Percutaneous breast lesion excision system (BLES): A new tool for complete closed excision of high risk lesions (Egyptian experience)

Abstract The objective of the study is to assess the use of “Intact” Breast lesion excision system as the primary method for histopathological diagnosis of suspicious small and borderline lesions as well as the unclassified microcalcifications. Material and method Eighty cases were included for BLES excision of radiologically high risk lesions. Results Eighty cases were successfully done, age range between 21 and 55 years old. 72.5% (58/80) cases were done under ultrasound guidance and 27.5% (22/80) cases were done under stereotactic guidance. Thirty percent (24/80) lesions were removed by using the 15 mm probe and 70% (56/80) lesions were removed by using the 20 mm probe size. The main indication was complete removal of a small indeterminate mass (30/80) followed by biopsy of unclassified micro calcifications, either without mass (18/80) or associated with a mass (16/80). Asymmetry (6/80) and distortion (4/80) and finally clustered micro cysts (6/80) were observed. (44/80) representing 55% were categorized as BIRADS 3 while (36/80) about 45% were categorized as BIRADS 4.30% (24/80) of lesions were benign (including fibroadenomas, fibrocystic changes and sclerosing adenosis), 52.5% (42/80) were potentially high risk lesions (including ADH, ALH and papillomas) and 17.5% (14/80) of lesions were malignant (including LCIS, DCIS and IDC). Open surgery was done for all the malignant and potentially malignant lesions and there was no underestimation. However there was no enough margin after BLES in (3/6) IDC. Conclusion BLES offers complete lesion removal thus much indicated in borderline lesions.