Consultation made with the patient and the procedure explained.
Written consent obtained.
Previous imaging and histological report reviewed.
Selection criteria:
Lesions smaller than 2 cm at our institute.
Biopsy proven Papillomas without atypia.
Approach:
Based on lesion location,
usually from the side of the lesion with adequate tract to preferable place the needle under the lesion.
Roll the patient so that the breast are stretched out and are gravity dependant for easy access.
Challenges of percutaneous technique of performing vacuum guided:
Large lesion.
Leasion in the subctanueos plane.
Lesion abutting the chest wall.
Small breasts.
Cost of Procedure:
Varies with institute however cost is appx AUD 350 for the disposable biopsy gun and the clip.
This is excluding procedure billing cost and other consumables.
Comparisions to surgical option:
Significantly cheaper than surgery and reduced perioperative morbidity.
No hookwire localization needed.
Smaller scar and reduced recovery time.
Duration: appx 45min.
Complications:
No major life threatening complications has been reported.
Local complications:
Hematoma formation(13 in 100).
Infection as a delayed complication.
Post Procedure: If age appropriate a Mammogram with clip in situ.
Follow up: USG follow up in 6 weeks.
Reccurence:
In our institute,
we have not encountered any short term recurrence.
Long term follow up yet to be assessed.
Contraindications:
Bleeding disorder.
Allergy to local anaesthetic.(Relative)
Pathology results:
Would usually state fragments of papilloma and margins cannot be assessed.