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Targeted Sonography-Guided Biopsy for Calcifications-Only Lesions on Mammography
S96
Ultrasound in Medicine and Biology
Breast / Biopsy P 073 se Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy: US-Guided Vacuum-Assisted Percutaneous Excision as an Alternative to Surgical Excision J. H. Youk,1 M. J. Kim,2 E. J. Son,1 J. Y. Kwak,2 E. Kim2 1 Radiology, Gangnam Severance Hospital, Yonsei University, Seoul/KR, 2 Radiology, Severance Hospital, Yonsei University, Seoul/KR Purpose: To evaluate the performance of sonographically (US) guided vacuum-assisted excision (VAE) for the postbiopsy management of benign papilloma without atypia after US-guided 14-gauge core needle biopsy (CNB). Material & Methods: After reviewing the histologic results of USguided CNB performed from January 2007 through May 2010, a total of 323 benign papillomas without atypia at CNB in 289 women having surgery (n 5 151) or US-guided VAE (n 5 172) were found. Their medical records and sonograms were reviewed and the collected variables were compared between VAE and surgery. To evaluate the performance of VAE, 76 lesions due to surgery (n 5 3) or at least 1 year’s follow-up (n 5 73) were selected. Results: For the postbiopsy management, VAE was favored in patients with previous breast cancer (100%, 9 of 9) (p 5 0.004). Surgery was favored in patients with associated symptom (64%, 65 of 102) (p , 0.0001), concurrent breast cancer (100%, 16 of 16) (p , 0.0001), and discordant lesion (73%, 16 of 22) (p 5 0.011). Lesion size in surgery (12 mm) was larger than in VAE (9 mm) (p 5 0.006). At 76 VAEs, one noninvasive carcinoma was diagnosed, but there was no false-negative result and histologic underestimation. Conclusion: US-guided VAE showed good performance in the management of benign papilloma without atypia after US-guided 14-gauge CNB. The choice between VAE and surgery were significantly different according to previous breast cancer, concurrent breast cancer, symptom, size, or imaging-pathologic concordance.
Volume 37, Number 8S, 2011 Conclusion: The size of the lesions, the age of the patients and the sonographic feature of cleft were the significant helpful variables to predict phyllodes tumor among FELCS diagnosed at breast core biopsy.
P 075 ee Iatrogenic Breast Lesions: Various Ultrasound Findings M. Nam,1 B. Han,2 E. Y. Ko,2 J. H. Shin,2 J. H. Moon,1 K. Lee,1 J. Hwang3 1 Radiology, Hallym University Sacred Heart Hospital, Anyang/KR, 2 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul/KR, 3Radiology, Kangnam Sacred Heart Hospital, Hallym University, Seoul/KR Learning Objectives: To show iatrogenic procedure-related changes in breast and axilla examinations, which lead to confusion or proper diagnosis. Background: When we perform breast ultrasound without information from previous procedures, there is a possibility of misjudging the unusual procedure-related changes as suspicious lesions, which can lead to a biopsy. Imaging Findings or Procedure Details: We will show various ultrasound findings, which were caused by previous iatrogenic procedures. These cases will include pseudoaneurysms related to the core biopsy, post-acupuncture abscess, post-vacuum-assisted biopsy change, panniculitis due to chemotherapy drug leakage, post-thyroid endoscopic surgery changes in the periareolar portion, fat necrosis in the periareolar portion due to the sentinel node identification procedure, changes after autologous fat injection, changes after cosmetic filler (Restylane) injection and changes after the application of oriental salve (Koyak). Conclusion: With through recognizion of these diverse findings, we can avoid misdiagnosis and unnecessary invasive procedures.
