Title: Percutaneous vacuum assisted complete exeresis guided by ultrasound of high risk lessions

Biography:

Elisabeth Sanabria is radiologist who has her exper se in breast management by a ending the Master of breast pathology and senology in University of Barcelona. She has been in charge of breast diagnosis and interven ons in the Valencian oncology Ins tute where she spent many years with dedica on and passion on her daily work.   Her methodology consisted in one visit – full personalized procedural a endance for each pa ent, with no recalling and no wai ng list, Mul disciplinary interac on and Clinical-radio-pathological correla on.
 

Abstract

Statement of the Problem: Women who have high risk lesions use to go on surgery being over treated or otherwise go through ac ve follow-up going underes ma on of malignant lesions. Lately a new op on has appeared for these cases off ering the reduc on of sub es ma on up to 0% and no overtreatment with neither physiological nor aesthe c impact in the life of these pa ents. The purpose of this study is to describe the technique and experience of this emerging indica on of the well-known breast vacuum assisted biopsy method. Methodology & Theore cal Orienta on: A percutaneous biopsy device vacuum assisted device (EncorUltra®) was used for the complete exeresis of the lessions. Ultrasound Toshiba Aplio 300 was the guidance equipment. Normal an sep c care were taken, 20ml lidocaine hydrochloride with 2% epinephrine was administered with 8mm large spine needle local injec on surrounding the whole lesion. Needles device used were 7G and 10G diameter. The complete excision was the prime objec ve, the excision of surrounded  ssues was secondary aim. Once the procedure ended three sterile tryp were located in the minimal entrance scar and local compression has being done during 20 minutes. A corsse e compressive bandage was performed in all cases and kept for 12hours. Clinical and ultrasound surveillance was performed 24 hours, 1 week, 6 months and yearly a er that. Results: 16 cases were done since April 2014 to April 2018. Complete resec on was performed in all cases but one (6,2%) which was core biopsy underes ma on with pathological result of esclerosant adenosis while a er VABB AP found milimetrical area of ductal invasive carcinoma. Thus, it went to conserva ve
surgery where the only fi nding where to puntacte microfocus of microinvasive carcinomas in the margins le . Most lessions where: hyperplasia of columnal cells (12,5%), atypical ductal hyperplasia (68,7%), fl orid ductal hyperplasia (6,2%), epithelial prolifera ve lesion(6,2%), papillary lesion(18,7%), classical lobular neoplasia LIN1(6,2%), fi brocys c changes (37,5%), eleven were complex lesion with more than one histological fi nding (68,7) and one pa ent (6,2%) diagnosed by FNAC of breast carcinoma and fi nally diagnosed of B3 lesion with VABB complete resec on.   Conclusions: Preliminary outcomes are very enthusias c. Nevertheless, we are including pa ents in an interna onal mul centric study ongoing trial as further studies are impera ve.