Breast Unit, First Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens, Greece.
In Vivo. 2011 Jul-Aug;25(4):703-5.
Vacuum-assisted breast biopsy (VABB) is used for the diagnosis of non-palpable breast lesions. Hematoma has been recognized as the main complication of the procedure. Its main disadvantage is the underestimation rate. Generally speaking, approximately up to 24 cores are excised in most published series. It has been suggested that excision of more cores per lesion can reduce the underestimation rate. The present study aims to evaluate hematoma formation with regard to the number of cores excised.
A total of 660 women underwent VABB; 232 women were allocated to the standard protocol (24-36 cores excised, 2-3 offsets) and 428 women were allocated to the extended protocol (96 cores excised, 8 offsets). Cases were derived from a double blind study, as well as from the periods before (standard protocol) and after (mainly extended protocol) the study. In all cases, the occurrence of organized hematomas within the subsequent 20 days was followed up by ultrasound.
In the standard protocol, the frequency of clinically significant and subsequently organized hematomas was 3.5%. However, in the extended protocol the respective hematoma percentage was 7.5%. Clinically significant and subsequently organized hematomas were significantly more frequent in the extended protocol (Pearson's chi-squared=4.29, p=0.038).
Despite the superiority of the extended protocol in terms of underestimation, the approximately two-fold increase in hematoma occurrence prompts the need for careful patient selection prior to its performance.
真空辅助乳房活检（VABB）用于诊断不可触及的乳房病变。血肿已被认为是该程序的主要并发症。其主要缺点是低估率。一般来说，在大多数已发表的系列中，大约切除 24 个核心。有人建议，每个病变切除更多的核心可以降低低估率。本研究旨在评估切除的核心数量与血肿形成的关系。
共有 660 名女性接受了 VABB；232 名女性被分配到标准方案（切除 24-36 个核心，2-3 个偏移量），428 名女性被分配到扩展方案（切除 96 个核心，8 个偏移量）。病例来自于一项双盲研究，以及研究之前（标准方案）和之后（主要是扩展方案）的时期。在所有情况下，在接下来的 20 天内通过超声跟踪观察是否有组织化血肿的发生。
在标准方案中，临床上显著且随后出现的血肿频率为 3.5%。然而，在扩展方案中，相应的血肿百分比为 7.5%。临床上显著且随后出现的血肿在扩展方案中明显更常见（皮尔逊卡方=4.29，p=0.038）。
尽管扩展方案在低估方面具有优势，但血肿发生率增加约两倍促使在进行该方案之前需要仔细选择患者。
