Sonographically guided directional vacuum-assisted breast biopsy using a handheld device

Area of Science:

• Breast imaging and intervention
• Minimally invasive biopsy techniques
• Oncology and surgical pathology

Background:

• Sonographically guided breast biopsy is crucial for diagnosing breast lesions.
• Traditional automated core biopsy devices have limitations, including potential for false-negative results and underestimation of disease.
• Minimizing diagnostic errors and improving patient outcomes are key goals in breast cancer screening.

Purpose of the Study:

• To evaluate the safety and efficacy of the 11-gauge handheld Mammotome for complete sonographic removal of breast masses ≤1.5 cm.
• To demonstrate the device's potential to reduce false-negative diagnoses compared to automated core biopsy devices.
• To assess the device's impact on diagnostic accuracy and procedural efficiency.

Main Methods:

• A prospective study involving 124 sonographically guided breast biopsies in 113 patients over 12 weeks.
• Utilized a handheld directional vacuum-assisted biopsy device (Mammotome) for lesions ≤1.5 cm.
• Biopsies continued until no sonographic evidence of the lesion remained, aiming for complete removal.

Main Results:

• Histopathological analysis revealed various malignancies (14 infiltrating ductal carcinomas, 4 with DCIS, 1 infiltrating lobular carcinoma, 1 DCIS) and benign lesions (99).
• Complete histological removal of one infiltrating ductal carcinoma was achieved with Mammotome biopsy.
• No underestimation of disease or epithelial displacement was observed in surgical excisions of malignancies.

Conclusions:

• The handheld Mammotome effectively minimizes shortcomings of automated core biopsy devices.
• It significantly reduces the risk of false-negatives and disease underestimation in breast mass biopsies.
• The device is recommended for sonographically guided biopsies of small breast masses (≤1.5 cm) due to its safety and efficacy.