Naglaa Mohamed Abdel Razek
Cairo University, Egypt
Title: Breast Intervention from basic to advanced
Biography
Biography: Naglaa Mohamed Abdel Razek
Abstract
Background: A biopsy remains the standard technique for diagnosing both palpable and non-palpable breast abnormalities and is the preferred initial method of evaluating almost all breast masses. Studies have shown that the combination of a physical examination, radiographic imaging and histopathological confirmation, also referred to as the triple-test, can produce accuracy levels of over 90% when all three components are concordant for benign or malignant disease. Under certain circumstances when a mass or radiographic abnormality is categorized as probably benign in the presence of high patient anxiety, family history of breast cancer or poor likelihood of compliance with recommended six-month follow-up imaging, a breast biopsy may be recommended for category three lesions. In National Comprehensive Cancer Network, a number of well-designed studies have demonstrated the safety and clinical utility of minimally invasive breast biopsy methods relative to open surgical biopsy. Advantages include less discomfort for the patient, a reduction in scarring and cosmetic defect, less invasive procedure, and quicker patient recovery.
Method: Large needle procedures:
BLES & VAB are two advanced automated large needle breast biopsy methods .To date , there is no clear international guide lines regarding the indications however we will try to put preferential indications of each technique based on the available international publications , NICE guideline (UK) as well as our experience in the two techniques ( 2000 VAB in 9 years and 300 BLES in 2yrs).
Conclusion:
BLES & VAB are used as the primary method for histopathology diagnosis of suspicious small & borderline lesions as well as the unclassified microcalcfications.
There are some limitations to BLES including; lactating females, patients with breast implants and patients presenting with a lesion close to the skin or in the axillary tail.
BLES is favored in high risk lesions & DCIS considering the relative high underestimation rate associated with VAB and not found with the BLES . Moreover BLES offers complete lesion removal with available margin evaluation.