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Breast needle core biopsy tract markers: A comparison between charcoal saline solution, a commercial tattoo device, and biopsy clip
A new publication from Dr. Jennifer Payne, Dr. Laura Fitzpatrick and Dr. Sian Iles!
Background: Charcoal solution tattoo for breast core biopsy (CB) tracts has been utilized for more than 30years at our institution.
Purpose: To evaluate the identification of CB sites and complication rate of charcoal solution tattoo in thepathologic assessment of breast excisions, in comparison with a cohort of patients whose CB sites weremarked by a commercial tattoo product (Spot Endoscopic MarkerTM) and a third cohort with a titaniumclip (Argon V-Mark clip).
Methods: A retrospective study of consecutive breast excisions from patients who had pre-operative breastCB and CB tract marker from September 20, 2015 to March 31, 2017 was performed. Eligible cases andrelevant data were abstracted from electronic pathology and diagnostic imaging files and operative notes.
Results: 1263 patients had at least one breast CB with a CB tract marker: 794 with charcoal; 164 with SpotTM;and 305 with a clip). Immediate (1.8-5.8%) and late (0.6-1%) complications were uncommon for all threemarkers. The presence of charcoal or SpotTM tattoos was recorded in 89.9% and 71.3% of pathology reports,respectively. A clip or biopsy site was demonstrated in 91.9% of cases with pathologic assessment and/orspecimen radiography. There were five surgical excisions with complications related to either a clip or SpotTM placement. Clip displacement occurred in 54/285 (18.9%) of cases with recorded clip measurements.Charcoal granulomas led to repeat CBs in two (0.25%) patients.
Conclusions: Charcoal, SpotTM tattoo markers, and biopsy clip performed similarly for CB tract pathologicidentification and had similar complication rates. Charcoal markers were easier to see macroscopically thanSpotTM. Accuracy of titanium clips for marking breast CB sites with stereotactic CB deployment was variable.
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