Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications

Scaperrotta, Gianfranco; Ferranti, Claudio; Capalbo, Emanuela; Paolini, Biagio; Marchesini, Monica; Suman, Laura; Folini, Cristina; Mariani, Luigi; Panizza, Pietro

doi:10.1016/j.ejrad.2015.11.001

Cited by 18 publications

(24 citation statements)

References 28 publications

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“…Nonparametric statistical analysis showed that the grade of the cancers was the only significant predictive factor of upgrade in our study which is in agreement with previously published reports. 21 None of the remaining predictive factors we assessed-molecular type, comedo presence, mammographic size-played a significant role in the upgrade of the disease in our population. However, we found that the initial mammographic size was significantly smaller in the downgrade cases, which could be related to the fact that we included the BLES excised lesions in the downgrade group; smaller lesions can be potentially completely removed by the BLES biopsy, and no residual disease will be found in the surgical result.…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

“…Regarding cancers, we report a total upgrade rate to more severe disease in 15.5% of cases, which is within the range of previously reported underestimation rates (3.2%-21.4%). 13,17,18,21 In the total of 14/90 cases with upgrade, only 7/90 cases (7.7%) were initially diagnosed as pure DCIS with invasive cancer eventually found in the final report. The remaining cases showed upgrade from microinvasion to invasion (4 cases, 4.4%) and from DCIS to microinvasion (3 cases, 3.3%).…”

Section: Discussionmentioning

confidence: 99%

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Predictive factors for breast lesion excision system (BLES) accuracy and safety in stereotactic biopsy of suspicious calcifications

Christou¹,

Koutoulidis

Koulocheri

et al. 2020

Breast J

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Aim To retrospectively assess the effectiveness and safety of BLES stereotactic biopsy of suspicious calcifications and investigate possible predictive factors for underestimation. Methods and materials Between January 2014 and January 2016, 400 biopsies of suspicious calcifications were performed in our Department using the BLES stereotactic device. The mean age of our population was 58.5 years (range 39‐78 years). The final surgical results were used as gold standard. The effectiveness of the method was statistically evaluated. Mammographic size, grade, molecular type, and presence of comedo type/necrosis were assessed as predictive factors. Results 90/400 (22.5%) cases were cancers (20% invasive cancers, 80% non‐invasive cancers). 38/400 cases were atypical lesions (9.5%). No underestimation was found in atypical lesions that underwent surgery (29/38 cases). Downgrade was achieved in 45.5% of cases (with complete removal in 34.4%), concordance in 43.3%, and upgrade was found in 15.5% of the cases; the initial mammographic size and the grade of the cancers were found to be statistically significant predictive factors. The total complication rate was 8.75%. Conclusions Breast lesion excision system is a highly accurate and safe stereotactic biopsy technique of suspicious calcifications with low underestimations and high downgrade/removal rates with the potential to alter the final surgical decision in selected cases.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictive factors for breast lesion excision system (BLES) accuracy and safety in stereotactic biopsy of suspicious calcifications

Christou¹,

Koutoulidis

Koulocheri

et al. 2020

Breast J

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“…Five hundred eighteen articles were excluded because they did not use the BLES device or a prototype. We identified 19 full-text versions of studies that used the BLES as a diagnostic or therapeutic device and that fulfilled all the inclusion criteria [4][5][6][7][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Figure 3 shows the results of the study search and identification of eligible studies.…”

Section: Studiesmentioning

confidence: 99%

“…The number of lesions ranged from 19 to 1170. Ten studies used stereotactic guidance during the BLES procedure [4,6,7,9,11,13,15,16,20,22]. Six studies used stereotactic or ultrasound guidance [5,10,12,14,21,23]; only Graham [17] performed all BLES procedures with ultrasound guidance.…”

Section: Studiesmentioning

confidence: 99%

A systematic review on the use of the Breast Lesion Excision System in breast disease

Sanderink¹,

Laarhuis²,

Strobbe³

et al. 2018

European Journal of Cancer

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Purpose: To outline the current status of and provide insight into possible future research on the breast lesion excision system (BLES) as a diagnostic and therapeutic device. Methods: A systematic search of the literature was performed using PubMed, Embase, and the Cochrane databases to identify relevant studies published between January 2002 and April 2018. Studies were considered eligible for inclusion if they evaluated the diagnostic or therapeutic accuracy or safety of BLES. Results: Ultimately, 17 articles were included. The reported underestimation rates of atypical ductal hyperplasia and ductal carcinoma in situ (DCIS) ranged from 0 to 14.3% and from 0 to 22.2%, respectively. Complete excision rates for invasive ductal carcinoma and DCIS ranged from 5.3 to 76.3%. Bleeding was the most frequently reported complication (0-11.8%). Device-related complications may arise, with an empty basket being the most common (0.6-3.6%). Thermal damage of the specimen, caused by the use of a radiofrequency cutting wire, was reported in eight of the included studies. Most thermal artifacts were reported as superficial and small (0.1-1.9 mm). Conclusions: The BLES, an automated, image-guided, single-pass biopsy system for breast lesions using radiofrequency is designed to excise and retrieve an intact tissue specimen. It is an efficient and safe breast biopsy method with acceptable complication rates, which may be used as an alternative to vacuum-assisted biopsies. The variable rate of complete excision raises questions about the possibility to use BLES as a therapeutic device for the excision of small lesions. Further research should focus on this aspect of BLES.

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Integrated Breast Biopsy for Best Radiological Diagnosis of Breast Cancer

Cassano

Trentin

2017

Breast Cancer

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Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications

Cited by 18 publications

References 28 publications

Predictive factors for breast lesion excision system (BLES) accuracy and safety in stereotactic biopsy of suspicious calcifications

Predictive factors for breast lesion excision system (BLES) accuracy and safety in stereotactic biopsy of suspicious calcifications

A systematic review on the use of the Breast Lesion Excision System in breast disease

Integrated Breast Biopsy for Best Radiological Diagnosis of Breast Cancer

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