Treatments - Vacuum Assisted Cores

Vacuum assisted cores to remove entire lesion under ultrasound.

The Procedure

Directional, vacuum-assisted breast biopsy is a procedure for undertaking biopsy for breast lesions including microcalcifications, masses, spiculated masses, asymmetric densities and multifocal disease. The procedure may be assisted by imaging guidance such as ultrasound and X-ray. It is a diagnostic procedure and is not, at this time, intended for therapeutic use.

Existing Procedures

Women who are found to have a suspicious breast lesion following mammography will be recalled for further diagnostic tests. These may include additional mammography, ultrasound fine needle or core biopsy, or wire/needle localization and open biopsy.

Core biopsy (including automated Tru-Cut) can be guided by ultrasound or X-ray. Following localization of the breast lesion, a 3 mm incision is made in the skin under local anesthesia. The biopsy is then performed using a coring needle housed in a spring-loaded automated biopsy gun. The coring needle is manually advanced into the breast to the appropriate depth and fired. The inner needle then moves forward to about 23 mm, followed by the outer cutting sheath. The core of tissue is obtained within the 17 mm trough. Pre-fire and post-fire images are taken to confirm the passage of the needle through the lesion. A single sample is obtained each time the device is fired. In general, the sample weight is about 17.2 mg. A minimum of five samples is usually required from each lesion to allow a conclusive histological diagnosis. The procedure takes approximately 45 minutes and no hospitalization is required. Only one sample is obtained per needle entry. Additional sampling requires additional needle entry. The sample is withdrawn along the needle entry tract.

Open biopsy was the most frequently performed biopsy procedure until a few years ago. Open biopsy is often directed by wire or needle inserted under mammograph or ultrasound control. An incision is made and a section of tissue is removed for histological examination. The surgery is usually performed as a day surgery procedure, often under general anesthesia.