Calcification retrieval at stereotactic, 11-gauge, directional, vacuum-assisted breast biopsy

To determine the frequencies of calcification retrieval and histologic underestimates at stereotactic, 11-gauge, directional, vacuum-assisted breast biopsy. Retrospective review of records revealed 112 calcific lesions in 80 women (aged 31-85 years) who underwent stereotactic, 11-gauge, directional,...

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Bibliographic Details
Published in:	Radiology Vol. 208; no. 1; p. 251
Main Authors:	Liberman, L, Smolkin, J H, Dershaw, D D, Morris, E A, Abramson, A F, Rosen, P P
Format:	Journal Article
Language:	English
Published:	United States 01-07-1998
Subjects:	Adult Aged Aged, 80 and over Biopsy, Needle - instrumentation Biopsy, Needle - methods Breast - pathology Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast Neoplasms - surgery Calcinosis - diagnostic imaging Calcinosis - pathology Calcinosis - surgery Carcinoma - pathology Carcinoma in Situ - pathology Carcinoma, Ductal, Breast - pathology Female Humans Hyperplasia Mammography Middle Aged Neoplasm Invasiveness Radiography, Interventional Retrospective Studies Stereotaxic Techniques Vacuum
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Summary:	To determine the frequencies of calcification retrieval and histologic underestimates at stereotactic, 11-gauge, directional, vacuum-assisted breast biopsy. Retrospective review of records revealed 112 calcific lesions in 80 women (aged 31-85 years) who underwent stereotactic, 11-gauge, directional, vacuum-assisted biopsy; a mean of 14 specimens per lesion were obtained. Calcification retrieval was defined as identification of calcifications on radiographs of specimens. Atypical ductal hyperplasia (ADH) underestimates were lesions that yielded ADH at stereotactic biopsy and carcinoma at surgery. Ductal carcinoma in situ (DCIS) underestimates were lesions that yielded DCIS at stereotactic biopsy and infiltrating carcinoma at surgery. Mammograms, stereotactic images, radiographs of specimens, and histologic findings were reviewed. Stereotactic, 11-gauge, directional, vacuum-assisted biopsy removed all calcifications in 51 (46%) lesions, some calcifications in 55 (49%) lesions, and no calcifications in six (5%) lesions. Failure to retrieve calcifications was significantly more likely in lesions 5 mm or smaller (12% [five of 43] vs 1% [one of 69], P = .03), in calcifications with amorphous morphology (21% [three of 14] vs 3% [three of 98], P < .03), or if the probe was fired outside the breast (12% [five of 40] vs 1% [one of 72], P = .02). Surgery revealed DCIS in one (10%) of 10 lesions that yielded ADH at stereotactic biopsy. Surgery revealed infiltrating carcinoma in one (5%) of 21 lesions that yielded DCIS at stereotactic biopsy. No underestimation occurred when all calcifications were removed. Stereotactic, 11-gauge, directional, vacuum-assisted biopsy resulted in successful calcification retrieval in 106 (95%) of 112 cases. Histologic underestimation was infrequent.
ISSN:	0033-8419
DOI:	10.1148/radiology.208.1.9646821