The Efficacy of Stereotactic Vacuum-assisted Biopsy and Needle Localization Vacuum-assisted Biopsy for Diagnosing Breast Microcalcification

Eung-Jik Lee; Se-Min Oh

doi:10.4048/jbc.2010.13.1.53

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Lee and Oh: The Efficacy of Stereotactic Vacuum-assisted Biopsy and Needle Localization Vacuum-assisted Biopsy for Diagnosing Breast Microcalcification

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2010; 13(1): 53-58.

Published online: 31 March 2010

DOI: https://doi.org/10.4048/jbc.2010.13.1.53

The Efficacy of Stereotactic Vacuum-assisted Biopsy and Needle Localization Vacuum-assisted Biopsy for Diagnosing Breast Microcalcification

Eung-Jik Lee, Se-Min Oh

Dr.Oh's Breast Center, Seoul, Korea.

Corresponding author (ohsemin2000@yahoo.co.kr)

Received 9 October 2009 Accepted 26 February 2010

Abstract

Purpose

This study was conducted to evaluate the efficacy of 2 percutaneous breast biopsy techniques for diagnosing microcalcification: stereotactic Vacuum-assisted biopsy (VAB) and needle localization VAB.

Methods

Between November 2002 and September 2007, 138 patients underwent percutaneous breast biopsy for microcalcification. Of these, 59 patients underwent needle localization VAB and 79 patients underwent stereotactic VAB with using a prone-table mammographic unit, respectively. Patients with focally clustered microcalcification underwent stereotactic VAB. Patients with diffuse or deep seated microcalcification and patients with small breast underwent needle localization VAB. We retrospectively reviewed the characteristics of the lesions and the percutaneous biopsy results for all the cases.

Results

Percutaneous biopsy was successful in 135 cases (97.8%). Of the 135 successfully performed cases, 34 cases (25.2%) were malignant and there were 4 (11.8%) underestimations. For the stereotactic VAB group, 13 of the successfully performed 76 cases (17.1%) were malignant and there were 2 (15.4%) underestimations. In needle localization VAB group, 21 (36.6%) of the 59 cases were malignant and there were 2 (9.5%) underestimations. There was no major complication in all the cases.

Conclusion

With using stereotactic VAB and needle localization VAB, we can biopsy accurately and safely in almost all cases with leaving only minimal scar. So, percutaneous biopsy can be considered as a substitute for surgical biopsy for microcalcification of the breast.

Keywords: Breast, Calcification, Vacuum-assisted biopsy

Figures and Tables

Figure 1

Stereotactic vacuum-assisted biopsy with prone-type mammographic unit. The 11G mammotome needle is placed in the breast to acquire the specimen.

Figure 2

(A) Prefire stereo scout view: positioning the probe proximal to the lesion. (B) Postexamination view and specimen mammography. The microcalcification particles seen in the stereo-scout view (A) are not visible anymore in the postexamination view (Left). The specimen mammogram demonstrates calcifications in multiple cores (Right).

Figure 3

Needle localization vacuum-assisted biopsy. (A, B) After the needle was inserted into the lesion, the proper location must be warranted with mammography (lateral and cephalocaudal view). (C) Specimen mammography shows proper A B C acquisition of calcification.

Figure 4

Needle localization vacuum-assisted biopsy. The skin above the lesion must be marked before the acquisition of tissue.

Table 1

General characteristics and clinical parameters of patients (n=135)

VAB=vacuum-assisted biopsy; BI-RADS=breast imaging-reporting and data system; UIQ=upper inner quadrant; UOQ=upper outer quadrant; LOQ=lower outer quadrant; LIQ=lower inner quadrant.

Table 2

Results of stereotactic VAB and needle localization VAB

VAB=vacuum-assisted biopsy; DCIS=ductal carcinoma in situ; ADH=atypical ductal hyperplasia; FCD=fibrocystic disease.

Table 3

Underestimation result of the stereotactic VAB and needle localization VAB

VAB=vacuum-assisted biopsy; DCIS=ductal carcinoma in situ.

Table 4

Detection rate of malignancy according to BI-RADS classification

VAB=vacuum-assisted biopsy; BI-RADS=Breast Imaging-Reporting and Data System.

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