Mammotome Biopsy Research Articles

Follicular lymphoma without lymphadenopathy incidentally diagnosed by sentinel lymph node biopsy during breast cancer surgery: a case report

BackgroundConcurrent breast cancer and malignant lymphoma is a rare phenomenon. This report describes malignant lymphoma that was incidentally diagnosed from a sentinel lymph node biopsy (SLNB) during breast cancer surgery.Case presentationA 73-year-old woman with a history of ovarian cancer and diabetes presented with right focal asymmetric density on a mammogram acquired during routine breast cancer screening. Ultrasonography (US) and magnetic resonance imaging (MRI) showed a 13.5-mm tumor in the upper lateral region of the right breast. A US-guided Mammotome biopsy revealed invasive ductal carcinoma of the right breast. Preoperative assessments including positron emission tomography–computerized tomography, found no evidence of axillary lymphadenopathy or distant metastasis. Because the breast cancer was stage I, the patient underwent a right mastectomy and a sentinel lymph node biopsy (SLNB) at our hospital. Pathological assessment of the biopsy revealed follicular lymphoma (FL), but no metastatic breast cancer. The patient was referred to hematology to stage the FL. Bone marrow findings were negative and stage I FL was diagnosed. After the mastectomy, she was monitored and given adjuvant therapy with an aromatase inhibitor.ConclusionsFollicular lymphoma was incidentally diagnosed from an SLNB obtained to determine the dissemination of early-stage breast cancer. Collaboration with hematologists is important to determine optimal treatment plans for such patients regardless of the rarity of such events.

Does Mammotome biopsy affect surgery option and margin status of breast conserving surgery in breast cancer?

The Mammotome, an image-guided, usually ultrasound-guided vacuum-assisted breast biopsy (US-VABB) system, has been widely used in the early diagnosis of breast disease and the complete excision of benign lesions. However, in some malignant lesions underestimated by U.S., whether Mammotome biopsy would affect the surgery option, especially the margin status in breast-conserving surgery (BCS), has never been studied. Between 2015 and 2019, 198 patients with 200 lesions who have been diagnosed with breast cancer by Mammotome elsewhere received surgery by pathological confirmation in our center. The clinicopathological characteristics, surgery options, therapies, and the details of the specimen, such as margin status of BCS, tumor residual after VABB, and hematoma were reviewed. Among 200 lesions, 90% were evaluated below US-BIRADS 4b before Mammotome biopsy and 94.5% with a tumor size ≤3 cm. 131 patients received mastectomy (66.2%) and 67 received BCS (33.8%). Hematoma and tumor residual were observed in 37.5% and 71.5% of all lesions, respectively. There is a higher incidence of hematoma in the mastectomy group than in the BCS group (44.4% vs. 23.9%, P=0.005). In BCS group, the positive margin was found in 7 patients at first examination including four focals with re-excision, two extensive with mastectomy and one focal but refusing further surgery. The ultimate success rate of BCS was 95.5%. Margin positivity correlated with tumor residual (P=0.044) but not with hematoma. Mammotome biopsy might lead to hematoma and tumor residual; however, it is not the determinant factor for a surgery option, and BCS is feasible through a complete excision of tumor residual to acquire negative margin.

Can measuring perilesional tissue stiffness and stiff rim sign improve the diagnostic performance between benign and malignant breast lesions?

