Breast Microcalcifications: Diagnostic Outcomes According to Image-Guided Biopsy Method.
10.3348/kjr.2015.16.5.996
- Author:
Sohi BAE
1
;
Jung Hyun YOON
;
Hee Jung MOON
;
Min Jung KIM
;
Eun Kyung KIM
Author Information
1. Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea. ekkim@yuhs.ac
- Publication Type:Original Article
- Keywords:
Mammography;
Calcification;
Ultrasonography;
Core needle biopsy;
Image-guided biopsy
- MeSH:
Adult;
Aged;
Biopsy, Large-Core Needle;
Breast/*pathology;
Breast Neoplasms/*pathology/ultrasonography;
Carcinoma, Intraductal, Noninfiltrating/pathology;
False Negative Reactions;
Female;
Humans;
Image-Guided Biopsy;
Imaging, Three-Dimensional;
Middle Aged;
Retrospective Studies;
Ultrasonography, Mammary
- From:Korean Journal of Radiology
2015;16(5):996-1005
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the diagnostic outcomes of ultrasonography-guided core needle biopsy (US-CNB), US-guided vacuum-assisted biopsy (US-VAB), and stereotactic-guided vacuum-assisted biopsy (S-VAB) for diagnosing suspicious breast microcalcification. MATERIALS AND METHODS: We retrospectively reviewed 336 cases of suspicious breast microcalcification in patients who subsequently underwent image-guided biopsy. US-CNB was performed for US-visible microcalcifications associated with a mass (n = 28), US-VAB for US-visible microcalcifications without an associated mass (n = 59), and S-VAB for mammogram-only visible lesions (n = 249). Mammographic findings, biopsy failure rate, false-negative rate, and underestimation rate were analyzed. Histological diagnoses and the Breast Imaging Reporting and Data System (BI-RADS) categories were reported. RESULTS: Biopsy failure rates for US-CNB, US-VAB, and S-VAB were 7.1% (2/28), 0% (0/59), and 2.8% (7/249), respectively. Three false-negative cases were detected for US-CNB and two for S-VAB. The rates of biopsy-diagnosed ductal carcinoma in situ that were upgraded to invasive cancer at surgery were 41.7% (5/12), 12.9% (4/31), and 8.6% (3/35) for US-CNB, US-VAB, and S-VAB, respectively. Sonographically visible lesions were more likely to be malignant (66.2% [51/77] vs. 23.2% [46/198]; p < 0.001) or of higher BI-RADS category (61.0% [47/77] vs. 22.2% [44/198]; p < 0.001) than sonographically invisible lesions. CONCLUSION: Ultrasonography-guided vacuum-assisted biopsy is more accurate than US-CNB when suspicious microcalcifications are detected on US. Calcifications with malignant pathology are significantly more visible on US than benign lesions.
