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Breast Microcalcifications: Diagnostic Outcomes According to Image-Guided Biopsy Method

 Sohi Bae  ;  Jung Hyun Yoon  ;  Hee Jung Moon  ;  Min Jung Kim  ;  Eun Kyung Kim 
 KOREAN JOURNAL OF RADIOLOGY, Vol.16(5) : 996-1005, 2015 
Journal Title
Issue Date
Adult ; Aged ; Biopsy, Large-Core Needle ; Breast/pathology* ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology* ; Carcinoma, Intraductal, Noninfiltrating/pathology ; False Negative Reactions ; Female ; Humans ; Image-Guided Biopsy ; Imaging, Three-Dimensional ; Middle Aged ; Retrospective Studies ; Ultrasonography, Mammary
Calcification ; Core needle biopsy ; Image-guided biopsy ; Mammography ; Ultrasonography
OBJECTIVE: To evaluate the diagnostic outcomes of ultrasonography-guided core needle biopsy (US-CNB), US-guided vacuum-assisted biopsy (US-VAB), and stereotactic-guided vacuum-assisted biopsy (S-VAB) for diagnosing suspicious breast microcalcification. MATERIALS AND METHODS: We retrospectively reviewed 336 cases of suspicious breast microcalcification in patients who subsequently underwent image-guided biopsy. US-CNB was performed for US-visible microcalcifications associated with a mass (n = 28), US-VAB for US-visible microcalcifications without an associated mass (n = 59), and S-VAB for mammogram-only visible lesions (n = 249). Mammographic findings, biopsy failure rate, false-negative rate, and underestimation rate were analyzed. Histological diagnoses and the Breast Imaging Reporting and Data System (BI-RADS) categories were reported. RESULTS: Biopsy failure rates for US-CNB, US-VAB, and S-VAB were 7.1% (2/28), 0% (0/59), and 2.8% (7/249), respectively. Three false-negative cases were detected for US-CNB and two for S-VAB. The rates of biopsy-diagnosed ductal carcinoma in situ that were upgraded to invasive cancer at surgery were 41.7% (5/12), 12.9% (4/31), and 8.6% (3/35) for US-CNB, US-VAB, and S-VAB, respectively. Sonographically visible lesions were more likely to be malignant (66.2% [51/77] vs. 23.2% [46/198]; p < 0.001) or of higher BI-RADS category (61.0% [47/77] vs. 22.2% [44/198]; p < 0.001) than sonographically invisible lesions. CONCLUSION: Ultrasonography-guided vacuum-assisted biopsy is more accurate than US-CNB when suspicious microcalcifications are detected on US. Calcifications with malignant pathology are significantly more visible on US than benign lesions.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
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