To evaluate tissue stiffness values around breast lesions and stiff rim sign for the differentiation of benign and malignant lesions. A total of 192 patients (mean age, 44.6 ± 13.6years) with 199 breast lesions were included in this retrospective study. All lesions were pathologically proven by US-guided core needle biopsy (CNB), Mammotome biopsy, or surgery. We first observed the presence or absence of a stiff rim sign, which was defined as a red or orange halo around the breast lesion. The shell around the breast lesion on SWE was then automatically drawn by machine, with a width of 1mm, 2mm, and 3mm. The elasticity moduli of the lesion and surrounding tissue were recorded, including maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), and elasticity ratio (shell/lesion ratio). The optimal thresholds of elasticity moduli were calculated according to the receiver operating characteristic (ROC) curve. There were 75 malignant lesions and 124 benign ones. The average Emax and Emean of lesions and shell were significantly higher in the malignant group than in the benign group (P < 0.05). The optimal cut-off value of Emax for diagnosing malignant lesions was 101.7kPa, with a sensitivity of 66.3% and specificity of 87.9%. The optimal cut-off value of Emean was 29.1kPa, with a sensitivity of 65.3% and specificity of 79.8%. The stiff rim sign had the highest diagnostic performance for malignancy as compared with other elastic parameters, with an accuracy of 88.4%. However, measuring peritumoral tissue stiffness can achieve relatively high sensitivity, whereas specificity was not improved significantly. The stiffness of tissue surrounding breast malignancies was significantly higher than the surrounding benign lesions. Stiff rim sign has the potential to improve the diagnostic performance of breast lesions.

Surgical Protocol in a West China Day Surgery Center During the COVID-19 Pandemic: Practice and Experience.

Background. Despite the danger of infection during the outbreak of the 2019 novel coronavirus (COVID-19) in Wuhan, many patients still need surgical treatment. Most elective surgeries were delayed because of the public health emergency. However, when patients have life-threatening emergencies or illnesses, surgeries are often needed as soon as possible. Moreover, due to hospital overcrowding during the COVID-19 outbreak, healthcare professionals initially struggled to address the issue due to a lack of experience. This is especially true for day surgery centers with higher patient mobility. Methods. We remodeled pathways to separate patients and medical personnel to minimize the COVID-19 infection rate. Further, strategies for medical staff education and potential patient education, ward disinfection and maintenance, setup with 3 more screening stations, patient and companion management, medical staff management, and perioperative management were implemented before starting elective day surgery. Results. From February 11 to March 11 in 2020, 202 day surgeries were performed. These were all elective surgeries and included ultrasound-guided Mammotome biopsy, endoscopic polypectomy, hernia repair, pediatric surgeries, cholecystectomy, choledochoscopy, radical mastectomy, percutaneous transhepatic cholangial drainage, liver biopsy, video-assisted thoracoscopic surgery, laparoscopic resection of colon cancer, colostomy apotheosis, and varicose vein surgery. On days 7, 14, and 30 after discharge, no postoperative complications were reported or infection of COVID-19 cases was reported. Conclusions. Using scientific and well-designed protocols, day surgery can ensure quality surgical care with while ensuring medical safety during the COVID-19 outbreak. These protocols may also be applied to other surgical departments in China.

A comparative study on ultrasound-guided elite, Mammotome, and core needle biopsy for diagnosing malignant breast masses.

IntroductionThe present study aims to clarify the advantages and disadvantages of elite biopsy, to provide a reference for selecting the puncture method.Material and methodsA total of 802 patients with a BI-RADS grade ≥ 4, as evaluated by the molybdenum target, and measurable lesions revealed by colour Doppler ultrasound, who were admitted at our department from January 2017 to January 2018, were enrolled in the present study. These patients were randomly divided into three groups: elite, Mammotome and core needle biopsy groups. The pathological underestimation rate, diagnostic accordance rate, haematoma incidence rate, and costs of these three biopsy methods were compared.ResultsThe difference in diagnostic accordance rates between the elite biopsy group and core needle biopsy group was statistically significant (98.9% vs. 94.7%, p = 0.003), as well as between the Mammotome biopsy group and core needle biopsy group (99.6% vs. 94.7%, p < 0.001). The difference in pathological underestimation rates between the elite biopsy group and core needle biopsy group was statistically significant (7.2% vs. 37.3%, p < 0.001), as well as between the Mammotome biopsy group and core needle biopsy group (1.6% vs. 7.2%, p < 0.001). The difference between the Mammotome biopsy group and elite biopsy group was not statistically significant. The incidence of haematoma in the Mommotome, elite, and core needle groups was 15.9%, 13%, and 21.7%, respectively (13% vs. 21.7%, p = 0.021).ConclusionsElite biopsy has a low rate of pathological underestimation and low incidence of haematoma, can improve the breast conserving rate, and has an affordable cost. As a biopsy method with high accuracy, safety, and economy, elite biopsy can be widely used in clinics.

