites, the skin location of surface masses, the skin location of thyroid nodule, and many other clinical marker areas, to further expand the scope of clinical application and value of the stickers.

Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Juvenile giant fibroadenoma of the breast: presentation of a clinical case

RESUMEN El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral unilateral, de crecimiento rápido e indolora. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 12 cm de diámetro en la mama de una niña de 13 años. Se realiza estudio radiológico e histológico de la lesión siendo categorizada como un fibroadenoma gigante juvenil por lo que se realiza tumorectomía completa con remodelación mamaria posterior. A los dos meses de seguimiento, la paciente se encuentra sin signos de recidiva, con buena situación general y a la espera de cirugía de remodelación mamaria.

ABSTRACT Juvenile giant fibroadenoma is a benign breast tumor and a rare variant of fibroadenomas. The clinical presentation is usually a painless, fast growing, unilateral tumor mass. In this article we present the case of a giant juvenile fibroadenoma of 12 cm in diameter in the breast of a 13-year-old girl. A radiological and histological study of the lesion was carried out and it was categorized as a juvenile giant fibroadenoma, so a complete lumpectomy with posterior breast remodeling was performed. After two months of follow-up, the patient is without signs of recurrence, in good general condition and waiting for the breast remodeling surgery.

Clinical application of wire guided localization of breast biopsy under X-ray guidance / 中国基层医药

Objective To study the diagnostic and treatment value of wire guided localization of breast biopsy for non-palpable breast lesions.Methods The clinical data of 314 cases of non-palpable breast lesion resection operation in our hospital were retrospectively analyzed.The accuracy rate of resection and postoperative pathological examination results were analyzed.Results All lesions were positioned accurately and completely resected,48 cases in 314 cases were breast cancer(15.3 ％),in which 42 cases were early breast cancer which were confirmed by pathology (87.5％).Conclusion Wire guided localization of breast biopsy has high accuracy,low cost,which is useful for the diagnosis of early breast cancer,there is a certain value in clinical application.

Application of full-field digital mammography three-dimensional positioning system for localization of nonpalpable breast lesions / 实用放射学杂志

Objective To evaluate the clinical value of full-field digital mammography three-dimensional (3D) positioning system for localization and excision of nonpalpable breast lesions.Methods 106 patients with nonpalpable breast lesions and underwent preoperative localization were analyzed retrospectively.They underwent wire-localization operation guided by mammography 3D positioning system (GE Senogrphe DS).The depth of wire insertion was calculated manually and automatically.Combined with the manual measurement, systematic measurement, skin elasticity and breast parenchyma structure, the positioning wire was placed.Then, the clinical resection was performed according to the wire localization.Results The localization accuracy of mammography 3D positioning system was 100%.11 patients appearedsyncope.With the rest, psychological comfort and fluid infusion, patients recovered quickly.Conclusion Full-field digital mammography 3D positioning system can improve the accuracy of clinical resection of nonpalpable breast lesion.

A Retrospective study on incidence of male mammography in a tertiary care hospital.

Background: Awareness of early breast cancer detection in women through mammography study (diagnostic as well as screening) for a diagnostic and direct approach to cross society (screening) with an early detection of breast cancer. But incidentally or coincidentally, so many males underwent the Mammography. Methods: A retrospective study was conducted with 45 males aged 15-75 years, who underwent mammography procedures co-incidentally, during well planned study of early detection of breast cancer for women through mammography for the duration of6 months at the Lord Buddha Medical College, Saharsa. Results: Even though relatively seems to be small in number, is having lots of significance to that, as only a few researchers carry out this type of study and Men hardly go for Mammography and even Medical fraternity hardly refers male for mammography. A total of 45 patients that too Men underwent mammography (an X-ray base technique to detect early breast lesions and mainly breast cancer) along with high frequency Sonography of each and every patient was carried out. Our study of 45 patients nearly showed the 3 patients having very high suspicions of malignancy means nearly 8% (Even though breast cancer in male is usually of 1%). Conclusion: So this retrospective analytical study conclude that even though routine mammography screening (In female every year) is not required in the male, but definitely it will be an a useful tool in patients having any type of complain related with breast like pain, enlargement or both, may help a lot to diagnose breast lesions like calcification, gynecomastia and breast cancer in early stage.

