Ultrasound-guided Mammotome Research Articles

Ultrasound classification-guided minimally invasive rotary cutting in granulomatous lobular mastitis

BackgroundTo summarize the clinical experience of ultrasound-guided minimally invasive surgery for granulomatous lobular mastitis (GLM), and explore the feasibility of this technique for treating GLM.MethodsThis retrospective study reviewed the clinical features and treatment outcome of 30 patients who were diagnosed pathologically as GLM from 2016.3 to 2019.5 in the Department of Breast Surgery, Women's and Children's Hospital, Xiamen University. These patients weretreated with ultrasound-guided Mammotome minimally invasive surgery, and we tried to classified the lesion into four distinct patterns (diffuse abscess mixed type, sheet hypoechoic type, localized abscess type, localized hypoechoic mass type) according to the sonographic findings and clinical symptoms to find out if these patterns correlated with treatment and recurrence rate.ResultsAfter a median follow-up of 12 months on average (4–42 months), 26 cases (86.7%) were cured without acute or chronic complications such as disseminated inflammation and bleeding. Post-operative bleeding occurred in 1 case, and 3 cases (10.00%) relapsed. The ultrasound classification had 0 cases of diffuse abscess mixed type, 17 cases (56.7%) of sheet hypoechoic type, 9 cases (30%) of localized abscess type, and 4 cases (13.3%) of localized hypoechoic mass type. All 3 recurrent cases were sheet hypoechoic type, which were cured after another open surgical resection and showed no recurrence during an average follow-up of 20 months (11–40 months).ConclusionsIn treating GLM patients with minimally invasive rotary cutting, ultrasound classification helps to select suitable patients, especially those with localized abscess and localized hypoechoic mass types with low recurrence rate, which is one of the safe and effective treatment methods.

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.

Ultrasound-guided mammotome for diagnosis and minimally invasive excision of mammary clustered calcifications.

e13034 Background: To validate the ultrasound-guided vacuum-assisted breast biopsy system (Mammotome) for diagnosis and minimally invasive excision of calcification in breast. Methods: In 20 patients, breast calcification lesions diagnosed by mammography were excised by ultrasound-guided Mammotome system with 8-gauge probe. The samples were taken mammography and followed by pathological examination. Results: All lesions were removed accurately and thoroughly with satisfactory cosmetic outcomes. No clinically significant hematoma developed. Each mass was resected through 9.15±2.70 cores on average over a mean of 11.65±3.88 minutes. Two cases of them were histologically diagnosed as ductal carcinoma in situ and 8 cases were fibroadenoma and 10 cases were adenosis. Conclusions: Ultrasound-guided Mammotome system can profit to diagnose and treat breast calcification lesions which is ultrasound positive. Ultrasound detection rate of microcalcifications is up to the instrument resolution and the operator's experience and patience.

Comparative study of Mammotome minimally invasive operation and traditional surgery in treating benign breast tumor

Objective To compare the effect of ultrasound-guided Mammotome minimally invasive operation and traditional surgery in treating benign breast tumor. Methods Eighty patients with benign breast tumor admitted to People′s Hospital of Beijing Daxing District from October 2015 to April 2016 were randomly divided into group A and group B. Patients in group A accepted ultrasound-guided Mammotome minimally invasive operation (n=40), while patients in Group B accepted traditional surgery(n=40). Operation time, incision length, blood loss, patient satisfaction, postoperative pain, and the occurrence rates of complications were compared between the two groups. Results All the tumors in two groups were removed. Patients in group A had shorter operation time(10.4±1.0) min, less blood loss(4.1±0.5) ml, smaller length of incision(0.34±0.04) cm (P<0.05 or P<0.01); also had less occurrence of complication (P<0.05); and patients in group A had better patient′s satisfaction(95%) (P<0.01). Conclusions Ultrasound-guided Mammotome minimally invasive operation is helpful to shorten operation time and incision length, and reduce blood loss, also improve satisfaction. It is valuable for application and popularization in primary hospital. Key words: Breast neoplasms; Surgical procedures, minimally invasive; Comparative study; Mammotome minimally invasive operation

452. Ultrasound-guided Mammotome Technique in the Breast Lesions - a Report of 2216 Cases

Background: Within the last decade, the development of innovative minimally invasive breast excisional biopsy technologies has made a significant impact on the diagnostic evaluation and removal of breast lesions. Our goal was to evaluate whether ultrasound-guided Mammotome procedure is safe and effective means for diagnosis of breast lesions (BIRAD 3 to BIRAD 5) and completely removal of benign breast lesions.

