Open Surgical Biopsy in Diagnosis of Mammographically Detected Suspicious Microcalcifications

Aleksandar Guzijan,Danijela Soprenić,Dragana Roganović

doi:10.7251/scmed1802132r

Abstract

Background: One of the earliest signs of breast cancer may be the presence of mammographically detected suspicious microcalcifications in the breast. The aim of the study was to present an open surgical biopsy of the mammographically detected suspicious microcalcifications in a breast, with preoperative wire marking of the lesions and intraoperative specimen radiography, as a reliable and valid procedure.Material and Methods: The study included 80 female patients underwent surgery because of mammographically detected suspicious microcalcifications. The method of preoperative ultrasound-guided wire marking of a zone of microcalcification was performed in all patients.After wire marking, the control native mammography in ML and CC projections was performed, in order to locate the microcalcifications relative to the wire. In all patients, the extirpation of the suspicious microcalcifications was verified by the specimen radiography.Results: In the definitive histopathological finding in situ component of ductal carcinoma of the breast was verified in nine (11,25%) examinees. High grade in situ component was verified in eight (10%) examinees and low grade in situ component in one examinee (1,25%). In 11 (13,75%) examinees, the invasive breast cancer with an extensive in situ component up to 50% was verified. In 46 (57,5%) of the examinees, benign, non-proliferative changes were verified, while proliferative changes characterized as premalignant condition (sclerosing adenosis, radial scar and atypical ductal hyperplasia) were verified in 14 (17,5%) examinees. Microcalcifications verified by specimen radiography are completely removed.Conclusion: Presence of mammographically detected suspicious microcalcifications has a significant predictive value in the early detection of breast cancer. The method of an open surgical biopsy, as an alternative to stereotactic biopsy, is valid in diagnostic of the mammographically suspicious microcalcifications.

Highlights

The breast cancer is the most common malignant neoplasm in women.[1]
Microcalcifications verified by specimen radiography are completely removed
Microcalcifications are the most commonly detected on the mammography and the most of them cannot be visualized with confidence on ultrasound

Summary

Introduction

The breast cancer is the most common malignant neoplasm in women.[1]. A mammography gives a possibility of detecting breast cancer in the early stage, when the lesion is non-palpable and when probability of cure is higher.[2]. We distinguish diffuse, regional, grouped, linear and segmental calcifications.[6] Microcalcifications are the most commonly detected on the mammography and the most of them cannot be visualized with confidence on ultrasound. The lesions detected only on mammography require stereotactically guided biopsy and specimen radiography of the extirpated tissue samples.[7] When performing a biopsy, a radiologist places the clips in order to mark the zone where the biopsy was performed. The aim of the study was to present an open surgical biopsy of the mammographically detected suspicious microcalcifications in a breast, with preoperative wire marking of the lesions and intraoperative specimen radiography, as a reliable and valid procedure

Objectives

Methods

Results

Discussion

Conclusion