Malignant microcalcification: prediction of excision margins by separating calcified and noncalcified core biopsies

H Cain,K Clark,J Westgarth,D Hemming,L Lunt,D Browell,T Fasih,A Mooney

doi:10.1186/bcr2691

Abstract

Suspicious microcalcification is investigated by vacuum-assisted core biopsy. Many patients, in whom malignancy is diagnosed, go on to have breast-conserving surgery where positive resection margins require re-operation. The aim of this study was to determine whether there is an increased risk of positive margins when malignancy is identified in cores without microcalcification.

Highlights

National Institute for Health and Clinical Excellence (NICE) guidelines recommend conventional ultrasound (CU) of the axilla as preliminary staging in patients with breast cancer
We examined the prognostic effect of size of ipsilateral breast tumour recurrence (IBTR) and metachronous contralateral breast cancer (MCBC) to assess potential benefit of surveillance mammography after breast cancer treatment
Results were sensitive to primary tumour characteristics used to define the likelihoods of developing an IBTR or MCBC

Summary

Introduction

NICE guidelines recommend conventional ultrasound (CU) of the axilla as preliminary staging in patients with breast cancer. Methods A retrospective analysis of 277 patients referred for MRI-guided vacuum biopsies of impalpable breast lesions visible only on MRI was performed. Our protocol for assessment of women with screen-detected malignancy was changed to include bilateral whole breast and axillary ultrasound (BBUS) following a prospective study that confirmed the benefit of this in 2002 [1]. This audit assesses the impact of introducing this change. Triple-negative breast cancer (TNBC) cases comprise approximately 15% of newly diagnosed breast cancers and are associated with poor prognosis and limited treatment options In this retrospective study from South Wales, 81 patients with breast cancer found to be ER, PR and HER2 negative were reviewed to determine whether there are common imaging and pathological findings. This study was based on the hypothesis that recall of benign solitary masses might be a major contributor to this as no prior imaging is available

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