Review article

https://doi.org/10.21860/medflum2024_313695

Indications for Interventional Procedures of the Breasts and Axillae

Petra Valković Zujić orcid.org/0000-0003-4029-5432 ; Klinički bolnički centar Rijeka, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Rijeka, Hrvatska
Jelena Rnjak ; Klinički bolnički centar Rijeka, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Rijeka, Hrvatska
Lovro Tkalčić ; Klinički bolnički centar Rijeka, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Rijeka, Hrvatska
Damir Miletić ; Klinički bolnički centar Rijeka, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Rijeka, Hrvatska
Franjo Lovasić ; Klinički bolnički centar Rijeka, Klinika za kirurgiju, Zavod za opću i onkološku kirurgiju, Rijeka, Hrvatska
Manuela Avirović orcid.org/0000-0002-6601-7521 ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za opću patologiju i patološku anatomiju, Rijeka, Hrvatska
Ana Car Peterko orcid.org/0000-0003-3148-0126 ; Klinički bolnički centar Rijeka, Klinika za kirurgiju, Zavod za opću i onkološku kirurgiju, Rijeka, Hrvatska

Abstract

Early diagnosis of breast cancer leads to better survival and less aggressive treatment. Imaging techniques such as ultrasound, mammography and magnetic resonance imaging are the basic breast imaging techniques that can be used to detect lesions at a very early, noninvasive stage. Pathohistologic tissue analysis is considered the gold standard in diagnosis, so biopsy of suspicious lesions in the breast is an indispensable part of treatment. In general, image-guided breast biopsy is required for nonpalpable lesions, but it is also recommended for palpable lesions as it improves the accuracy of diagnosis. Ultrasound-, mammographic-, or magnetic resonance-guided breast procedures are reliable methods, and placement of a tissue marker after biopsy is a sign of good practice. Marking lesions after mammography-guided biopsy and lesions smaller than 5 mm is particularly important, as these lesions can be completely removed and preoperative marking is then much more difficult. The same principle applies to neoadjuvant treatment, where the tumor may have already completely regressed, so that marking the tissue enables precise surgical intervention. For marking of pathological lymph nodes, it is advisable to use specially markers that are clearly visible under all imaging modalities and allow precise marking of the lymph node during neoadjuvant treatment. Preoperative localization of nonpalpable lesions is used to optimize surgical excision to obtain negative margins without sacrificing normal tissue. This review also describes minimally invasive techniques such as thermal ablation, cryoablation, and high-frequency focused ultrasound as alternatives to surgical excision to reduce complications, achieve better cosmetic results, and shorten hospital stay. This review describes the spectrum of image-guided procedures performed at the Clinical Hospital Center in Rijeka.

Keywords

Breast Neoplasms; Early Detection of Cancer; Image-Guided Biopsy; Magnetic Resonance Imaging; Mammography; Ultrasonography

Hrčak ID:

313695

URI

https://hrcak.srce.hr/313695

Publication date:

1.3.2024.

Article data in other languages: croatian

Visits: 1.573 *