Stereotactic vacuum-assisted breast biopsies in 500 women with microcalcifications: radiological and pathological correlations.
OBJECTIVE
We compared radiological assessment with pathological diagnoses in 500 consecutive vacuum-assisted breast biopsies performed for microcalcifications.


METHODS
Lesions were biopsied using a 11-gauge mammotome device. Before biopsy, microcalcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Histopathological and radiological diagnosis were compared.


RESULTS
Histopathology revealed 333 (67%) benign lesions. Benign lesions were classified as BI-RADS 3 in 19%, and as suspicious in 35%. 167 lesions (33%) were malignant. Malignant lesions were classified as suspicious or highly suggestive of malignancy in 63%. Frequency of malignancy in BI-RADS categories 4 and 5 was 35% and 100%, respectively. In BI-RADS 3 microcalcifications, the malignancy frequency was 19%. The mammographic features with the highest positive predictive value for malignancies were pleomorphic morphology (42%) and a linear or segmental distribution (51%). The microcalcification morphology was not reliably able to predict malignancy.


CONCLUSIONS
In this study, BI-RADS 3 microcalcification lesions had a malignancy rate that is higher than previously reported. Vacuum-assisted biopsy is useful in any indeterminate and suspicious microcalcifications and provides maximum information before any operative intervention.
Kettritz
Ute
U
Department of Radiology, Berlin-Buch Breast Unit, HELIOS Klinikum Berlin Medical Center, Wiltbergstrasse 50, HS 120, 13125 Berlin, Germany. ukettritz@berlin.helios-kliniken.de
Morack
Günter
G
Decker
Thomas
T
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008327:Mammography; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D013238:Stereotaxic Techniques; D014618:Vacuum