Surgeon Performed Vacuum Assisted Breast Biopsy/Excision Is a Viable Paradigm for the Management of Benign and B3 Lesions-An Australian Multicenter Experience.

IF 2.5 3区 医学 Q2 SURGERY
Deepali Poels, Daniel de Viana, Tirsa Van Wyngaard, Ian Bennett, Michael Law
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引用次数: 0

Abstract

Background: Open excisional biopsy is currently the mainstay of management of a variety of benign and indeterminant (B3) breast lesions in Australasia. Vacuum assisted biopsy (VAB) and vacuum assisted excision (VAE) are being increasingly adopted into the management algorithm of such breast lesions internationally and are beginning to gain interest in Australasia. This study aims to review the experience and outcomes of a series of surgeon-performed ultrasound (US) guided VAB/VAEs undertaken by specialist breast surgeons in Australasian including its application and clinical deployment.

Methods: An Australian multicenter trial of US-guided surgeon-performed VAB and VAE of benign or indeterminant breast lesions was conducted by three experienced breast surgeons from major breast services. The study involved prospectively collected data on 462 US-guided VAB/VAEs in 397 patients, in both outpatient and day case settings from 2015 to 2024. Malignant lesions proven on previous biopsies were excluded.

Results: A total of 462 surgeon-performed US-guided vacuum-assisted procedures were undertaken in 397 patients. 137 procedures (29%) were performed as diagnostic VABs and 325 (71%) were undertaken as VAEs. Successful complete excision was achieved in 308 (95%) of cases where the intent of the procedure was complete excision, defined as absence of any lesion seen on US following the procedure and on subsequent interval US examination. Duration of follow-up ranged from 6 months to 9 years. The average size of lesions was 20 mm in the diagnostic VAB group and 11 mm in the VAE excision group. The average time for either procedure was approximately 15 min. No infection was reported and hematomas requiring surgical evacuation were < 1%.

Conclusion: VAB/VAE are minimally invasive techniques well suited for management of variety of benign and B3 breast lesions. US guided VAB/VAE interventions are reliable, safe, and quick to perform in both day procedure or outpatient settings and can be readily learned by breast surgeons, especially those who already possess experience in breast interventional US. We have demonstrated its utility and viable deployment in contemporary Australian breast surgical practice and would advocate for its adoption in the Australasian surgical management algorithm, especially for small B3 lesions.

外科医生进行真空辅助乳腺活检/切除是良性和B3病变管理的可行范例-澳大利亚多中心经验。
背景:在澳大拉西亚,开放式切除活检是目前治疗各种良性和不确定(B3)乳腺病变的主要方法。真空辅助活检(VAB)和真空辅助切除(VAE)在国际上越来越多地被采用到这类乳腺病变的治疗算法中,并开始在澳大利亚引起人们的兴趣。本研究旨在回顾澳大利亚专科乳房外科医生进行的一系列超声引导VAB/VAEs的经验和结果,包括其应用和临床部署。方法:澳大利亚的一项多中心试验,由三名经验丰富的乳腺外科医生在美国指导下进行乳腺良性或不确定病变的VAB和VAE。该研究前瞻性地收集了2015年至2024年期间397名患者的462例美国引导的VAB/ vae数据,包括门诊和日间病例设置。排除既往活检证实的恶性病变。结果:397例患者共进行了462例外科医生引导的真空辅助手术。137例(29%)作为诊断性vab进行,325例(71%)作为vae进行。308例(95%)手术目的为完全切除的病例成功完成了完全切除,定义为在手术后和随后的间隔超声检查中没有任何病变。随访时间从6个月到9年不等。诊断性VAB组的平均病灶大小为20 mm, VAE切除组的平均病灶大小为11 mm。两种手术的平均时间约为15分钟。结论:VAB/VAE是一种微创技术,非常适合于各种乳腺良性和B3型病变的治疗。超声引导下的VAB/VAE干预在日间手术或门诊环境中都是可靠、安全、快速的,乳房外科医生很容易学习,特别是那些已经拥有乳房介入超声经验的医生。我们已经证明了它在当代澳大利亚乳房手术实践中的实用性和可行性,并将提倡在澳大利亚手术管理算法中采用它,特别是对于小的B3病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Surgery
World Journal of Surgery 医学-外科
CiteScore
5.10
自引率
3.80%
发文量
460
审稿时长
3 months
期刊介绍: World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.
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