Mammotome Excision Research Articles

2292: Factors affecting the efficacy of mammotome excision for removal of benign breast lesions

Objectives: To assess the performance of Mammotome excision in the percutaneous removal of benign breast masses, and evaluate the factors influencing the rate of residual lesion and complications including hematoma. Methods: We reviewed 263 cases of percutaneous removal of breast mass using large core Mammotome (Ethicon Endo-surgery, Cincinnati, USA). All lesions were US BIRADS 3 category or benign lesion confirmed by previous biopsy. Indications to remove the mass were patient’s anxiety, fear for malignancy, difficulty for following up and so on. We retrospectively analyzed the characteristics of masses removed, presence of any complication, success of complete removal. Results: Pathologic results were mostly benign (98%) but four lesions were malignant or borderline. No clinically significant complication occurred. Imaginary complete removal rate was 95% immediately after procedure and 92% in 6 months follow up sonography. The cases with residual lesions showed larger size, shorter distance from the nipple and larger number of removed mass. Hematomas were more frequently observed in lesions close to the nipple. Conclusions: US-guided percutaneous removal using mammotome was useful method for the treatment of benign breast masses, but we should pay attention to the lesions close to the nipple to prevent hematoma and residual lesions.

The Results and Usefulness of Marker Clip Placement after Ultrasound-guided Mammotome Excision of Breast Lesion

Purpose: We wanted to know the results and the usefulness of placing a marker clip (a surgical titanium clip) after ultrasound (US)-guided excisional mammotome biopsy for breast lesion. Materials and Methods: We have placed marker clips at the biopsy sites after performing US-guided excisional mammotome biopsies in 24 cases (mean age; 46 years, mean size of the 12.6 mm, pathologic results; benign in 19 cases, malignant in 5 cases) from Nov. 2003 to Jun. 2004. We designed the needle that we used. Twenty-five cases of follow-up sonography (at 1-month follow-up; 13 cases, at 6-months follow-up; 12 cases) were performed for 18 cases of clip placement. We retrospectively reviewed the success rate and the complications for 24 cases of clip placement, and we analyzed the visibility, conspicuity and location of the clips on 25 cases of follow-up sonography for 18 cases of clip placement. Results: The marker clip is successfully placed in all 24 cases (100%). None of the patients complained of pain or infection, except for 1 case of a large hematoma (3.5 cm). On the follow-up sonography, the titanium clip was well visualized as a short echogenic line on the interval follow-up (for the 1-month follow-up; 85%, for the 6 month follow-up; 84%) and parenchymal composition of the breast was well observed at the location of the clip (intraparenchymal; 80%, parenchyma-fat interface; 90%). The clips were easily found when there was hematoma (85%) or scar (89%). Marker clips were found within the hematoma, scar or the distorted region of tissue in all cases (100%), and there was no evidence of migration on the post-biopsy findings.