Published online before print April 3, 2003, 10.1148/radiol.2272020476
Breast Masses: Removal of All US Evidence during Biopsy by Using a Handheld Vacuum-assisted Device—Initial Experience1
David E. March, MD,
Bret F. Coughlin, MD,
Ruth B. Barham, MPH,
Robert A. Goulart, MD,
Stephen V. Klein, MD,
Martin E. Bur, MD,
James L. Frank, MD and
Grace Makari-Judson, MD
1 From the Department of Radiology (D.E.M., B.F.C., S.V.K.), Baystate Comprehensive Breast Center/Regional Cancer Program (R.B.B.), Department of Pathology (R.A.G., M.E.B.), Department of Surgery (J.L.F.), and Division of Hematology and Oncology (G.M.J.), Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199. From the 2001 RSNA scientific assembly. Received April 25, 2002; revision requested June 21; revision received August 16; accepted September 30. Supported by an RSNA Seed Grant and by the Rays of Hope charitable fund. Address correspondence to D.E.M.
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Figure 1a. Images in a 44-year-old woman with a left breast mass that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a lobulated solid lesion (arrows) of 0.9 cm in mean diameter. All US evidence of the lesion was removed during VAB; the histologic diagnosis was fibroadenoma. (b) Follow-up US image obtained in the radial plane 6 months after biopsy shows a crescentic residual mass (arrows) measuring 0.4 cm in mean diameter that was obscured during the VAB procedure.
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Figure 1b. Images in a 44-year-old woman with a left breast mass that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a lobulated solid lesion (arrows) of 0.9 cm in mean diameter. All US evidence of the lesion was removed during VAB; the histologic diagnosis was fibroadenoma. (b) Follow-up US image obtained in the radial plane 6 months after biopsy shows a crescentic residual mass (arrows) measuring 0.4 cm in mean diameter that was obscured during the VAB procedure.
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Figure 2a. Images in a 42-year-old woman with a mass with calcifications that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a markedly hypoechoic mass (arrow) of 0.6 cm in mean diameter with angular margins. (b) US image obtained immediately after VAB with the device still inserted shows the biopsy probe (arrows) and no residual mass. (c) Radiograph of the specimens taken from the mass shows calcifications (arrows). The histologic diagnosis was DCIS (intermediate and high grades, solid and cribriform types). (d) Radiograph of five biopsy samples taken from the cavity margins does not reveal calcifications, and no carcinoma was found at histologic examination of these specimens. The excised surgical specimen contained residual DCIS extending up to 0.5 cm from the edge of the VAB cavity.
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Figure 2b. Images in a 42-year-old woman with a mass with calcifications that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a markedly hypoechoic mass (arrow) of 0.6 cm in mean diameter with angular margins. (b) US image obtained immediately after VAB with the device still inserted shows the biopsy probe (arrows) and no residual mass. (c) Radiograph of the specimens taken from the mass shows calcifications (arrows). The histologic diagnosis was DCIS (intermediate and high grades, solid and cribriform types). (d) Radiograph of five biopsy samples taken from the cavity margins does not reveal calcifications, and no carcinoma was found at histologic examination of these specimens. The excised surgical specimen contained residual DCIS extending up to 0.5 cm from the edge of the VAB cavity.
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Figure 2c. Images in a 42-year-old woman with a mass with calcifications that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a markedly hypoechoic mass (arrow) of 0.6 cm in mean diameter with angular margins. (b) US image obtained immediately after VAB with the device still inserted shows the biopsy probe (arrows) and no residual mass. (c) Radiograph of the specimens taken from the mass shows calcifications (arrows). The histologic diagnosis was DCIS (intermediate and high grades, solid and cribriform types). (d) Radiograph of five biopsy samples taken from the cavity margins does not reveal calcifications, and no carcinoma was found at histologic examination of these specimens. The excised surgical specimen contained residual DCIS extending up to 0.5 cm from the edge of the VAB cavity.
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Figure 2d. Images in a 42-year-old woman with a mass with calcifications that was discovered at screening mammography. (a) US image obtained before VAB in the radial plane shows a markedly hypoechoic mass (arrow) of 0.6 cm in mean diameter with angular margins. (b) US image obtained immediately after VAB with the device still inserted shows the biopsy probe (arrows) and no residual mass. (c) Radiograph of the specimens taken from the mass shows calcifications (arrows). The histologic diagnosis was DCIS (intermediate and high grades, solid and cribriform types). (d) Radiograph of five biopsy samples taken from the cavity margins does not reveal calcifications, and no carcinoma was found at histologic examination of these specimens. The excised surgical specimen contained residual DCIS extending up to 0.5 cm from the edge of the VAB cavity.
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Figure 3a. (a) Mediolateral oblique mammogram obtained before VAB in a 43-year-old woman with a palpable left breast mass (arrow) of 1.2 cm in mean diameter. (b) US image obtained during VAB demonstrates the remaining visible portion of the mass (arrows); this portion was subsequently removed with the biopsy probe (arrowheads). (c) Mediolateral oblique mammogram obtained after the procedure shows a biopsy cavity (arrows) with no residual mass. A metallic clip has been placed at the biopsy site. The histologic diagnosis was fibroadenoma. At 6-month follow-up (results not shown) there was no residual palpable mass; however, a small residual mass of 0.5 cm in mean diameter was visible at US.
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Figure 3b. (a) Mediolateral oblique mammogram obtained before VAB in a 43-year-old woman with a palpable left breast mass (arrow) of 1.2 cm in mean diameter. (b) US image obtained during VAB demonstrates the remaining visible portion of the mass (arrows); this portion was subsequently removed with the biopsy probe (arrowheads). (c) Mediolateral oblique mammogram obtained after the procedure shows a biopsy cavity (arrows) with no residual mass. A metallic clip has been placed at the biopsy site. The histologic diagnosis was fibroadenoma. At 6-month follow-up (results not shown) there was no residual palpable mass; however, a small residual mass of 0.5 cm in mean diameter was visible at US.
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Figure 3c. (a) Mediolateral oblique mammogram obtained before VAB in a 43-year-old woman with a palpable left breast mass (arrow) of 1.2 cm in mean diameter. (b) US image obtained during VAB demonstrates the remaining visible portion of the mass (arrows); this portion was subsequently removed with the biopsy probe (arrowheads). (c) Mediolateral oblique mammogram obtained after the procedure shows a biopsy cavity (arrows) with no residual mass. A metallic clip has been placed at the biopsy site. The histologic diagnosis was fibroadenoma. At 6-month follow-up (results not shown) there was no residual palpable mass; however, a small residual mass of 0.5 cm in mean diameter was visible at US.
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Copyright © 2003 by the Radiological Society of North America.
