title: Therapeutic application of ultrasound-guided 8-gauge Mammotome system in presumed benign breast lesions.
abstract: The stereotactic or ultrasound-guided vacuum-assisted breast biopsy (Mammotome, MMT) system is a minimally invasive surgical technique. Increasingly, it is used to remove benign breast lesions as management. To evaluate the therapeutic value of 8-gauge ultrasound-guided MMT system (UMS) in presumed benign breast lesions, a retrospective analysis was performed on a series of 2,167 consecutive 8-gauge UMS procedures. The parameters used in this analysis included lesion size, location, breast imaging reporting and data system for ultrasound category, histopathologic diagnosis, and others. A total of 1,119 women whose mean ages were 36.6 years (range: 12-71, SD: 9.6) underwent 2,167 consecutive 8-gauge UMS procedures. Among the patients, 298 cases (26.63%) did not have palpable mass, 430 (38.43%) had multiple lesions, and 237 (21.18%) had bilateral ones. The average size of excised lesions was 15.8 mm (range: 5-55, SD: 6.7) in the largest dimension, including 294 lesions < 10 mm (13.57%); 1,359 lesions, 10-19 mm (62.71%); 420 lesions, 20-29 mm (19.38%), and 94 lesions ≥ 30 mm (4.34%). Predominant lesions (81.59%) were solid on ultrasound image and nearly half (48.59%) of them were localized in the upper outer quadrant. Histopathologic diagnosis revealed that the overwhelming majority of specimens (96.61%) were benign, most of which manifested as fibroadenoma and fibrocystic changes, while high-risk lesions were revealed in 31 (2.29%) cases and malignancies in 15 (1.11%). Average time for procedure was 8.6 minutes (range: 3.5-38, SD: 5.4) and mean number of cores removed in the procedure was 9.3 (range: 2-42, SD: 3.7). Complete excision was achieved predominantly (99.82%). Complications (59, 5.27%) in which hematoma (41, 3.66%) was the majority were acceptable. In conclusion, the 8-gauge UMS procedure is a safe and potent therapeutic management with satisfactory cosmetic outcome for benign and high-risk breast lesions, especially for bilateral, multiple, and nonpalpable ones. It is a reliable biopsy tool for suspected lesions as well. Eradication and maximal cosmesis can be achieved with few complications if the targeted lesion is limited to 30 mm.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
authors.forename: Hao-jun
authors.initials: HJ
authors.lastname: Luo
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Tu
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Cheng-yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Guang-lun
authors.initials: GL
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002648:Child; D004438:Ecchymosis / Q000209:etiology; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005348:Fibrocystic Breast Disease / Q000473:pathology; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009339:Needles; D019106:Postoperative Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014618:Vacuum; D055815:Young Adult