P 076 se P 074 se Fibroepithelial Lesions with Cellular Stroma of Breast Diagnosed on Sonographically Guided Core Needle Biopsy H. K. Jung,1 E. Kim,2 K. H. Ko1 1 Radiology, Bundang CHA General Hospital, Sungnam-si/KR, 2 Radiology, Severance Hospital, Yonsei University, Seoul/KR Purpose: The purpose of this study was to evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed on sonography guided core needle biopsy of breast masses and to determine whether the clinical and imaging features of this lesion could predict phyllodes tumor. Material & Methods: We retrospectively reviewed the pathologic results of sonography-guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure and underwent subsequent surgical excision were included in this study. Their medial records and radiologic images were retrospectively reviewed. Results: The results of surgical excision showed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. The lesion size and the patient age were statistically significantly different between phyllodes tumors and non-phyllodes tumors (p 5 0.0078, p 5 0.0207). Among the sonographic features, only cleft was statistically differently more visible in phyllodes tumors than in non-phyllodes tumors (n 5 14 (70%)/n 5 6 (30%), p 5 0.0016).
Targeted Sonography-Guided Biopsy for Calcifications-Only Lesions on Mammography S. Chen,1 Y. Cheung,2 H. Tsai,1 Y. Lo,1 S. Shen,1 W. Kuo,1 C. Yu,1 P. Huang,2 S. Ueng3 1 Department of Surgery, Chang Gung Memorial Hospital, Taipei/TW, 2 Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taipei/TW, 3Department of Pathology, Chang Gung Memorial Hospital, Taipei/TW Purpose: To assess the calcifications retrieval rate and underestimate rate of mammographically detected calcifications by different modalities of image-guided biopsy. Material & Methods: There were 52 sonography-guided excisional biopsy, 141 stereotactic core biopsy and 22 sonography-guided vacuum-assisted core needle biopsy (SVAB) for non-mass, calcifications-only lesions that detected on mammography between Jan 2008 and Dec. 2010. The retrieval rate was defined as calcifications retrieved on specimen mammography after biopsy. Underestimate rate was defined as proportion of under-staged ductal carcinoma in-situ (DCIS) or invasive cancer for atypical ductal hyperplasia (ADH) or understaged invasive cancer for DCIS. Results: The shape of calcifications on mammography were classified as malignant features such as pleomorphic and/or linear type in 51%. The distribution of calcifications on mammography classified as clustered in 68% and as regional in 23%. The final pathological diagnosis of calcifications-only lesion was 159 benign and 56 malignant tumors. The calcifications retrieval rate, were 100%, 98.6%, and 94.4% (p 5 0.4) in
Abstracts patients who underwent sonography-guided excision, stereotactic biopsy and SVAB, respectively. The ADH underestimate rate were 0%, 5.7% and 0% and DCIS underestimate rate 11.1%, 9.1% and 0%, respectively, in sono-guided excision, stereotactic biopsy and SVAB. Conclusion: There was no significant difference in successful calcifications retrieval between sonography-guided excision, SVAB and stereotactic biopsy. Same underestimate rate was found in the sonography-guided excision and stereotactic biopsy and no underestimate found in SVAB.
P 077 ee Indications and Rationale of US-Guided Breast Biopsy: Biopsy or Not? J. H. Lee,1 Y. M. Park,2 J. S. Park,2 M. Lee,3 D. C. Kim,3 H. Kwon,3 S. H. Cho,3 K. J. Nam4 1 Radiology, Breast Center, Dong-A University College of Medicine, Busan/KR, 2Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan/KR, 3Breast Center, Dong-A University College of Medicine, Busan/KR, 4Radiology, Dong-A University College of Medicine, Busan/KR Learning Objectives: The purpose of this exhibit is to summarize the indications and rationale of US-guided biopsy for the breast lesions with a variety of ultrasonographic images. Background: Ultrasonography is now considered integral in the evaluation of breast lesions and has increased the detection of small nonpalpable breast lesions. Also, breast biopsy has increased. So, it is necessary to safely reduce the number of benign-result biopsies without missing a cancer. Imaging Findings or Procedure Details: The following lesions: biopsy or not? 1) synchronous BI-RADS category 3 nodules detected in patients with breast cancer. 2) Probably benign breast masses that increase in size, but still remain benign in morphology at follow-up US. 3) Breast lesions with unexpected focal hypermetabolic activity in patients undergoing FDG PET/CT. 4) Low echoic area in the breast tissue at sonography. 5) Palpable breast masses with probably benign morphology. 6) Palpable abnormalities of the breast with normal MG and normal US. Conclusion: Awareness of the indications and rationale of US-guided biopsy for the various breast lesions will help us to decide whether to perform a biopsy or not and may reduce the number of benign-result biopsies without increasing the chance of missing a cancer.