Optical tomography image ultrasonography system in the diagnosis of breast cancer / 医学研究生学报

Objective The incidence of breast cancer in China obviously keeps rising in recent years. The optical tomo?graphy image ultrasonography system ( OPTIMUS) is gradually applied in clinic as a new imaging diagnostic technique, but few system?atic studies are reported on its application to the diagnosis of breast tumors. The aim of this study was to assess the value of OPTIMUS in differentiating benign and malignant breast masses by measuring the maximum hemoglobin concentration ( MHC) in the lesions using OPTIMUS with the help of the results of controlled pathological study. Methods This prospective study included 380 cases of breast tumor ( 210 benign and 170 malignant ) treated from April 2009 to April 2014. We measured the MHC using OPTIMUS, detected the expressions of VEGF and PECAM?1/CD31 by immunohistochemistry, calculated the optimal threshold valve of MHC in predicting breast malignancy with the ROC curve, and analyzed the correlation of the MHC value with benign and malignant lesions, lymph node metasta?sis, and the expressions of VEGF and PECAM?1/CD31. Results The mean MHC was significantly higher in the malignant than in the benign lesions ([215.33±69.31] vs [116.50±55.31] μmol/L, P<0.01). The area under the ROC curve (AUC) was 0.836 (95%CI 0.684-0.989). The optimal threshold valve in the diagnosis of malignant breast lesions was 135.00 μmol/L, with a sensitivity of 84.7% and a specificity of 89%. When the tumor was≤2 cm, the MHC was significantly higher in the patients with lymph node metas?tasis than in those without ([207.73±66.43] vs [184.36±62.13] μmol/L, P<0.05). However, the MHC was markedly lower in the benign masses with VEGF and PECAM?1/CD31 negative than in the malignant lesions with VEGF and PECAM?1/CD31 positive ([116.50±55.31] vs [205.73±72.46] μmol/L, P<0.05) and strongly positive ([244.21±63.56] μmol/L, P<0.05). Strongly posi?tive expressions of VEGF and PECAM?1/CD31 were positively correlated with MHC ( P<0.05) . Conclusion Measurement of MHC by OPTIMUS contributes to the differential diagnosis of benign and malignant breast lesions and has a potential value for preoperative assessment of the prognosis of breast cancer.

Comparative Study on the Preventive Use of 3 Kinds of Cephalosporins for 1 066 Patients with Breast Lesion Resection in Shaanxi Province / 中国药房

OBJECTIVE:To compare the effects of prophylactic application of 3 different antibiotics on prognosis in patients underwent breast lesion resection. METHODS:1 066 patients with breast lasion resection from 12 hospitals of Shaanxi province were divided into trial group(360 cases),control group A(352 cases)and control group B(354 cases)according to random num-ber table. Trial group was given first generation cephalosporin cefazolin;control group A was given second generation cephalospo-rin cefuroxime;control group B was given third generation cephalosporin cefoperazone sodium and tazobactam sodium. The dosage regimens of 3 groups were as follows:relevant drug 2 g added into 0.9%Sodium chloride injection 100 ml,ivgtt,0.5 h before sur-gery,medication course≤24 h after surgery in trial group. Those indexes of 3 groups were observed,such as post-operative ADR, incision healing,infection,hospitalization duration,phamaceutical costs per capita. RESULTS:There was no statistical signifi-cance in the rate of incision healing and the rate of post-operative infection among 3 groups(P>0.05). The incidence of post-opera-tive ADR,hospitalization duration and phamaceutical costs per capita in observation group were significantly lower or shorter than in control group A and B,with statistical significance(P<0.05). CONCLUSIONS:Cefazolin is better than cefuroxime and cefo-perazone sodium and tazobactam sodium to reduce the postoperative adverse reaction,antibiotics cost per capita and hospital drug cost per capita,shorten the hospitalization duration.

“Giant breast lipoma” an unusual presentation: a rare case report.

