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Margin-free excision of small solid breast carcinomas using the Intact Breast Lesion Excision System®: is it feasible?

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Abstract

Background

The Breast Lesion Excision System® (BLES®) is a stereotactic vacuum-assisted breast biopsy device that utilizes radiofrequency in order to excise non-palpable mammographic lesions for pathologic diagnosis. The purpose of this study was to evaluate the efficacy of BLES® in performing complete, margin-free excisions of small solid carcinomas.

Methods

Our retrospective study of prospectively enrolled patients included 50 cases of non-palpable, BIRADS ≥ 4, solid by means of mammography and sonography, lesions. All these patients underwent a BLES® breast biopsy procedure from June 2010 to June 2014 and had a malignant diagnosis. According to each patient’s pathologic diagnosis, appropriate surgical treatment was recommended. Postoperatively, surgical specimens were histologically analyzed, aiming to determine whether residual malignant disease was present in the specimen cavity formatted by BLES®.

Results

Ductal carcinoma in situ (DCIS) was diagnosed in 5 patients and invasive carcinoma (IC) in 45 patients, at primary BLES® pathology report. Tumor-free resection margins (< 0.5 and < 1 mm) were accomplished in only 8/24 subcentimeter cases (33.3%). Absence of residual disease upon surgical excision was confirmed in 23/24 subcentimeter cases (95.8%) and 2/26 of the cases measuring > 1 cm (7.69%). Statistical analysis revealed that mammographic size was the only significant prognostic factor for complete excision (i.e., with no residual disease in the biopsy cavity) of a malignant lesion.

Conclusions

Our results indicate that it is possible, when using the BLES® device, to completely excise small (≤ 10 mm) breast carcinomas that appear radiologically as solid lesions. This subset of patients should be investigated regarding the therapeutic potential of this method.

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Author information

Author notes

  1. Ioannis K. Papapanagiotou

    Present address: , 68 Meteoron Str., Glyfada, 16562, Athens, Greece

Authors and Affiliations

  1. Breast Unit, 1st Propaedeutic University Surgery Clinic, Hippocratio General Hospital, University of Athens, Vas. Sofias 114, 115 27, Athens, Greece

    Ioannis K. Papapanagiotou, Vasileios Kalles, Paraskevi Liakou, Nikolaos V. Michalopoulos, Wasim Al-Harethee, Georgia Georgiou, Maria Matiatou, Anastasia Pazaiti, Georgios E. Theodoropoulos, Evangelos Menenakos & Georgios C. Zografos

  2. Department of Radiology, Hippocratio General Hospital, University of Athens, Vas. Sofias 114, 115 27, Athens, Greece

    Dimitra Koulocheri

  3. Department of Pathology, School of Medicine, University of Athens, Tetrapoleos 18, 115 27, Athens, Greece

    Afroditi Nonni

Authors
  1. Ioannis K. Papapanagiotou
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  2. Dimitra Koulocheri
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  5. Nikolaos V. Michalopoulos
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  6. Wasim Al-Harethee
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  7. Georgia Georgiou
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  11. Georgios E. Theodoropoulos
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  12. Evangelos Menenakos
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  13. Georgios C. Zografos
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Corresponding author

Correspondence to Ioannis K. Papapanagiotou.

Ethics declarations

Ethical approval–patient consent

Approval for this present study was obtained by the Ethics Committee and the Scientific Board of our University Hospital. Furthermore, a written consent was also acquired from all our patients.

Funding source

No funding body or any other commercial sponsorship was obtained for this study.

Conflict of interest

The authors declare no conflict of interest, financial or otherwise, in the data acquisition or preparation of this paper.

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Papapanagiotou, I.K., Koulocheri, D., Kalles, V. et al. Margin-free excision of small solid breast carcinomas using the Intact Breast Lesion Excision System®: is it feasible?. Breast Cancer 25, 134–140 (2018). https://doi.org/10.1007/s12282-017-0802-z

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  • DOI: https://doi.org/10.1007/s12282-017-0802-z

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