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Erschienen in: Annals of Surgical Oncology 1/2007

01.01.2007

Hematoma-Directed Ultrasound-Guided (HUG) Breast Lumpectomy

verfasst von: Margaret Thompson, MD, Ronda Henry-Tillman, MD, Aaron Margulies, MD, Jeff Thostenson, MS, Gwen Bryant-Smith, MD, Robert Fincher, MD, Soheila Korourian, MD, V Suzanne Klimberg, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2007

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Abstracts

Background

Needle localization breast biopsy (NLBB) is presently the primary means of localizing non-palpable lesions. Disadvantages of NLBB include vasovagal episodes, patient discomfort, and miss rates. Because hematomas naturally fill the cavity after vacuum-assisted breast biopsies (VABB), we hypothesized that ultrasound (US) could be used to find and accurately excise the actual biopsy site of non-palpable breast lesions without a needle.

Methods

This is a retrospective study from January 2000 to July 2005. Electronic chart review identified patients with non-palpable breast lesions detected by means of mammogram who then underwent lumpectomy via NLBB or the hematoma-directed ultrasound-guided technique (HUG). HUG involved localizing the hematoma with a 7.5-MHz US probe and using the “line of sight” technique straight down toward the chest wall. A block of tissue encompassing the hematoma was then excised.

Results

Localization procedures were performed in 186 patients—63 (34%) via needle localization and 123 (66%) via HUG. The previous VABB site in 100% of patients was successfully excised using HUG, 65 of 123 (53%) were benign and 58 of 123 (47%) were malignant; margins were positive in 13 of these 58 (22%). NLBB was successful in 100% of patients, 44 of 63 (70%) were benign and 19 of 63 (30%) were malignant; margins were positive in 14 of these 19 (73%). Margin positivity was significantly higher for NLBB than HUG (P = 0.0001, Fisher Exact).