Application of ultrasound-guided vacuum-assisted percutaneous excision technique in non-palpable breast lesions

Objective: To determine the efficacy of ultrasound-guided vacuum-assisted percutaneous excision technique in treating non-palpable breast lesions. Materials and Methods: Between January 2012 and November 2014, a total of 452 non-palpable breast lesions diagnosed by ultrasonography in 400 patients were treated by ultrasound-guided vacuum-assisted percutaneous excision. All patients received pressure dressings, which were removed after 48 hours, then rechecked after three months. Results: Ultrasonography clearly displayed all 452 breast lesions during the mammotome biopsy. The operative process was successfully guided. All patients were free from infections or pneumothoraces, as well as skin lesions; four patients developed postoperative local hematomas and five patients had local bruising. The incidence of local hematomas was 6.0% (27/452). One mass residue was detected during the ultrasonographic follow up after three months. Conclusion: Ultrasound-guided vacuum-assisted percutaneous excision for non-palpable breast lesions has advantages, including simple operation, accurate positioning, safety, minimal invasion, fewer complications, rapid recovery, and good cosmetic appearance. It can substitute the traditional surgical approach and is thus recommended as an alternative minimally invasive technique.

Steroids administered after vacuum-assisted biopsy in the management of idiopathic granulomatous mastitis

AimsThe aetiology and treatment options for idiopathic granulomatous mastitis (IGM) are controversial. The aim was to study the clinical and diagnostic features and discuss medical and surgical treatment for IGM...

Differences and Relationships Between Normal and Atypical Ductal Hyperplasia, Ductal Carcinoma In Situ, and Invasive Ductal Carcinoma Tissues in the Breast Based on Raman Spectroscopy.

The aim of this study was to find the differences and relationships between normal, atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS), and invasive ductal carcinoma (IDC) lesions of the breast based on biochemical characteristics determined by Raman spectroscopy (RS). After collecting 39 frozen sections from patients who underwent surgical resection or mammotome biopsy, nine normal tissues, seven ADH, eight DCIS, and 15 IDC lesions were detected using confocal RS. We then used leave-one-out cross-validation (LOOCV) and radial basis function (RBF) to build a support vector machine (SVM) diagnosis model. Pronounced mean Raman spectra differences were observed between normal tissues, ADH, DCIS, and IDC tissues. Most noticeable was the increased protein and reduced lipid levels of ADH tissues compared to normal tissues. The major spectra differences in ADH, DCIS, and IDC spectrograms were evidenced by a red shift with a broad peak of CH2 (1301 cm-1), the intensity of the stretching vibration peak of carotenoids (1526 cm-1), a relatively strong band of amide-I (1656 cm-1), and the nuclear (882 cm-1) acid peak. Atypical ductal hyperplasia tissues had the largest constituent variations between subjects. During the disease progression, IDC tissues have smaller inter-subject constituent variations than DCIS and ADH tissues. The overall accuracy of SVM model is 74.39%. The sensitivities of normal tissue, ADH, DCIS, and IDC are 62.5%, 50%, 90%, and 66.7%, respectively. The specificities of normal tissue, ADH, DCIS, and IDC are 100%, 100%, 66.7%, and 89.06%, respectively. Atypical ductal hyperplasia shows significant differences and the relationship between normal tissue and malignant disease. Further study to explain the biochemical relationships between these differences will shed more light into a better understanding of the mechanism by which ADH converts to DCIS and to IDC.

A rare and unusual cause of mammographic calcification in the breast

Clinical questionA 45-year-old woman is found, on family history screening, to have calcification within the upper outer quadrant of her right breast. A diagnostic mammotome biopsy was performed. Review the...

