title: Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications.
abstract: OBJECTIVE
  To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤ 1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients.
  
  
  METHODS
  This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture.
  
  
  RESULTS
  Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤ 1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576).
  
  
  CONCLUSIONS
  The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients.
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: gianfranco.scaperrotta@istitutotumori.mi.it.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Scaperrotta
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferranti
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Capalbo
authors.affiliation: Department of Diagnostic Pathology and Laboratory, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Paolini
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Marchesini
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Suman
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Folini
authors.affiliation: Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
authors.affiliation: Department of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Panizza
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology* / Q000601:surgery*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Breast neoplasms; Carcinoma; Image-guided biopsy; Intraductal; Resection margins