title: Hematoma-directed and ultrasound-guided breast-conserving surgery for nonpalpable breast cancer after Mammotome biopsy.
abstract: Stereotactic vacuum-assisted (Mammotome) breast biopsy is a powerful diagnostic tool for detecting microcalcifications on mammography, but it is difficult to remove the targeted lesion precisely when subsequent breast-conserving surgery is to be carried out. We achieved satisfactory results by performing hematoma-directed breast-conserving surgery after stereotactic Mammotome biopsy in seven patients. To identify the exact location of the Mammotome biopsy during the breast-conserving surgery, we created an iatrogenic hematoma in the biopsy cavity using patient's blood. This hematoma was detected easily on intraoperative ultrasonography in all patients, and was palpable as a soft mass in five of the seven patients. The microcalcifications were completely removed in all patients, and no cancer cells were found in the margin surfaces after breast-conserving surgery. There were no complications during the injection of the patient's blood into the biopsy cavity or during the hematoma-directed surgery. We describe this new procedure of hematoma-directed breast-conserving surgery following Mammotome biopsy for nonpalpable cancer with microcalcifications.
authors.affiliation: Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Inui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Watatani
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Hojo
authors.forename: Kyoko
authors.initials: K
authors.lastname: Hirai
authors.forename: Munehisa
authors.initials: M
authors.lastname: Yamato
authors.forename: Makoto
authors.initials: M
authors.lastname: Fujishima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Azumi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shiozaki
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease; D015412:Mastectomy, Segmental; D008875:Middle Aged; D016217:Ultrasonography, Mammary