P 078 ee Preoperative Supplemental Ultrasound-Guided Procedures for the Tailored Breast-Conserving Surgery: Pictorial Review and Appropriate Indications J. Hwang,1 B. Han,2 E. Y. Ko,2 J. H. Shin,2 M. Nam3 1 Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul/KR, 2Department of Radiology, Samsung medical center, Sungkyunkwan University School of Medicine, Seoul/KR, 3Radiology, Hallym University Sacred Heart Hospital, Anyang/KR Learning Objectives: 1. To review and introduce various preoperative ultrasound-guided procedures for the tailored breast-conserving surgery. 2. To create an awareness of possible indications and pitfalls. 3. To apply appropriate method for pre-operative localization. Background: For several decades, breast-conserving surgery (BCS) is increasingly used as an alternative to mastectomy for the treatment of early breast cancer. However, for the successful BCS, negative margin is essential for the local control of breast cancer. Owing to the advent
S97
ultrasound technique and its convenience, various supplemental procedures have been widely used for tailoring breast-conserving surgery. Imaging Findings or Procedure Details: CONTENT ORGANIZATION: 1) Second look ultrasound (targeted US): preoperative MRI to additionally detect suspicious lesion. 2) Intraoperative US: for the localization or for the specimen US. 3) US-guided skin marking: for the multiple lesions or large area of lesions. 4) US-guided aspiration of suspicious metastatic LN: for the avoidance of unneccessary sentinel LN biopsy. 5) US-guided wire localization for the US visible microcalcifications. 6) US-guided wire localization for the nonpalpable solid mass. 7) US-guided charcoal localization: nonpalpable solid mass or postbiopsy hematoma (after stereotactic vacuum-assisted biopsy or excisional biopsy). Conclusion: 1. You should know various methods, proper indication and individual pitfalls of various supplemental US-guided procedures for the tailored breast-conserving surgery. 2. You could apply the appropriate US-guided procedures for the optimal surgical strategy.
P 079 se Vanishing Lesion During US-Guided Core Needle Biopsy: Can We Exclude Malignancy? S. Y. Moon,1 N. H. Park,1 J. Y. Park,2 C. S. Park,1 M. S. Kim,1 H. J. Park1 1 Radiology, Myongji Hospital, Kwandong University, Gyeonggi-do/KR, 2 Radiology, Breast, Myongji Hospital, Kwandong University, Gyeonggi-do/KR Purpose: We analyzed the pathology of vanishing lesion during core needle biopsy of breast to ascertain whether this finding can be a radiologic clue to exclude malignancy or not. Material & Methods: 548 women underwent US-guided core needle biopsy between January 2009 and February 2011 and 98 vanishing lesions were detected in 91 patients. Automated gun biopsy with 14G needle (Magnum Ò) were used and vanishing lesion was defined as nonvisualization or volume loss more than 90% after needle passage with less than 3 times. Before biopsy, 81 lesions (82.6%) were classified as BIRADS category 4a, 12 lesions (12.2%) showed significant interval change of size and shape on follow-up study and 5 lesions (5.1%) were category 3 with clinical suspicions. Results: 548 women underwent US-guided core needle biopsy between January 2009 and February 2011 and 98 vanishing lesions were detected in 91 patients. Automated gun biopsy with 14G needle (Magnum Ò) were used and vanishing lesion was defined as nonvisualization or volume loss more than 90% after needle passage with less than 3 times. Before biopsy, 81 lesions (82.6%) were classified as BIRADS category 4a, 12 lesions (12.2%) showed significant interval change of size and shape on follow up study and 5 lesions (5.1%) were category 3 with clinical suspicions. Conclusion: Vanishing lesion during core needle biopsy can be the clue to exclude malignancy.
