Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique

Rocha, Rafael Dahmer; Pinto, Renata Reis; Tavares, Diogo Paes Barreto Aquino; Gonçalves, Cláudia Sofia Aires

doi:10.1590/s0100-39842013000400010

Cited by 19 publications

(21 citation statements)

References 46 publications

(103 reference statements)

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“…The introduction of new techniques has allowed the diagnosis of early-stage lesions and more conservative treatments. Currently, the histopathological diagnosis of breast cancer is carried out by means of minimally invasive methods, whenever possible by means of imaging-guided percutaneous biopsy ( 1 ) . On its turn, the evaluation of axillary lymph node staging constitutes one of the most relevant prognostic indicators for breast cancer patients ( 2 - 8 ) , as the axilla is the receptor of approximately 95% of the breast lymphatic drainage ( 9 , 10 ) .…”

Section: Introductionmentioning

confidence: 99%

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

et al. 2015

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ObjectiveTo propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer.Materials and MethodsProspective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA.ResultsThe overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases.ConclusionAxillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy.

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Section: Introductionmentioning

confidence: 99%

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

et al. 2015

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“…The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). Global accuracy was assessed as very good (8), good (12), moderate (3), poor (2) and very poor (0). At least one enhancing MR lesion was identified in all participants.…”

Section: Resultsmentioning

confidence: 99%

“…However, when undertaking procedures such as biopsy and guide wire insertion under realtime ultrasound control, the technique used can impede direct rtMRnUS control. During biopsy and guide wire insertion, the breast is compressed by the transducer and the operator's hand to ensure immobilization of the lesion during the procedure [12]. This immobilization results in a loss of registration due to deformation, as outlined above.…”

Section: Discussionmentioning

confidence: 99%

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Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

Pickles

Gibbs

Hubbard

et al. 2018

Senologie - Zeitschrift für Mammadiagnostik und -therapie

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Purpose To report the feasibility, accuracy and initial clinical experience of the use of real-time magnetic resonance navigated ultrasound (rtMRnUS) in the surgical planning of breast-conserving surgery (BCS) via guide wire insertion. Materials and Methods 29 participants were recruited into this prospective ethics committee approved study. The first 4 cases were utilized as a training set. Participants underwent a supine contrast-enhanced breast MR examination with external fiducials and corresponding ink marks placed on the skin of the affected breast to act as co-registration pairs. MR examinations included both functional and morphological images. A LOGIQ E9 ultrasound system (GE Healthcare, Milwaukee, WI, USA) equipped with a 6 – 15 MHz transducer was utilized for rtMRnUS. To facilitate point co-registration of the previously acquired MR dataset with the real-time ultrasound, co-registration pairs were identified on both imaging modalities. The following co-registration quality metrics were recorded: root mean square deviation (RMSD), lesion and global accuracies. Post co-registration guide wire insertion was performed. Results Co-registration was successfully undertaken in all participants. Results from 25 participants are presented. The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). The global accuracy was assessed as very good (8), good (12), moderate (3) and poor (2) while the median (min, max) lesion accuracy was recorded at 8.9 mm (2.1 mm, 33.2 mm). Conclusion The use of rtMRnUS to facilitate guide wire insertion is a feasible technique. Generally, very good or good global registration can be expected. Lesion accuracy results indicate that a median difference, in 3 D space, of 9 mm can be expected between imaging modalities.

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“…However, when undertaking procedures such as biopsy and guide wire insertion under real-time ultrasound control the technique used can impede direct rtMRnUS control. During biopsy and guide wire insertion the breast is compressed by the transducer and the operator's hand to ensure immobilisation of the lesion during the procedure [12]. This immobilisation results in a loss of registration due to deformation, as outlined above.…”

Section: Discussionmentioning

confidence: 99%

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

et al. 2015

View full text Add to dashboard Cite

To report the feasibility, accuracy and initial clinical experience of the use of real-time magnetic resonance navigated ultrasound (rtMRnUS) in the surgical planning of breast-conserving surgery (BCS) via guide wire insertion. 29 participants were recruited into this prospective ethics committee approved study. The first 4 cases were utilized as a training set. Participants underwent a supine contrast-enhanced breast MR examination with external fiducials and corresponding ink marks placed on the skin of the affected breast to act as co-registration pairs. MR examinations included both functional and morphological images. A LOGIQ E9 ultrasound system (GE Healthcare, Milwaukee, WI, USA) equipped with a 6 - 15 MHz transducer was utilized for rtMRnUS. To facilitate point co-registration of the previously acquired MR dataset with the real-time ultrasound, co-registration pairs were identified on both imaging modalities. The following co-registration quality metrics were recorded: root mean square deviation (RMSD), lesion and global accuracies. Post co-registration guide wire insertion was performed. Co-registration was successfully undertaken in all participants. Results from 25 participants are presented. The median (min, max) RMSD was 3.3 mm (0.6 mm, 8.8 mm). The global accuracy was assessed as very good (8), good (12), moderate (3) and poor (2) while the median (min, max) lesion accuracy was recorded at 8.9 mm (2.1 mm, 33.2 mm). The use of rtMRnUS to facilitate guide wire insertion is a feasible technique. Generally, very good or good global registration can be expected. Lesion accuracy results indicate that a median difference, in 3 D space, of 9 mm can be expected between imaging modalities.

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Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique

Cited by 19 publications

References 46 publications

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

Registration of Supine MR Mammography with Breast Ultrasound for Surgical Planning of Breast Conserving Surgery: A Feasibility Study

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