Ultrasonography-guided vacuum-assisted biopsy of microcalcifications: Comparison of the diagnostic yield of calcified cores and non-calcified cores on specimen radiographs

• Published in: Acta radiologica (1987) 2010-03, Vol.51 (2), p.123-127
• Main Authors: Cho, Nariya, Moon, Woo Kyung, Chang, Jung Min, Park, Sang Hee, Lyou, Chae Yeon, Park, In Ae
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Biopsy, Needle - methods; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - pathology; Calcinosis - diagnostic imaging; Calcinosis - pathology; Female; Genital system. Mammary gland; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammary gland diseases; Mammography; Medical sciences; Middle Aged; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Tumors; Ultrasonography, Interventional; Ultrasonography, Mammary; Vacuum
• ISSN: 0284-1851; 1600-0455
• DOI: 10.3109/02841850903348982

Background: Microcalcifications found on mammography of asymptomatic women can be sampled by ultrasound (US)-guided percutaneous breast biopsy when stereotactic core biopsy is unavailable or unsuccessful. The role of specimen radiograph needs to be reevaluated after US-guided biopsy. Purpose: To compare retrospectively the histological diagnoses of calcified cores and non-calcified cores as depicted on specimen radiographs after a US-guided, 11-gauge, vacuum-assisted biopsy using surgical histology as the reference standard. Material and Methods: A total of 135 consecutive patients underwent a US-guided vacuum-assisted biopsy for calcifications with malignant histological results from 135 lesions. For each lesion, calcification was identified in at least one core on specimen radiographs. Calcified cores and non-calcified cores depicted on specimen radiographs were separately submitted to the pathology department. The pathological diagnoses of calcified cores and non-calcified cores were compared with final diagnoses at surgical excision. Results: Of a total of 2049 core specimens that were obtained (mean, 15 per lesion; range, 4-35 per lesion), 794 cores (mean, 5.9 per lesion; range, 1-17 per lesion) contained calcifications and 1255 cores (mean, 9.3 cores per lesion; range, 1-34 cores per lesion) did not contain calcifications. Calcified cores were more likely to enable an accurate diagnosis of cancer as compared to non-calcified cores (67%, 91 of 135 versus 52%, 70 of 135; P = 0.009). A diagnosis of cancer was more likely to be missed with non-calcified cores as compared to calcified cores (16%, 21 of 135 versus 4%, 5 of 135; P = 0.002). There was no difference in the underestimation of malignancy between calcified cores (29%, 39 of 135) and non-calcified cores (33%, 44 of 135) (P = 0.510). Conclusion: Calcified cores depicted on specimen radiographs are more accurate for a diagnosis of cancer as compared to non-calcified cores obtained during US-guided vacuum-assisted biopsy of microcalcifications.