NEW TISSUE ACQUISITION TECHNIQUES FOR BREAST LESIONS

Abstract

Recent innovations in breast tissue acquisition led to the development of unique direct frontal systems which add new possibilities in comparison to traditional biopsy tools. Preclinical and single center clinical trials proved their usefulness in particular for molecular biology and tissue banking. Now multicenter clinical experience is described. Completeness of diagnosis including gene profiling and molecular biology, patient comfort, costs of the procedure and tissue quality were the primary research goals. A total of 153 women with a suspect legio were eligible. The lesions were detected by clinical examination mammography, ultrasound, and/or MRI. Performance is evaluated by comparing the pathology results of the samples and definitive pathology at subsequent surgery or follow-up of the patient in case of benign lesions. In case of malignancy, the amount and quality of tissue should be sufficient for gene profiling and other molecular biology techniques. Both manual and computerized systems were used throughout the study. An average of 1.7 biopsies per procedure was taken with an average diameter of 4.06 mm and a length of 1.3 cm. All patients had sufficient sample size for diagnosis, including molecular biology. None of the patients suffered from a moderate to serious complication and the procedure was in general extremely well tolerated. Hermatoma was seen in only 4 patients that could be treated with conservative measures. Post-procedure esthetic results were excellent. Correct diagnosis was made in 151 patients. One patient had a minimal invasive cancer on definite pathology after resection, while the sample contained only DCIS. The costs of the procedure can be substantially lowered to less than 10 USD by use of the reusable manual system. Direct frontal tissue acquisition systems give excellent diagnostic results without major patient discomfort and with high quality tissue samples. The system is particularly useful in various difficult or dangerous situations that are now relatively contraindicated and for obtaining sufficient tissue for molecular biology. The new procedures can be performed at significantly reduced costs allowing more women to access early and better detection of breast cancer.