Breast Lesion Excision System in the diagnosis and treatment of intraductal papillomas – A feasibility study

Niinikoski, Laura; Hukkinen, Katja; Leidenius, Marjut; Ståhls, Anders; Meretoja, Tuomo J.

doi:10.1016/j.ejso.2017.10.213

Cited by 12 publications

(27 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Five hundred eighteen articles were excluded because they did not use the BLES device or a prototype. We identified 19 full-text versions of studies that used the BLES as a diagnostic or therapeutic device and that fulfilled all the inclusion criteria [4][5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Figure 3 shows the results of the study search and identification of eligible studies.…”

Section: Studiesmentioning

confidence: 99%

“…Ten studies used stereotactic guidance during the BLES procedure [4,6,7,9,11,13,15,16,20,22]. Six studies used stereotactic or ultrasound guidance [5,10,12,14,21,23]; only Graham [17] performed all BLES procedures with ultrasound guidance.…”

Section: Studiesmentioning

confidence: 99%

“…Eight studies were performed for diagnostic purposes only [4,6,7,9,11,13,15,17]. In two studies, one or more biopsies were performed to remove benign lesions for which histology was already known [21,23]. One study aimed at a complete, tumor-free margin excision of small solid carcinomas [22].…”

Section: Studiesmentioning

confidence: 99%

“…The decision to use the BLES was entirely based on the radiologist's assessment. Presence of bias risk of the index test was uncertain in 11 studies [6,7,9,12,13,[15][16][17][20][21][22] and high in two studies [10,23]. The risk of bias in the "reference standard" domain was generally scored low.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…The risk of bias in the flow and timing was generally scored as high, because not all patients with a high-risk lesion (HRL) or malignancy based on the BLES received surgical excision. Only five studies [15,[20][21][22][23] were scored with a low risk of this bias and one [7] with an unclear risk of bias. All studies were deemed applicable to the research question.…”

Section: Quality Assessmentmentioning

confidence: 99%

See 4 more Smart Citations

A systematic review on the use of the Breast Lesion Excision System in breast disease

Sanderink¹,

Laarhuis²,

Strobbe³

et al. 2018

European Journal of Cancer

View full text Add to dashboard Cite

Purpose: To outline the current status of and provide insight into possible future research on the breast lesion excision system (BLES) as a diagnostic and therapeutic device. Methods: A systematic search of the literature was performed using PubMed, Embase, and the Cochrane databases to identify relevant studies published between January 2002 and April 2018. Studies were considered eligible for inclusion if they evaluated the diagnostic or therapeutic accuracy or safety of BLES. Results: Ultimately, 17 articles were included. The reported underestimation rates of atypical ductal hyperplasia and ductal carcinoma in situ (DCIS) ranged from 0 to 14.3% and from 0 to 22.2%, respectively. Complete excision rates for invasive ductal carcinoma and DCIS ranged from 5.3 to 76.3%. Bleeding was the most frequently reported complication (0-11.8%). Device-related complications may arise, with an empty basket being the most common (0.6-3.6%). Thermal damage of the specimen, caused by the use of a radiofrequency cutting wire, was reported in eight of the included studies. Most thermal artifacts were reported as superficial and small (0.1-1.9 mm). Conclusions: The BLES, an automated, image-guided, single-pass biopsy system for breast lesions using radiofrequency is designed to excise and retrieve an intact tissue specimen. It is an efficient and safe breast biopsy method with acceptable complication rates, which may be used as an alternative to vacuum-assisted biopsies. The variable rate of complete excision raises questions about the possibility to use BLES as a therapeutic device for the excision of small lesions. Further research should focus on this aspect of BLES.

show abstract

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review on the use of the Breast Lesion Excision System in breast disease

Sanderink¹,

Laarhuis²,

Strobbe³

et al. 2018

European Journal of Cancer

View full text Add to dashboard Cite

show abstract

A retrospective observational study of intraductal breast papilloma and its coexisting lesions: A real‐world experience

Wang

Sun

et al. 2020

Cancer Medicine

View full text Add to dashboard Cite

show abstract

Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

Rageth

O’Flynn

Pinker

et al. 2018

Breast Cancer Res Treat

199

261

View full text Add to dashboard Cite

Purpose The second International Consensus Conference on B3 lesions was held in Zurich, Switzerland, in March 2018, organized by the International Breast Ultrasound School to re-evaluate the consensus recommendations. Methods This study (1) evaluated how management recommendations of the first Zurich Consensus Conference of 2016 on B3 lesions had influenced daily practice and (2) reviewed current literature towards recommendations to biopsy. Results In 2018, the consensus recommendations for management of B3 lesions remained almost unchanged: For flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL) and radial scars (RS) diagnosed on core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB), excision by VAB in preference to open surgery, and for atypical ductal hyperplasia (ADH) and phyllodes tumors (PT) diagnosed at VAB or CNB, first-line open surgical excision (OE) with follow-up surveillance imaging for 5 years. Analyzing the Database of the Swiss Minimally Invasive Breast Biopsies (MIBB) with more than 30,000 procedures recorded, there was a significant increase in recommending more frequent surveillance of LN [65% in 2018 vs. 51% in 2016 ( p = 0.004)], FEA (72% in 2018 vs. 62% in 2016 ( p = 0.005)), and PL [(76% in 2018 vs. 70% in 2016 ( p = 0.04)] diagnosed on VAB. A trend to more frequent surveillance was also noted also for RS [77% in 2018 vs. 67% in 2016 ( p = 0.07)]. Conclusions Minimally invasive management of B3 lesions (except ADH and PT) with VAB continues to be appropriate as an alternative to first-line OE in most cases, but with more frequent surveillance, especially for LN.

show abstract

Breast Lesion Excision System in the diagnosis and treatment of intraductal papillomas – A feasibility study

Abstract: The BLES procedure is an acceptable method for the management of small benign and high-risk breast lesions such as intraductal papillomas in selected patients. Thus, a great amount of diagnostic surgical biopsies can be avoided.

Cited by 12 publications

References 22 publications

A systematic review on the use of the Breast Lesion Excision System in breast disease

A systematic review on the use of the Breast Lesion Excision System in breast disease

A retrospective observational study of intraductal breast papilloma and its coexisting lesions: A real‐world experience

Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

Contact Info

Product

Resources

About