Mammotome Biopsy – Minimally Invasive Therapy for Benign Breast Lumps

Focal breast lesions are often detected during breast self-examination or during routine medical tests and imaging procedures. In general, breast conditions are divided into non-cancerous lesions (cysts), benign tumors (fibroadenomas, papillomas, and lipomas), and malignant tumors (breast cancer). Benign tumors and non-cancerous conditions are more common than breast cancer, generally in the younger population, but the correct diagnosis and treatment can be difficult.

The diagnostics of focal breast lesions involves imaging methods and biopsies. Breast ultrasound scan, mammography, and MRI are the most widespread imaging techniques. When combined, these diagnostic methods prove highly reliable. The ultimate diagnosis is based on a histopathological examination of the tissue samples biopsied from suspicious lesions. Core needle biopsy is the most popular, offering the possibility to collect sections of the suspicious tissue. Fine-needle biopsy or excisional (surgical) biopsies are less common in the diagnostics of breast conditions.

Benign breast lesions can either be removed during a surgical procedure performed under general or local anesthesia, or by means of a minimally invasive mammotome biopsy.
Mammotome biopsy is an ultrasound-guided vacuum-assisted core needle biopsy used in breast tumor diagnostics. It is a minimally invasive procedure in which samples of suspicious tissue can be collected and benign breast lumps can be removed as a whole. The procedure is ultrasound-guided and performed in specialized healthcare facilities. It can also be guided by stereotactic mammography.

Mammotome biopsy uses a single-use biopsy needle connected to a vacuum system via cables, a handle to operate the needle, and a central unit that generates negative pressure and monitors the operation of the device. The procedure is performed in an outpatient setting, under local anesthesia, in a supine position. The biopsy needle is inserted through a small incision (2–3 mm long) to the area of the lesion. A section of the tissue is suctioned into the needle and cut off with a knife. The tissue specimen is then automatically suctioned out of the breast and sent for histopathological assessment. Once the tumor is excised and the specimens are collected, the needle is removed and a compression dressing is applied. The wound is very small and no sutures are required. The patients are usually monitored for 30 minutes after the procedure before going home. To minimize the risk of bleeding and hematoma, the compression dressing should be kept on for 24 hours.

Complications associated with mammotome biopsy are rare but include hematomas and mild pain at the incision site, fainting, wound healing problems, keloid formation, and allergic reactions to the local anesthetic. Bleeding requiring surgical intervention is very rare. In exceptional cases, the chest wall can be punctured, resulting in pneumothorax.

The samples collected during a mammotome biopsy are sent for histopathological examination to determine the type of lesion. If the lesion is found to be benign, the treatment is complete. If a malignant tumor is identified, patients are re-referred for specialist treatment.

Mammotome biopsy procedures, minimally invasive treatment of benign breast lumps, are performed at the Brothers Hospitallers Hospital by Tomasz Gach, PhD.

The procedure is fully paid for by the patient.

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