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.