title: Interventional bleeding, hematoma and scar-formation after vacuum-biopsy under stereotactic guidance: Mammotome(®)-system 11 g/8 g vs. ATEC(®)-system 12 g/9 g.
abstract: OBJECTIVE
  To evaluate prospectively the correlation of scar-formations after vacuum-assisted biopsy with different systems and needle-sizes and interventional bleeding/post-interventional hematoma.
  
  
  METHODS
  Between 01/2008 and 12/2009, 479 patients underwent vacuum-assisted biopsy under stereotactic-guidance, using the Mammotome(®)-system with 11/8-gauge and ATEC(®)-system with 12/9-gauge, whereas in 178 cases with representative benign histology no surgical-biopsy after vacuum-assisted biopsy was performed and at least a 2-plane-follow-up-mammogram after 6 month post-vacuum-assisted biopsy was available. Bleeding during intervention, hematoma post-intervention and scar-tissue was scored as minimal and moderate/severe. Statistical analysis included Chi-Square-trend-test, p-value <0.05 was considered to be significant.
  
  
  RESULTS
  Significantly more bleedings and post-interventional hematomas for 8-gauge-Mammotome(®)-system vs. 11-gauge-Mammotome(®)-system (41.9% vs. 8.4%, p<0.001/35.5% vs. 16.7%, p=0.029), no significant-differences for the ATEC(®)-systems 9-gauge vs. 12-gauge (26.9% vs. 29.7%, p=0.799/42.3% vs. 43.2%, p=0.596). 11-gauge-Mammotome(®)-system vs. ATEC(®)-12-gauge-system revealed significantly less bleedings/hematomas (8.4% vs. 29.7%, p=0.015/16.7% vs. 43.2%, p=0.001), no significant differences for the large-systems (p=0.135/p=0.352). Follow-up of Mammotome(®)-11/8-gauge-system system has shown 13.1/16.1% minimal scar-formation and 1.2/3.2% moderate/severe scars, whereas ATEC(®)-12/9-gauge-system has shown 10.8/3.8% minimal scar-formation and 0/11.5% moderate/severe scars, no significant differences. No significant difference was found when comparing Mammotome(®)-11/8-g-systems vs. ATEC(®)-12/9-g-systems (p=0.609/p=0.823). There was also no correlation between risk of scar-formation after occurrence of bleeding or hematoma with any examined VAB-system or any needle size in this study (p=0.800).
  
  
  CONCLUSIONS
  Using larger needle-sizes significantly (Mammotome(®))/not significant for ATEC(®)) more interventional bleedings and post-interventional hematomas were detected, only a tendency concerning scar-formation.
authors.affiliation: Bereich Mammadiagnostik und Intervention, Universitätsklinikum Schleswig-Holstein Campus Kiel, Michaelisstr. 16, 24105 Kiel, Deutschland, Germany. fschaefer@uni-kiel.de
authors.forename: F K W
authors.initials: FK
authors.lastname: Schaefer
authors.forename: B M
authors.initials: BM
authors.lastname: Order
authors.forename: C
authors.initials: C
authors.lastname: Eckmann-Scholz
authors.forename: A
authors.initials: A
authors.lastname: Strauss
authors.forename: F
authors.initials: F
authors.lastname: Hilpert
authors.forename: K
authors.initials: K
authors.lastname: Kroj
authors.forename: J
authors.initials: J
authors.lastname: Biernath-Wüpping
authors.forename: M
authors.initials: M
authors.lastname: Heller
authors.forename: W
authors.initials: W
authors.lastname: Jonat
authors.forename: P J
authors.initials: PJ
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000295:instrumentation* / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D015984:Causality; D002921:Cicatrix / Q000453:epidemiology* / Q000209:etiology; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006406:Hematoma / Q000453:epidemiology* / Q000209:etiology; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008867:Microtomy / Q000295:instrumentation / Q000706:statistics & numerical data; D008875:Middle Aged; D009339:Needles / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000706:statistics & numerical data*