US-guided vacuum-assisted biopsy of microcalcifications in breast lesions and long-term follow-up results.
OBJECTIVE
To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results.


METHODS
US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups.


RESULTS
There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients.


CONCLUSIONS
US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where microcalcifications are visible with the use of high-resolution US.
Kim
Hua Sun
HS
Department of Radiology and Institution of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Kim
Min Jung
MJ
Kim
Eun Kyung
EK
Kwak
Jin Young
JY
Son
Eun Ju
EJ
Oh
Ki Keun
KK
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002114:Calcinosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary; D014618:Vacuum