Page 109 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology UGVAE of breast lesions

The available literature on UGVAE remains limited, antiplatelet or anti-aggregation medications were required
highlighting the need for further exploration. This study to stop them 5 days before the examination. Furthermore,
aims to bridge this gap by presenting UGVAE as a viable all patients underwent a coagulation profile assessment
diagnostic and therapeutic technique for managing before imaging to ensure their suitability for the procedure.
benign breast lesions. UGVAE is considered a therapeutic All included lesions were confirmed to be benign, with no
method because it offers a minimally invasive alternative high-risk findings. Fine needle aspiration cytology was not
to surgical excision, achieving high rates of complete lesion performed, as it is no longer a standard practice in breast
removal while preserving favorable cosmetic outcomes. biopsies.
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Studies have demonstrated that UGVAE provides efficacy
comparable to open surgery in terms of lesion clearance 2.2. Imaging features
while significantly reducing procedural morbidity, Lesion characteristics, such as size, shape, echogenicity,
recovery time, and the need for general anesthesia. 17,27 and anatomical location, were evaluated using ultrasound
Furthermore, research suggests that UGVAE ensures and, where applicable, mammography, following the
long-term stability with low recurrence rates, making it a BI-RADS lexicon for standardized reporting.
reliable option for treating benign breast lesions such as FA
21
and papillomas. In addition, the present study evaluates 2.3. Experimental procedure
the procedure’s performance, potential complications, and UGVAE was performed using 7-gauge and 10-gauge
overall outcomes, offering valuable insights into its clinical needles by two experienced breast radiologists, each with
utility and effectiveness. a decade of experience in breast imaging. The procedure
was carried out under continuous ultrasound guidance to
2. Methods ensure precision and accuracy.
2.1. Study design and subjects
2.3.1. Procedure steps
This single-center, retrospective cohort study was approved 2.3.1.1. Needle placement and tissue extraction
by the Institutional Review Board of King Abdullah
International Medical Research Center (approval code: After confirming the correct needle placement, multiple
RJ20/052/J; approval date: April 26, 2020). Over a 4-year tissue samples were extracted from the target lesion
period, from 2016 to 2020, a total of 991 ultrasound- under ultrasound guidance. Complete lesion excision
guided breast biopsies were performed. Among these cases, was achieved in most cases, confirmed by the absence
67 female patients with a single breast lesion underwent of sonographic evidence of the lesion at the end of the
UGVAE for complete lesion excision. All patients who procedure.
underwent UGVAE during this timeframe were included 2.3.1.2. Tissue marker placement
in the study. The parameters analyzed included patient
demographics, imaging characteristics of the lesions (both A tissue marker was placed at the excision site to
mammographic and sonographic), as well as pathological facilitate future imaging correlation. The marker’s position
and clinical follow-up outcomes. The clinical indications was confirmed using ultrasound and/or mammography
for UGVAE included patient preference, the presence (Figure 1).
of pain, palpable lumps, nipple discharge, discordant
previous biopsy results, or interval changes in breast 2.3.1.3. Post-excision measures
imaging-reporting and data system (BI-RADS) 3 lesions. Following lesion excision, firm pressure was applied to the
Ultrasound examinations were conducted using a Logiq excision site for 10 min to control bleeding. A pressure
P5 ultrasound system (General Electric Healthcare, United dressing was then applied.
States) equipped with a 7.5 MHz linear array probe.
Before imaging, we ensured that patients were not on 2.3.1.4. Sample preservation
anticoagulation therapy, particularly newer anticoagulants All extracted tissue samples were immediately preserved in
that may not be detected in standard blood tests. Therefore, 10% formaldehyde and sent for histopathological analysis.
we specifically inquired about the use of such medications.
In addition, we confirmed that patients were not taking 2.3.2. Post-procedural care
antiplatelet medications. For patients on anticoagulation Comprehensive post-procedural instructions were
therapy, we instructed them to discontinue the medication provided to the patients, including:
2 days before the procedure. For other medications that
can be detected in blood tests, discontinuation was advised 2.3.2.1. Dressing care
5 days before the procedure. Similarly, patients taking The pressure dressing was to be removed after 8 h.

Volume 9 Issue 2 (2025) 101 doi: 10.36922/ejmo.8436