Mammotome

A Mammotome device is a vacuum-assisted breast biopsy (VAC) device that uses image guidance such as x-ray, ultrasound and/or MRI to perform breast biopsies. A biopsy using a Mammotome device can be done on an outpatient basis with a local anesthetic. Mammotome is a registered trademark of Devicor Medical Products, Inc., part of Leica Biosystems.[1]

Schematic representation of a vacuum-assisted biopsy probe

Indications

Stereotaxic macrobiopsies are often indicated after seeing suspicious elements on a mammography (mass, microcalcifications or focal abnormal changes in the tissues).[2] It is always used to analyse those elements but can sometimes also remove it completely.[3] It is often used when:

  • The mammography shows a suspicious solid mass.
  • The mammography shows a suspicious "islet" of microcalcifications.
  • The breast tissue seems deformed.
  • A new mass or microcalcification islet is spotted in a zone previously targeted by surgery.

Risks associated with the procedure

Side effects:[4]

  • Common: bruising, mild discomfort during the procedure, mild bleeding and tenderness at the biopsy site.
  • Rare: significant bleeding or pain during biopsy, significant tenderness and bleeding at the biopsy site.

Complications:

  • Rare: Post-biopsy breast infection. Allergic reaction to the local anaesthetic.

Complications from biopsies can delay subsequent breast surgery.

The procedure may, rarely, fail due to inaccurate sampling of the lesion; results may underestimate the severity of the lesion although these risks do not differ from other biopsy or surgical procedures. Occasionally, even after a successful biopsy, the diagnosis may remain uncertain and require a surgical biopsy, especially when atypical or precancerous cells are found on core biopsy.

Limitations of the procedure

Lesions accompanied by diffuse calcium deposits scattered throughout the breast or located near the chest wall are difficult to target or evaluate by stereotactic biopsy. If the mammogram shows only a vague change in tissue density but no definite mass or nodule, the x-ray-guided method may not be successful.[5]

  • Mammotome entry in the public domain NCI Dictionary of Cancer Terms

References
  1. Hoorntje LE, Peeters PH, Mali WP, Borel Rinkes IH. Vacuum-assisted breast biopsy: a critical review. Eur J Cancer. 2003;39:1676–1683
  2. Laufer U, Frentzel K, Knoben B, Kirchner J, Donnerstag F, Liermann D. - [Minimally invasive stereotactic breast biopsy with the "mammotome". Methodology and personal experiences] -Zentralbl Chir. 1998;123 Suppl 5:63-5
  3. Dhillon MS, Bradley SA, England DW. Mammotome biopsy: impact on preoperative diagnosis rate. Clin Radiol. 2006;61:469–474.
  4. Liberman, L. Stereotactic Core Biopsy. In: Dershaw D. , editor. Imaging-Guided Interventional Breast Techniques. New York: Springer; 2003. pp. 87–118
  5. Mendez A, Cabanillas F, Echenique M, Malekshamran K, Perez I, Ramos E. Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy (SVABB). Ann Oncol. 2004;15:450–454

 This article incorporates public domain material from the U.S. National Cancer Institute document: "Dictionary of Cancer Terms".

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