Vacuum assisted cores to remove entire lesion under ultrasound

The Procedure
Directional, vacuum-assisted breast biopsy is a procedure for undertaking biopsy for breast lesions including microcalcifications, masses, spiculated masses, asymmetric densities and multifocal disease. The procedure may be assisted by imaging guidance such as ultrasound and X-ray. It is a diagnostic procedure and is not, at this time, intended for therapeutic use.

Existing Procedures

Women who are found to have a suspicious breast lesion following mammography will be recalled for further diagnostic tests. These may include additional mammography, ultrasound fine needle or core biopsy, or wire/needle localization and open biopsy. 

Core biopsy (including automated Tru-Cut) can be guided by ultrasound or X-ray. Following localization of the breast lesion, a 3 mm incision is made in the skin under local anesthesia. The biopsy is then performed using a coring needle housed in a spring-loaded automated biopsy gun. The coring needle is manually advanced into the breast to the appropriate depth and fired. The inner needle then moves forward to about 23 mm, followed by the outer cutting sheath. The core of tissue is obtained within the 17 mm trough. Pre-fire and post-fire images are taken to confirm the passage of the needle through the lesion. A single sample is obtained each time the device is fired. In general, the sample weight is about 17.2 mg. A minimum of five samples is usually required from each lesion to allow a conclusive histological diagnosis. The procedure takes approximately 45 minutes and no hospitalization is required. Only one sample is obtained per needle entry. Additional sampling requires additional needle entry. The sample is withdrawn along the needle entry tract. 

Open biopsy was the most frequently performed biopsy procedure until a few years ago. Open biopsy is often directed by wire or needle inserted under mammograph or ultrasound control. An incision is made and a section of tissue is removed for histological examination. The surgery is usually performed as a day surgery procedure, often under general anesthesia.

Cryoablation For Fibroadenomas

What is cryoablation?
Cryoablation is the process of using extremely cold temperatures to freeze and destroy targeted tissue. The freezing process can be continuously seen during the procedure using ultrasound.

What are the treatment options for fibroadenomas?
Fibroadenomas are benign tumors made up of both glandular breast tissue and stromal (fibroconnective) tissue. They are most common in young women in their twenties and thirties, but they may occur at any age. Some fibroadenomas are too small to feel and can be seen only under the microscope, but some are several inches across. They tend to be round and have borders that are distinct from the surrounding breast tissue, so they often feel like a marble within the breast. Some women have only one fibroadenoma, but others may have several. Fibroadenoma can be easily diagnosed by fine needle aspiration or needle core biopsy.

Traditionally, the only treatment for fibroadenomas was surgical removal. This typically involved sedation, an incision to remove the tumor, and stitches. The Visica Treatment System offers you a truly minimally invasive alternative. The Visica procedure uses cold therapy (cryoablation) to destroy the fibroadenoma through an incision so small that it only needs a small adhesive bandage and no stitches afterward.

Sentinelnode Procedure

The sentinel node procedure is a new technique used by breast surgical specialists to find out whether there are breast cancer cells in the lymph nodes in your axilla.

Traditionally, when a woman had a mastectomy all, or almost all, of the tissue in the axilla was removed along with the breast. This tissue consists of fat, lymph nodes, lymph and blood vessels, and some nerves. Removal of this tissue either as part of a mastectomy or through a separate incision in the axilla is called an axillary dissection. Surgeons used to think that the best way to treat breast cancer was to remove the entire breast and any cancer cells that might be in the axillary tissue. During the last 20 years, we now understand that removing the axilla does not prevent the spread of breast cancer. At about this same time, we learned that we can treat breast cancer with breast conservation (removing only the cancer from the breast, followed by radiation to the remaining breast tissue). And we found that we could make a separate incision in the axilla and remove some, but not all, of the tissue there. We also learned that those women who do have cancer cells in their axilla benefit from additional treatment with chemotherapy or hormone therapy. Also, in those women who have some cancer cells in their nodes, it sometimes helps us to know how many nodes have these cells so that we can plan additional treatment.

Mammosite Radiation (brachytherapy)

The MammoSite system to deliver internal beam radiation to breast cancer patients after the surgical removal of a breast lump (lumpectomy). Internal beam radiation, or brachytherapy, significantly reduces the amount of time required with standard external beam radiation and may cause fewer side effects. While the new treatment has not been found to be more effective than traditional radiation therapy, the FDA approval provides breast cancer patients with another, more convenient option and could reduce the number of women who have their entire breasts removed with mastectomy.