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Stereotactic Radioguided Surgery by SiteSelect for Subclinical Mammographic Lesions

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Abstract

Background

We defined the indications for and evaluated the results of a new technique for radioguided surgery, the SiteSelect system. The procedure allows en-bloc resection of the breast parenchyma under local anesthesia.

Methods

This prospective study was based on 167 patients operated on between December 2000 and October 2003 with 2 phases. The first step was an evaluation of the feasibility of the procedure with the 15-mm cannula, and the second was therapeutic with the 22-mm cannula.

Results

The mean duration of the procedure was 42 minutes. In 96.9% of procedures, the lesion was excised successfully. Only one complication (hematoma) and two failures and were observed. Histological examination revealed benign disease in 65.8% of cases and cancer in 34.2% of cases. In the latter cases, the specimen margins were histologically involved in 86.2% of cases with the 15-mm procedure and in 41% with the 22-mm procedure. During the first evaluation, all patients with a cancer underwent systematic surgical re-excision: residual tumor was present in 18 cases (64.2%). The biopsy was painless for 88 patients, and the cosmetic result was good in all cases.

Conclusions

This study shows that the SiteSelect procedure allows resection of the lesion in 96.9% of cases. Combined with complementary surgical lumpectomy during the same operation, this procedure achieved a success rate of 98.7%. In the case of cancer, the 15-mm cannula is not wide enough to allow free margins. The use of a new 22-mm cannula, currently under evaluation, might solve this problem.

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References

  1. SH Parker JD Lovin WE Jobe et al. (1990) ArticleTitleStereotactic breast biopsy with a gun Radiology 176 741–7 Occurrence Handle2167501 Occurrence Handle1:STN:280:By%2BA2Mnnsl0%3D

    PubMed  CAS  Google Scholar 

  2. SH Parker JD Lovin WE Jobe BJ Burke KD Hopper WF Yakes (1991) ArticleTitleNon palpable breast lesions: stereotactic automated large-core biopsies Radiology 180 403–7 Occurrence Handle1648757 Occurrence Handle1:STN:280:By6B1MjgslE%3D

    PubMed  CAS  Google Scholar 

  3. F Burbank (1997) ArticleTitleMammographic findings after 14-gauge automated needle and 14-gauge directional, vacuum-assisted stereotactic breast biopsies Radiology 204 153–6 Occurrence Handle9205238 Occurrence Handle1:STN:280:ByiA2cbitlA%3D

    PubMed  CAS  Google Scholar 

  4. L Liberman DD Dershow EA Morris AF Abramson CM Thornton PP Rosen (1997) ArticleTitleClip placement after stereotactic vacuum-assisted breast biopsy Radiology 205 417–22 Occurrence Handle9356622 Occurrence Handle1:STN:280:DyaK1c%2FhvFCgtw%3D%3D

    PubMed  CAS  Google Scholar 

  5. F Burbank SH Parker (1998) ArticleTitleMethods for evaluating the quality of an image-guided breast biopsy program Semin Breast Dis 1 71–83

    Google Scholar 

  6. RJ Jackman F Burbank SH Parker et al. (2001) ArticleTitleStereotactic breast biopsy of non palpable lesions: determinants of ductal carcinoma in situ underestimation rates Radiology 218 497–502 Occurrence Handle11161168 Occurrence Handle1:STN:280:DC%2BD3M3lvVeisw%3D%3D

    PubMed  CAS  Google Scholar 

  7. E Lifrange RF Dondelinger V Fridman C Colin (2001) ArticleTitleEn bloc excision of nonpalpable breast lesions using the advanced breast biopsy instrumentation system: an alternative to needle guided surgery? Eur Radiol 11 796–801 Occurrence Handle11372610 Occurrence Handle1:STN:280:DC%2BD38%2FhtVKjug%3D%3D

