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The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas.

Povoski SP - World J Surg Oncol (2007)

Bottom Line: Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome(R) excision procedures performed during seven separate sessions.A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites.As such, this innovative approach is highly recommended in similar appropriately selected patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA. stephen.povoski@osumc.edu.

ABSTRACT

Background: Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions.

Case presentation: A female patient presented with 16 breast lesions (eight within each breast), documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome(R) excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions.

Conclusion: This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.

No MeSH data available.


Related in: MedlinePlus

Ultrasound image in longitudinal axis showing the 8-gauge vacuum-assisted device positioned just beneath the ultrasound lesion once the cutter blade has been fully activated across the aperture of the tissue collection chamber.
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Figure 1: Ultrasound image in longitudinal axis showing the 8-gauge vacuum-assisted device positioned just beneath the ultrasound lesion once the cutter blade has been fully activated across the aperture of the tissue collection chamber.

Mentions: A total of 11 separate 8-gauge vacuum-assisted excision procedures, using the previously described breast biopsy system [2-10], were performed to a total of 14 different ultrasound lesions during seven separate sessions over a ten and one-half month period of time (Table 2). The technique used for all 11 of the ultrasound-guided 8-gauge vacuum-assisted excision procedures performed in this current report has been previously described and reported by the present author [10]. Real-time ultrasound guidance was performed using the Philips HDI 5000 SonoCT system (Philips Medical Systems Andover, Massachusetts), with a variable frequency transducer L12-5 (range 4.75 to 10.0 MHz). After local anesthetic was administered to the proposed 8-gauge vacuum-assisted excision site, a 5 mm skin incision was made with a #11 blade. Then, under real-time ultrasound guidance, the 8-gauge vacuum-assisted device was passed through the 5 mm skin incision and positioned just beneath the ultrasound lesion (Figure 1) and multiple 8-gauge cores were consecutively harvested while sequentially rotating the 8-gauge vacuum-assisted device over an array spanning approximately 180 degrees. Ongoing ultrasound assessment of the progression of lesion excision and final verification of presumed complete lesion excision was performed in real-time in both the longitudinal and transverse planes to the long axis of the 8-gauge device. After completion of core acquisition, the 8-gauge device was removed and a 14-gauge Cormarkā„¢ rigid microclip device (Ethicon Endo-Surgery, Inc., Cincinnati, Ohio) was inserted through the same breast parenchymal track under real-time ultrasound guidance for placement of a microclip into the excision cavity (Figure 2). A single microclip was placed at the site of each ultrasound-guided 8-gauge vacuum-assisted excision procedures, except for that of the ultrasound-guided 8-gauge vacuum-assisted excision procedure for lesions 11 and 12, in which case two adjacent microclips were placed. Thereafter, as a standard and to assure adequate hemostasis, manual compression to the breast was performed for approximately ten minutes. No peri-procedural bleeding complications occurred. Finally, the 5 mm incision site was reapproximated with standard adhesive skin closure strips.


The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas.

Povoski SP - World J Surg Oncol (2007)

Ultrasound image in longitudinal axis showing the 8-gauge vacuum-assisted device positioned just beneath the ultrasound lesion once the cutter blade has been fully activated across the aperture of the tissue collection chamber.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2147012&req=5

Figure 1: Ultrasound image in longitudinal axis showing the 8-gauge vacuum-assisted device positioned just beneath the ultrasound lesion once the cutter blade has been fully activated across the aperture of the tissue collection chamber.
Mentions: A total of 11 separate 8-gauge vacuum-assisted excision procedures, using the previously described breast biopsy system [2-10], were performed to a total of 14 different ultrasound lesions during seven separate sessions over a ten and one-half month period of time (Table 2). The technique used for all 11 of the ultrasound-guided 8-gauge vacuum-assisted excision procedures performed in this current report has been previously described and reported by the present author [10]. Real-time ultrasound guidance was performed using the Philips HDI 5000 SonoCT system (Philips Medical Systems Andover, Massachusetts), with a variable frequency transducer L12-5 (range 4.75 to 10.0 MHz). After local anesthetic was administered to the proposed 8-gauge vacuum-assisted excision site, a 5 mm skin incision was made with a #11 blade. Then, under real-time ultrasound guidance, the 8-gauge vacuum-assisted device was passed through the 5 mm skin incision and positioned just beneath the ultrasound lesion (Figure 1) and multiple 8-gauge cores were consecutively harvested while sequentially rotating the 8-gauge vacuum-assisted device over an array spanning approximately 180 degrees. Ongoing ultrasound assessment of the progression of lesion excision and final verification of presumed complete lesion excision was performed in real-time in both the longitudinal and transverse planes to the long axis of the 8-gauge device. After completion of core acquisition, the 8-gauge device was removed and a 14-gauge Cormarkā„¢ rigid microclip device (Ethicon Endo-Surgery, Inc., Cincinnati, Ohio) was inserted through the same breast parenchymal track under real-time ultrasound guidance for placement of a microclip into the excision cavity (Figure 2). A single microclip was placed at the site of each ultrasound-guided 8-gauge vacuum-assisted excision procedures, except for that of the ultrasound-guided 8-gauge vacuum-assisted excision procedure for lesions 11 and 12, in which case two adjacent microclips were placed. Thereafter, as a standard and to assure adequate hemostasis, manual compression to the breast was performed for approximately ten minutes. No peri-procedural bleeding complications occurred. Finally, the 5 mm incision site was reapproximated with standard adhesive skin closure strips.

Bottom Line: Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome(R) excision procedures performed during seven separate sessions.A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites.As such, this innovative approach is highly recommended in similar appropriately selected patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA. stephen.povoski@osumc.edu.

ABSTRACT

Background: Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions.

Case presentation: A female patient presented with 16 breast lesions (eight within each breast), documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome(R) excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions.

Conclusion: This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.

No MeSH data available.


Related in: MedlinePlus