Management of breast fibroadenomas by ultrasound-guided vacuum-assisted biopsy - Three years experience

Objective: Fibroadenoma is a common benign breast tumor occurring in young women. The management of fibroadenoma is still debatable. During the last decade, ultrasound-guided vacuum-assisted biopsy (UGVAB) has been widely used in the treatment of breast fibroadenoma. We wanted to evaluate the role of UGVAB in the diagnosis, treatment and complete excision of breast fibroadenoma. Materials and Methods: From July 2000 to July 2003, 113 consecutive patients, with radiographically or clinically suspected breast fibroadenomas 0.5 to 2 cm in size, were prospectively referred for UGVAB. The clinical outcome (complications, diagnostic rate and complete excision rate) of all patients were reviewed. Results: All 113 UGVAB tissues were sent to the pathology department for histological examination and all but one were diagnosed as fibroadenomas (99%). The exception was confirmed as lobular carcinoma in situ (LCIS). All tumors 0.5 cm to 1.5 cm in size were completely excised by UGVAB. However, the complete excision rate was only 67% for tumors 1.6 cm to 2 cm in size. Two patients had pneumothorax (1.76%) and 13 patients had severe ecchymosis (11.5%) after UGVAB. The average time for completion of the procedure was 48 minutes (range 20 to 150 minutes). There were no wound infections and all patients were satisfied with the cosmetic results. Conclusions: In our three-year experience, UGVAB is a fast and accurate method for breast tumor diagnosis. Moreover, tumors measuring 1.5 cm or less can be completely removed under UGVAB. Therefore, we believe that UGVAB is a safe and effective method of treatment for small fibroadenomas.