Interventional bleeding, hematoma and scar-formation after vacuum-biopsy under stereotactic guidance: Mammotome®-system 11g/8g vs. ATEC®-system 12g/9g

Abstract: Purpose: To evaluate prospectively the correlation of scar-formations after vacuum-assisted biopsy with different systems and needle-sizes and interventional bleeding/post-interventional hematoma. Methods and materials: Between 01/2008 and 12/2009, 479 patients underwent vacuum-assisted biopsy under stereotactic-guidance, using the Mammotome®-system with 11/8-gauge and ATEC®-system with 12/9-gauge, whereas in 178 cases with representative benign histology no surgical-biopsy after vacuum-assisted biopsy was performed and at least a 2-plane-follow-up-mammogram after 6 month post-vacuum-assisted biopsy was available. Bleeding during intervention, hematoma post-intervention and scar-tissue was scored as minimal and moderate/severe. Statistical analysis included Chi-Square-trend-test, p-value <0.05 was considered to be significant. Results: Significantly more bleedings and post-interventional hematomas for 8-gauge-Mammotome®-system vs. 11-gauge-Mammotome®-system (41.9% vs. 8.4%, p <0.001/35.5% vs. 16.7%, p =0.029), no significant-differences for the ATEC®-systems 9-gauge vs. 12-gauge (26.9% vs. 29.7%, p =0.799/42.3% vs. 43.2%, p =0.596). 11-gauge-Mammotome®-system vs. ATEC®-12-gauge-system revealed significantly less bleedings/hematomas (8.4% vs. 29.7%, p =0.015/16.7% vs. 43.2%, p =0.001), no significant differences for the large-systems (p =0.135/p =0.352). Follow-up of Mammotome®-11/8-gauge-system system has shown 13.1/16.1% minimal scar-formation and 1.2/3.2% moderate/severe scars, whereas ATEC®-12/9-gauge-system has shown 10.8/3.8% minimal scar-formation and 0/11.5% moderate/severe scars, no significant differences. No significant difference was found when comparing Mammotome®-11/8-g-systems vs. ATEC®-12/9-g-systems (p =0.609/p =0.823). There was also no correlation between risk of scar-formation after occurrence of bleeding or hematoma with any examined VAB-system or any needle size in this study (p =0.800). Conclusion: Using larger needle-sizes significantly (Mammotome®)/not significant for ATEC®) more interventional bleedings and post-interventional hematomas were detected, only a tendency concerning scar-formation. [Copyright &y& Elsevier]