Initial experience with novel micro-pulse biopsy system in axillary lymph node

Aim:

Recently a new biopsy method has been developed with technical characteristics well suited for challenging biopsy cases. The aim was to get initial experience with this system and assess its suitability for use in axillary lymph nodes.

Materials:

The new biopsy system (NeoNavia, NeoDynamics, Sweden) incorporates a pneumatic mechanism that provides impulses to the needle, allowing the operator to stepwise advance the needle through tissue with minimal effort. This could provide greater control of the needle tip position and easier penetration of structures such as lymph nodes. To maximize sampling yield a 14G open-tip full-core needle design is employed. In combination with pulsed insertion this allows for an arbitrary sample length.

Methods:

Breast cancer patients undergoing surgery underwent a biopsy of axillary lymph nodes using the new system. Samples quality and tissue yield adequacy were judged by the operator and the pathologist.

Results:

Four physicians performed 43 sampling attempts in 23 patients. In all attempts a sample was retrieved. 84% (36/43) of samples were judged “very good” or “good” by the operator. Tissue yield was judged adequate in 100% of cases by the pathologist when at least two samples had been obtained.

Summary:

The system offers potential for improved biopsy sampling and initial results in axillary nodes are promising. It is currently being evaluated in the PULSE trial, a multi-centre study by the AWOgyn e.V. working group.