Tahoun Laila Abu, Maraqa Bayan
Department of Diagnostic Radiology - Breast Imaging Unit, King Hussein Cancer Center, Jordan.
Department of Laboratory Medicine and Pathology, King Hussein Cancer Center, Jordan.
J Ultrason. 2022 Feb 8;22(88):e57-e63. doi: 10.15557/JoU.2022.0010. eCollection 2022 Mar.
Ultrasound-guided vacuum-assisted biopsy is being increasingly used in the diagnosis of breast lesions. The advantages of vacuum-assisted biopsy over core needle biopsy include large sample and higher diagnostic accuracy. Indications for ultrasound-guided vacuum-assisted biopsy include suspicious calcifications visible on ultrasound, architectural distortion, and very subtle or insinuating lesions.
We present three patients treated for breast cancer with breast-conserving surgery who developed suspicious findings on mammogram and MRI at or near the surgical scar. The findings were subtle, small, or atypical lesions on ultrasound. Ultrasound-guided vacuum-assisted biopsy was performed, and recurrence was diagnosed. The technique was advantageous due to real-time imaging, ability to control the path of the needle, obtaining multiple cores with a single skin puncture and single pass, supine position, no radiation, and no IV contrast.
Ultrasound-guided vacuum-assisted biopsy should be considered in cases involving multiple suspicious findings at or near the surgical scar, with subtle or atypical sonographic correlates. Vacuum-assisted biopsy is indicated; yet ultrasound guidance is more comfortable, no radiation and no contrast.
超声引导下真空辅助活检在乳腺病变诊断中的应用日益广泛。与粗针活检相比，真空辅助活检的优势在于样本量大且诊断准确性更高。超声引导下真空辅助活检的适应证包括超声可见的可疑钙化、结构扭曲以及非常微小或隐匿性病变。
我们报告了3例接受保乳手术治疗乳腺癌的患者，她们在手术瘢痕处或其附近的乳房X线摄影和MRI检查中出现了可疑发现。这些发现为超声检查时的微小、小型或非典型病变。进行了超声引导下真空辅助活检，诊断为复发。该技术具有实时成像、能够控制针的路径、单次皮肤穿刺和单次进针获取多个组织芯、仰卧位、无辐射且无需静脉注射造影剂等优势。
对于手术瘢痕处或其附近存在多个可疑发现且伴有微小或非典型超声表现的病例，应考虑采用超声引导下真空辅助活检。需要进行真空辅助活检；而超声引导更舒适，无辐射且无需造影剂。
