Surgeon-Performed Vacuum-Assisted Biopsy of the Breast: Results from a Multicentre Australian Study
Surgeon-Performed Vacuum-Assisted Biopsy of the Breast: Results from a Multicentre Australian Study
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DOI：
10.1007/s00268-019-05266-7
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发表时间：
2019-11-11
影响因子：
2.6
通讯作者：
Saboo, Apoorva
中科院分区：
文献类型：
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作者：
Bennett, Ian;de Viana, Daniel;Saboo, Apoorva
背景图像引导介入技术，如真空辅助活检，越来越多地用于乳腺疾病的诊断和管理。本研究的目的是报告一系列真空辅助活检和真空辅助切除术的结果，这些手术是由专业乳腺外科医生在门诊进行的。方法在澳大利亚进行了一项多中心试验，在三个参与中心的三名外科医生参与下，对乳腺病变进行超声引导下外科医生进行真空辅助活检（VAB）和真空辅助切除（VAE）。仅对假定或证实的良性乳腺病变进行VAE。结果197例患者共进行了225例超声引导下真空辅助手术。在225例VAB手术中，51例（22.7%）作为诊断性核心进行，174例（77.3%）作为核心切除进行。在174例旨在完全切除病变的VAE手术中，165例（94.8%）成功切除病变，通过术后超声检查无任何病变或后续间隔超声检查无病变来判断是否完全切除。共199例手术在门诊患者中局部麻醉下进行，26例手术在手术室中neurolept麻醉下进行。诊断性核心组的平均病变尺寸为19.3 mm，核心切除组为10.6 mm。两种手术的平均时间约为14 min。结论熟悉超声的专业乳腺外科医生可以很容易地提高技能，安全，迅速地进行真空辅助手术。VAE是一种微创的乳腺病变治疗方法，是一种乳腺外科医生应该熟练掌握的技术。
Background Image-guided interventional techniques such as vacuum-assisted biopsy are being increasingly utilised in the diagnosis and management of breast conditions. The purpose of this study was to report the outcome of a series of vacuum-assisted biopsies and vacuum-assisted excisions performed by specialist breast surgeons in a largely outpatient setting. Methods An Australian multicentre trial of ultrasound-guided surgeon-performed vacuum-assisted biopsy (VAB) and vacuum-assisted excision (VAE) of breast lesions was conducted involving three surgeons in three participating centres. VAEs were performed for presumed or proven benign breast lesions only. Results A total of 225 surgeon-performed ultrasound-guided vacuum-assisted procedures were undertaken in 197 patients. Of the 225 VAB procedures, 51 (22.7%) were performed as diagnostic cores and 174 (77.3%) were undertaken as core excisions. Of the 174 VAE procedures undertaken with intent of completely excising the lesion, successful excision of the lesion was achieved in 165 of these cases (94.8%), with complete excision being judged by the absence of any lesion seen on ultrasound following the procedure or the absence of the lesion on a subsequent interval ultrasound examination. A total of 199 procedures were performed in the outpatients setting under local anaesthesia, and 26 procedures were performed in an operating theatre setting under neurolept anaesthesia. The average size of lesions was 19.3 mm in the diagnostic core group and 10.6 mm in the core excision group. The average time for either procedure was approximately 14 min. Conclusion Specialist breast surgeons familiar with ultrasound can be readily upskilled to perform vacuum-assisted procedures safely and expeditiously. VAE represents a minimally invasive method of breast lesion management and is a technique with which breast surgeons should become adept.