A novel way of hook wire placement for surgical resection of suspicious breast lesions using the stereotactic vacuum assisted breast biopsy table

BACKGROUND Computer-aided diagnosis (CAD) is a useful tool that can provide a reference for the differential diagnosis of benign and malignant breast lesion. Previous studies have demonstrated that CAD can improve the diagnostic performance. However, conventional ultrasound (US) combined with CAD were used to adjust the classification of category 4 lesions has been few assessed. OBJECTIVE The objective of our study was to evaluate the diagnosis performance of conventional ultrasound combined with a CAD system S-Detect in the category of BI-RADS 4 breast lesions. METHODS Between December 2018 and May 2020, we enrolled patients in this study who received conventional ultrasound and S-Detect before US-guided biopsy or surgical excision. The diagnostic performance was compared between US findings only and the combined use of US findings with S-Detect, which were correlated with pathology results. RESULTS A total of 98 patients (mean age 51.06 ±16.25 years, range 22-81) with 110 breast masses (mean size1.97±1.38cm, range0.6-8.5) were included in this study. Of the 110 breast masses, 64/110 (58.18%) were benign, 46/110 (41.82%) were malignant. Compared with conventional ultrasound, a significant increase in specificity (0% to 53.12%, P<.001), accuracy (41.81% to70.19%, P<.001) were noted, with no statistically significant decrease on sensitivity(100% to 95.65% ,P=.48). According to S-Detect-guided US BI-RADS re-classification, 30 out of 110 (27.27%) breast lesions underwent a correct change in clinical management, 74of 110 (67.27%) breast lesions underwent no change and 6 of 110 (5.45%) breast lesions underwent an incorrect change in clinical management. The biopsy rate decreased from 100% to 67.27 % (P<.001).Benign masses among subcategory 4a had higher rates of possibly benign assessment on S-Detect for the US only (60% to 0%, P<.001). CONCLUSIONS S-Detect can be used as an additional diagnostic tool to improve the specificity and accuracy in clinical practice. S-Detect have the potential to be used in downgrading benign masses misclassified as BI-RADS category 4 on US by radiologist, and may reduce unnecessary breast biopsy. CLINICALTRIAL none

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Accuracy and outcomes of stereotactic vacuum‐assisted breast biopsy for diagnosis and management of nonpalpable breast lesions

The Kaohsiung Journal of Medical Sciences ◽

10.1002/kjm2.12100 ◽

2019 ◽

Vol 35 (10) ◽

pp. 640-645 ◽

Cited By ~ 2

Author(s):

Huei‐Yi Tsai ◽

Min‐Fang Chao ◽

Fu Ou‐Yang ◽

Jung‐Yu Kan ◽

Jui‐Sheng Hsu ◽

...

Keyword(s):

Breast Biopsy ◽

Breast Lesions ◽

Diagnosis And Management ◽

Nonpalpable Breast Lesions

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Radiation doses during stereotactic guided vacuum-assisted breast biopsy for calcified breast lesions

Nihon Nyugan Kenshin Gakkaishi (Journal of Japan Association of Breast Cancer Screening) ◽

10.3804/jjabcs.27.56 ◽

2018 ◽

Vol 27 (1) ◽

pp. 56-61

Author(s):

Yoshihiro Kozawa ◽

Ritsuko Fujimitsu ◽

Mikiko Shimakura ◽

Kaori Tominaga ◽

Mami Nishikawa ◽

...

Keyword(s):

Breast Biopsy ◽

Breast Lesions ◽

Radiation Doses

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Histological Assessment of Breast Lesions Identified Exclusively by Magnetic Resonance

The American Surgeon ◽

10.1177/000313481408001007 ◽

2014 ◽

Vol 80 (10) ◽

pp. 944-947

Author(s):