Breast / Cancer P 080 se Flow Index of 3D Breast Ultrasound was Strongly Correlated with Axillary Lymph Nodes Metastases in the Absence of Lymphovascular Invasion C. Su, S. Kuo, D. Chen Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua/TW Purpose: Axillary lymph nodes (ALN) are the most commonly involved sites of disease in breast cancer that has spread outside the primary
Ultrasound in Medicine and Biology
Breast / Biopsy P 073 se Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy: US-Guided Vacuum-Assisted Percutaneous Excision as an Alternative to Surgical Excision J. H. Youk,1 M. J. Kim,2 E. J. Son,1 J. Y. Kwak,2 E. Kim2 1 Radiology, Gangnam Severance Hospital, Yonsei University, Seoul/KR, 2 Radiology, Severance Hospital, Yonsei University, Seoul/KR Purpose: To evaluate the performance of sonographically (US) guided vacuum-assisted excision (VAE) for the postbiopsy management of benign papilloma without atypia after US-guided 14-gauge core needle biopsy (CNB). Material & Methods: After reviewing the histologic results of USguided CNB performed from January 2007 through May 2010, a total of 323 benign papillomas without atypia at CNB in 289 women having surgery (n 5 151) or US-guided VAE (n 5 172) were found. Their medical records and sonograms were reviewed and the collected variables were compared between VAE and surgery. To evaluate the performance of VAE, 76 lesions due to surgery (n 5 3) or at least 1 year’s follow-up (n 5 73) were selected. Results: For the postbiopsy management, VAE was favored in patients with previous breast cancer (100%, 9 of 9) (p 5 0.004). Surgery was favored in patients with associated symptom (64%, 65 of 102) (p , 0.0001), concurrent breast cancer (100%, 16 of 16) (p , 0.0001), and discordant lesion (73%, 16 of 22) (p 5 0.011). Lesion size in surgery (12 mm) was larger than in VAE (9 mm) (p 5 0.006). At 76 VAEs, one noninvasive carcinoma was diagnosed, but there was no false-negative result and histologic underestimation. Conclusion: US-guided VAE showed good performance in the management of benign papilloma without atypia after US-guided 14-gauge CNB. The choice between VAE and surgery were significantly different according to previous breast cancer, concurrent breast cancer, symptom, size, or imaging-pathologic concordance.
Volume 37, Number 8S, 2011 Conclusion: The size of the lesions, the age of the patients and the sonographic feature of cleft were the significant helpful variables to predict phyllodes tumor among FELCS diagnosed at breast core biopsy.
P 075 ee Iatrogenic Breast Lesions: Various Ultrasound Findings M. Nam,1 B. Han,2 E. Y. Ko,2 J. H. Shin,2 J. H. Moon,1 K. Lee,1 J. Hwang3 1 Radiology, Hallym University Sacred Heart Hospital, Anyang/KR, 2 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul/KR, 3Radiology, Kangnam Sacred Heart Hospital, Hallym University, Seoul/KR Learning Objectives: To show iatrogenic procedure-related changes in breast and axilla examinations, which lead to confusion or proper diagnosis. Background: When we perform breast ultrasound without information from previous procedures, there is a possibility of misjudging the unusual procedure-related changes as suspicious lesions, which can lead to a biopsy. Imaging Findings or Procedure Details: We will show various ultrasound findings, which were caused by previous iatrogenic procedures. These cases will include pseudoaneurysms related to the core biopsy, post-acupuncture abscess, post-vacuum-assisted biopsy change, panniculitis due to chemotherapy drug leakage, post-thyroid endoscopic surgery changes in the periareolar portion, fat necrosis in the periareolar portion due to the sentinel node identification procedure, changes after autologous fat injection, changes after cosmetic filler (Restylane) injection and changes after the application of oriental salve (Koyak). Conclusion: With through recognizion of these diverse findings, we can avoid misdiagnosis and unnecessary invasive procedures.
P 076 se P 074 se Fibroepithelial Lesions with Cellular Stroma of Breast Diagnosed on Sonographically Guided Core Needle Biopsy H. K. Jung,1 E. Kim,2 K. H. Ko1 1 Radiology, Bundang CHA General Hospital, Sungnam-si/KR, 2 Radiology, Severance Hospital, Yonsei University, Seoul/KR Purpose: The purpose of this study was to evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed on sonography guided core needle biopsy of breast masses and to determine whether the clinical and imaging features of this lesion could predict phyllodes tumor. Material & Methods: We retrospectively reviewed the pathologic results of sonography-guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure and underwent subsequent surgical excision were included in this study. Their medial records and radiologic images were retrospectively reviewed. Results: The results of surgical excision showed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. The lesion size and the patient age were statistically significantly different between phyllodes tumors and non-phyllodes tumors (p 5 0.0078, p 5 0.0207). Among the sonographic features, only cleft was statistically differently more visible in phyllodes tumors than in non-phyllodes tumors (n 5 14 (70%)/n 5 6 (30%), p 5 0.0016).
