Intraoperative localization after stereotactic breast biopsy without a needle

Area of Science:

• Radiology
• Breast Imaging
• Surgical Oncology

Background:

• Needle localization breast biopsy (NLBB) is standard for excising breast lesions post-vacuum-assisted breast biopsy (VABB).
• NLBB has limitations including miss rates (0-22%), vasovagal reactions, and scheduling challenges.
• Hematomas from VABB may offer an alternative localization method.

Purpose of the Study:

• To evaluate the efficacy of intraoperative ultrasonography (US) in guiding the excision of VABB sites using the resultant hematoma for localization.
• To assess the feasibility of using US for localizing and excising VABB sites, potentially overcoming NLBB limitations.

Main Methods:

• Twenty patients underwent VABB followed by intraoperative US-guided excision of the biopsy site.
• The hematoma created by VABB served as the primary target for US visualization and guided excision.

Main Results:

• Intraoperative US successfully visualized the VABB site in 19 out of 20 patients, enabling accurate excision.
• One patient required repeat imaging due to initial clip visualization issues on specimen mammography, though the targeted area was removed under US guidance.

Conclusions:

• Intraoperative ultrasonography is effective for identifying and guiding the excision of hematomas resulting from VABB.
• This US-guided technique offers improved patient comfort and scheduling flexibility, potentially serving as a valuable alternative to traditional NLBB weeks after the initial VABB procedure.