Conclusions

This study suggests that HUG is more accurate in localizing non-palpable lesions than NLBB. By eliminating the additional procedure needed for NLBB, HUG may also be more time- and cost efficient. HUG makes VABB not only a less invasive diagnostic procedure, but also a localization procedure.
Literatur
2.
Zurück zum Zitat Potterton AJ, Peakman DJ, Young JR. Ultrasound demonstration of small breast cancers detected by mammographic screening. Clin Radiol 1994; 49(11):808–813PubMedCrossRef Potterton AJ, Peakman DJ, Young JR. Ultrasound demonstration of small breast cancers detected by mammographic screening. Clin Radiol 1994; 49(11):808–813PubMedCrossRef
3.
Zurück zum Zitat Smith LF, Henry-Tillman R, Rubio IT, Korourian S, Klimberg VS. Intraoperative localization after stereotactic breast biopsy without a needle. Am J Surg 2001; 182(6):584–589PubMedCrossRef Smith LF, Henry-Tillman R, Rubio IT, Korourian S, Klimberg VS. Intraoperative localization after stereotactic breast biopsy without a needle. Am J Surg 2001; 182(6):584–589PubMedCrossRef
4.
Zurück zum Zitat Rissanen TJ, Makarainen HP, Mattila SI, et al. Wire localized biopsy of breast lesions: A review of 425 cases found in screening or clinical mammography. Clin Radiol 1993; 47(1):14–22PubMedCrossRef Rissanen TJ, Makarainen HP, Mattila SI, et al. Wire localized biopsy of breast lesions: A review of 425 cases found in screening or clinical mammography. Clin Radiol 1993; 47(1):14–22PubMedCrossRef
5.
Zurück zum Zitat Hasselgren PO, Hummel RP, Georgian-Smith D, Fieler M. Breast biopsy with needle localization: accuracy of specimen x-ray and management of missed lesions. Surgery 1993; 114(4):836–840; discussion 840–842PubMed Hasselgren PO, Hummel RP, Georgian-Smith D, Fieler M. Breast biopsy with needle localization: accuracy of specimen x-ray and management of missed lesions. Surgery 1993; 114(4):836–840; discussion 840–842PubMed
6.
Zurück zum Zitat Homer MJ, Smith TJ, Safaii H. Prebiopsy needle localization. methods, problems, and expected results. Radiol Clin North Am 1992; 30(1):139–153 Homer MJ, Smith TJ, Safaii H. Prebiopsy needle localization. methods, problems, and expected results. Radiol Clin North Am 1992; 30(1):139–153
7.
Zurück zum Zitat Snider HC, Jr, Morrison DG. Intraoperative ultrasound localization of nonpalpable breast lesions. Ann Surg Oncol 1999; 6(3):308–314PubMedCrossRef Snider HC, Jr, Morrison DG. Intraoperative ultrasound localization of nonpalpable breast lesions. Ann Surg Oncol 1999; 6(3):308–314PubMedCrossRef
8.
Zurück zum Zitat Burbank F, Forcier N. Tissue marking clip for stereotactic breast biopsy: initial placement accuracy, long-term stability, and usefulness as a guide for wire localization. Radiology 1997; 205(2):407–415PubMed Burbank F, Forcier N. Tissue marking clip for stereotactic breast biopsy: initial placement accuracy, long-term stability, and usefulness as a guide for wire localization. Radiology 1997; 205(2):407–415PubMed
9.
Zurück zum Zitat Liberman L, Dershaw DD, Morris EA, Abramson AF, Thornton CM, Rosen PP. Clip placement after stereotactic vacuum-assisted breast biopsy. Radiology 1997; 205(2):417–422PubMed Liberman L, Dershaw DD, Morris EA, Abramson AF, Thornton CM, Rosen PP. Clip placement after stereotactic vacuum-assisted breast biopsy. Radiology 1997; 205(2):417–422PubMed
10.
Zurück zum Zitat Fajardo LL, Bird RE, Herman CR, DeAngelis GA. Placement of endovascular embolization microcoils to localize the site of breast lesions removed at stereotactic core biopsy. Radiology 1998; 206(1):275–278PubMed Fajardo LL, Bird RE, Herman CR, DeAngelis GA. Placement of endovascular embolization microcoils to localize the site of breast lesions removed at stereotactic core biopsy. Radiology 1998; 206(1):275–278PubMed
11.
Zurück zum Zitat Gray RJ, Salud C, Nguyen K, et al. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 2001; 8(9):711–715PubMedCrossRef Gray RJ, Salud C, Nguyen K, et al. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 2001; 8(9):711–715PubMedCrossRef
13.
Zurück zum Zitat Parker SH, Lovin JD, Jobe WE, et al. Stereotactic breast biopsy with a biopsy gun. Radiology 1990; 176(3):741–747PubMed Parker SH, Lovin JD, Jobe WE, et al. Stereotactic breast biopsy with a biopsy gun. Radiology 1990; 176(3):741–747PubMed
14.
