Role of vacuum assisted biopsy(mammotome) in early detection of breast cancer

Background: The role of vacuum-assisted biopsy tecnique (Mammotome) in detection of early breast cancer (eBC) is still under evaluation. This minimal invasive device has similar diagnostic accuracy of conventional core biopsy with few traumatisms and aesthetical consequences. However mammotome can understimate some pathologies such as atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). The aim of our study is to evaluate advantages of eco-guided mammotome biopsy in early detection and eventual complete excision of BC. Patients and methods: Form January 2003 to January 2006, 229 female patients (pts) with breast lesions were studied. The average age was 48 years (range 19–75). Performance status (ECOG) was 0/1. The previous ultrasound examination showed regular lesions in 173 pts (75,6%), irregular nodules in 39 pts (16,9 %), poly-lobate nodules in 13 pts (5,6%) and dishomogeneous echostructure in 4 pts (1,7%). In 181 patients a rx mammography was also performed. All patients underwent biopsy under echographic guidance using Mammotome with 11-Gauge needle. Results: Hystology of biopsies carried out with Mammotome confirmed the benign nature (fibroadenoma) of all 173 pts with echographically regular nodules. There were 12 positive malignant pathology (10 ductal, 2 lobular infiltrating carcinoma), 17 benign sclerosis adenosing lesions, 4 ADH and 4 fibroadenomas diagnosed in pts with irregular nodules. The remaining biopsies showed NOS benign lesions. The procedure was well tolerated and no side effects were reported. The only complication of Mammotome biopsy is represented by haematoma in a low percentage of pts Conclusion: Mammotome biopsy of echographically evidenced lesions of the breast, in our experience, is preferable if suspicion of malignancy is high. Comparing with FNAC it gives more informations in terms of invasivity, grading, histotype and hormonal receptors. It is a well tolerated procedure with little discomfort for the patient. Today this device could be considered as an innovative technique for the diagnosis of BC against it incisional and excisional biopsy and FNAC too.