Examination of Stereotactic Mammotome Biopsy in this Hospital

Examination of Stereotactic Mammotome Biopsy in this Hospital

The Diagnostic Value of Micropure Imaging in Breast Suspicious Microcalcificaion

The purpose of this study was to evaluate the diagnostic value of Micropure Imaging (MI) in breast lesions differentiation by comparison with B-mode ultrasonography (B-US) and Doppler ultrasonography (DU). A total of 135 consecutive patients (all females) with 135 suspicious lesions were examined and skin marked by MI before mammotome biopsies. All patients (age range, 20-86 years; mean age, 42.5 ± 15.6 years) were the first onset, not in the pregnancy or lactation and had no history of radiation or chemotherapy. The maximum diameter of lesions ranged from 0.2 to 9.6 cm (average 1.98 ± 1.3 cm). Their final diagnoses were obtained by histologic examination. The study protocol was approved by the hospital review board; each patient gave written informed consent. One hundred thirty-five breast lesions were classified into 90 nonmalignant and 45 malignant types. To 86 breast lesions with microcalcification, MI showed more microcalcification and coincided better with pathology results than B-US did (P < .05). The specificity of MI was higher than that of B-US and DU; the sensitivity of DU was significantly higher than that of B-US and MI (P < .001). By combining B-US, DU, and MI, the detection accuracy was 86.7%. Receiver-operator characteristic curves showed the area under the curve of B-US, DU, and MI was 0.865, 0.934, and 0.923(P = .000), respectively. Moreover, the interobserver agreements of MI were the highest, 0.922 (observer 1 vs. observer 2), 0.866 (observer 1 vs. observer 3), and 0.916 (observer 2 vs. observer 3). MI as an adjunct ultrasound modality holds some promise in locating and differentiating breast lesions.

Abstract P2-05-10: Explore the differences and relationships between normal and ADH, DCIS and IDC tissues in breast based on Raman spectroscopy

Abstract Background: Atypical ductal hyperplasia (ADH) is a premalignant breast lesion associated with an increased risk of breast cancer which shares some but not all the features of ductal carcinoma in situ (DCIS). The mechanism that ADH changes to DCIS and even invasive ductal carcinoma (IDC) is still not clear now. There is a pressing need to develop screening techniques that are accurate, minimally invasive and, more sensitive to identify early neoplastic changes and hence improve early breast cancer diagnosis. Our aim was to explore the differences and relationships between normal, ADH, DCIS and IDC lesions of the breast based on biochemical characteristics determined by Raman spectroscopy Methods: Frozen sections were collected from 39 patients (all ladies) who underwent surgical resection or mammotome biopsy at the Department of Breast Surgery, the First Hospital of Jilin University. After operation the samples were immediately frozen at -20-25 ° and two contiguous sections (6 µm thickness) were cut from a sample by freezing microtome. One was stained with haematoxylin and eosin for routine histopathological analysis; the same position of the other section was detected by Microscopic confocal Raman spectrometer (HORIBA JY Lab800, 633nm) with its mirror image (the H&amp;E section). After Raman measurement, the sections were routinely processed, stained with H&amp;E and histologically examined. Support vector machine (SVM) was used to differentiate different breast lesions. Results: A total of 475 Raman spectra were obtained from 9 normal breast tissues, 7 ADH, 8 DCIS, and 15 IDC breast tissues. Pronounced mean Raman spectra differences were observed between normal tissues, ADH, DCIS and IDC tissues. The significant features of normal tissues are 1301, 1438, 1652, and 1743 cm-1, these peak positions are attributed to lipids, and the spectra profiles of normal tissues have no strong protein peaks. Most noticeable was the increased protein and reduced lipid levels of ADH tissues compared to normal tissues. The peak relative intensity of 1158 cm-1 which is attributed to the vibrational modes of C-C stretch of proteins has significantly increased from normal tissues to DCIS and IDC in breast. The major spectra differences in ADH, DCIS and IDC spectra were evidenced by a red shift with a broad peak of CH2, the intensity of the stretching vibration peak of carotenoids, a relatively strong band of amide-I, and the nuclear acid peak. ADH tissues had the largest constituent variations between subjects. During the disease progression, IDC tissues have smaller inter-subject constituent variations than DCIS and ADH tissues. The accuracies of SVM are 93% and 95% in discriminating normal and IDC, while only 50% and 51% in discriminating ADH and DCIS. Conclusion: Malignant transformations in tissue are associated with complex biochemical changes and may provide an effective way to evaluate the malignancy by Raman spectroscopy as it reveals differences between normal tissues, ADH, DCIS and IDC tissues in the breast. Further study to explain the biochemical relationships between these differences will shed more light into a better understanding of the mechanism by which ADH and DCIS convert to IDC. Citation Format: Bing Han, Haipeng Zhang, Chao Zheng, Ye Du, Lijia Liang, Weiqing Xu, Zhimin Fan. Explore the differences and relationships between normal and ADH, DCIS and IDC tissues in breast based on Raman spectroscopy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-05-10.