Lipomas are most common benign tumour derived from adipose tissue. Lipoma breast is somewhat difficult to diagnose clinically because of fatty consistency of breast. So preoperative diagnostic work up like FNAC, USG, mammography are important to confirm the diagnosis. Lipoma breast measuring more than 10cm in diameter or weighining more than 1kg is called giant lipoma of breast are tumour infrequently observed. Because of rarity, size & location we presented a case report of giant breast lipoma including USG, mammographic FNAC and intraoperative finding with review of literature.

Sclerosing adenosis clinically feigning as carcinoma breast: A case report.

Sclerosing Adenosis (SA) is a lobulocentric proliferative process that involves both the epithelial and the mesenchymal component of the breast suggesting benignity. The disease has an increased incidence among reproductive-age and perimenopausal women, especially between 35 and 50 years of age. The clinical, radiological, and histopathological properties of sclerosing adenosis may resemble malignancy, which is the factor responsible for the clinical significance of the disease. Early diagnosis of sclerosing adenosis (SA) is very important as it is associated with a doubling of the risk of developing breast carcinoma, even though its role in carcinogenesis remains to be controversial and unclear. The main histopathological alterations of the terminal ductal lobular unit (TDLU) present as a widening and distortion of lobules with an increased number of acini and stromal fibrosis. The lesion is also called an “adenosis tumor of the breast” or “nodular sclerosing adenosis” if it presents as a palpable mass. Sclerosing adenosis is present in 12% of benign proliferative lesions and 20-25% of malignant lesions on histopathological examination. On mammography (MG), it can present as opacity, focal asymmetry, architectural distortion, or micro calcifications, mimicking a carcinoma. We have presented a case of 42 year old female who was diagnosed as carcinoma breast clinically and on radiology. Mammography showed a fibrosed lesion of size 4.5x3 cm with focal specks of microcalcification and irregular borders. But repeated fine needle aspiration cytology (FNAC) smears revealed small and large clusters of ductal epithelial cells with minimal anisonucleosis with background showing amorphous crystalline material and stromal fragments. Basing on FNAC, plan of surgery changed and a wide local excision with 2 cm normal margins was done and the specimen sent for histopathological examination (HPE), which revealed the lesion as sclerosing adenosis (SA).

Retrospective analytical 10 years study of male mammography.

Background: Awareness of early breast cancer detection in women through mammography study (diagnostic as well as screening) was planned by Mangal Medi Centre through referral doctors for diagnostic and direct approach to cross society (screening) with an early detection of breast cancer. But incidentally or coincidentally so many males underwent the Mammography. So those reports were analysis retrospective. Methods: Retrospective study of 92 men who underwent mammography procedures co-incidentally, during well planned study of early detection of breast cancer for women through mammography in last 10 years in one of the NGO named Mangal Medi Center Aurangabad. Those findings were analysed and hereby are presented, in which age varied as low as 11 years and as high as 77 years. Results: Even though relatively seems to be small in number, is having lot of significance to that, as only few researcher carry out this type of study and Men hardly go for Mammography and even Medical fraternity hardly refers male for mammography. A total of 92 patients that too Men underwent mammography (X-ray base technique to detect early breast lesions and mainly breast cancer) along with high frequency Sonography of each and every patient were carried out. Conclusions: Our study of 92 patients nearly showed the 6 patients having very high suspicions of malignancy means nearly 8% (Even though breast cancer in male is usually of 1%). So this retrospective analytical study concludes that even though routine mammography screening (In female every year) is not required in male but definitely it will be an a useful tool in patients having any type of complain related with breast like pain, enlargement or both, may help a lot to diagnose breast lesions like calcification, gynaecomastia and breast cancer in early stage (as a general rule breast cancer in male is diagnosed in late stage due to myth that breast cancer is not seeing in male, lack of self-awareness and coming in late stage with larger tumour size resulting you higher morbidity and mortality.

Research on the diagnostic value of 18G and 16G needle ultrasound-guided breast biopsy / 中国医学装备

Objective:To evaluate the diagnostic value of 18G and 16G needle biopsy of breast lesions.Methods: Onr hundred and fifteen patients with breast lesions those were excised through surgery. Each lesion was under ultrasound-guided needle biopsy(US-CNB) with 18G and 16G, then underwent surgical resection of mass and pathological histology. Histological findings of US-CNB and the surgical specimens were analyzed for sensitivities, false negative rates, and underestimate rates.Results: Among 84 cases of breast cancer proved by surgical pathology, the sensitivity, specificity, false negative rate of 18G and 16G biopsy diagnosis were followed by 95.2% and 97.6%, 89.6% and 94.3%, 4.8% and 2.4%. Paired chi-square test showed no significant difference between the two methods.Conclusion: 18G and 16G needle biopsy has no significant difference in the diagnosis of breast lesions.