    PubMed  CAS  Google Scholar 

  8. WR Marti M Zuber D Oertli et al. (2001) ArticleTitleAdvanced breast biopsy instrumentation for the evaluation of impalpable lesions: a reliable diagnostic tool with little therapeutic potential Eur J Surg 167 15–8 Occurrence Handle11213814 Occurrence Handle1:STN:280:DC%2BD3MzitFOguw%3D%3D

    PubMed  CAS  Google Scholar 

  9. HI Vargas RV Agbunag I Khaikhali (2000) ArticleTitleState of the art of minimally invasive breast biopsy: principles and practice Breast Cancer 7 370–9 Occurrence Handle11114867 Occurrence Handle1:STN:280:DC%2BD3M3lvFyisg%3D%3D Occurrence Handle10.1007/BF02966407

    Article  PubMed  CAS  Google Scholar 

  10. N Atallah R Karam T Younane G Aftimos (2000) ArticleTitleStereotaxic excisional biopsy of non-palpable breast lesions by the ABBI (Advanced Breast Biopsy Instrumentation) technique. Advantages. Disadvantages. Indications. Apropos of 67 cases J Med Liban 48 70–6 Occurrence Handle11028153 Occurrence Handle1:STN:280:DC%2BD3cvnslOjtg%3D%3D

    PubMed  CAS  Google Scholar 

  11. RL Smathers (2000) ArticleTitleAdvanced breast biopsy instrumentation device: percentages of lesion and surrounding tissue removed AJR Am J Roentgenol 175 801–3 Occurrence Handle10954470 Occurrence Handle1:STN:280:DC%2BD3cvnsFejsQ%3D%3D

    PubMed  CAS  Google Scholar 

  12. BS Schwartzberg JJ Goates SA Keeler JA Moore (2000) ArticleTitleUse of advanced breast biopsy instrumentation while performing stereotactic breast biopsies: review of 150 consecutive biopsies J Am Coll Surg 191 9–15 Occurrence Handle10898178 Occurrence Handle1:STN:280:DC%2BD3czlsVGnsQ%3D%3D

    PubMed  CAS  Google Scholar 

  13. E Lifrange C Colin (2000) ArticleTitleSupraconservative breast surgery J Gynecol Obstet Biol Reprod 29 285–7 Occurrence Handle1:STN:280:DC%2BD3c3ms1Sgtw%3D%3D

    CAS  Google Scholar 

  14. GS Ferzli T Puza S Vanvorst-Bilotti R Waters (1999) ArticleTitleBreast biopsies with ABBI(R): experience with 183 attempted biopsies Breast J 5 26–8 Occurrence Handle11348252

    PubMed  Google Scholar 

  15. ER Denton MJ Michell AR Wilson P Britton (1999) ArticleTitleStereotactic excisional breast biopsy performed by interventional radiologists using the ABBI system Br J Radiol 72 828–9 Occurrence Handle10624356 Occurrence Handle1:STN:280:DC%2BD3c%2FovFCrsA%3D%3D

    PubMed  CAS  Google Scholar 

  16. V Velanovich FR Lewis SuffixJr SD Nathanson et al. (1999) ArticleTitleComparison of mammographically guided breast biopsy techniques Ann Surg 229 625–30 Occurrence Handle10235520 Occurrence Handle1:STN:280:DyaK1M3kvFGquw%3D%3D

    PubMed  CAS  Google Scholar 

  17. AJ Leibman D Frager P Choi (1999) ArticleTitleExperience with breast biopsies using the Advanced Breast Biopsy Instrumentation system AJR Am J Roentgenol 172 1409–12 Occurrence Handle10227527 Occurrence Handle1:STN:280:DyaK1M3kt1SltA%3D%3D

    PubMed  CAS  Google Scholar 

  18. B Damascelli LF Frigerio R Lanocita et al. (1998) ArticleTitleStereotactic excisional breast biopsy performed by interventional radiologists using the advanced breast biopsy instrumentation system Br J Radiol 71 1003–11 Occurrence Handle10211058 Occurrence Handle1:STN:280:DyaK1M3islGjtg%3D%3D

