Annals of Surgical Oncology

, Volume 12, Issue 2, pp 181–188 | Cite as

Stereotactic Radioguided Surgery by SiteSelect for Subclinical Mammographic Lesions

  • Virginie Doridot
  • Martine Meunier
  • Carl El Khoury
  • Claude Nos
  • Anne Vincent-Salomon
  • Brigitte Sigal-Zafrani
  • Krishna B. Clough



We defined the indications for and evaluated the results of a new technique for radioguided surgery, the SiteSelect system. The procedure allows en-bloc resection of the breast parenchyma under local anesthesia.


This prospective study was based on 167 patients operated on between December 2000 and October 2003 with 2 phases. The first step was an evaluation of the feasibility of the procedure with the 15-mm cannula, and the second was therapeutic with the 22-mm cannula.


The mean duration of the procedure was 42 minutes. In 96.9% of procedures, the lesion was excised successfully. Only one complication (hematoma) and two failures and were observed. Histological examination revealed benign disease in 65.8% of cases and cancer in 34.2% of cases. In the latter cases, the specimen margins were histologically involved in 86.2% of cases with the 15-mm procedure and in 41% with the 22-mm procedure. During the first evaluation, all patients with a cancer underwent systematic surgical re-excision: residual tumor was present in 18 cases (64.2%). The biopsy was painless for 88 patients, and the cosmetic result was good in all cases.


This study shows that the SiteSelect procedure allows resection of the lesion in 96.9% of cases. Combined with complementary surgical lumpectomy during the same operation, this procedure achieved a success rate of 98.7%. In the case of cancer, the 15-mm cannula is not wide enough to allow free margins. The use of a new 22-mm cannula, currently under evaluation, might solve this problem.


