Journal List > J Breast Cancer > v.10(4) > 1036083

Choi, Moon, Kim, Kim, Chu, and Cho: Pathological Correlation of Re-excised Breast Lesions after the use of the Ultrasound-Guided Vacuum-Assisted Biopsy Device (Mammotome®)

Abstract

Purpose

The Mammotome® biopsy is a relatively newsurgical technique that is a minimally invasive image-guided procedure, requiring a small incision that produces a barely noticeable scar. The technique is a useful method for the surgical biopsy of properly selected patients. We reviewed the pathology of the biopsies for the proper selection of a mammotome biopsy in patients with re-excised breast tumors.

Methods

During a 24-month period, we performed vacuumassisted breast biopsies for 277 likely benign breast lesions using ultrasound and fine-needle aspiration cytology or a core needle biopsy, in 203 patients. The age of the patients ranged from 15 to 67 yr (average age 36.6 yr), and the average size of the lesions was 2.39±1.06 cm (minimum size 0.5 cm, maximum size 5.0 cm). We retrospectively analyzed the pathological findings of the re-excised breast lesions.

Results

The pathology of ultrasound-guided vacuum biopsies of the benign-appearing breast lesions were fibroadenomas (69.7%), intraductal papillomas (6.1%), fibrocystic disease (7.9%), phyllodes tumors (2.9%), malignant tumors (1.4%), ductal hyperplasia (2.9%), and other benign diseases (9.1%). Re-excision by a conventional method was performed for nine patients. Reasons for re-excision were the presence of five proven malignancies (a malignant phyllodes tumor in 2 cases, a tubular carcinoma in 1 case, a papillary carcinoma in 1 case and a ductal carcinoma in situ [DCIS] in 1 case), a possible atypical ductal hyperplasia (ADH) malignancy, two marginal involvement in phyllodes tumors and the possible extension of a lesion as an atypical papilloma. In the re-excised specimens, residual tissues were noticed in eight cases. An ADH lesion was proven as a DCIS.

Conclusion

A case of suggested marginal involvements and/or a possible malignancy should be re-excised because of the high possibility of remnant lesions being present after the mammotome biopsy. The cytological and pathological review must be performed precisely before performing the mammotome procedures with considering of the clinical and radiological findings.

Figures and Tables

Table 1
Pathologic results of pre-Mammotome® cytology
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Table 2
Pathologic result by ultrasound-guided vacuum-assisted biopsy device (Mammotome®)
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Table 3
Clinical characteristics and pathologic correlation of the re-excised breast lesions after ultrasound-guided vacuum assisted biopsy device (Mammotome®)
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FNA=fine needle aspiration; ADH=atypical ductal hyperplasia; DCIS=ductal carcinoma in situ.

*Initial size: long diameter of the mass on ultrasonographic finding.

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