Effect of Introducing Hematoma Ultrasound-Guided Lumpectomy in a Surgical Practice : Journal of the American College of Surgeons

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Original scientific article

Effect of Introducing Hematoma Ultrasound-Guided Lumpectomy in a Surgical Practice

Larrieux, Gregory BS; Cupp, Julie A. MD; Liao, Junlin PhD; Scott-Conner, Carol E.H. MD, PhD, FACS; Weigel, Ronald J. MD, PhD, FACS*

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Journal of the American College of Surgeons 215(2):p 237-243, August 2012. | DOI: 10.1016/j.jamcollsurg.2012.04.018



Preoperative needle localization (NL) is the gold standard for lumpectomy of nonpalpable breast cancer. Hematoma ultrasound-guided (HUG) lumpectomy can offer several advantages. The purpose of this study was to compare the use of HUG with NL lumpectomy in a single surgical practice.


Patients with nonpalpable lesions who underwent NL or HUG lumpectomy from January 2007 to December 2009 by a single surgeon were identified from a breast surgery database. Ease of scheduling, volume excised, re-excision rates, operating room time, and health care charges were the main outcomes variables. Univariate and multivariate analyses were performed to compare the 2 groups.


Lumpectomy was performed in 110 patients, 55 underwent HUG and 55 underwent NL. Hematoma ultrasound-guided lumpectomy was associated with a nearly 3-fold increase in the odds ratio of additional tissue being submitted to pathology (p = 0.039), but neither the total amount of breast tissue removed, nor the need for second procedure were statistically different between the 2 groups. Duration of the surgical procedure did not vary between the 2 groups; however, the time from biopsy to surgery was shorter for HUG by an expected 9.7 days (p = 0.019), implying greater ease of scheduling. Mean charges averaged $250 less for HUG than for NL, but this difference was not statistically significant.


Hematoma ultrasound-guided is equivalent to NL with regard to volume of tissue excised, need for operative re-excision, and operating room time. Adoption of HUG in our practice allowed for more timely surgical care.

© 2012 by Lippincott Williams & Wilkins, Inc.

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