Ultrasound-guided Mammotome system in diagnosis and minimally invasive resection of calcification in breast

Objective To evaluate the feasibility of using the ultrasound-guided vacuum-assisted breast biopsy system(Mammotome) for diagnosis and minimally invasive resection of calcification in the breast.Methods Fourteen patients with breast calcification lesions who were diagnosed by mammography were resected by ultrasound-guided Mammotome system with 8G probe.The samples were subjected to mammography,followed by pathological examination.Results All the lesions were removed accurately and radically with satisfactory cosmetic outcomes;there were no clinically significant hematoma after operation.Each lesion was resected via(9±2.22) peelings and took a mean of(12.93±3.45) min.Pathological examination confirmed 2 cases of ductal carcinoma in situ,5 cases of fibroadenoma,and 7 cases adenosis.Conclusion Ultrasound-guided Mammotome system can be used for diagnosis and treatment of breast calcification lesions which are ultrasound positive.The technique is accurate,time-saving,and mini-invasive,but it requires more experience and patience from the operators.

Application of ultrasound-guided mammotome minimally invasive surgery in breast tumor

Objective To investigate the clinical application of ultrasound-guided mammotome surgery in breast tumor.Methods 579 breast tumors from 273 patients underwent minimally invasive surgery by ultrasoundguided mammotome system.Results Through 0.5cm incisal opening,all tumors were exactly,completely resected and no infaust surgery complication happened.Conclusion The way of minimally invasive surgery of breast tumor by ultrasound-guided mammotome system was simple,precise,safe,minimally invasive and was accurate diagnosis.So popularizing this minimally invasive techniques was deserved. Key words: Ultrasound; Mammotome; Minimally invasive; Breast tumor

Evaluation on pathologic status of the residual lesions after ultrasound- guided, 8-gauge vacuum-assisted mammotome® system biopsy for nonpalpable malignant breast lesions and its influencing factors

The vacuum-assisted Mammotome® system is now considered highly accurate for ultrasound-guided diagnostic biopsy and selective excision of suspicious breast lesions. Our goal is to evaluate the residual lesions pathologic status after ultrasound-guided, 8-gauge vacuum-assisted mammotome® system biopsy for nonpalpable malignant breast lesions, and to explore its influencing factors. A total of 281 patients with nonpalpable breast lesions underwent ultrasound-guided, 8-gauge mammotome® biopsy from August 2005 to February 2009, of whom 56 with malignant lesion received subsequent surgery. Multiple variables, including patient demographics, characteristics of the breast lesion (based on ultrasound and mammography), procedural and histopathological features were evaluated. A total of 56 (19.9%) of 281 lesions were diagnosed as pathological breast cancer by mammotome® excisional biopsy. 100% of all lesions were accurately diagnosed by ultrasound-guided mammotome® biopsy, and no further ultrasonographic evidence of lesions were noted among the 193 patients of benign pathologies that were compliant with follow-up. Of the 56 malignant cases, 41 (73%) lesions were completely excised (based on pathology), and the incidence rate of negative surgical margin was 93% during the subsequent breast-conserving surgery. There were significant correlations between the original ultrasound breast lesion size and shape with successful complete excision of nonpalpable lesion by the ultrasound-guided, 8-gauge mammotome® biopsy procedure. The ultrasound-guided, 8-gauge mammotome® breast biopsy system is highly accurate and successful for excisional biopsy of nonpalpable suspicious breast lesions. This procedure should be routinely applied in the treatment of patients with nonpalpable suspicious breast lesions. Key words: Breast malignant lesion, ultrasound-guided, vacuum-assisted mammotome®, excisional biopsy.

Ultrasound-guided Mammotome system in diagnosis and minimally invasive resection of breast cystic-solid lesion

Ultrasound-guided Mammotome system in diagnosis and minimally invasive resection of breast cystic-solid lesion

0022 Ultrasound-guided Mammotome® biopsy for breast microcalcification using 2-dimensional mammography localization

0022 Ultrasound-guided Mammotome® biopsy for breast microcalcification using 2-dimensional mammography localization

Evaluation and indications of ultrasound-guided vacuum-assisted core needle breast biopsy

The Mammotome is a diagnostic tool used under stereotactic or with ultrasound guidance. A clear indication for Mammotome use under stereotactic guidance is when a non-palpable microcalcification is a target. However, the indications for the use of the Mammotome under ultrasound guidance vary among institutions, and it is difficult to find a place for the Mammotome among conventional biopsy techniques. The Mammotome biopsy has been available in our hospital since July 1999. We assessed the effectiveness and indications of ultrasound-guided Mammotome biopsy. We performed Mammotome biopsies in 433 cases requiring histological diagnosis from July 1999 to September 2006, using an 11-gauge articulated arm-type Mammotome under ultrasound guidance. There were 377 mass lesions including 83 non-palpable cases and 56 hypoechoic lesions. The indications for Mammotome biopsy were 162 cases with inconsistent fine needle aspiration (FNA) and imaging findings, 114 cases indeterminate by FNA, 68 cases of an identified pathological type before neoadjuvant chemotherapy and confirmation of hormone receptor status, 36 inadequate cases by FNA, 20 cases of confirmation of fibroadenoma and other benign tumors, 8 removal cases of fibroadenoma, 8 microcalcification cases, and 17 others. The target lesion was obtained in 99.5% of the cases. Ultrasound-guided Mammotome biopsy is an accurate and useful diagnostic method that enables sufficient amounts of tissue to be obtained with minimal invasion and few complications. The Mammotome is the first choice for obtaining a definitive pathological diagnosis in breast lesions.

