Introduction To evaluate current use of breast biopsy markers (BBM) amongst Australian and New Zealand radiologists. Methods Radiologists attending a national breast conference were invited to complete an online survey addressing demographics, BBM use following ultrasound, stereotactic, tomosynthesis and MRI‐guided biopsy, frequency of early BBM displacement, preoperative lesion localisation (PLL) and axillary BBM use. Results Overall response rate was 52% (60/115). The majority (n = 45) 75% practiced in Australia. 98% had BBMs available in their practice, 40% reported BBM costs weren’t covered by insurance. 27% would use BBMs more often if they were, with some utilising smaller gauge devices for lesion sampling to minimise need for BBM use and patient out‐of‐pocket costs. Ultrasound‐guided procedures were associated with lower rates of clinically significant BBM displacement (P = 0.001). Considering PLL, 44% were able to perform US‐guided PLL in <25% of cases. Poor sonographic visibility was the commonest reason why this wasn’t possible. In the axilla, BBMs were mainly used to mark positive nodes in pre‐neoadjuvant chemotherapy patients. Conclusion This survey is the first to provide data on BBM use amongst a sample of predominantly Australian and New Zealand radiologists, and provides compelling evidence of significantly lower incidence of BBM displacement with US‐guided procedures. Our results suggest some radiologists may hesitate to use BBMs due to cost, and this can influence their choice of biopsy technique. Provision of a Medicare item Number for BBMs may lead to increased adoption of best practice guidelines for preoperative diagnosis of breast lesions.
Introduction In Australia, the usual approach to breast lesions where core biopsy returns an uncertain result (“B3” breast lesion) is to perform surgical diagnostic open biopsy (DOB). This is associated with patient time off work, costs of hospital admission, risks of general anaesthesia and surgical complications. The majority of B3 lesions return benign results following surgery. Vacuum assisted excision biopsy (VAEB) is a less invasive, lower cost alternative, and is standard of care for selected B3 lesions in the United Kingdom. Similar use of VAEB in Australia, could save many women unnecessary surgery. The aim of this study was to document our experience during the introduction of VAEB as an alternative to DOB for diagnosis of selected B3 lesions. Methods The multidisciplinary team developed an agreed VAEB pathway for selected B3 lesions. Technically accessible papillary lesions, mucocele‐like lesions and radial scars without atypia measuring ≤ 15mm were selected. Results Over a 7 month period, 18 women with 20 B3 lesions were offered VAEB. 16 women (18 lesions) chose VAEB over DOB. Papillomas were the commonest lesion type. All lesions were successfully sampled: 17/18 were benign. One lesion (6%) was upgraded to malignancy (ductal carcinoma in situ on VAEB, invasive ductal carcinoma at surgery). No major complications occurred. Patient satisfaction was high: 15/16 respondents would again choose VAEB over surgery. Conclusion VAEB is a patient‐preferred, safe, well‐tolerated, lower‐cost alternative to DOB for definitive diagnosis of selected B3 breast lesions.
This 637-page hard back book by expert European contributors and editors is crammed full of 2025 high-quality illustrations. Together with over 100 online videos, it brings paediatric ultrasound to life.There are two introductory chapters, the first outlining practical advice for performing ultrasound in a paediatric setting and the second a concise overview of the physics of ultrasound, including latest advances.Chapters 3 through 17 are divided according to anatomical systems and utilise the helpful style of normal anatomy/variants followed by pathology. Each chapter without exception has a plethora of high-quality images complemented by concise text, written in clear terms. In addition, each chapter contains 'tips from the pro' which offer helpful, practical advice. Eight chapters are supplemented by excellent on-line videos. Interventional procedures including biopsy and drainage are covered in chapter 18.This book requires a standard of ultrasound experience and is not a step-by-step guide to performing paediatric ultrasound. It covers all the body parts in a concise fashion rather than in an exhaustive manner. Diagnostic Pediatric Ultrasound would be a valuable reference book in any ultrasound department that performs paediatric ultrasound. It will appeal to radiology trainees, consultants and sonographers alike. It is highly recommended by both the reviewing radiology consultant and radiology trainee.
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