Zurück zum Zitat Lee CH, Egglin TK, Philpotts L, Mainiero MB, Tocino I. Cost-effectiveness of stereotactic core needle biopsy: analysis by means of mammographic findings. Radiology 1997; 202(3):849–854PubMed Lee CH, Egglin TK, Philpotts L, Mainiero MB, Tocino I. Cost-effectiveness of stereotactic core needle biopsy: analysis by means of mammographic findings. Radiology 1997; 202(3):849–854PubMed
15.
Zurück zum Zitat Liberman L, Dershaw DD, Morris EA, Abramson AF, Thornton CM, Rosen PP. Clip placement after stereotactic vacuum-assisted breast biopsy. Radiology 1997; 205(2):417–422PubMed Liberman L, Dershaw DD, Morris EA, Abramson AF, Thornton CM, Rosen PP. Clip placement after stereotactic vacuum-assisted breast biopsy. Radiology 1997; 205(2):417–422PubMed
16.
Zurück zum Zitat Israel PZ, Fine RE. Stereotactic needle biopsy for occult breast lesions: a minimally invasive alternative. Am Surg 1995; 61:87–91PubMed Israel PZ, Fine RE. Stereotactic needle biopsy for occult breast lesions: a minimally invasive alternative. Am Surg 1995; 61:87–91PubMed
17.
Zurück zum Zitat Velanovich V, Lewis FR, Jr, Nathanson SD, et al. Comparison of mammographically guided breast biopsy techniques. Ann Surg 1999; 229:625–630; discussion 630–633PubMedCrossRef Velanovich V, Lewis FR, Jr, Nathanson SD, et al. Comparison of mammographically guided breast biopsy techniques. Ann Surg 1999; 229:625–630; discussion 630–633PubMedCrossRef
18.
Zurück zum Zitat Fuhrman GM, Cederbom GJ, Bolton JS, et al. Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. Ann Surg 1998; 227:932–939PubMedCrossRef Fuhrman GM, Cederbom GJ, Bolton JS, et al. Image-guided core-needle breast biopsy is an accurate technique to evaluate patients with nonpalpable imaging abnormalities. Ann Surg 1998; 227:932–939PubMedCrossRef
19.
Zurück zum Zitat Meyer JE, Smith DN, Lester SC, et al. Large-core needle biopsy of nonpalpable breast lesions. JAMA 1999; 281:1638–1641PubMedCrossRef Meyer JE, Smith DN, Lester SC, et al. Large-core needle biopsy of nonpalpable breast lesions. JAMA 1999; 281:1638–1641PubMedCrossRef
20.
Zurück zum Zitat Yim JH, Barton P, Weber B, et al. Mammographically detected breast cancer. Benefits of stereotactic core versus wire localization biopsy. Ann Surg 1996; 223(6):688–697; discussion 697–700 Yim JH, Barton P, Weber B, et al. Mammographically detected breast cancer. Benefits of stereotactic core versus wire localization biopsy. Ann Surg 1996; 223(6):688–697; discussion 697–700
21.
Zurück zum Zitat Bassett L, Winchester DP, Caplan RB, et al. Stereotactic core-needle biopsy of the breast: a report of the joint task force of the American College of Radiology, American College of Surgeons, and College of American Pathologists. CA Cancer J Clin 1997; 47(3):171–190PubMed Bassett L, Winchester DP, Caplan RB, et al. Stereotactic core-needle biopsy of the breast: a report of the joint task force of the American College of Radiology, American College of Surgeons, and College of American Pathologists. CA Cancer J Clin 1997; 47(3):171–190PubMed
22.
Zurück zum Zitat Smith LF, Rubio IT, Henry-Tillman R, Korourian S, Klimberg VS. Intraoperative ultrasound-guided breast biopsy. Am J Surg 2000; 180(6):419–423PubMedCrossRef Smith LF, Rubio IT, Henry-Tillman R, Korourian S, Klimberg VS. Intraoperative ultrasound-guided breast biopsy. Am J Surg 2000; 180(6):419–423PubMedCrossRef
23.
Zurück zum Zitat Schwartz GF, Goldberg BB, Rifkin MD, D’Orazio SE. Ultrasonography: an alternative to x-ray-guided needle localization of nonpalpable breast masses. Surgery 1988; 104(5):870–873PubMed Schwartz GF, Goldberg BB, Rifkin MD, D’Orazio SE. Ultrasonography: an alternative to x-ray-guided needle localization of nonpalpable breast masses. Surgery 1988; 104(5):870–873PubMed
24.
Zurück zum Zitat Harlow SP, Krag DN, Ames SE, Weaver DL. Intraoperative ultrasound localization to guide surgical excision of nonpalpable breast carcinoma. J Am Coll Surg 1999; 189(3):241–246PubMedCrossRef Harlow SP, Krag DN, Ames SE, Weaver DL. Intraoperative ultrasound localization to guide surgical excision of nonpalpable breast carcinoma. J Am Coll Surg 1999; 189(3):241–246PubMedCrossRef
25.
Zurück zum Zitat Rubio IT, Henry-Tillman R, Klimberg VS. Surgical use of breast ultrasound. Surg Clin North Am 2003; 83(4):771–788PubMedCrossRef Rubio IT, Henry-Tillman R, Klimberg VS. Surgical use of breast ultrasound. Surg Clin North Am 2003; 83(4):771–788PubMedCrossRef
