Hematoma-directed and ultrasound-guided breast-conserving surgery for nonpalpable breast cancer after Mammotome biopsy

Stereotactic vacuum-assisted (Mammotome™) breast biopsy is a powerful diagnostic tool for detecting microcalcifications on mammography, but it is difficult to remove the targeted lesion precisely when subsequent breast-conserving surgery is to be carried out. We achieved satisfactory results by perf...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2008-03, Vol.38 (3), p.279-282
Main Authors: Inui, Hiroki, Watatani, Masahiro, Hashimoto, Yukihiko, Hojo, Toshiya, Hirai, Kyoko, Yamato, Munehisa, Fujishima, Makoto, Azumi, Tatsuya, Shiozaki, Hitoshi
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy, Needle - instrumentation
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Carcinoma, Ductal, Breast - pathology
Carcinoma, Ductal, Breast - surgery
Hematoma - etiology
How to Do It
Humans
Iatrogenic Disease
Mastectomy, Segmental
Medicine
Medicine & Public Health
Middle Aged
Surgery
Surgical Oncology
Ultrasonography, Mammary
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Summary:Stereotactic vacuum-assisted (Mammotome™) breast biopsy is a powerful diagnostic tool for detecting microcalcifications on mammography, but it is difficult to remove the targeted lesion precisely when subsequent breast-conserving surgery is to be carried out. We achieved satisfactory results by performing hematoma-directed breast-conserving surgery after stereotactic Mammotome biopsy in seven patients. To identify the exact location of the Mammotome biopsy during the breast-conserving surgery, we created an iatrogenic hematoma in the biopsy cavity using patient’s blood. This hematoma was detected easily on intraoperative ultrasonography in all patients, and was palpable as a soft mass in five of the seven patients. The microcalcifications were completely removed in all patients, and no cancer cells were found in the margin surfaces after breast-conserving surgery. There were no complications during the injection of the patient’s blood into the biopsy cavity or during the hematoma-directed surgery. We describe this new procedure of hematoma-directed breast-conserving surgery following Mammotome biopsy for nonpalpable cancer with microcalcifications.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-007-3595-4