Abstract
Fibroadenomas are the commonest benign breast tumours. Prior to vacuum-assisted large-volume biopsy, surgical excision was the only therapeutic option available. Our unit introduced Mammotome (Ethicon Endo-Surgery, Cincinnati, OH, USA) in January 2006, with Mammotome excision offered from September 2006 (for lesions 25 mm or less). We reviewed the change in practice with the advent of Mammotome. Patients with histological diagnosis of fibroadenoma throughout 2006 and 2007 were identified. The radiology and histology were reviewed. A total of 355 fibroadenomas were diagnosed in 333 patients: 252 presented symptomatically, 81 were screen-detected. Thirty-five diagnostic Mammotomes were performed (33 had been nondiagnostic on needle-core biopsy, two had radiology/pathology discordance). Definitive diagnosis was consequently made in 34 cases. One patient with nondiagnostic Mammotome had subsequent surgical biopsy of benign fibroadenoma. Seventy patients underwent excision. Fifteen were ultrasound Mammotome excisions; 13 confirmed fibroadenoma and two were phylloides (having surgical cavity excision subsequently). Fifty-five were surgical excisions; 33 were either unsuitable for Mammotome excision or the patient chose surgery; 11 were B2/B3 lesions and pathology recommended surgical excision; and the remaining 11 were before the introduction of Mammotome excision. Mammotome offers patient choice regarding excision of fibroadenomas, and reduces the number of surgical biopsies.
Highlights
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment
The aim was to document attitudes to male radiographers and the effect on the programme performance parameters through a postal questionnaire completed by 85.8% of a random sample of 2,000 women recently screened by BreastCheck
Nine per cent would not have proceeded if the radiographer was male; 17.5% agreed that ‘If there were male radiographers I would not return for another screening appointment’; and 18.3% were unsure
Summary
Breast-sparing oncoplastic procedures (BSOP) offer a predictive marker guiding use of anti-oestrogen therapy, and radical new alternative to mastectomy and conventional breast- expression profiling appears to select patients more or less likely to conserving surgery in early breast cancer treatment. We have compared the results of screening with analogue and digital technology over our first 2 years, in terms of recall rates, cancer detection rates and positive predictive value, and found no overall significant difference in any of these parameters. Abnormalities are graded as A, B or C at consensus by the radiologists and reporting radiographers depending upon the mammographic likelihood of cancer and biopsy This means that patients can be allocated to one of our three assessment clinics and at specific times within those clinics to facilitate workflow. Methods A retrospective analysis of all breast cancer patients with recurrence who had completed 5 years of follow-up was performed. Infection control is not routinely included in the quality assurance process of all units
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