26.
Zurück zum Zitat Henry-Tillman R, Johnson AT, Smith LF, Klimberg VS. Intraoperative ultrasound and other techniques to achieve negative margins. Semin Surg Oncol 2001; 20(3):206–213PubMedCrossRef Henry-Tillman R, Johnson AT, Smith LF, Klimberg VS. Intraoperative ultrasound and other techniques to achieve negative margins. Semin Surg Oncol 2001; 20(3):206–213PubMedCrossRef
27.
28.
Zurück zum Zitat Pezner RD, Lipsett JA, Desai K, et al. To boost or not to boost: decreasing radiation therapy in conservative breast cancer treatment when “inked” tumor resection margins are pathologically free of cancer. Int J Radiat Oncol Biol Phys 1988; 14(5):873–877PubMed Pezner RD, Lipsett JA, Desai K, et al. To boost or not to boost: decreasing radiation therapy in conservative breast cancer treatment when “inked” tumor resection margins are pathologically free of cancer. Int J Radiat Oncol Biol Phys 1988; 14(5):873–877PubMed
29.
Zurück zum Zitat Spivack B, Khanna MM, Tafra L, Juillard G, Giuliano AE. Margin status and local recurrence after breast-conserving surgery. Arch Surg 1994; 129(9):952–956; discussion 956–957PubMed Spivack B, Khanna MM, Tafra L, Juillard G, Giuliano AE. Margin status and local recurrence after breast-conserving surgery. Arch Surg 1994; 129(9):952–956; discussion 956–957PubMed
30.
Zurück zum Zitat Freedman G, Fowble B, Hanlon A, et al. Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy. Int J Radiat Oncol Biol Phys 1999; 44(5):1005–1015PubMedCrossRef Freedman G, Fowble B, Hanlon A, et al. Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy. Int J Radiat Oncol Biol Phys 1999; 44(5):1005–1015PubMedCrossRef
31.
Zurück zum Zitat Park CC, Mitsumori M, Nixon A, et al. Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence. J Clin Oncol 2000; 18(8):1668–1675PubMed Park CC, Mitsumori M, Nixon A, et al. Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence. J Clin Oncol 2000; 18(8):1668–1675PubMed
32.
Zurück zum Zitat Fortin A, Larochelle M, Laverdiere J, Lavertu S, Tremblay D. Local failure is responsible for the decrease in survival for patients with breast cancer treated with conservative surgery and postoperative radiotherapy. J Clin Oncol 1999; 17(1):101–109PubMed Fortin A, Larochelle M, Laverdiere J, Lavertu S, Tremblay D. Local failure is responsible for the decrease in survival for patients with breast cancer treated with conservative surgery and postoperative radiotherapy. J Clin Oncol 1999; 17(1):101–109PubMed
33.
Zurück zum Zitat Singletary SE. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 2002; 184(5):383–393PubMedCrossRef Singletary SE. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 2002; 184(5):383–393PubMedCrossRef
34.
Zurück zum Zitat Swanson GP, Rynearson K, Symmonds R. Significance of margins of excision on breast cancer recurrence. Am J Clin Oncol 2002; 25(5):438–441PubMedCrossRef Swanson GP, Rynearson K, Symmonds R. Significance of margins of excision on breast cancer recurrence. Am J Clin Oncol 2002; 25(5):438–441PubMedCrossRef
35.
Zurück zum Zitat Lechner M, Day D, Elvecrog EL, et al. Ultrasound visibility of a new biopsy marker on serial evaluations. Radiology 2002; 225:115 Lechner M, Day D, Elvecrog EL, et al. Ultrasound visibility of a new biopsy marker on serial evaluations. Radiology 2002; 225:115
36.
Zurück zum Zitat Birdwell RL, Jackman RJ. Clip or marker migration 5–10 weeks after stereotactic 11-gauge vacuum-assisted breast biopsy: report of two cases. Radiology 2003; 29(2):541–544CrossRef Birdwell RL, Jackman RJ. Clip or marker migration 5–10 weeks after stereotactic 11-gauge vacuum-assisted breast biopsy: report of two cases. Radiology 2003; 29(2):541–544CrossRef
37.
Zurück zum Zitat Parikh JR. Ultrasound demonstration of clip migration to skin within 6 weeks of 11-gauge vacuum-assisted stereotactic breast biopsy. Breast J 2004; 0(6):539–542CrossRef Parikh JR. Ultrasound demonstration of clip migration to skin within 6 weeks of 11-gauge vacuum-assisted stereotactic breast biopsy. Breast J 2004; 0(6):539–542CrossRef
38.
Zurück zum Zitat Burnside ES, Sohlich RE, Sickles EA. Movement of a biopsy-site marker clip after completion of stereotactic directional vacuum-assisted breast biopsy: case report. Radiology 2001; 21(2):504–507CrossRef Burnside ES, Sohlich RE, Sickles EA. Movement of a biopsy-site marker clip after completion of stereotactic directional vacuum-assisted breast biopsy: case report. Radiology 2001; 21(2):504–507CrossRef
