gms | German Medical Science

Purpose: To evaluate the differences between the 8G and 11G needle using the Mammotome® Vacuumbiopsy for suspect lesions of the breast regarding complete or representative removal of the lesion, complication rate and patient acceptance.

Method: Between 01/2000 and 09/2004, 123 patients underwent a Mammotome® Vacuumbiopsy of the breast (8G: n=48, 11G: n=75). All lesions were classified as BI-RADS 3, 4 or 5. Depending on the preoperative detection method, the procedures were performed under sonographic or mammographic guidance as an outpatient procedure and under local anaesthesia (pressure bandage for 24h). All patients were postoperatively followed up performing a clinical exam, sonography and mammogram. Using a scale between 0 – 10 (0= no pain – 10 intolerable pain) patients were asked about their subjective impression of pain. The median follow up was 41 months, average age 53 years (30 – 88).

Results: Median size of the lesions in mm: 8G=16; 11G=15; representative removal: 8G n=20 (41,7%); 11G n=40 (53,3%); complete removal: 8G n=28 (58,3%); 11G n=35 (46,7%); heamatoma requiring surgical revision: 8G n=0; 11G n=0; cutaneous heamatoma: 8G n=36 (75%); 11G n=57 (76%); median duration of heamatoma in d: 8G=13; 11G n=10; infections requiring antibiotics: 8G n=0; 11G n=0; cutaneous scaring: 8G n=5 (10,4%); 11G n=8 (10,7%); median impression of pain postop.: 8G=3,6; 11G=3,2; median impression of pain 1 week postop.: 8G=0,7; 11G=0,6; median impression of pain during follow up: 8G=0,1; 11G=0,3

Conclusion: No significant differences could be determined concerning diagnostic safety (p=0,20) or concerning the complication rate (cutaneous heamatoma: p=0,90; cutanous scaring: p=0,60) using either the 8G or 11G needle. Because of the very sharp cutting edge we recommend the use of the 8G needle in cases of very firm breast tissue. The amount of tissue to be removed depends not on the size of the needle. The limiting factors are complications such as bleeding and pain. By using the 8G needle the amount of time that is necessary to perform the procedure can be reduced. The costs for the 8G needle are slightly higher compared to the 11G.