Η χρήση των ραδιοσυχνοτήτων στη βιοψία εκτομής μη ψηλαφητών μαστογραφικών αλλοιώσεων: μελέτη των επιπλοκών της μεθόδου

Abstract

OBJECTIVE:The Breast Lesion Excision System (BLES) is a novel, automatic breast biopsy device that utilizes radiofrequency to excise suspicious non-palpable mammographic lesions. The purpose of the present prospective study is to report and evaluate the complications of this new technique along with the thermal damage in the tissue.MATERIALS AND METHODS:We used the BLES device in 132 consecutive patients (134 procedures) with non-palpable mammographic lesions. The inclusion criteria consisted of suspicious microcalcifications, solid lesions and asymmetric density. In order to retrieve an intact biopsy specimen, we used the 12mm, 15mm or 20mm tissue basket under local anesthesia, depending on the size of the lesion. Complications were recorded and classified as immediate if occurring during or shortly after the procedure, or late, if occurring in the post-procedure days. For the evaluation of the thermal tissue damage we used the BLES device in 265 patients with non-palpable mammographic lesions performing 273 stereotactic biopsies. Thermal damage was recorded and stratified to severe damage, moderate damage, minor damage and no damage. In addition we estimated the percent of lipocytes in the specimen.RESULTS:The procedure was considered successful in all cases, with mammographic confirmation of appropriate excision of the targeted lesion. Although, in a single case the basket initially failed to deploy. Immediate complications were encountered in 11 patients, with minor hemorrhage being the most common (n=6). 17 patients suffered late complications, in seven of whom delayed wound healing was observed. Overall, 27 patients suffered Grade 1 complications (20.14%), one patient experienced a Grade 2 complication while no patients encountered Grade 3-5 complications. .Thermal damage was noticed in 14 cases (5.13%). Severe thermal damage was present in 5 specimens (4 with benign lesions, 1IDC). Moderate damage occurred in 5 specimens (4 with benign lesions, 1IDC) and minor damage was present in 4 specimens all of them benign. A statistically significant positive correlation was noticed between the lipocyte percent and the thermal damage (p<0.05). CONCLUSIONS:According to our experience, the BLES device is an efficient and safe breast biopsy method, with low complication rates, which are minor in their majority. In addition the frequency of thermal damage in the specimen was relatively low and did not seem to interfere with diagnosis. It appears to be a very promising alternative to other, minimally invasive, breast biopsy techniques.