Victoria O'connor ◽

Elizabeth Arena ◽

Joslyn Albright ◽

Nefertiti Brown ◽

Ryan O'connor ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance ◽

Breast Biopsy ◽

Ductal Carcinoma ◽

Low Grade ◽

Breast Lesions ◽

Significant Family History ◽

Ductal Hyperplasia ◽

Significant Pathology

Radiologic–pathologic correlation of lesions diagnosed by magnetic resonance (MR) is precluded by insufficient data on histological characteristics of lesions suspicious on MR but not visible on concurrent mammogram or ultrasound. The objective of this study was to describe histological features of breast lesions diagnosed exclusively by MR. The participants underwent MR-guided breast biopsy between 2007 and 2012 for a suspicious lesion not identified by mammography or ultrasound. Histology slides were interpreted retrospectively by a breast pathologist. Of 126 patients (126 lesions), 34 (27%) had new breast cancer, 51 (40.5%) previous breast cancer, and 41 (32.5%) dense breasts or a significant family history of breast cancer. MR identified 23 (18.3%) invasive cancers: 20 were Grade 1 and 17 were ductal. Of the 126 lesions, 16 (13%) were ductal carcinoma in situ (DCIS), four were atypical ductal hyperplasia and atypical lobular hyperplasia (3%), and 68 (54%) were benign. Fifteen biopsies (12%) had no significant pathology. Five DCIS lesions were upgraded to T1 invasive cancers. Approximately 30 per cent of suspicious lesions detected exclusively by MR are invasive or in situ cancers that are predominantly low grade. Further studies are needed to determine if malignant lesions can be prospectively distinguished by MR characteristics.

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Localization of nonpalpable breast lesions using hook-wire combined with isosulfan blue dye

Journal of Surgical Oncology ◽

10.1002/jso.10119 ◽

2002 ◽

Vol 82 (1) ◽

pp. 73-74 ◽

Cited By ~ 4

Author(s):

George C. Zografos ◽

Carmen Doumitriou ◽

Dimitrios Lappas ◽

George Karatzikos ◽

Emi Bami ◽

...

Keyword(s):

Blue Dye ◽

Breast Lesions ◽

Isosulfan Blue ◽

Isosulfan Blue Dye ◽

Hook Wire ◽

Nonpalpable Breast Lesions

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An experience with the Advanced Breast Biopsy Instrumentation (ABBI) system in the management of non-palpable breast lesions

European Radiology ◽

10.1007/s00330-001-1250-9 ◽

2002 ◽

Vol 12 (7) ◽

pp. 1703-1710 ◽

Cited By ~ 12

Author(s):

Pina L. Insausti ◽

J. Alberro ◽

F. Regueira ◽

J. Imaña ◽

I. Vivas ◽

...

Keyword(s):

Breast Biopsy ◽

Advanced Breast ◽

Breast Lesions ◽

Palpable Breast

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Accurate excision of nonpalpable breast lesions with the new device system.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11557 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11557-e11557

Author(s):

Zhongyao Luo

Keyword(s):

Breast Tissue ◽

Breast Biopsy ◽

Low Cost ◽

Pathological Examination ◽

Breast Lesions ◽

Localization Method ◽

Needle Localization ◽

New Device ◽

Small Nodule ◽

Nonpalpable Breast Lesions

e11557 Background: A histological diagnosis for nonpalpable breast lesions (NPBL) is required to determine suitable therapy. The open-breast biopsy (OBB) is the gold standard to determine the nature of NPBL. However, it is not easy to accurately remove whole breast lesions due to insufficient safe margin of lesions excised. To improve accuracy for removal of NPBL, we designed new tools to assist surgeons to accurately localize and remove NPBL during OBB. Methods: The new device system has two primary parts. First is a set of accurate-resection devices composed of a rotary cutter, a pair of inner and outer tubes, two pairs of concave and convex curved hooks, and a curved incision plate. The second part is the 12 o'clock localization method used to accurately position lesions three-dimensionally after the breast tissue is excised cylindrically. Thus, the exact location of breast lesions removed can be precisely traced back to the original breast tissue location. Results: 100 patients with a total of 149 OBB were studied using the new device system guided with needle localization under ultrasound. 112 out of 149 procedures were identified as nodule. Among 112 cases, 95 were breast fibroadenomas, 10 were mammary adenosis with a trend to form fibroadenoma, 5 were mammary adenosis, and 2 were adipomas. The remaining 37 cases possessed clusters of calcified lesions with small nodule. 32 were benign lesions with calcinosis, and the other 5 lesions were identified as breast cancer. Pathological examination demonstrated that 144 NPBL were accurately resected with accurate-resection devices. However, 19 out of 144 breast lesions were not completely removed the first time. Thus the second surgical procedure was performed for the 19 cases based on 12 o'clock localization method. The results demonstrated that the remaining lesions were accurately and completely eliminated with the second procedure. All patients were followed up with for 2 to 48 months post procedures. These patients treated with accurate resection devices were very satisfied with no breast deformation. Conclusions: The new device system is easy to use and has very low cost. It is very comfortable for the patient and is of great help in accurately localizing and resecting the lesions to the surgeon.

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