Breast cancer Margins SiteSelect Stereotactic surgical biopsy 


  1. 1.
    Parker, SH, Lovin, JD, Jobe, WE,  et al. 1990Stereotactic breast biopsy with a gunRadiology1767417PubMedGoogle Scholar
  2. 2.
    Parker, SH, Lovin, JD, Jobe, WE, Burke, BJ, Hopper, KD, Yakes, WF 1991Non palpable breast lesions: stereotactic automated large-core biopsiesRadiology1804037PubMedGoogle Scholar
  3. 3.
    Burbank, F 1997Mammographic findings after 14-gauge automated needle and 14-gauge directional, vacuum-assisted stereotactic breast biopsiesRadiology2041536PubMedGoogle Scholar
  4. 4.
    Liberman, L, Dershow, DD, Morris, EA, Abramson, AF, Thornton, CM, Rosen, PP 1997Clip placement after stereotactic vacuum-assisted breast biopsyRadiology20541722PubMedGoogle Scholar
  5. 5.
    Burbank, F, Parker, SH 1998Methods for evaluating the quality of an image-guided breast biopsy programSemin Breast Dis17183Google Scholar
  6. 6.
    Jackman, RJ, Burbank, F, Parker, SH,  et al. 2001Stereotactic breast biopsy of non palpable lesions: determinants of ductal carcinoma in situ underestimation ratesRadiology218497502PubMedGoogle Scholar
  7. 7.
    Lifrange, E, Dondelinger, RF, Fridman, V, Colin, C 2001En bloc excision of nonpalpable breast lesions using the advanced breast biopsy instrumentation system: an alternative to needle guided surgery?Eur Radiol11796801PubMedGoogle Scholar
  8. 8.
    Marti, WR, Zuber, M, Oertli, D,  et al. 2001Advanced breast biopsy instrumentation for the evaluation of impalpable lesions: a reliable diagnostic tool with little therapeutic potentialEur J Surg167158PubMedGoogle Scholar
  9. 9.
    Vargas, HI, Agbunag, RV, Khaikhali, I 2000State of the art of minimally invasive breast biopsy: principles and practiceBreast Cancer73709PubMedCrossRefGoogle Scholar
  10. 10.
    Atallah, N, Karam, R, Younane, T, Aftimos, G 2000Stereotaxic excisional biopsy of non-palpable breast lesions by the ABBI (Advanced Breast Biopsy Instrumentation) technique. Advantages. Disadvantages. Indications. Apropos of 67 casesJ Med Liban48706PubMedGoogle Scholar
  11. 11.
    Smathers, RL 2000Advanced breast biopsy instrumentation device: percentages of lesion and surrounding tissue removedAJR Am J Roentgenol1758013PubMedGoogle Scholar
  12. 12.
    Schwartzberg, BS, Goates, JJ, Keeler, SA, Moore, JA 2000Use of advanced breast biopsy instrumentation while performing stereotactic breast biopsies: review of 150 consecutive biopsiesJ Am Coll Surg191915PubMedGoogle Scholar
  13. 13.
    Lifrange, E, Colin, C 2000Supraconservative breast surgeryJ Gynecol Obstet Biol Reprod292857Google Scholar
  14. 14.
    Ferzli, GS, Puza, T, Vanvorst-Bilotti, S, Waters, R 1999Breast biopsies with ABBI(R): experience with 183 attempted biopsiesBreast J5268PubMedGoogle Scholar
  15. 15.
    Denton, ER, Michell, MJ, Wilson, AR, Britton, P 1999Stereotactic excisional breast biopsy performed by interventional radiologists using the ABBI systemBr J Radiol728289PubMedGoogle Scholar
  16. 16.
    Velanovich, V, Lewis, FR,Jr, Nathanson, SD,  et al. 1999Comparison of mammographically guided breast biopsy techniquesAnn Surg22962530PubMedGoogle Scholar
  17. 17.
    Leibman, AJ, Frager, D, Choi, P 1999Experience with breast biopsies using the Advanced Breast Biopsy Instrumentation systemAJR Am J Roentgenol172140912PubMedGoogle Scholar
  18. 18.
    Damascelli, B, Frigerio, LF, Lanocita, R,  et al. 1998Stereotactic excisional breast biopsy performed by interventional radiologists using the advanced breast biopsy instrumentation systemBr J Radiol71100311PubMedGoogle Scholar
  19. 19.
    Bloomston, M, D’Angelo, P, Galliano, D, Butler, J,Jr, Dean, R, Rosemurgy, AS 1999One hundred consecutive advanced breast biopsy instrumentation procedures: complications, costs, and outcomeAnn Surg Oncol61959PubMedGoogle Scholar
  20. 20.
    Jackman, RJ, Burbank, F, Parker, SH,  et al. 1997Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted breast biopsyRadiology2044858PubMedGoogle Scholar
  21. 21.
    Corn, CC 2003Review of 125 SiteSelect stereotactic large-core breast biopsy proceduresBreast J914752PubMedGoogle Scholar
  22. 22.
    Rebner, M, Chesbrough, R, Gregory, N 1999Initial experience with the advanced breast biopsy instrumentation deviceAJR Am J Roentgenol1732216PubMedGoogle Scholar
  23. 23.
    Parker, SH 1998The Advanced Breast Biopsy Instrumentation: another Trojan horse? AJR Am J Roentgenol171513PubMedGoogle Scholar
  24. 24.
    Singlebarry, SE, Fornage, BD, Sneige, N,  et al. 2002Radiofrequency ablation of early-stage invasive breast tumors: an overviewCancer J817780CrossRefGoogle Scholar
  25. 25.
    Izzo, F, Thomas, R, Delrio, P,  et al. 2001Radiofrequency ablation in patients with primary breast carcinoma: a pilot study in 26 patientsCancer92203644CrossRefPubMedGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc. 2005

Authors and Affiliations

  • Virginie Doridot
    • 1
  • Martine Meunier
    • 2
  • Carl El Khoury
    • 2
  • Claude Nos
    • 1
  • Anne Vincent-Salomon
    • 3
  • Brigitte Sigal-Zafrani
    • 3
  • Krishna B. Clough
    • 1
  1. 1.Department of General and Breast SurgeryInstitut CurieParisFrance
  2. 2.Department of RadiologyInstitut CurieParisFrance
  3. 3.Department of PathologyInstitut CurieParisFrance

Personalised recommendations