Abstract P2-05-15: Exploring type II microcalcifications in benign, premalignant and malignant breast lesions by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS)

Abstract Background: Type II microcalcifications, most often seen in proliferative lesions, including both benign and malignant pathologies. But whether the emergence of type II microcalcifications associated with cell canceration is still not clear now. Raman spectroscopy is a powerful, non-invasive analytical tool which can provide detailed and meaningful information about biochemical composition of tissues at molecular level. Our aim was to find the differences and relationships of type II microcalcifications between fibroadenoma, ADH tissues, and DCIS, IDC in breast based on their various biochemical characteristics by Raman spectroscopy. Methods: The frozen sections were collected from 15 patients (all female; ages 25-57) who underwent surgical resection or mammotome biopsy at the Department of Breast Surgery, the First Hospital of Jilin University. After operation the samples were immediately frozen at -20∼-25° and two contiguous sections (6 µm thickness) were cut from a sample by freezing microtome. One was stained with haematoxylin and eosin for routine histopathological analysis and found the microcalcification locations by three expert breast pathologists; the same position of the other section was detected by Microscopic confocal Raman spectrometer (HORIBA JY Lab800, 633nm) with its mirror image (the H&amp;E section). After the spectra we needed had been obtained, the Au@SiO2 shell-isolated nanoparticles (SHINs) were added to the surface of frozen sections immediately and then the spectra with SHINs were collected. Results: A total of 122 Raman spectra and 119 SHINERS spectra were obtained from the microcalcifications in 3 fibroadenoma tissues, 3 ADH, and 5 DCIS, 4 IDC breast tissues. The Raman signals were significantly enhanced by SHINs. Except the major peak at 958-960 cm-1 which attributed to the vibrational modes of calcium hydroxyapatite, the results show no calcium oxalate dihydrate peaks but several other chemical species. The peaks of these species appear at 1002, 1072, 1126, 1446, 1556, and 1657 cm-1, these are attributed to amino acid residue (phenylalanine), nucleic acids, lipids, carotenoids, and Amide I, respectively. The fibroadenoma and ADH microcalcifications mean spectral have the same peak at 1072cm-1, which belongs to the O-P-O stretch of nucleic acids, but in DCIS and IDC tissues the peak changes to 1078cm-1. The ADH have more obvious peak at 1657 cm-1 which assigned to different vibrational modes of the backbone and Amide I, but in DCIS and IDC tissues, the Amide I bands were disappeared. In the DCIS microcalcifications mean spectral, the peaks attributed to amino acid residue (phenylalanine) at 1003, 1031 cm-1 and lipids (CH2 and CH3 bending) at 1301, 1441 cm-1 show more stronger. Meanwhile, compare with DCIS, the IDC spectral shows more stronger nucleic acids peaks and weaker lipids peaks. Conclusion: We have demonstrated the potential of SHINERS to differentiate Type II microcalcifications found in fibroadenoma, ADH, and DCIS, IDC breast tissues. The results presented in this paper provide the biochemical characteristics of the Type II microcalcifications among these tissues, and may represent a key factor responsible for mechanisms of carcinogenesis. Citation Format: Haipeng Zhang, Bing Han, Chao Zheng, Ye Du, Lijia Liang, Weiqing Xu, Zhimin Fan. Exploring type II microcalcifications in benign, premalignant and malignant breast lesions by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-05-15.

