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Item Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging(SPRINGEROPEN, 2020-01-01) Bick, Ulrich; Trimboli, Rubina M.; Athanasiou, Alexandra; Balleyguier, Corinne; Baltzer, Pascal A. T.; Bernathova, Maria; Borbely, Krisztina; Brkljacic, Boris; Carbonaro, Luca A.; Clauser, Paola; Cassano, Enrico; Colin, Catherine; Esen, Gul; Evans, Andrew; Fallenberg, Eva M.; Fuchsjaeger, Michael H.; Gilbert, Fiona J.; Helbich, Thomas H.; Heywang-Koebrunner, Sylvia H.; Herranz, Michel; Kinkel, Karen; Kilburn-Toppin, Fleur; Kuhl, Christiane K.; Lesaru, Mihai; Lobbes, Marc B. I.; Mann, Ritse M.; Martincich, Laura; Panizza, Pietro; Pediconi, Federica; Pijnappel, Ruud M.; Pinker, Katja; Schiaffino, Simone; Sella, Tamar; Thomassin-Naggara, Isabelle; Tardivon, Anne; Van Ongeval, Chantal; Wallis, Matthew G.; Zackrisson, Sophia; Forrai, Gabor; Herrero, Julia Camps; Sardanelli, Francesco; EUSOBI, European Soc Breast ImagingWe summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as ``high-risk{''} or B3 lesions). Finally, seven frequently asked questions are answered.Item Robotic nipple sparing mastectomy through a single incision: Advantages of starting with posterior dissection(TURKISH SURGICAL ASSOC, 2020-01-01) Uras, Cihan; Arikan, Akif Enes; Kara, Halil; Dulgeroglu, Onur; Avsar, YakupObjective: Loss of breast, which is an important body marking of women, causes a huge decrease in quality of life (QoL) after treatment. In order to overcome this morbidity and increase QoL, nipple sparing mastectomy (NSM) has been developed. Even though the demand for better cosmetic results has yielded endoscopic nipple sparing mastectomy, limitations like unsuitable optical window and limited manual control of rigid-tip instruments, and struggling to keep dissection space have led robotic nipple sparing mastectomy (rNSM) to be developed. Material and Methods: Records of three patients who underwent to rNSM for invasive breast carcinoma with DaVinci Xi (Intuitive Surgical, Sunnyvale, CA) in affiliated hospitals of Acibadem Mehmet Ali Aydinlar University, Research Institute of Senology in 2018 were investigated retrospectively. In all breasts (n= 4), dissection was started from the posterior side of breast. Results: In the unit, 738 breast cancer patients underwent surgery between 2018 and 2019 with an NSM ratio of 31.4\% (n= 232). Of these patients, three underwent rNSM with DaVinci Xi robotic system. The operation was performed on the left breast in one patient, right in one, and bilateral in one patient. Only in patient \#2, who was a neoadjuvant chemotherapy recipient, seroma was observed six weeks after surgery (3 weeks after removal of drains) and spontaneously resolved in 4 weeks. No other complication was seen in all patients. In the follow-up period of median 21 months, no loco-regional recurrence or distant metastasis was seen. Conclusion: A single incision robotic mastectomy can be performed easily and safely when the dissection starts from the pre-pectoral plane rather than the subcutaneous plane.Item Clinical Evaluation of Breast in Childhood(AVES, 2019-01-01) Karaayvaz, SeldaChildhood breast masses are mostly benign conditions starting from the newborn period continuing on to adolescence yet can cause high anxiety in the child and the family as well. As a complaint or physical finding, usually palpable mass, pain or discharge from the nipple is apparent in patients. All the clinicians interested in pediatric field should have full knowledge of immature and developing breasts so to proper diagnose and avoid overtreatment with unnecessary diagnostic or surgical procedures. Though malignancy or life-threatening disease has a very low probability during childhood, all child patients should be evaluated and followed up carefully. Especially training and then encouraging young people to periodically start self-assessment of the breasts after their 19th birthday while warning the ones who have had therapeutic chest radiation previously to begin self-assessment 8 years after the procedure or at 25 years of age whichever comes last, will be an appropriate intervention.