Histological evaluation of the resection margin for percutaneus excision of breast fibroadenoma with using ultrasound-guided Mammotome®

Histological evaluation of the resection margin for percutaneus excision of breast fibroadenoma with using ultrasound-guided Mammotome®

Vacuum-Assisted Core Biopsy (Mammotome) for the Diagnosis of Non-Palpable Breast Lesions: Four-Year Experience in an Italian Center

Microinvasive biopsy techniques are increasingly employed in the diagnostic assessment of non-palpable breast lesions (NPBLs). This study reports the four-year experience of an Italian surgical center in the evaluation of the diagnostic effectiveness versus adverse effects of vacuum-assisted core biopsy (Mammotome). 314 NPBLs with a dubious ultrasound and/or radiographic appearance were subjected to mammography-guided (86) or ultrasound-guided (228) Mammotome biopsy. The procedure could be completed and was diagnostic in 305 cases (P < 0.0001). Adverse events were transient light-headedness. In two cases and moderate bleeding in three cases. Histological processing of the biopsies showed 227 cases of benign disease (74.42%), 68 cases of carcinoma (20 carcinomas in situ and 48 infiltrating carcinomas) (22.29%), nine cases of atypical ductal hyperplasia (2.95%) and one atypical lobular hyperplasia (0.33%). Only 12 patients reported mild discomfort relative to the procedure. The difference between the number of patients reporting discomfort and that of patients reporting no discomfort at all was highly significant (P < 0.0001). The results confirm that Mammotome biopsy is a highly effective procedure for the diagnosis of NPBLs, with minimal negative effects.

Excision of benign breast tumor by an Ultrasound-Guided hand held Mammotome biopsy device

Excision of benign breast tumor by an Ultrasound-Guided hand held Mammotome biopsy device

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.

Usefulness of Ultrasound-guided Mammotome Biopsy for Microcalcification

Purpose: To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. Materials and Methods: Twenty-one calcific lesions in 21 women (aged 33-56 years) underwent ultrasoundguided, vacuum-assisted, mammotome biopsy and a mean of 14 specimens per lesion were obtained. Calcification retrieval was defined as identification of calcifications on specimen radiographs. In the 13 cases of calcifications which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammography-guidance. Radiographs of the specimens and histologic findings were reviewed and scheduled follow-up imaging was performed for evaluation of the complications of biopsy. Results: Ultrasound-guided, vacuum-assisted, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcification on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance. Surgery revealed DCIS in 1 (4.8%) of 21 lesions, infiltrating ductal carcinoma in two (9.5%), fibroadenomas with calcifications in 6 (28.6%), fibroadenomas with adenosis in 2 (9.5%), and fibrocystic change with calcifications in 10 (47.6%). Clinical significant complications did not occur on follow-up examination in any of the cases. Conclusion: Ultrasound-guided, vacuum-assisted, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images.

Ultrasound-guided mammotome vacuum biopsy for the diagnosis of impalpable breast lesions.

To assess the diagnostic accuracy of ultrasound-guided mammotome vacuum biopsy in impalpable breast lesions. Seventy-three patients who presented with impalpable breast lesions that were suspicious for malignancy at mammography and/or sonography were included in the study. In the first instance the women underwent ultrasound-guided fine-needle aspiration cytology, then, 3 days later, histological biopsy with an ultrasound-guided mammotome device. The patients with both cytological and histological diagnoses of malignancy underwent surgery; those with a negative (for malignancy) cytological diagnosis, but with a histological diagnosis of atypical hyperplasia or sclerosing adenosis, underwent surgical biopsy. The diagnostic accuracy of fine-needle aspiration cytology was 67.2%; the sensitivity was 86.7%, the specificity was 48.4%, the negative predictive value was 78.9% and the positive predictive value was 61.9%. In comparison, the diagnostic accuracy of histological sampling by mammotome vacuum biopsy was 97.3%; the sensitivity was 94.7%, the specificity was 100%, the negative predictive value was 94.6% and the positive predictive value was 100%. Thus there was a statistically significant difference in diagnostic accuracy between fine-needle aspiration cytology and mammotome vacuum biopsy (67.2% vs. 97.3%; chi2 test, P < 0.001). The 2.7% (2/73) failure rate of mammotome biopsy was likely to be due to an error in the positioning of the needle. The subsequent surgical biopsy proved that two cases, negative for malignancy by mammotome biopsy, were in fact malignant. Our data confirm the value of sonography for the diagnosis of breast carcinoma in the preclinical phase and the efficacy of ultrasound sampling using a mammotome device to confirm the diagnosis in impalpable breast lesions.