Korean J Radiol.  2008 Dec;9(6):503-509. 10.3348/kjr.2008.9.6.503.

US-Guided Vacuum-Assisted Biopsy of Microcalcifications in Breast Lesions and Long-Term Follow-Up Results

• Kim HS
• Kim MJ
• Kim EK
• Kwak JY
• Son EJ
• Oh KK

• KMID: 1118871
• DOI: http://doi.org/10.3348/kjr.2008.9.6.503

Abstract

OBJECTIVE
To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. MATERIALS AND METHODS: US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. RESULTS: There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. CONCLUSION: US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where microcalcifications are visible with the use of high-resolution US.

Keyword

Breast, US; Breast, Biopsy; Breast, Calcification

MeSH Terms

Adult
Aged
*Biopsy/methods
Breast/*pathology
Breast Neoplasms/*diagnosis/pathology/radiography
Calcinosis/*pathology
Female
Humans
Mammography
Middle Aged
*Ultrasonography, Interventional
Ultrasonography, Mammary
Vacuum

Figure

• 

  Fig. 1 44-year-old female who underwent mammography for routine breast screening. A. Magnification view of left breast reveals suspicious clustered and pleomorphic microcalcification (white arrow). B. Careful US study of left breast shows microcalcification of suspicion (white arrows) in left upper central aspect. C. Patient underwent 11 gauge US-guided vacuam-assisted biopsy targeted at microcalcification. D. Specimen mammography shows that aimed microcalcification is retrieved (white arrows). Patient was diagnosed with ductal carcinoma in situ and underwent further partial mastectomy, which also revealed presence of ductal carcinoma in situ.

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