Vacuum Assisted Breast Biopsy (VAB) is a safe and minimally invasive procedure in which a sample of breast tissue is removed for examination with a vacuum pump. It has advantages over open surgical biopsy: faster patient recovery, and lower cost and patient morbidity. With a biopsy guidance system with tomosynthesis it is possible to locate exactly the depth of target lesion. Before procedure it is necessary to choose most efficient biopsy approach. Also, the knowledge of the patient's mental and physical comorbidities, anticoagulation status, small or thin breasts, and breast implants, is important for a successful biopsy. VAB limiting factors are target less than 10 mm away from the skin (with a minimum notch of 12 mm), and compressed breast that reaches less than 30 mm thick (part of the notch is out of the skin, not being able to perform the VAB). Rolled view is a technique that enables the clinician to perform a VAB in small or thin breasts by providing more tissue depth between the surface and the target lesion. This procedural modification adds versatility to the VAB technique, extending its potential clinical application.
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We report a case of papillary thyroid carcinoma (PTC) discovered by elastography (E). A 54 years old female with a studied thyroid nodule during 5 years, was performed E. This study shown an inner area of stiffness, that was punctured. The cytology reported suspicious of papillary carcinoma. The E improves the diagnostic performance of ultrasound (US). It is an additional tool that helps guide fine-needle aspiration (FNA) and estimates preoperative malignancy risk.
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