Hematoma-directed ultrasound-guided breast biopsy

LaNette F. Smith, Ronda Henry-Tillman, Steve Harms, Theodore Hronas, Anne T. Mancino, Kent C. Westbrook, Sohelia Korourian, Mary P. Jones, Vicki Klimberg

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective and Summary Background Data: The standard technique for removal of nonpalpable breast lesions is needle localization breast biopsy. Because traumatic hematomas can often be seen with ultrasound, the authors hypothesized that iatrogenically induced hematomas could be used to guide the excision of nonpalpable lesions using ultrasound. Methods: Twenty patients with nonpalpable breast lesions detected by magnetic resonance imaging only were enrolled in this single-institution trial, approved by the institutional review board. A hematoma consisting of 2 to 5 mL of the patient's own blood was injected into the breast to target the nonpalpable lesion. Intraoperative ultrasound of the hematoma was used to direct the excisional biopsy. Results: The average age of women was 53.8 ± 10 years. Ninety-five percent of lesions detected by magnetic resonance imaging were localized by hematoma injection. All the hematomas used to recognize targeted lesions were identified at surgery by ultrasound and removed without complication. Eight (40%) of the lesions were malignant, with an average tumor size of 12 ± 6 mm (range 4-25). The remaining 12 lesions (60%) comprised papillomas, sclerosing adenosis, radial scar, fibroadenoma, and areas of atypical ductal hyperplasia. Conclusion: The results of this pilot study show the effectiveness of hematoma-directed ultrasound-guided breast biopsy for nonpalpable lesions seen by magnetic resonance imaging. This new procedure is potentially more comfortable for the patient because no wire or needle is left in the breast. It is technically faster and easier because ultrasound is used to visualize directly the location of the hematoma at surgery and to confirm lesion removal in the operating room by specimen ultrasound. The hematoma can be placed several days before biopsy, easing scheduling, and without fear of the migration that may occur with needle localization. This method may have ready application to mammographically detected lesions.

Original languageEnglish (US)
Pages (from-to)669-675
Number of pages7
JournalAnnals of Surgery
Volume233
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Hematoma
Breast
Biopsy
Needles
Magnetic Resonance Imaging
Fibroadenoma
Carcinoma, Intraductal, Noninfiltrating
Research Ethics Committees
Papilloma
Operating Rooms
Fear
Cicatrix
Injections

ASJC Scopus subject areas

  • Surgery

Cite this

Smith, L. F., Henry-Tillman, R., Harms, S., Hronas, T., Mancino, A. T., Westbrook, K. C., ... Klimberg, V. (2001). Hematoma-directed ultrasound-guided breast biopsy. Annals of Surgery, 233(5), 669-675. https://doi.org/10.1097/00000658-200105000-00011

Hematoma-directed ultrasound-guided breast biopsy. / Smith, LaNette F.; Henry-Tillman, Ronda; Harms, Steve; Hronas, Theodore; Mancino, Anne T.; Westbrook, Kent C.; Korourian, Sohelia; Jones, Mary P.; Klimberg, Vicki.

In: Annals of Surgery, Vol. 233, No. 5, 2001, p. 669-675.

Research output: Contribution to journalArticle

Smith, LF, Henry-Tillman, R, Harms, S, Hronas, T, Mancino, AT, Westbrook, KC, Korourian, S, Jones, MP & Klimberg, V 2001, 'Hematoma-directed ultrasound-guided breast biopsy', Annals of Surgery, vol. 233, no. 5, pp. 669-675. https://doi.org/10.1097/00000658-200105000-00011
Smith LF, Henry-Tillman R, Harms S, Hronas T, Mancino AT, Westbrook KC et al. Hematoma-directed ultrasound-guided breast biopsy. Annals of Surgery. 2001;233(5):669-675. https://doi.org/10.1097/00000658-200105000-00011
Smith, LaNette F. ; Henry-Tillman, Ronda ; Harms, Steve ; Hronas, Theodore ; Mancino, Anne T. ; Westbrook, Kent C. ; Korourian, Sohelia ; Jones, Mary P. ; Klimberg, Vicki. / Hematoma-directed ultrasound-guided breast biopsy. In: Annals of Surgery. 2001 ; Vol. 233, No. 5. pp. 669-675.
@article{8466d37b17394fdb92b2e49de8d8a205,
title = "Hematoma-directed ultrasound-guided breast biopsy",
abstract = "Objective and Summary Background Data: The standard technique for removal of nonpalpable breast lesions is needle localization breast biopsy. Because traumatic hematomas can often be seen with ultrasound, the authors hypothesized that iatrogenically induced hematomas could be used to guide the excision of nonpalpable lesions using ultrasound. Methods: Twenty patients with nonpalpable breast lesions detected by magnetic resonance imaging only were enrolled in this single-institution trial, approved by the institutional review board. A hematoma consisting of 2 to 5 mL of the patient's own blood was injected into the breast to target the nonpalpable lesion. Intraoperative ultrasound of the hematoma was used to direct the excisional biopsy. Results: The average age of women was 53.8 ± 10 years. Ninety-five percent of lesions detected by magnetic resonance imaging were localized by hematoma injection. All the hematomas used to recognize targeted lesions were identified at surgery by ultrasound and removed without complication. Eight (40{\%}) of the lesions were malignant, with an average tumor size of 12 ± 6 mm (range 4-25). The remaining 12 lesions (60{\%}) comprised papillomas, sclerosing adenosis, radial scar, fibroadenoma, and areas of atypical ductal hyperplasia. Conclusion: The results of this pilot study show the effectiveness of hematoma-directed ultrasound-guided breast biopsy for nonpalpable lesions seen by magnetic resonance imaging. This new procedure is potentially more comfortable for the patient because no wire or needle is left in the breast. It is technically faster and easier because ultrasound is used to visualize directly the location of the hematoma at surgery and to confirm lesion removal in the operating room by specimen ultrasound. The hematoma can be placed several days before biopsy, easing scheduling, and without fear of the migration that may occur with needle localization. This method may have ready application to mammographically detected lesions.",
author = "Smith, {LaNette F.} and Ronda Henry-Tillman and Steve Harms and Theodore Hronas and Mancino, {Anne T.} and Westbrook, {Kent C.} and Sohelia Korourian and Jones, {Mary P.} and Vicki Klimberg",
year = "2001",
doi = "10.1097/00000658-200105000-00011",
language = "English (US)",
volume = "233",
pages = "669--675",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Hematoma-directed ultrasound-guided breast biopsy