Clinical Effectiveness Study of Full Field Digital Mammography Stereotactic Core Needle Biopsy and Stereotactic Needle Localization in the Diagnosis of Nonpalpable Breast Lesions / 医学研究杂志

Objective To investigate the full digital mammography X-ray stereotactic biopsy catheter guide wire ( full field digital mammography stereotactic core needle biopsy, FFDM SCNB) diagnosis of small breast lesions ( nonpalpable breast lesion, NPBL) clinical effectiveness. Methods Admitted in our hospital from October 2011 to October 2013 period 61 cases NPBL patients as observed objects were given FFDM SCNB and pathological examination ( histopathological examination, HE) , after the diagnostic accuracy of the standard diagnostic evaluation, and data were statistically analyzed. Results The SCNB NPBL 82 were detected, of which malignant NPBL 40 (48. 78%), benign NPBL 40 (48. 78%), benign and malignant unknown NPBL 2 (2. 22%);HE were detected in malignant NPBL 40 (48. 78%), benign NPBL 42 (51. 22%), benign and malignant unknown 0 (0. 00%);SCNB diagnostic accuracy of 74 (90. 24%) ca-ses were misdiagnosed 6 (7. 32%) cases were missed 2 (2. 44%) patients, compared with no diagnosis HE significant difference(P>0.05). Conclusion This study was to compare the diagnosis of 61 cases of patients NPBL found FFDM SCNB not in terms of diagnostic ac-curacy in patients with HE significant difference(P>0. 05), and there is less invasive, small-destructive, no scars, and economic secur-ity advantage, worthy reference.

Comparison and experience of two vacuum assisted biopsy systems in benign breast lesions: EnCor and Mammotome / 中国综合临床

Objective To investigate application value of two vacuum assisted biopsy systems in benign breast lesions and compare the advantages and disadvantages of EnCor and Mammotome system.Methods Vacuum assisted excision was performed on 346 benign breast lesions in 227 patients (EnCor with 103 cases, Mammotome with 124 cases) from November 2012 to May 2013, including 162 cases using EnCor system and 184 cases using Mammotome system.Results Duration of operation in EnCor group was (14.18± 4.21) minutes,in Mammotome group was (18.77 ± 7.06) minutes, and the difference was significant (P ＜ 0.001) .Weight of tissues in Mammotome group was (6.87± 3.43) g, in EnCor group was (8.32± 1.18) g, and the difference was significant (P ＜ 0.001).No significant differences were found in postoperative hematoma (P =0.58), postoperative pain (P =0.35), incidence of residual tumor (P =0.15).Conclusion Compared Mammotome group, EnCor group had significantly shorter duration.But using Mammotome system, the specimens can be observed directly.Mammotome is more suitable for women of childbearing age, it can preserve lactation function.There is no significant difference in complication and residual tumor of two vacuum assisted biopsy system in benign breast lesions.

Clinical application of preoperative ultrasound-guided guide-wire localization in diagnosing tiny breast lesions / 介入放射学杂志

Objective To discuss the clinical application of ultrasound-guided preoperative guide-wire localization in diagnosing tiny breast lesions. Methods A total of 56 patients with impalpable tiny breast lesions were enrolled in this study . Preoperative guide-wire localization of the lesion was performed under high-frequency ultrasound guidance, which was followed by tracking resection of the lesion. The clinical data were retrospectively analyzed. Results Successful localization and complete resection of the lesion was accomplished in all 56 patients. The lesions included invasive ductal carcinoma (n=11), intraductal carcinoma (n=5), ductal carcinoma in situ (n=2), mucinous carcinoma (n=2), fibroadenoma (n=24), atypical hyperplasia (n=6), intraductal papilloma (n=4) and plasma-cell mastitis (n=2). Conclusion Ultrasound-guided preoperative guide-wire localization is a safe and reliable technique for the diagnosis of impalpable tiny breast lesions. It can precisely localize the lesion , which is very helpful for making a complete resection of the lesion and avoiding unnecessary breast injury. Therefore , this technique should be recommended in clinical practice.

