EVALUATION OF CLUSTERED MICROCALCIFICATIONS, INITIALLY GRADED AS LIKELY MALIGNANT ON BASELINE MAMMOGRAPHY, WITH STEREOTACTIC BIOPSY: A RAD-PATH CORRELATION

Abstract

Background: Stereotactic-guided breast biopsy is an invincible tool to sample abnormalities visible only on mammography with subtle or occult ultrasound findings. Common mammographic abnormalities which require stereotactic core biopsy include calcifications, architectural distortion and satellite lesions. With advancement in techniques for adequate localisation of lesions, the use of stereotactic needle breast biopsy is exponentially increasing. A study was performed to look for frequency of benignancy or malignancy of microcalcifications and architectural distortions in patients initially falling in malignant category of Breast Imaging-Reporting and Data System of American College of Radiology (BI-RADS®) Assessment Categories.Materials and Methods: Patient presenting in outpatient (OPD) clinic who underwent stereotactic biopsies for labelled malignant on mammograms from May 2015 to May 2018 was included in retrospective study. Age, technique used, baseline mammogram and histopathology were reviewed.Results: A total of 91 patients underwent stereotactic biopsy. Age range varied between 28 and 81 years. Stereotacticguided biopsies were taken using a standard 14-gauge core needle with long throw of 22 mm excursion. None of the biopsy was inconclusive. In comparison with baseline mammograms and histopathology, 40% of the clusters of microcalcification which were initially labelled as malignant turned out to be malignant on histopathology as well, whereas 60% were reported as benign breast parenchyma.Conclusion: Agreement between the diagnostic accuracy of microcalcifications on mammogram and histopathology of same lesions after stereotactic biopsy was comparable to international figures with probability of being benign surpassing malignant on routine screening.Key words: Breast cancer, mammography, microcalcifications, stereotactic biopsy