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Bài thuyết trình Evaluation of the initial efficacy in the removal of benign breast lesions by vacuum-assisted biopsy in radiology center of Bach Mai hospital

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Evaluation of the initial efficacy in the removal of  
benign breast lesions by vacuum-assisted biopsy  
in radiology center of Bach Mai hospital  
Dr. Lê Nguyệt Minh  
Radiology center of Bach Mai hospital  
Introduction  
• Benign breast lesions is one of the  
common diseases:  
– America: 1 million women diagnosed benign  
breast lesions/ year  
– Thailand: 73% benign breast lesions / study of  
2532 patients biopsied.  
• Pain, discomfort in breast is sensitive  
reduce the quality of life  
Treatm
Vacuum- assisted breast  
biopsy (VABB)  
Aim  
• to evaluate the initial efficacy in the  
removal of benign breast lesions by  
vacuum-assisted biopsy  
Excision surgery  
… leave a scar  
Vacuum- assisted breast biopsy  
(VABB)  
• 11G ~ 7G  
• Using Vacuum and Rotating cutter  
• One insertion and Serial sampling  
• Enough specimen for Pathology  
• Excision of Benign Tumor  
After VABB  
Vacuum Assisted Breast Biopsy  
1995  
1996  
1998  
2002  
FDA  
Fred Burbank,  
Mark Retchard  
Zannis  
Total lesionremoval  
High asthetic  
Meta analysis of efficacy and safety between Mammotome vacuum-assisted  
breast biopsy and open excision for benign breast tumor  
Boni Ding, Daojin Chen, Xiaorong Li, Hongyan Zhang, Yujun Zhao  
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China Correspondence to: Yujun Zhao. Organ  
Transplantation Center, Third Xiangya Hospital, Central South University, Changsha 410013, China.  
Gland Surgery 2013;2(2):69-79  
Indication of VABB  
• Diagnostic indications:  
– Biopsy small lesion (<5mm) – ultrasound visible  
– Biopsy suspicious grouped microcalcification  
• Therapeutic indications:  
– Remove symptomatic BIRADS 3-lesion,  
probably benign, woman are not willing to  
follow-up  
– Remove intraductal papilloma which cause  
nipple discharge  
Intraindications  
• Absolute intraindications:  
– Allergy to local anethesia  
– Severe systematic disease  
– Coagulation disorder  
– Local inflamation  
– Patient is too nervous, can not corporate  
• Relative intraindication:  
– Cancer in other location  
Subjects and method  
• Prospective cohort study  
– From January to June 2018  
– 21 woman with 31 lesions  
– Data and pre-, during , post procedure images  
stored in PACS  
– Assess complications post procedure.  
Results  
• Characteristics of subjects  
– Mean of age 37,5± 11,7  
Symptoms  
Number of Percentage %  
lesion  
Pain  
30  
96,8  
63,3  
Pain related menstrual  
period  
19  
27  
Mass papable  
87,1  
8. Oluwole S.F. và Freeman H.P. (1979). Analysis of benign breast lesions in blacks. Am J Surg, 137(6), 786–789.  
9. 9. Park H.-L., Kwak J.-Y., Lee S.-H. và cộng sự. (2005). Excision of Benign Breast Disease by Ultrasound-Guided Vacuum  
Assisted Biopsy Device (Mammotome). Ann Surg Treat Res, 68(2), 96–101.  
Result  
• Result of pathology  
Pathoanatomy  
Fibroadenoma  
Number of lesions  
Percent %  
54,8  
17  
08  
Fibrocystic breast  
disease  
25,8  
abscess  
01  
01  
01  
03,2  
03,2  
03,2  
Sclerosing adenosis  
Papiloma intra  
tubular  
others  
03  
31  
09,7  
100  
Tꢀng  
Result  
Time of  
Amount of Lidocain 2%  
Size on  
pha 1:5 (ml) ultrasound  
(mm)  
biopsy (min) samples  
Mean ± SD 12,3 ± 8,3 10,8 ± 6,7  
10,6 ± 4,1  
11,7 ±5,4  
Mode  
Minimum  
Maximum  
Total  
10,0  
5
8,0  
3
10,0  
5
5
22  
31  
48  
31  
335  
20  
383  
328  
11.  
Clinical application of mammotome minimally invasive biopsy system for excision of 560 benign breast lumps--《Lingnan  
Modern Clinics in Surgery》2007年05期. <http://en.cnki.com.cn/Article_en/CJFDTOTAL-LNWK200705013.htm>, accessed:  
04/06/2018.  
Results  
• There is a proportional correlation between the size of the  
lesions and other factors such as the amount of anesthetics  
used, the volume of the hematoma after the biopsy, the time  
of wound removal and the size of the biopsy needle  
Correlation between  
the volume of lesion  
R
P
Size of biopsy needle Test Mann-Whitney U = 84 0,185  
Volume of hematoma 0,467  
Amount of anesthetic 0,674  
The time of biopsy 0,659  
0,008  
0,000  
0,000  
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