39.
Zurück zum Zitat Philpotts LE, Lee CH. Clip migration after 11-gauge vacuum-assisted stereotactic biopsy: case report. Radiology 2002; 22(3):794–796CrossRef Philpotts LE, Lee CH. Clip migration after 11-gauge vacuum-assisted stereotactic biopsy: case report. Radiology 2002; 22(3):794–796CrossRef
40.
Zurück zum Zitat Harris AT. Clip migration within 8 days of 11-gauge vacuum-assisted stereotactic breast biopsy: case report. Radiology 2003; 28(2):552–554CrossRef Harris AT. Clip migration within 8 days of 11-gauge vacuum-assisted stereotactic breast biopsy: case report. Radiology 2003; 28(2):552–554CrossRef
41.
Zurück zum Zitat Parikh JR. Clip migration within 15 days of 11-gauge vacuum-assisted stereotactic breast biopsy: case report. Am J Roentgenol 2005; 84(3 Suppl):S43–46 Parikh JR. Clip migration within 15 days of 11-gauge vacuum-assisted stereotactic breast biopsy: case report. Am J Roentgenol 2005; 84(3 Suppl):S43–46
42.
Zurück zum Zitat Parikh JR. Delayed migration of Gel Mark Ultra Clip within 15 days of 11-gauge vacuum-assisted stereotactic breast biopsy. Am J Roentgenol 2005; 85(1):203–206 Parikh JR. Delayed migration of Gel Mark Ultra Clip within 15 days of 11-gauge vacuum-assisted stereotactic breast biopsy. Am J Roentgenol 2005; 85(1):203–206
43.
Zurück zum Zitat Nurko J, Mancino AT, Whitacre E, Edwards MJ. Surgical benefits conveyed by biopsy site marking system using ultrasound localization. Am J Surg 2005; 190(4):618–622PubMedCrossRef Nurko J, Mancino AT, Whitacre E, Edwards MJ. Surgical benefits conveyed by biopsy site marking system using ultrasound localization. Am J Surg 2005; 190(4):618–622PubMedCrossRef
44.
Zurück zum Zitat Mullen DJ, Eisen RN, Newman RD, Perrone PM, Wilsey JC. The use of carbon marking after stereotactic large-core-needle breast biopsy. Radiology 2001; 218(1):255–260PubMed Mullen DJ, Eisen RN, Newman RD, Perrone PM, Wilsey JC. The use of carbon marking after stereotactic large-core-needle breast biopsy. Radiology 2001; 218(1):255–260PubMed
45.
Zurück zum Zitat Gray RJ, Salud C, Nguyen K, et al. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 2001; 8(9):711–715PubMedCrossRef Gray RJ, Salud C, Nguyen K, et al. Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization. Ann Surg Oncol 2001; 8(9):711–715PubMedCrossRef
46.
Zurück zum Zitat Kass R, Kumar G, Klimberg VS, et al. Clip migration in stereotactic biopsy. Am J Surg 2002; 184(4):325–331PubMedCrossRef Kass R, Kumar G, Klimberg VS, et al. Clip migration in stereotactic biopsy. Am J Surg 2002; 184(4):325–331PubMedCrossRef
47.
Zurück zum Zitat Gennari R, Galimberti V, De Cicco C, et al. Use of technetium-99m-labeled colloid albumin for preoperative and intraoperative localization of nonpalpable breast lesions. J Am Coll Surg 2000; 190(6):692–698; discussion 698–699PubMedCrossRef Gennari R, Galimberti V, De Cicco C, et al. Use of technetium-99m-labeled colloid albumin for preoperative and intraoperative localization of nonpalpable breast lesions. J Am Coll Surg 2000; 190(6):692–698; discussion 698–699PubMedCrossRef
48.
Zurück zum Zitat Thind CR, Desmond S, Harris O, Nadeem R, Chagla LS, Audisio RA. Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience. Clin Radiol 2005; 60(6):681–686PubMedCrossRef Thind CR, Desmond S, Harris O, Nadeem R, Chagla LS, Audisio RA. Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience. Clin Radiol 2005; 60(6):681–686PubMedCrossRef
49.
Zurück zum Zitat Zgajnar J, Hocevar M, Frkovic-Grazio S, Hertl K, Schweiger E, Besic N. Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions. Neoplasma 2004; 51(5):385–389PubMed Zgajnar J, Hocevar M, Frkovic-Grazio S, Hertl K, Schweiger E, Besic N. Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions. Neoplasma 2004; 51(5):385–389PubMed
Metadaten
Titel
Hematoma-Directed Ultrasound-Guided (HUG) Breast Lumpectomy
verfasst von
Margaret Thompson, MD
Ronda Henry-Tillman, MD
Aaron Margulies, MD
Jeff Thostenson, MS
Gwen Bryant-Smith, MD
Robert Fincher, MD
Soheila Korourian, MD
V Suzanne Klimberg, MD
Publikationsdatum
01.01.2007
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 1/2007
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9076-y

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