Abstract P5-03-02: What is the optimal diagnostic approach for small breast lesions? Fine needle aspiration cytology vs. Vacuum-assisted core needle biopsy

Abstract [Background] Although advanced imaging technology enables us to detect small breast lesions, it remains a challenge whether it is a benign or malignant tumor with imaging findings alone. A definitive diagnosis is required with cytological or pathological diagnosis under ultrasonography guidance. Excessive examinations and malpractice are also concerned with increased examinations. The purpose of the study was to identify the optimal diagnostic approach for small breast lesions.[Patients and Methods] We reviewed a total of 1532 cases of ultrasonography-guided vacuum-assisted core needle biopsy (VAB) performed at a single institution between June 1996 and December 2013. There were 519 small breast lesions (274 non-palpable lesions and 245 non-mass lesions). Ultrasonographic examinations were performed on a LOGIC 500 (GE Healthcare, Waukesha, WI, USA) using an 11 MHz linear transducer before November 2011, and on Aplio MX (TOSHIBA, Minato, Tokyo, Japan) using an 8 MHz linear transducer since then. We performed VAB under ultrasonography guidance using 11-gauge probes (Mammotome Biopsy system; Biopsys Medical Inc., Irvine, CA, USA) for diagnosis and 8-gauge probes for excision of the lesion.[Results] The mean age of the 519 patients was 52.7 years. Ultrasonography-guided fine needle aspiration cytology (FNAC) was performed before VAB in 269 cases (51.8%). The FNAC revealed 76 malignant, 23 suspected malignant, 92 indeterminate, 47 benign or normal, and 31 inadequate cases. Of these FNAC results, the final pathological diagnosis was benign in 2 of 76 malignant and 6 of 21 suspected malignant cases, and malignant in 4 of 47 benign cases. Accordingly, the true positive, true negative, false positive, and false negative rates for the 146 cases (excluding the indeterminate and inadequate cases) by FNAC were 95.8%, 84.3%, 15.7%, and 4.2%, respectively. The pathological results of the VAB specimens were malignant in 229 and benign in 290 cases. Of the 290 cases classified as benign by VAB, we performed post-VAB excisional biopsy in 20 cases. The reasons for this second pathological examination were malignant or suspicious findings for malignancy by FNAC (8 cases), inconsistent imaging and FNAC findings (5 cases), and others (7 cases). Excisional biopsy revealed malignancy in 3 of these 20 cases. Furthermore, we re-performed VAB in 9 out of the original 290 cases, and these were all diagnosed benign as with the first VAB. Excision of the lesion was the primary reason for the second VAB (6 cases), followed by inconsistencies with the imaging findings (2 cases), and suspected malignancy by FNAC (1 case). The true positive, true negative, false positive and false negative rates of VAB were 98.7%, 100%, 0%, and 1.3%, respectively. The mean follow-up duration was 43 months. [Conclusion] To prevent the excessive examinations, FNAC should be excluded from the initial diagnostic approach for small breast lesions. VAB is a highly reliable technique as the initial diagnosis for small breast lesions with high true positive and true negative rates and a very low false positive rate. The optimal strategy for diagnostic procedures should be adopted in consideration of reducing stress and anxiety in patients and costs. Citation Format: Satoko Nakano, Masahiko Otsuka, Akemi Mibu, Toshinori Oinuma. What is the optimal diagnostic approach for small breast lesions? Fine needle aspiration cytology vs. Vacuum-assisted core needle biopsy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-03-02.

Early diagnosis and treatment of breast cancer in Japanese kidney transplant recipients: a single center experience.

BackgroundThe incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients.FindingsBetween 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammography, and breast ultrasonography have been performed for such patients. Diagnostic studies, including core needle or mammotome biopsy, were performed for suspected malignancies. Patients with malignant neoplasm were administered the appropriate treatment and followed-up to assess tumor response and symptoms.Nine patients were diagnosed with breast cancer during the follow-up period. The mean age at the initial detection of the breast cancer was 47.7 ± 8.4 years. The mean interval from transplantation to diagnosis was 148.7 ± 37.1 months. Of the 9 patients, 8 were detected through the screening test; 7 were treated with breast conservative surgery and 1 was treated with modified radical mastectomy. The cancer stages were 0 (n = 2), I (n = 6), and II (n = 1). The incidence of breast cancer tended to be unchanged with time between transplantation and diagnosis, inconsistent with the increase in the duration of immunosuppression.ConclusionAnnual screening tests are crucial in the early diagnosis of breast cancer. Early treatment of breast cancer can result in an excellent prognosis in kidney transplant recipients.