Targeted Sonography-Guided Biopsy for Calcifications-Only Lesions on Mammography S. Chen,1 Y. Cheung,2 H. Tsai,1 Y. Lo,1 S. Shen,1 W. Kuo,1 C. Yu,1 P. Huang,2 S. Ueng3 1 Department of Surgery, Chang Gung Memorial Hospital, Taipei/TW, 2 Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taipei/TW, 3Department of Pathology, Chang Gung Memorial Hospital, Taipei/TW Purpose: To assess the calcifications retrieval rate and underestimate rate of mammographically detected calcifications by different modalities of image-guided biopsy. Material & Methods: There were 52 sonography-guided excisional biopsy, 141 stereotactic core biopsy and 22 sonography-guided vacuum-assisted core needle biopsy (SVAB) for non-mass, calcifications-only lesions that detected on mammography between Jan 2008 and Dec. 2010. The retrieval rate was defined as calcifications retrieved on specimen mammography after biopsy. Underestimate rate was defined as proportion of under-staged ductal carcinoma in-situ (DCIS) or invasive cancer for atypical ductal hyperplasia (ADH) or understaged invasive cancer for DCIS. Results: The shape of calcifications on mammography were classified as malignant features such as pleomorphic and/or linear type in 51%. The distribution of calcifications on mammography classified as clustered in 68% and as regional in 23%. The final pathological diagnosis of calcifications-only lesion was 159 benign and 56 malignant tumors. The calcifications retrieval rate, were 100%, 98.6%, and 94.4% (p 5 0.4) in
Abstracts patients who underwent sonography-guided excision, stereotactic biopsy and SVAB, respectively. The ADH underestimate rate were 0%, 5.7% and 0% and DCIS underestimate rate 11.1%, 9.1% and 0%, respectively, in sono-guided excision, stereotactic biopsy and SVAB. Conclusion: There was no significant difference in successful calcifications retrieval between sonography-guided excision, SVAB and stereotactic biopsy. Same underestimate rate was found in the sonography-guided excision and stereotactic biopsy and no underestimate found in SVAB.
P 077 ee Indications and Rationale of US-Guided Breast Biopsy: Biopsy or Not? J. H. Lee,1 Y. M. Park,2 J. S. Park,2 M. Lee,3 D. C. Kim,3 H. Kwon,3 S. H. Cho,3 K. J. Nam4 1 Radiology, Breast Center, Dong-A University College of Medicine, Busan/KR, 2Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan/KR, 3Breast Center, Dong-A University College of Medicine, Busan/KR, 4Radiology, Dong-A University College of Medicine, Busan/KR Learning Objectives: The purpose of this exhibit is to summarize the indications and rationale of US-guided biopsy for the breast lesions with a variety of ultrasonographic images. Background: Ultrasonography is now considered integral in the evaluation of breast lesions and has increased the detection of small nonpalpable breast lesions. Also, breast biopsy has increased. So, it is necessary to safely reduce the number of benign-result biopsies without missing a cancer. Imaging Findings or Procedure Details: The following lesions: biopsy or not? 1) synchronous BI-RADS category 3 nodules detected in patients with breast cancer. 2) Probably benign breast masses that increase in size, but still remain benign in morphology at follow-up US. 3) Breast lesions with unexpected focal hypermetabolic activity in patients undergoing FDG PET/CT. 4) Low echoic area in the breast tissue at sonography. 5) Palpable breast masses with probably benign morphology. 6) Palpable abnormalities of the breast with normal MG and normal US. Conclusion: Awareness of the indications and rationale of US-guided biopsy for the various breast lesions will help us to decide whether to perform a biopsy or not and may reduce the number of benign-result biopsies without increasing the chance of missing a cancer.
