EIS showed mediocre overall diagnostic accuracy for classifying suspicious breast lesions. Quantitative analysis of positive EIS findings did not help to differentiate between false and true positive spots.

SummaryPatients with an elevated level of urokinase plasminogen activator (uPA) in breast cancer tissue have an adverse prognosis. This study evaluated the prognostic relevance of uPA detection in disseminated tumour cells in bone marrow. Bone marrow was sampled intraoperatively from both iliac crests in 280 patients with primary breast cancer. Interphase cells were enhanced and stained immunocytologically with two antibodies: 2E11, which detects TAG 12 -a tumour-associated glycoprotein typically expressed by almost all breast cancer cells -and the anti-uPA antibody HD-UK9. Thirty-five of the 2E1 1-positive women (n = 132, 47%) developed metastatic disease (median follow-up time 44 months). Of these, most were uPA positive (n = 23, 65%) and only 12 were uPA negative. Patients with uPApositive cells in bone marrow (n = 98, 35%) had a significantly shorter metastasis-free interval (36 months) than women who were uPA negative (44.5 months). The worst prognosis was seen in patients positive for both markers (29.5 months), followed by those who were uPA negative and 2E11 positive (37 months). The detection of uPA on disseminated tumour cells characterizes a subgroup of patients with an even worse prognosis, who should undergo more aggressive adjuvant systemic therapy. For the first time, it was possible to evaluate an important qualitative parameter involved in the process of breast cancer metastases.

ZusammenfassungFragestellung: Ist die Komplettentfernung benigner Mammabefunde (Fibroadenome als Indikatorläsion) mit der sonographisch kontrollierten Hand Held Vakuumbiopsie (HHVB) möglich und mit welchen Komplikationen muss man rechnen? Material und Methode: Bei 480 Patientinnen wurden unklare Befunde der Brust mittels sonographischer HHVB (8 und 11 Gauche) abgeklärt, und diese Patientinnen im Rahmen einer retrospektiven Analyse, an der 9 Zentren teilnahmen, nachbeobachtet. Ziele der Nachbeobachtungen waren die sonographische Untersuchung des biopsierten Areals nach Residuen direkt nach dem Eingriff sowie im Rahmen der Nachuntersuchung. Ebenfalls wurden die Komplikationen erfasst und ausgewertet. Der mediane Nachbeobachtungszeitraum lag bei 7 Monaten (3 ± 35 Monate). Alle Biopsien wurden ambulant in Lokalanästhesie durchgeführt. Eingeschlossen wurden ausschlieûlich Patientinnen mit histologisch gesichertem Fibroadenom. Ergebnisse: Bei 480 Eingriffen mit der HHVB konnte in 421 Fällen (88%) direkt nach dem Eingriff und in 402 Fällen (84 %) auch bei der Nachuntersuchung eine Komplettentfernung sonographisch nachgewiesen werden. In nur einem Fall trat eine antibio-Abstract Aim: Is complete removal of a benign breast lesion (fibroadenoma as an indicative lesion) with sonographically controlled handheld vacuum biopsy (HHVB) possible and what type of complications are to be expected? Material and Method: 480 patients with an unclear lesion of the breast were classified using the sonographically guided HHVB (8 and 11 Gauche), retrospectively analysed and followed up. 9 centres were involved. The aim of the follow-up was the sonographic examination of the biopsy area, looking for residuals directly after the procedure as well as in conjunction with the follow-up. Complications were also registered and evaluated. The median time of follow-up was 7 months (3 ± 35 months). All biopsies were done as outpatient procedures under local anaesthesia. Included were only patients with a positive histology of fibroadenoma. Results: Of the 480 procedures using HHVB, 421 cases (88%) were totally removed directly after the procedure and 402 cases (84%) in the follow-up as could be seen by the sonogram. In only one case was antibiotic therapy necessary because of infection.

In patients with benign lesions on imaging, open biopsies can be avoided by LCNB. In patients with biopsy proven carcinoma, therapy planning is improved. The addition of morphobiological parameters allows early individual treatment.

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