Approximately 1.3 million surgical breast biopsies are performed in the United States every year, and about 80% of them are for benign conditions. The standard of care has progressed from open surgical biopsy in order to make a diagnosis to minimally invasive image-guided breast biopsy. While this is a much better technique for obtaining a diagnosis, one problem is that the lump still remains in place. This may cause significant anxiety for the woman with the breast mass. In addition, at times the mass is shown to have atypical or abnormal cells, in which case, surgical excision with a clear margin of normal tissue is indicated. Many of these lesions will be found to be completely benign after surgical excision, which means that the woman has undergone a surgical procedure which may have been able to be avoided.

A device is available that allows for removal of a breast mass in the office under local anesthesia and ultrasound guidance. Use of the Halo device will result in complete removal of the breast mass, just like with surgical excision. When used for small masses, the Halo procedure removes the breast mass with a rim of normal surrounding tissue. Therefore, the pathologist is able to evaluate the entire lesion. The procedure is performed in the office under local anesthesia; no general anesthesia or hospital stay is needed. In addition, the scar is comparable to a needle biopsy rather than a standard surgical procedure. Currently, the device is being used for small benign lesions such as fibroadenomas and papillomas.

Over the past 20-30 years, we have progressed from the point of performing radical mastectomy for breast cancer to performance of lumpectomy with sentinel node biopsy. Further progress continues to be made in the treatment of both benign and malignant breast disease. The Halo device allows for complete removal of a breast mass using minimally invasive technology. The advantage of complete removal is the potential avoidance of an additional surgery, as more thorough pathologic evaluation of the specimen is possible. In addition, the patient has the benefit of knowing that the entire breast mass has been removed. This device is another tool in the exciting field of minimally invasive breast procedures, and allows us to treat our patients effectively without surgery. I am excited about the potential uses for this device in the treatment of both benign and malignant breast disease.