P 078 ee Preoperative Supplemental Ultrasound-Guided Procedures for the Tailored Breast-Conserving Surgery: Pictorial Review and Appropriate Indications J. Hwang,1 B. Han,2 E. Y. Ko,2 J. H. Shin,2 M. Nam3 1 Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul/KR, 2Department of Radiology, Samsung medical center, Sungkyunkwan University School of Medicine, Seoul/KR, 3Radiology, Hallym University Sacred Heart Hospital, Anyang/KR Learning Objectives: 1. To review and introduce various preoperative ultrasound-guided procedures for the tailored breast-conserving surgery. 2. To create an awareness of possible indications and pitfalls. 3. To apply appropriate method for pre-operative localization. Background: For several decades, breast-conserving surgery (BCS) is increasingly used as an alternative to mastectomy for the treatment of early breast cancer. However, for the successful BCS, negative margin is essential for the local control of breast cancer. Owing to the advent
S97
ultrasound technique and its convenience, various supplemental procedures have been widely used for tailoring breast-conserving surgery. Imaging Findings or Procedure Details: CONTENT ORGANIZATION: 1) Second look ultrasound (targeted US): preoperative MRI to additionally detect suspicious lesion. 2) Intraoperative US: for the localization or for the specimen US. 3) US-guided skin marking: for the multiple lesions or large area of lesions. 4) US-guided aspiration of suspicious metastatic LN: for the avoidance of unneccessary sentinel LN biopsy. 5) US-guided wire localization for the US visible microcalcifications. 6) US-guided wire localization for the nonpalpable solid mass. 7) US-guided charcoal localization: nonpalpable solid mass or postbiopsy hematoma (after stereotactic vacuum-assisted biopsy or excisional biopsy). Conclusion: 1. You should know various methods, proper indication and individual pitfalls of various supplemental US-guided procedures for the tailored breast-conserving surgery. 2. You could apply the appropriate US-guided procedures for the optimal surgical strategy.
P 079 se Vanishing Lesion During US-Guided Core Needle Biopsy: Can We Exclude Malignancy? S. Y. Moon,1 N. H. Park,1 J. Y. Park,2 C. S. Park,1 M. S. Kim,1 H. J. Park1 1 Radiology, Myongji Hospital, Kwandong University, Gyeonggi-do/KR, 2 Radiology, Breast, Myongji Hospital, Kwandong University, Gyeonggi-do/KR Purpose: We analyzed the pathology of vanishing lesion during core needle biopsy of breast to ascertain whether this finding can be a radiologic clue to exclude malignancy or not. Material & Methods: 548 women underwent US-guided core needle biopsy between January 2009 and February 2011 and 98 vanishing lesions were detected in 91 patients. Automated gun biopsy with 14G needle (Magnum Ò) were used and vanishing lesion was defined as nonvisualization or volume loss more than 90% after needle passage with less than 3 times. Before biopsy, 81 lesions (82.6%) were classified as BIRADS category 4a, 12 lesions (12.2%) showed significant interval change of size and shape on follow-up study and 5 lesions (5.1%) were category 3 with clinical suspicions. Results: 548 women underwent US-guided core needle biopsy between January 2009 and February 2011 and 98 vanishing lesions were detected in 91 patients. Automated gun biopsy with 14G needle (Magnum Ò) were used and vanishing lesion was defined as nonvisualization or volume loss more than 90% after needle passage with less than 3 times. Before biopsy, 81 lesions (82.6%) were classified as BIRADS category 4a, 12 lesions (12.2%) showed significant interval change of size and shape on follow up study and 5 lesions (5.1%) were category 3 with clinical suspicions. Conclusion: Vanishing lesion during core needle biopsy can be the clue to exclude malignancy.
Breast / Cancer P 080 se Flow Index of 3D Breast Ultrasound was Strongly Correlated with Axillary Lymph Nodes Metastases in the Absence of Lymphovascular Invasion C. Su, S. Kuo, D. Chen Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua/TW Purpose: Axillary lymph nodes (ALN) are the most commonly involved sites of disease in breast cancer that has spread outside the primary