Vacuum Assisted-Biopsy and Mammo-Guided Localization and Excisional Biopsy in the Microcalcifications Sampling of Breast: An Experience of Single Institution

Abstract

Background: Sterotactic vacuum assisted biopsy (ST-VAB) is safe and effective method for nonpalpable mammographically visible microcalcifications or masses. ST-VAB is less invasive and is associated with less scar formation than surgical excision. Also ST-VAB can avoid unnecessary additional surgery. But ST-VAB has possibility of histologic underestimation of high-risk lesions such as atypical ductal hyperplasia and atypical lobular hyperplasia. Objectives: To evaluate the outcome of ST-VAB and mammography-guided localization and excisional biopsy (MGL-EB) for microcalcifications. Patients and Methods: Two radiologists retrospectively reviewed the medical records of patients who underwent breast biopsy for microcalcification from January 2011 to March 2013. They underwent ST-VAB (n = 22) and MGL-EB (n = 34). The clinicoradiological factors of two groups were evaluated, respectively. The malignancy rate and imaging histologic discordant rate in the two groups were assessed. We evaluated follow-up studies of all patients for newly developed or missed breast cancer. Results: The malignancy rates were 13.6% (3/22) for ST-VAB and 17.6% (6/34) for MGL-EB, respectively. Subsequent surgery was performed in five patients (n = 3, ST-VAB; n = 2, MGL-EB) and they were all confirmed as ductal carcinoma in situ. The discordant rates were 22.7 % (5/22) for ST-VAB and 14.7 % (5/34) for MGL-EB after imaging-histologic correlation. There was no malignancy detected on follow up studies. Conclusion: ST-VAB and MGL-EB are reliable biopsy methods for microcalcifications. In proper indications, breast microcalcifications could be obtained by each method without missing diagnosis of breast cancer.