Ultrasound-guided Vacuum-assisted Excision of Papillary Breast Lesions as an Alternative to Surgical Excision: 7-year Experience

Objective Removal of papillary breast lesions following percutaneous biopsy is advocated due to their diagnostic challenges. Image-guided vacuum-assisted excision is a treatment option for managing papillary breast lesions. The aim of our study was to review our experience in ultrasound-guided vacuu...

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Bibliographic Details
Published in:Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi 2020-12, Vol.23 (4), p.253-260
Main Authors: Chau, CM, Fung, EPY, Wong, CW, Kwok, KM, Leung, AYH, Wong, LKM, Wong, KCK, Mak, WS, Lam, HS, Cho, DHY
Format: Article
Language:English
Subjects:
Biopsy
Breast cancer
Cancer
Lumpectomy
Pathology
Patients
Tumors
Ultrasonic imaging
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Summary:Objective Removal of papillary breast lesions following percutaneous biopsy is advocated due to their diagnostic challenges. Image-guided vacuum-assisted excision is a treatment option for managing papillary breast lesions. The aim of our study was to review our experience in ultrasound-guided vacuum-assisted excision (US-VAE) of papillary breast lesions. Methods This was a retrospective review of patients with biopsy-proven papillary breast lesions who underwent US-VAE from January 2011 to April 2018. The clinical, radiological, and initial biopsy findings and the US-VAE procedure data were collected. The final histology was reviewed for any evidence of malignancy. Patients were followed up by clinical assessment and ultrasound. Lesion excision was considered successful removed if no residual or recurrence was found at follow-up. Results A total of 71 patients with 76 papillary lesions underwent US-VAE over a 7-year period. No major complications were observed. The overall cancer upgrade rate on pathology was 5.3%, with cancer upgrade rates for papillary lesions with atypia and without atypia of 16.7% and 3.1%, respectively. Mean follow-up time was 12.8 months. Two residual lesions were found during follow-up, for a successful lesion removal rate of 97.2%. Conclusion The highly successful lesion removal rate with low residual or recurrence for benign papillary lesions confirms that US-VAE avoids surgical excision in patients with biopsy-proven papillary lesions. It remains a safe and effective alternative to surgical excision in managing biopsy-proven papillary lesions.
ISSN:2223-6619
2307-4620
DOI:10.12809/hkjr2017066