    PubMed  CAS  Google Scholar 

  19. M Bloomston P D’Angelo D Galliano J Butler SuffixJr R Dean AS Rosemurgy (1999) ArticleTitleOne hundred consecutive advanced breast biopsy instrumentation procedures: complications, costs, and outcome Ann Surg Oncol 6 195–9 Occurrence Handle10082046 Occurrence Handle1:STN:280:DyaK1M7otVSrsQ%3D%3D

    PubMed  CAS  Google Scholar 

  20. RJ Jackman F Burbank SH Parker et al. (1997) ArticleTitleAtypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted breast biopsy Radiology 204 485–8 Occurrence Handle9240540 Occurrence Handle1:STN:280:ByiA1c3ltlI%3D

    PubMed  CAS  Google Scholar 

  21. CC Corn (2003) ArticleTitleReview of 125 SiteSelect stereotactic large-core breast biopsy procedures Breast J 9 147–52 Occurrence Handle12752621

    PubMed  Google Scholar 

  22. M Rebner R Chesbrough N Gregory (1999) ArticleTitleInitial experience with the advanced breast biopsy instrumentation device AJR Am J Roentgenol 173 221–6 Occurrence Handle10397130 Occurrence Handle1:STN:280:DyaK1Mzitlamuw%3D%3D

    PubMed  CAS  Google Scholar 

  23. SH Parker (1998) ArticleTitleThe Advanced Breast Biopsy Instrumentation: another Trojan horse? AJR Am J Roentgenol 171 51–3 Occurrence Handle9648762 Occurrence Handle1:STN:280:DyaK1czhtFSqtA%3D%3D

    PubMed  CAS  Google Scholar 

  24. SE Singlebarry BD Fornage N Sneige et al. (2002) ArticleTitleRadiofrequency ablation of early-stage invasive breast tumors: an overview Cancer J 8 177–80 Occurrence Handle10.1097/00130404-200203000-00011

    Article  Google Scholar 

  25. F Izzo R Thomas P Delrio et al. (2001) ArticleTitleRadiofrequency ablation in patients with primary breast carcinoma: a pilot study in 26 patients Cancer 92 2036–44 Occurrence Handle10.1002/1097-0142(20011015)92:8<2036::AID-CNCR1542>3.0.CO;2-W Occurrence Handle1:STN:280:DC%2BD3MrkvVKgug%3D%3D Occurrence Handle11596017

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Virginie Doridot MD.

Additional information

(Brigitte Sigal-Zafrani) On behalf of the Institut Curie Breast Cancer Group (Appendix 1).

Appendix 1

Appendix 1

The members of the Institut Curie Breast Cancer Group are as follows: Bernard Asselain, MD, Alain Aurias, MD, Emmanuel Barillot, MD, Francois Campana, MD, Krishna Clough, MD, Patricia De Cremoux, MD, Olivier Delattre, MD, Veronique Dieras, MD, Jean-Marc Extra, MD, Alain Fourquet, MD, Henri Magdelenat, MD, Martine Meunier, MD, Claude Nos, MD, Thao Palangie, MD, Pierre Pouillart, MD, Marie-France Poupon, MD, Francois Radvanyi, MD, Xavier Sastre-Garau, MD, Brigitte Sigal-Zafrani, MD, Dominique Stoppa-Lyonnet, MD, Anne Tardivon, MD, Fabienne Thibault, MD, Jean Paul Thiery, MD, and Anne Vincent-Salomon, MD.

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Doridot, V., Meunier, M., Khoury, C.E. et al. Stereotactic Radioguided Surgery by SiteSelect for Subclinical Mammographic Lesions. Ann Surg Oncol 12, 181–188 (2005). https://doi.org/10.1245/ASO.2005.01.004

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  • DOI: https://doi.org/10.1245/ASO.2005.01.004

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