title: Causes of failure in removing calcium in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy.
abstract: OBJECTIVE
  The aim of this study was to determine the causes and rate of failure in removing calcification in microcalcification-only lesions using 11-gauge stereotactic vacuum-assisted breast biopsy.
  
  
  METHODS
  In total, 1365 microcalcification-only lesions were included in this study. The breast biopsy database was reviewed retrospectively. The biopsies were divided into two groups based on whether the specimen X-ray showed calcium within the cores. Breast composition, lesion size, calcification distribution, density on mammography, and the number of specimens were compared between the two groups.
  
  
  RESULTS
  In 11 (0.8%) biopsies, no calcium in the specimen radiography could be identified. Re-biopsy was performed in five cases. The initial biopsy result was unchanged at the second biopsy in three cases containing calcium, while in the other two cases, a benign biopsy result was upgraded to atypical ductal hyperplasia and ductal carcinoma in situ, respectively. In six cases, the biopsy was not repeated despite the absence of calcium in the specimen X-ray. In three of these cases, calcifications were reported histopathologically and deemed to be too small to be identified on specimen X-ray. In two of six patients, sufficient information was found in the cores without microcalcification to indicate the need for surgery. One patient refused re-biopsy. A statistically significant higher failure rate was observed in low-density calcification compared with intermediate or high-density calcification on mammography.
  
  
  CONCLUSIONS
  The failure to retrieve microcalcification is uncommon when an 11-gauge vacuum-assisted breast biopsy is used. Low-density calcifications have a higher rate of failure. In cases in which no calcium is observed in specimen radiography, repeated biopsy is recommended.
authors.affiliation: Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey. drhaticegumus@hotmail.com
authors.forename: Hatice
authors.initials: H
authors.lastname: Gümüş
authors.forename: Metehan
authors.initials: M
authors.lastname: Gümüş
authors.forename: Haresh
authors.initials: H
authors.lastname: Devalia
authors.forename: Philippa
authors.initials: P
authors.lastname: Mills
authors.forename: David
authors.initials: D
authors.lastname: Fish
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
authors.forename: Aşur
authors.initials: A
authors.lastname: Uyar
authors.forename: Ali
authors.initials: A
authors.lastname: Sever
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods; D001941:Breast Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D013238:Stereotaxic Techniques; D017211:Treatment Failure; D014618:Vacuum; D055815:Young Adult