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Benign Breast Lesions: Minimally Invasive Vacuum-assisted Biopsy with 11-Gauge Needles—Patient Acceptance and Effect on Follow-up Imaging Findings¹

¹ From the Departments of Radiology (S.H., M.W., H.C.) and Obstetrics and Gynecology (M.M.), Lainz Hospital, Wolkersbergenstrasse 1, 1130 Vienna, Austria. Received November 26, 2001; revision requested February 11, 2002; final revision received August 8; accepted August 21. Address correspondence to S.H. (e-mail: s.pankl@telering.at).

View larger version (64K): [in a new window]   Figure 1. Patient questionnaire.

View larger version (114K): [in a new window]   Figure 2a. (a) Magnified craniocaudal mammogram of a 2-cm fibroadenoma in a 29-year-old woman before biopsy. (Original magnification, x4.) (b) Magnified craniocaudal mammogram obtained immediately after US-guided biopsy shows a defect of approximately 1.5 cm in diameter corresponding to the pathway of the biopsy needle. (c) Craniocaudal mammogram obtained 1 week after biopsy reveals a hematoma in the biopsy bed. (d) On a transverse US image, the hematoma corresponds to a semisolid mass. (e) Transverse US image obtained 6 months after c and d shows interval resolution of the hematoma.

View larger version (114K): [in a new window]   Figure 2b. (a) Magnified craniocaudal mammogram of a 2-cm fibroadenoma in a 29-year-old woman before biopsy. (Original magnification, x4.) (b) Magnified craniocaudal mammogram obtained immediately after US-guided biopsy shows a defect of approximately 1.5 cm in diameter corresponding to the pathway of the biopsy needle. (c) Craniocaudal mammogram obtained 1 week after biopsy reveals a hematoma in the biopsy bed. (d) On a transverse US image, the hematoma corresponds to a semisolid mass. (e) Transverse US image obtained 6 months after c and d shows interval resolution of the hematoma.

View larger version (100K): [in a new window]   Figure 2c. (a) Magnified craniocaudal mammogram of a 2-cm fibroadenoma in a 29-year-old woman before biopsy. (Original magnification, x4.) (b) Magnified craniocaudal mammogram obtained immediately after US-guided biopsy shows a defect of approximately 1.5 cm in diameter corresponding to the pathway of the biopsy needle. (c) Craniocaudal mammogram obtained 1 week after biopsy reveals a hematoma in the biopsy bed. (d) On a transverse US image, the hematoma corresponds to a semisolid mass. (e) Transverse US image obtained 6 months after c and d shows interval resolution of the hematoma.

View larger version (122K): [in a new window]   Figure 2d. (a) Magnified craniocaudal mammogram of a 2-cm fibroadenoma in a 29-year-old woman before biopsy. (Original magnification, x4.) (b) Magnified craniocaudal mammogram obtained immediately after US-guided biopsy shows a defect of approximately 1.5 cm in diameter corresponding to the pathway of the biopsy needle. (c) Craniocaudal mammogram obtained 1 week after biopsy reveals a hematoma in the biopsy bed. (d) On a transverse US image, the hematoma corresponds to a semisolid mass. (e) Transverse US image obtained 6 months after c and d shows interval resolution of the hematoma.

View larger version (136K): [in a new window]   Figure 2e. (a) Magnified craniocaudal mammogram of a 2-cm fibroadenoma in a 29-year-old woman before biopsy. (Original magnification, x4.) (b) Magnified craniocaudal mammogram obtained immediately after US-guided biopsy shows a defect of approximately 1.5 cm in diameter corresponding to the pathway of the biopsy needle. (c) Craniocaudal mammogram obtained 1 week after biopsy reveals a hematoma in the biopsy bed. (d) On a transverse US image, the hematoma corresponds to a semisolid mass. (e) Transverse US image obtained 6 months after c and d shows interval resolution of the hematoma.

View larger version (102K): [in a new window]   Figure 3a. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.

View larger version (113K): [in a new window]   Figure 3b. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.

View larger version (107K): [in a new window]   Figure 3c. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.

View larger version (135K): [in a new window]   Figure 3d. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.

View larger version (109K): [in a new window]   Figure 3e. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.

View larger version (127K): [in a new window]   Figure 3f. (a) Craniocaudal mammogram shows a cluster of microcalcifications (arrow), assigned a benign diagnosis, that were sampled at stereotactic biopsy at the request of the 43-year-old patient. (b) Craniocaudal mammogram shows the removal site (arrow). All microcalcifications have been removed. (c) Craniocaudal mammogram of the removal site obtained 1 week after biopsy shows a partly ill-defined lesion (arrow) of mixed density. (d) Transverse US image obtained 1 week after biopsy shows a fluid collection at the removal site. (e) Craniocaudal mammogram obtained 6 months after biopsy reveals a discrete change at the biopsy site (arrow), which appears as an area of increased focal density that is without distinct margins and is interspersed with fat. Compared with its appearance on c, this area appears to have decreased in size. (f) On a transverse US image obtained at the same time as e, no architectural distortion is depicted.