AU - Smith, LaNette F.

AU - Henry-Tillman, Ronda

AU - Harms, Steve

AU - Hronas, Theodore

AU - Mancino, Anne T.

AU - Westbrook, Kent C.

AU - Korourian, Sohelia

AU - Jones, Mary P.

AU - Klimberg, Vicki

PY - 2001

Y1 - 2001

N2 - Objective and Summary Background Data: The standard technique for removal of nonpalpable breast lesions is needle localization breast biopsy. Because traumatic hematomas can often be seen with ultrasound, the authors hypothesized that iatrogenically induced hematomas could be used to guide the excision of nonpalpable lesions using ultrasound. Methods: Twenty patients with nonpalpable breast lesions detected by magnetic resonance imaging only were enrolled in this single-institution trial, approved by the institutional review board. A hematoma consisting of 2 to 5 mL of the patient's own blood was injected into the breast to target the nonpalpable lesion. Intraoperative ultrasound of the hematoma was used to direct the excisional biopsy. Results: The average age of women was 53.8 ± 10 years. Ninety-five percent of lesions detected by magnetic resonance imaging were localized by hematoma injection. All the hematomas used to recognize targeted lesions were identified at surgery by ultrasound and removed without complication. Eight (40%) of the lesions were malignant, with an average tumor size of 12 ± 6 mm (range 4-25). The remaining 12 lesions (60%) comprised papillomas, sclerosing adenosis, radial scar, fibroadenoma, and areas of atypical ductal hyperplasia. Conclusion: The results of this pilot study show the effectiveness of hematoma-directed ultrasound-guided breast biopsy for nonpalpable lesions seen by magnetic resonance imaging. This new procedure is potentially more comfortable for the patient because no wire or needle is left in the breast. It is technically faster and easier because ultrasound is used to visualize directly the location of the hematoma at surgery and to confirm lesion removal in the operating room by specimen ultrasound. The hematoma can be placed several days before biopsy, easing scheduling, and without fear of the migration that may occur with needle localization. This method may have ready application to mammographically detected lesions.

AB - Objective and Summary Background Data: The standard technique for removal of nonpalpable breast lesions is needle localization breast biopsy. Because traumatic hematomas can often be seen with ultrasound, the authors hypothesized that iatrogenically induced hematomas could be used to guide the excision of nonpalpable lesions using ultrasound. Methods: Twenty patients with nonpalpable breast lesions detected by magnetic resonance imaging only were enrolled in this single-institution trial, approved by the institutional review board. A hematoma consisting of 2 to 5 mL of the patient's own blood was injected into the breast to target the nonpalpable lesion. Intraoperative ultrasound of the hematoma was used to direct the excisional biopsy. Results: The average age of women was 53.8 ± 10 years. Ninety-five percent of lesions detected by magnetic resonance imaging were localized by hematoma injection. All the hematomas used to recognize targeted lesions were identified at surgery by ultrasound and removed without complication. Eight (40%) of the lesions were malignant, with an average tumor size of 12 ± 6 mm (range 4-25). The remaining 12 lesions (60%) comprised papillomas, sclerosing adenosis, radial scar, fibroadenoma, and areas of atypical ductal hyperplasia. Conclusion: The results of this pilot study show the effectiveness of hematoma-directed ultrasound-guided breast biopsy for nonpalpable lesions seen by magnetic resonance imaging. This new procedure is potentially more comfortable for the patient because no wire or needle is left in the breast. It is technically faster and easier because ultrasound is used to visualize directly the location of the hematoma at surgery and to confirm lesion removal in the operating room by specimen ultrasound. The hematoma can be placed several days before biopsy, easing scheduling, and without fear of the migration that may occur with needle localization. This method may have ready application to mammographically detected lesions.

UR - http://www.scopus.com/inward/record.url?scp=0035033444&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035033444&partnerID=8YFLogxK

U2 - 10.1097/00000658-200105000-00011

DO - 10.1097/00000658-200105000-00011

M3 - Article

VL - 233

SP - 669

EP - 675

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 5

ER -