A case of rare primary cystic-type squamous cell carcinoma of the breast that could be preoperatively diagnosed

Primary squamous cell carcinoma of the breast (SCCB) is a rare disease, with a worldwide incidence <0.1%. In many cases, it is clinically characterized by rapid growth. Cyst formation due to central necrosis of the tumor accompanies its growth of the tumor in approximately 60-80% of all cases. Furthermore, it is considered difficult to diagnose SCCB solely on the basis of findings from diagnostic imaging. For large intracystic tumors, mammotome biopsy or core needle biopsy (CNB) is rarely performed. Instead, fine-needle aspiration (FNA) targeted at the tumor inside the cyst is often performed. The accurate diagnosis rate of SCCB using FNA is lower than that for ordinary-type breast cancer. If the cyst is large, the solid tumor shadow outside the cyst behind or around the cyst may be masked or hidden by the large cyst, which can sometimes yield an unclear view of the tumor shadow or make it impossible to visualize the shadow. In the present case, the contents within the cyst were completely aspirated and collected during the first step (FNA), thereby yielding a clearer, complete view of the solid tumor located outside the cyst. Thus, the subsequent step (CNB) was able to be performed in a more accurate and reliable manner. The combined use of FNA and CNB proved to be useful in making a preoperative diagnosis of SSCB accompanying a cyst.

The availability of mammotome biopsy in UK breast units: Results of a national questionnaire study

The availability of mammotome biopsy in UK breast units: Results of a national questionnaire study

Abstract P4-01-20: Explore the differences and relationships between normal, ADH tissues and DCIS, IDC in breast by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS)

Abstract Background: The mechanism that ADH changes to DCIS and even IDC is still not clear now. Raman spectroscopy is a powerful, non-invasive analytical tool which can provide detailed and meaningful information about biochemical composition of tissues at molecular level. Our aim was to find the differences and relationships between normal, ADH tissues and DCIS, IDC in breast based on their various biochemical characteristics by Raman spectroscopy. Methods: The frozen sections were collected from 39 patients (all female; ages 27-74) who underwent surgical resection or mammotome biopsy at the Department of Breast Surgery, the First Hospital of Jilin University. After operation the samples were immediately frozen at -20∼-25°C and two contiguous sections (6 μm thickness) were cut from a sample by freezing microtome. One was stained with haematoxylin and eosin for routine histopathological analysis; the other was detected by Microscopic confocal Raman spectrometer (HORIBA JY Lab800, 633nm) with its mirror image (the H&amp;E section). After the spectra we needed had been obtained, the Au@SiO2 shell-isolated nanoparticles (SHINs) were added to the surface of frozen sections immediately and then the spectra with SHINs were collected. Results: A total of 475 Raman spectra and 470 SHINERS spectra were obtained from 9 normal breast tissues, 7 ADH, 8 DCIS, and 15 IDC breast tissues. The Raman signals were significantly enhanced by SHINs. The main spectral features of normal tissues at around 1301, 1442, 1654, and 1743 cm−1 are attributed to lipids. Meanwhile, no strong protein peaks emerged. The peaks of ADH, DCIS and IDC tissues located at 1004, 1033, 1610 and 1658 cm−1 from vibrational modes of proteins shows more stronger. 830, 880, 970, 1090 and 1157cm−1, representing DNA feature peaks, hold the same rules. Table 1: Peak assignments of the Raman spectra of Breast tissues (wavenumbers in cm-1)NBADHDCISIDCMajor Assignments 880878880O-P-O stretch, DNA1003100410041003phenylalanine1092109210911090O-P-O stretch, DNA1301,14421302,14421303,14431303,1442CH2 twist and CH2 deformation, lipids 15261527C = C stretch of carotene 165816581658Amide I, α-helix1743174717451747C = O stretch, lipids These show that diseased tissues contained more proteins and nucleic acids. The spectra of DCIS and IDC tissues contained 1527 cm−1, stemming from C = C stretching of carotene. The spectral features between ADH, DCIS and IDC tissues are described as followings: firstly, the concentrations of proteins, nucleic acids and carotene increased gradually but lipids content reduced from ADH to IDC. Secondly, ADH and DCIS tissues have extraordinary strong band of amide I, but in IDC tissues the peak almost cannot observed. Additionally, DCIS tissues have the red shifted and broad peak of CH2, which explains acyl backbone of lipids and proteins has fractured. Conclusion: The changes including content and molecular structure of lipids, carotene, proteins and nucleic acids accompany with deterioration, indicating the Raman spectroscopy can be used to explore the differences and relationships between normal, ADH tissues and DCIS, IDC in breast. Simultaneously, it might be used to discover the mechanism that ADH convert to DCIS. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-20.

