Preoperative mammotome biopsy of ducts beneath the nipple areola complex

Eur J Surg Oncol. 2006 May;32(4):410-2. doi: 10.1016/j.ejso.2006.01.013. Epub 2006 Mar 3.


Aim: To evaluate the role of ultrasound guided mammotome biopsy of the ducts beneath the nipple areola complex (NAC), as a new technique in detecting the occult involvement of the NAC in breast cancer patients prior to nipple preserving subcutaneous mastectomy.

Method: A prospective study where 33 women requesting nipple preserving mastectomy for invasive or in situ disease were offered the procedure to determine if leaving the nipple was safe. A 5 mm skin incision was made after infiltration with local anaesthetic and the 11G mammotome needle was positioned beneath the nipple under ultrasound guidance which was turned through 360 degrees as the biopsies were taken. The procedures were performed by trained non-radiologists.

Results: Thirty-three women had 36 procedures. Seven out of the 36 had a positive mammotome biopsy. Twenty-three patients had 26 NAC preserving mastectomies with immediate reconstruction. Three had bilateral procedures. Ten patients had NAC sacrificed. The histopathology of the mastectomy specimen correlated 100% with the mammotome biopsy.

Conclusion: Preoperative ultrasound guided mammotome biopsy of the ducts beneath the NAC is a safe, reliable and accurate technique and is evolving as an oncologically safe procedure. The large mammotome needle can be visualized easily under high resolution, near field high frequency scanners and this increases the accuracy of the biopsy. It can replace the traditional frozen section and be used as an alternate. It can be performed safely by an appropriately trained non-radiologist (surgeon/breast clinician).

Publication types

  • Comparative Study

MeSH terms

  • Biopsy, Needle / instrumentation
  • Biopsy, Needle / methods*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / surgery
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / surgery
  • Carcinoma, Lobular / diagnostic imaging
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / surgery
  • Diagnosis, Differential
  • Female
  • Humans
  • Mammary Glands, Human / pathology*
  • Mastectomy, Subcutaneous / methods*
  • Neoplasm Staging
  • Nipples / pathology*
  • Preoperative Care
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography