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


OBJECTIVE
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.


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).


CONCLUSIONS
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.
Cho
Nariya
N
Department of Radiology and Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Moon
Woo Kyung
WK
Chang
Jung Min
JM
Park
Sang Hee
SH
Lyou
Chae Yeon
CY
Park
In Ae
IA
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D016217:Ultrasonography, Mammary; D014618:Vacuum