Clinical application of preop erative ultrasound-guided guide-wire localization in diagnosing tiny breast lesions / 介入放射学杂志

Objective To discuss the clinical application of ultrasound-guided preoperative guide-wire localization in diagnosing tiny breast lesions. Methods A total of 56 patients with impalpable tiny breast lesions were enrolled in this study. Preoperative guide-wire localization of the lesion was performed under high-frequency ultrasound guidance, which was followed by tracking resection of the lesion. The clinical data were retrospectively analyzed. Results Successful localization and complete resection of the lesion was accomplished in all 56 patients. The lesions included invasive ductal carcinoma (n=11), intraductal carcinoma (n=5), ductal carcinoma in situ (n=2), mucinous carcinoma (n=2), fibroadenoma (n=24), atypical hyperplasia (n=6), intraductal papilloma (n=4) and plasma-cell mastitis (n=2). Conclusion Ultrasound-guided preoperative guide-wire localization is a safe and reliable technique for the diagnosis of impalpable tiny breast lesions. It can precisely localize the lesion, which is very helpful for making a complete resection of the lesion and avoiding unnecessary breast injury. Therefore, this technique should be recommended in clinical practice.

The application strategy for mammotome in breast diseases / 中华内分泌外科杂志

Objective To explore the indication,operative methods,operation skill and prevention of complications of mammotome(MMT) in breast diseases.Methods From Aug.2009 to Aug.2013,3676 breast lesions in 1356 patients received MMT micro-invasive operation by decussation process with different incision and needle tracks according to the location of lesions.Experience of the indication,operation technique and prevention of complications were summed up.Results 775 lesions were in left breast and 639 in right breast.652 patients had single lesion and 865 patients had multiple lesions.The pathology results:320 cysts (8.71％,320/3676) were adenosis of breast with mammary duct ectasia or with metaplasia apocrine.36 solid and cystic tumors (0.98％,36/3676)were intraductal papillomas.3310 solid tumors (90.04％)included 13 breast cancers (0.39％,13/3310),2246 fibroadenomas(67.85％,2246/3310) and 1051 adenosis(31.75％,1051/3310).10nodules of calcification were adenosis of breast.13 patients with breast cancer received modified radical mastectomy.The postoperative results:skin bruises in 184 cases(5％),hematoma in 36 cases(0.98％).No postoperative residual was found.Conclusion According to the strict application of MMT minimally invasive surgery and by decussation process based on the appropriate incision and needle track,MMT minimally invasive surgery can achieve safe,minimally invasive,good-looking and completely removal effect.

Usefulness and Complications of Ultrasonography-Guided Vacuum Assisted Biopsy for the Removal of Benign Breast Lesions

PURPOSE: To evaluate the usefulness and complications of ultrasonography (US)-guided vacuum assisted biopsy (VAB) for the removal of benign breast lesions, and the short- and long-term changes after VAB as shown on follow-up US. MATERIALS AND METHODS: From January 2007 to May 2008, 110 sonographically benign lesions in 62 patients were sampled via US-guided VAB. We prospectively evaluated the sonographic findings 1 week and 6 months after VAB in all patients to determine the presence of residual tumors, hematomas and scarring. We evaluated the prevalence of hematoma, pain, skin dimpling, fibrotic scarring and residual tumors after US-guided VAB, and determined if correlation existed between complications, size of the lesions and lesion pathology. RESULTS: The age of the patients was 15-65 years, with a mean age of 36.5 years. The pathologic diagnoses were fibroadenomas (41.8%, n = 46), fibrocystic changes (30.9%, n = 34), fibroadenomatoid hyperplasias (13.6%, n = 15), fibroadenomatoid mastopathies (6.3%, n = 7), adenoses (3.6%, n = 4), hamartomas (1.8%, n = 2) and phyllodes tumors (1.8%, n = 2). Complications 1 week after the US-guided VAB included hematomas (n = 39, 35.4%), pain (n = 23, 20.9%), fibrotic scars (n = 26, 23.68%), residual tumors (n = 4, 3.6%) and skin dimplings (n = 4, 3.6%). Complications 6 months after the US-guided VAB included hematomas (n = 12, 10.9%), pain (n = 3 2.7%), fibrotic scars (n = 14, 12.7%), and residual tumors (n = 17, 15.4%). Residual tumor after US-guided VAB existed in association with 15.2% of fibroadenomas (7/46), 14.7% of fibrocystic changes (5/34), 13.3% of fibroadenomatoid hyperplasias (2/15), 25% of adenoses (1/4), and 100% of phyllodes tumors (2/2). CONCLUSION: US-guided VAB is an effective procedure for removal of benign breast lesion. Periodic follow up studies at 1week and 6months after the VAB are useful to assess Post-VAB complications.

