Hye Young Choi MD, Presenter: Nothing to Disclose

Eun Sook Ko MD, Abstract Co-Author: Nothing to Disclose

Jinjong You MD, Abstract Co-Author: Nothing to Disclose

The aims of this study are to evaluate periodic changes at ultrasound (US) after total removal by US-guided directional vacuum-assisted biopsy (VAB) of benign breast lesions, and to determine factors that may influence on it.

For 26 benign lesions that had been totally removed of all US evidence during US-guided directional VAB performed with 8-gauge or 11-gauge needles, US changes were prospectively evaluated 1 week, 1 month, and 6 months after biopsy. Patient satisfaction and expectation for accuracy were assessed on the basis of a patient-completed questionnaire.

No significant adverse events were occurred during the procedure. At 1-week follow-up, hematomas were observed in 81% (20/26) of patients. 1 month after biopsy, although hematomas were resolved except two patients, severe architectural distortions mimicking malignancy were newly developed in all patients. 6 months after biopsy, all patients had variable degrees of architectural distortion, but less severe compared to 1-month follow-up. Among these 26 patients, three (12%) had a residual lesion. In terms of degrees of hematoma or architectural distortion there were no association with factors such as needle gauge, number of specimens, size of the lesion. 23 patients had various complaints during the procedure. The most common complaint during the procedure was anxiety about cancer (78%, 18/23), three reported pain, and two reported uncomfortable positioning. 1 week after biopsy, the most common complaint was anxiety for residual lesion (58%, 14/24). Expected accuracy of the procedure was about 70% in 58% (15/26) of patients.

Directional VAB of the breast produces changes that alter sonographic appearance at follow-up image. Familiarity with these changes is important to avoid unnecessary biopsies in patients treated with US-guided VAB.

US-guided VAB produces changes on follow-up imaging mimicking malignancy. Knowledge about these changes may prevent unnecessary recall or biopsy for the patient treated with US-guided VAB.

Choi, H, Ko, E, You, J, Periodic US Findings after Removal of All US Evidence during Biopsy by US-guided Vacuum-assisted Device.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015073.html