Ultrasound-Guided Vacuum-Assisted Biopsy in Small Breast: A Cost-Saving Solution

A Multicenter, Randomized, Controlled Study of the Breast Biopsy and Circumferential Excision System for Breast Lesions

BACKGROUND

This study aimed to verify the effectiveness, safety, and reliability of the breast biopsy and circumferential excision system.

METHODS

It was designed as a multicenter, randomized, open-label, positive control, noninferiority trial. A total of 168 subjects who met the breast lesion screening requirements of the clinical trial protocol were randomly divided into a breast biopsy and circumferential excision dual cutting system test group or Mammotome control group. The main outcome was the successful removal rate of suspected lumps during surgery. Secondary outcomes included the operative times for individual lumps, weight of removed cord tissue, and several indicators of device performance. Safety indicators, including routine blood, blood biochemical and electrocardiogram examinations, were measured at baseline and 24 hours and 48 hours after the operation. Postoperative complications and combined medication use were observed and recorded until 7 days after the operation.

RESULTS

The results showed no significant differences in efficacy and safety between the 2 groups (main efficacy, P = .7463; all secondary efficacy indicators, P > .05, except weight of removed cord tissue [P = .0070] and touch sensitivity of the device interface [P = .0275]; all safety indicators, P > .05). The results suggested that the test device is effective and is acceptable safe for use in breast lesion biopsy.

CONCLUSION

For patients with a high incidence of breast lesions, the results of this study provide a safe, effective, sensitive and accessible option for the removal of breast mass biopsies at a price much lower than that of imported devices.

Value of ultrasound BI‑RADS classification in preoperative evaluation of the ultrasound‑guided Mammotome‑assisted minimally invasive resection of breast masses: A retrospective analysis

The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) classification has been used for the diagnosis of breast masses for several decades and constantly updated, but the terminology used to describe breast ultrasound findings is still evolving and a great amount of large sample data is necessary to verify and improve ultrasound BI-RADS. The objective of the present study was to explore the value of ultrasound Breast Imaging Reporting and Data System (US BI-RADS) classification in the preoperative evaluation of the US-guided Mammotome-assisted minimally invasive resection of breast masses. A total of 1,028 patients with 1,341 breast masses from a single hospital were selected for retrospective analysis. All patients underwent minimally invasive resection using a US-guided Mammotome device, and postoperative pathological examinations were performed for all samples. The preoperative US BI-RADS classification and postoperative pathological examination results were compared and analyzed. A receiver operating characteristic (ROC) curve was used to analyze the preoperative evaluation efficacy of the US BI-RADS classification in US-guided Mammotome-assisted minimally invasive breast mass resection. Among the 1,341 breast masses that underwent resection, 1,307 were benign and 34 were malignant. The specificity, sensitivity, accuracy, positive predictive value and negative predictive value of the US BI-RADS classification in the preoperative diagnosis of malignant breast masses were 83.47, 100.00, 83.89, 13.60 and 100.00%, respectively, and the area under the ROC curve was 0.917. It may be concluded that the US BI-RADS classification has a good preoperative diagnostic performance and can provide an accurate assessment prior to Mammotome-assisted minimally invasive resection. It may help surgeons to make reasonable decisions for subsequent therapy and therefore is worthy of further clinical use.

Ultrasound-guided vacuum-assisted breast biopsy in the diagnosis of cancer recurrence at the surgical scar: a report of three cases

Aim of the study

Ultrasound-guided vacuum-assisted biopsy is being increasingly used in the diagnosis of breast lesions. The advantages of vacuum-assisted biopsy over core needle biopsy include large sample and higher diagnostic accuracy. Indications for ultrasound-guided vacuum-assisted biopsy include suspicious calcifications visible on ultrasound, architectural distortion, and very subtle or insinuating lesions.

Case description

We present three patients treated for breast cancer with breast-conserving surgery who developed suspicious findings on mammogram and MRI at or near the surgical scar. The findings were subtle, small, or atypical lesions on ultrasound. Ultrasound-guided vacuum-assisted biopsy was performed, and recurrence was diagnosed. The technique was advantageous due to real-time imaging, ability to control the path of the needle, obtaining multiple cores with a single skin puncture and single pass, supine position, no radiation, and no IV contrast.

Conclusions

Ultrasound-guided vacuum-assisted biopsy should be considered in cases involving multiple suspicious findings at or near the surgical scar, with subtle or atypical sonographic correlates. Vacuum-assisted biopsy is indicated; yet ultrasound guidance is more comfortable, no radiation and no contrast.

Advances in Ultrasound-Guided Vacuum-Assisted Biopsy of Breast Microcalcifications

Microcalcification is one of the significant indications for or can even be the sole mammographic feature of breast cancer, especially occult breast cancer. Biopsy and pathologic examination are the most important methods used to identify the nature of suspicious microcalcifications. Stereotactic vacuum-assisted breast biopsy (S-VAB) is the most commonly used biopsy method for microcalcifications currently because of the high detection rate of mammography for microcalcifications. However, in recent years, several clinical studies have gradually found that ultrasound-guided vacuum-assisted breast biopsy (US-VAB) could be an alternative to S-VAB for microcalcifications to some extent, and has its own advantages of flexibility, real-time performance, comfort and high accessibility compared with mammography. An overview of US-VAB of microcalcifications is provided with respect to success rate, diagnostic accuracy, advantages and limitations. On the basis of numerous studies and clinical experience, US-VAB proved to be a valid alternative to S-VAB, with comparable diagnostic accuracy if the microcalcification foci could be detected by ultrasound. And for patients with ultrasound-invisible microcalcifications who are not suitable for or tolerable of S-VAB, US-VAB combined with mammography localization of microcalcifications can also be considered.

Patient Satisfaction in the Complete Removal of Giant Breast Fibroadenoma under Vacuum-Associated Breast Biopsy Procedure

INTRODUCTION: Fibroadenomas are one of the most common benign tumors of the breast in the adolescent population. They account for 68% of all breast masses and 44–94% of all biopsied breast lesions. Fibroadenomas can range from asymptomatic masses to painful and rapidly growing tumors that can cause significant esthetic distortions of the breast. With breast examinations becoming common in women as young as their 20s, excision of benign breast tumors using vacuum-assisted breast biopsy (VABB) became more common. The VABB procedure with ultrasound guiding is still used for removal benign breast tumors. CASE REPORT: A 24-year ago woman presents with complaints of a lump in the right breast for 3 years, the lump is slow growing. The mass diameter is about 6 cm and no ulcers. Ultrasound examination found a solid mass, firm boundaries, regular contours, mobile in the outer quadrant of the right breast, no specific microcalcification size 6.13 cm × 3.11 cm × 5.33 cm (BIRADS 4a). Core biopsy examination showed fibroadenoma mammae intracanalicular and pericanalicular. We used an 8G needle and got 458 slices about 100 g. After the procedure, a total removal is obtained by ultrasound examination from a previously existing mass of 6 cm. CONCLUSIONS: The VABB procedure is very effective and efficient in removing breast fibroadenoma (benign lesion) and the results are satisfactory. The advantage of this procedure apart from the cosmetic aspect which does not leave any marks is also a high level of safety. From our case, we can take complete removal with a diameter of 6 cm, whereas in the previous literature, it can only remove a mass of 3–4 cm in size.