Ultrasound-guided mammotome excision biopsy for benign breast lesions

OBJECTIVE: A 15-month review of all mammotome excision breast biopsies in the Medical City to evaluate our experience in excising benign breast lesions using this technique by taking into consideration the complications encountered and patient satisfaction regarding the procedure and the postoperative result.METHODS: The study included all patients seen by two breast surgeons of the Medical City Breast Clinic from May 2007 to July 2008 with both palpable breast masses visible on ultrasound with a Breast Imaging Reporting a Data System (BIRADS) classification of 2-4. Women with lesions at high risk for malignancy were excluded from the study. Patient demographics were noted, lesions were classified according to BIRADS classification and data regarding the procedure, compilations incurred and patient satisfaction ratings were obtained.RESULTS: One hundred nineteen patients with ages ranging from 17 to 72 years old underwent ultrasound guided mammotome excision at the TMC-Breast Clinic removing a total of 167 lesions. Majority (82%) of patients were premenopausal whereas 22 (18%) were postmenopausal. Ecchymosis (73%) was the most frequent complication during the procedure due to hematoma formation, pain and a skin nick that require suturing. Of the 25 patients who had a previous open biopsy, 23 (92%) preferred mammotome excision over open breast biopsy.CONCLUSION: Ultrasound-guided mammotome excision is a safe and well-tolerated alternative to open excision biopsy for benign lesions of the breast.

Excision of Benign Breast Lesion by an Ultrasound-Guided Mammotome Biopsy Device

PURPOSE: Percutaneous vacuum-assisted breast biopsy (Mammotome, Fa. Ethicon Endo-Surgery Breast Care) is now commonly performed as the initial approach to diagnose and treat benign breast lesions. It can obviate the need for surgery in women with benign lesions and often lead to a one-stage surgical procedure when malignant lesions are diagnosed. The purpose of this study was to report the outcome of the Mammotome biopsy.. METHODS: We performed 902 cases of Mammotome biopsy (total 474 patients) to confirm the diagnosis and to excise the lesion between January 2003 and December 2006. Among all these cases, 888 cases with radiographically suspected benign lesions, below BI-RADS category 4, were followed up for more than 6 months and we analyzed clinical and pathologic results of these cases, retrospectively. Ultrasonographic follow-up examinations were performed and no malignant tumor or atypical ductal hyperplasia was included. RESULTS: The mean patient age was 42 (range: 17~76) years. The average size of lesion was 1.12 (range: 0.20~5.0) cm. In BI-RADS category, there were 450 (49.8%) C2 lesions, 158 (17.8%) C3 lesions and 251 (27.8%) C4 lesions. Histology revealed 506 cases (56.0%) of fibrocystic disease, 295 (32.7%) fibroadenomas, 11 (1.1%) intraductal papillomas, 16 cases (1.7%) of sclerosing adenosis, 21 cases (2.5%) of ductal epithelial hyperplasia, 18 cases (2.1%) of fat necrosis, 3 cases (0.3%) of gynecomastia, 18 cases (1.9%) of chronic inflammation. 824 lesions (92.8%) were completely removed, 39 cases (4.4%) of residual lesion and 25 cases (2.8%) of postoperative scar were reported. CONCLUSION: Mammotome biopsy is an effective diagnostic and therapeutic management of benign breast lesions with minimal-invasiveness and minimizes postoperative complications.