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Sonographically Guided Directional Vacuum-Assisted Breast Biopsy

Preliminary Experience in Venezuela

Jorge A. Perez-Fuentes1, Itala R. Longobardi1, Victor F. Acosta1, Carmen E. Marin1 and Laura Liberman2

1 Ceclines, Av. Libertador, Edificio Siclar, PB, Urb. La Florida 1050, Caracas, Venezuela.
2 Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.



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  		Fig. 1A. —Asymptomatic 45-year-old woman with nonpalpable mass detected at mammography. Sonogram shows solid mass of 1.2 cm at maximal diameter in lower inner quadrant of left breast.

 


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  		Fig. 1B. —Asymptomatic 45-year-old woman with nonpalpable mass detected at mammography. Photograph obtained during sonographically guided 11-gauge vacuum-assisted biopsy shows 11-gauge probe in breast.

 


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  		Fig. 1C. —Asymptomatic 45-year-old woman with nonpalpable mass detected at mammography. Sonogram obtained during biopsy shows 11-gauge probe positioned in breast with collecting area of probe (arrows) deep in relation to mass.

 


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  		Fig. 1D. —Asymptomatic 45-year-old woman with nonpalpable mass detected at mammography. Photograph shows one (arrows) of 19 specimens obtained during 11-gauge vacuum-assisted biopsy of this mass. Histologic analysis yielded benign fibroadenoma, concordant with imaging features. No residual lesion was identified at 13-month follow-up.

 


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  		Fig. 2A. —Asymptomatic 69-year-old woman. Screening mammogram, including mediolateral oblique and craniocaudal images, shows 0.7-cm spiculated mass in upper outer quadrant of left breast (arrows).

 


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  		Fig. 2B. —Asymptomatic 69-year-old woman. Sonogram shows hypoechoic solid mass (arrows) corresponding to lesion seen in A.

 


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  		Fig. 2C. —Asymptomatic 69-year-old woman. Left mammogram obtained after sonographically guided 11-gauge vacuum-assisted biopsy and clip placement shows clip (arrows) at biopsy site. No residual lesion was identified at sonography or mammography. Histologic analysis of vacuum-assisted biopsy specimen revealed infiltrating ductal carcinoma. At surgery, biopsy site was identified, but no residual carcinoma was found. Sentinel node was free of tumor.

 

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