Excision of Benign Breast Disease by Ultrasound-Guided Vacuum Assisted Biopsy Device (Mammotome)

ABSTRACT

PURPOSE: The mammotome biopsy is a new surgical technique that is a minimally invasive, image guided procedure, requiring just one small incision and without the need for multiple insertions in the breast. The aim of this study was to evaluate the efficacy and the safety of mammotome biopsy device in the percutaneous removal of breast masses using ultrasound guidance. METHODS: From Jan. 2003 to sept. 2004, a total of 1003 US-guided excisional mammotome biopsy were performed in 827 patients at Kangnam Cha hospital. Lesions with BI-RADS category 3 and 4a features by ultrasonography were included in this study. Lesions below 1.0 cm were removed by 11 gauge probe, and lesions above 1.0 cm were removed by 8 gauge probe. Ultrasonographic follow-up were performed on 3~6 months later to assess residual tissue and scarring. RESULTS: Mean patient age was 36.2 years(range 14-75 years). The average size of lesion was 1.21cm (SD+- 0.43cm). The majority of lesions, 63.5%, were nonpalpable and 36.5% were palpable. The majority of specimens (99.2) were benign. Most of benign specimens (75.7) consisted of fibroadenoma and fibrocystic changes. 8 lesions (0.8%) were malignant. Mean time required to perform mammotome procedures was 6.4+/-3.9 minutes and mean number of cores removed were 14.2+/-7.9 pieces. No bleeding or infections occurred postoperatively. CONCLUSIONS: This study demonstrates that percutaneous breast biopsy using mammotome system is feasible, effective and safe method for the diagnostic and therapeutic management of benign breast lesions with minimal morbidity. And it allows for the complete excision of the lesions less than 3 cm in size. A breast surgeon can use Mammotome to replace open biopsy and core needle procedure for the initial biopsy of breast lesions.