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ABSTRACT: The gold standard for breast biopsy procedures is currently an open excision of the suspected lesion. However, an excisional biopsy inevitably makes a scar. The cost and morbidity associated with this procedure has prompted many physicians to evaluate less invasive, alternative procedures. More recently, image-guided percutaneous core-needle biopsy has become a frequently used method for diagnosing palpable and non-palpable breast lesions. Although sensitivity rates for core-needle biopsy are high, it has the disadvantage of histological underestimation, which renders the management of atypical ductal hyperplasia, papillary lesions, and fibroepithelial lesions somewhat difficult. Vacuum assisted breast biopsy (VABB) was developed to overcome some of these negative aspects of core-needle biopsy. VABB allows for a sufficient specimen to be obtained with a single insertion and can provide a more accurate diagnosis and completely remove the lesion under real-time ultrasonic guidance. The advantage of complete lesion removal with VABB is to reduce or eliminate sampling error, to decrease the likelihood of a histological underestimation, to decrease imaging-histological discordance, to decrease the re-biopsy rate, and to diminish the likelihood of subsequent growth on follow-up. In recent years, with the advancement of VABB instruments and techniques, many outcome studies have reported on the use of VABB for resecting benign breast lesions with a curative intent. VABB is highly accurate for diagnosing suspicious breast lesions and is highly successful at treating presumed benign breast lesions. Thus, in the near future, VABB will be routinely offered to all appropriately selected patients.
Journal of breast cancer. 03/2011; 14(1):1-7.
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Sei Hyun Ahn,
Byung Ho Son,
Kyung-Sik Yoon,
Dong-Young Noh,
Wonshik Han,
Sung-Won Kim,
Eun Sook Lee, Hai-Lin Park,
Young Joon Hong,
Jae Jin Choi,
Seo Yun Moon,
Mi Jeong Kim,
Kye Hyun Kim,
Beom Seok Kwak,
Dae-Yeon Cho
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ABSTRACT: We analyzed the mutation spectrum of BRCA1 and BRCA2 genes in 354 Korean breast cancer patients. Overall, 40 patients carried 25 distinct BRCA1/2 mutations including 12 novel mutations. Seven district mutations were found in multiple unrelated patients, with the BRCA2 c.7480C>T mutation detected in eight unrelated patients, accounting for 50% of the mutations detected in BRCA2. The large number (25/40, 62.5%) of recurrent mutations suggests the possibility of developing a simple screening test for these mutations. The frequency of mutations was related to the number and kinds of risk factors, varying from 10.4 to 25% in the five major risk factor groups. The frequency of BRCA mutations in patients with two or more risk factors was markedly higher than that in patients with one risk factor.
Cancer Letters 01/2007; 245(1-2):90-5. · 4.24 Impact Factor
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ABSTRACT: The purpose of our study was to evaluate the utility of the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) sonographic final assessment system and palpation-guided fine-needle aspiration (FNA) for evaluation of palpable breast lesions.
Our computerized database identified 160 palpable lesions of the breast in which follow-up palpation-guided FNA, targeted sonography, and pathologic confirmation were performed. We used BI-RADS sonographic data on all lesions. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of malignancy were calculated for sonography and palpation-guided FNA. Two-sample binomial proportion tests were used as the statistical analysis (P<.05).
The FNA results were defined as benign, atypical cells, suspicious for malignancy, malignancy, and insufficiency. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 90.9%, 82.7%, 84.3%, 57.7%, and 97.2%, respectively, on sonography and 75.8% to 90.9%, 82.7% to 98.4%, 84.3% to 94.4%, 57.7% to 92.6%, and 93.9% to 97.2% on FNA. There was no statistically significant difference for sensitivity and negative predictive value between the two examinations.
The diagnostic accuracy of sonography was similar to that of palpation-guided FNA for not missing the malignancy. Clinical application of FNA results can be difficult, especially when the result is insufficiency or atypical cells. Moreover, FNA is invasive and overlaps other procedures. Therefore, we conclude that sonography can replace palpation-guided FNA for diagnosis of palpable lesions of the breast when the BI-RADS sonographic final assessment system is used appropriately.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 11/2006; 25(10):1255-61. · 1.25 Impact Factor
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ABSTRACT: A 37-year-old woman presented with breast pain after breast augmentation utilizing autologous fat obtained by liposuction. Mammography and sonography demonstrated fat necrosis in the right breast and a solid inflammatory mass in the left breast. The diagnoses were confirmed by biopsy.
Journal of Clinical Ultrasound 32(6):299-301. · 0.81 Impact Factor
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ABSTRACT: A 52-year-old man presented with a palpable left neck mass that had been present for several months. A sonogram showed a 2-cm hypoechoic mass with internal coarse macrocalcifications in the left lobe of the thyroid gland. CT revealed a well-demarcated hypodense mass within the left thyroid lobe. A left thyroidectomy was performed at the patient's request because of the possibility of malignancy based on sonographic findings. Pathologically, the mass was composed of pseudostratified ciliated columnar epithelial cells simulating respiratory epithelium surrounded by florid lymphoid hyperplasia with germinal centers, consistent with an intrathyroidal lymphoepithelial cyst.
Journal of Clinical Ultrasound 34(6):298-300. · 0.81 Impact Factor
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ABSTRACT: Epidermal inclusion cysts rarely occur in the breast, but when they do, the consequences can be severe. Here, we report the case of a 23-year-old woman who presented with a palpable mass in the right breast. The mass had persisted for 4 years and had been causing pain for 1 month at the time of the patient's presentation. We examined the mass by means of mammography and sonography. Sonographic examination revealed a well-circumscribed solid, avascular mass suggestive of an epidermal inclusion cyst. Excision was performed at the patient's request. Histopathologic examination of the mass after excision confirmed the diagnosis of epidermal inclusion cyst and its localization within the breast parenchyma. To our knowledge, reports on epidermal inclusion cysts within the breast parenchyma are rare.
Journal of Clinical Ultrasound 32(3):141-3. · 0.81 Impact Factor