Mammotome® biopsy system for the resection of breast lesions: Clinical experience in two high-volume teaching hospitals

Ultrasound-guided vacuum-assisted breast biopsy (VABB) is regarded as a feasible, effective, minimally invasive and safe method for the removal of benign breast lesions, without the occurrence of serious complications. The aim of this study was to evaluate the feasibility, efficacy and safety of ultrasound-guided VABB using the Mammotome® biopsy system in the treatment of breast lesions. The clinical outcomes of 3,681 patients with breast lesions were evaluated following excisions by ultrasound-guided VABB in two high-volume teaching hospitals. From January 2008 to December 2012, a total of 4,867 ultrasound-guided VABB procedures were performed in the 3,681 patients, who had a mean age of 37.8 years (range, 16–73 years). The parameters examined in this analysis included lesion size, lesion location in the inner breast, Breast Imaging Reporting and Data System (BI-RADS) ultrasound category and histopathological diagnosis. Ultrasonography follow-up was performed at 3–6 month intervals in order to assess recurrence. The size of the investigated lesions ranged between 6 and 62 mm and a histopathological diagnosis was made in 100% of cases. The results indicated that the majority of specimens (98.89%) were benign. On average, the ultrasound-guided VABB was performed in 10.3 min (range, 7.5–43 min) and the mean number of cores removed in the procedure was 8.1 (range, 3–32). A complete excision was achieved in the majority of cases (99.7%). The presence of a hematoma was the most common complication following the biopsy, and was observed in 27.5% of patients. The mean follow-up period was 25.5 months (range, 1–60 months), during which the rate of recurrence was 4.4%. The results indicated that ultrasound-guided VABB using the Mammotome biopsy system is an effective and safe procedure that is able to rapidly remove the majority of benign breast lesions using a small incision and without the occurrence of scarring or complications.

Meta analysis of efficacy and safety between Mammotome vacuum-assisted breast biopsy and open excision for benign breast tumor.

To compare the efficacy and safety between Mammotome vacuum-assisted breast biopsy (Mammotome VABB) and conventional open excision for benign breast tumor. A computer-based online search of Medline, PubMed, Embase, Ovid, Cochrane Library, VIP, Wanfang, CNKI and Chinese Biological Medicine Database was performed, and conference references were manually searched. With the Cochrane Collaboration Guidelines, all randomized controlled trials comparing mammotome minimally invasive operation and conventional open excision were systematically reviewed. The Cochrane Collaboration's RevMan 5.0 software was used for data analysis. A total of 15 studies involving 5,256 patients was included. Meta-analyses showed no significant difference in the size of tumor, postoperative hematomas, ecchymosis, ecchymoma and residual disease between Mammotome VABB and conventional open excision. Mammotome VABB was superior to open excision as to the size of incision, intraoperative blood loss, operative time, healing time, size of scar, wound infection and breast deformation. Mammotome VABB is an ideal method for benign breast tumor.