US of breast biopsy specimens.

Abstract

From January 1990 through December 1992, 1,585 preoperative wire localization procedures of occult breast lesions were performed at the authors' institution. Of these, 739 (47%) were masses, and ultrasound (US) guidance was performed to localize 30 lesions. In five of the 30 lesions, no mass was seen at radiography of the specimen, but US of the specimen helped confirm complete excision.

Intraoperative Ultrasound‐Guided Excision of Nonpalpable Breast Lesions

“…We performed specimen US by applying gel over the excised tissue. Other authors have placed the specimen in a cellophane bag (20) or in a container filled with a small amount of saline (2), but we did not find this necessary.…”

“…US‐guided aspiration biopsy or core needle biopsies of solid breast masses (5,13,15) and aspiration drainage of cysts, abscesses, or other fluid collections are frequently performed (6,10,16–19). Ultrasound is used to guide needle placement preoperatively in 2–4% of cases in which localization is required (20,21). US has also been used to guide the injection of dye (22) or radioactive colloid preoperatively into breast lesions.…”

“…Some reports have described the use of US in the evaluation of breast surgical specimens (32,33). US can confirm complete excision of breast masses (2,20) in a similar way to specimen radiographs which document mammographic lesions or calcifications. In our study, specimen US successfully documented the excised lesion in all cases.…”

Intraoperative sonographic localization of breast masses: success with specimen sonography and surgical bed sonography to confirm excision.

“…In 2 cases, the masses were not seen on the specimen sonograms, prompting reexcision, but no follow-up imaging was reported. 5 Frenna et al 6 reported on the use of imaging for localizing breast masses but used sonography in only 30 of 739 masses. In 5 of these 30 cases, specimen radiographs showed no masses; therefore, specimen sonography was then performed, confirming excision of the lesions in these 5 cases.…”

“…In 5 of these 30 cases, specimen radiographs showed no masses; therefore, specimen sonography was then performed, confirming excision of the lesions in these 5 cases. 6 A surgical miss was defined as the failure to remove all or part of the mass. In a series by Hasselgren et al, 13 the miss rate for mammographic localization was 4.2%, and false-negative specimen radiographs occurred in 55% of cases.…”