Parenchymal Distortion Research Articles

Bir Radyal Skar Olgusu: Mamografi ve MRG Bulguları

Radial scar is an idiopathic entity that represents a diagnostic challenge due to its similarity with breast cancer radiologically. The screening mammography of a 65-year-old female patient revealed asymmetrical parenchymal distortion. Breast ultrasound showed minor cysts and magnetic resonance imaging detected adjacent nodules with no contrast enhancement. Then, the lesion was excised with the help of mammography-guided needle localization method. Pathologic diagnosis was moderate ductal epithelial hyperplasia and radial scar. Although radial scar is a benign breast lesion, it mimics breast cancer mammographically and sonographically.

Accessory fissures of the lung: evaluation with multiplanar reformation on 64-slice spiral CT

Objective To classify the accessory fissures and assess the frequency of accessory fissures of the lung by 64-slice spiral CT (MSCT). Methods Of 2664 patients, 847 patients were included in this study excluding the patients with pulmonary parenchymal distortion, pleural disease or lobectomy. Allvolume raw data with a slice thickness of 0.6 mm were reformatted in sagittal and coronal orientations with 3 mm thickness and the accessory fissures were assessed. Results A total of 177 accessory fissures in 144 patients (17.0%) were detected. Most of the accessory fissures were incomplete except 10 fissures on the right lung (8.2%) and 2 fissures on the left lung (3.6%) were complete. The most common fissurewas the superior accessory fissure on the right low lobe (n = 112,13.2%) ,followed by the left minor fissure (n= 51,6.0%), the right inferior accessory fissure( n = 6,0. 7% ), the left superior accessory fissure ( n =4, 0.5%), the azygos fissure (n = 3,0.4%) and the accessory fissure on the right upper and middle lobe(n = 1,0.1%). Conclusion 64-slice CT is an efficient method to observe and classify the accessory fissures of the lung with MPR technique and can provide reliable and useful imaging information for the clinician. Key words: Lung; Anatomy,comparative; Tomography,X-ray computed

Mammographic findings of women recalled for diagnostic work-up in digital versus screen-film mammography in a population-based screening program

Limited information is available concerning differences in the radiological findings of women recalled for diagnostic work-up in digital mammography (DM) versus screen-film mammography (SFM) screening. To compare the radiological findings, their positive predictive values (PPVs) for cancer and other process indicators of DM screening performed by computed radiography (CR) technology and SFM screening in a population-based program. The material consisted of women, 50-59 years of age, who were invited for screening: 30 153 women with DM in 2007-2008 and 32 939 women with SFM in 1999-2000. The attendance rate was 77.7% (23 440) in the DM arm and 83.8% (27 593) in the SFM arm. In the DM arm, 1.71% of those screened (401) and in the SFM arm 1.59% (438) were recalled for further work-up. The images resulting in the recall were classified as: 1) tumor-like mass, 2) parenchymal distortion/asymmetry, 3) calcifications, and 4) combination of mass and calcifications. The distributions of the various radiological findings and their PPVs for cancer were compared in both study groups. The recall rates, cancer detection rates, test specificities, and PPVs of the DM and SFM groups were also compared. Women were recalled for diagnostic work-up most often due to tumor-like mass. It was more common in SFM (1.08% per woman screened) than in DM (0.93%). The second most common finding was parenchymal distortion and asymmetry, more often in DM (0.58%) than in SFM (0.37%). Calcifications were the third most common finding. DM exposed calcifications more often (0.49%) than SFM (0.26%). The PPVs for cancer of the recalls were higher in DM than in SFM in all subgroups of radiological findings. The test specificities were similar (DM 98.9%, SFM 98.8%). Significantly more cancers were detected by DM (cancer detection rate 0.623% per woman screened, n=146) than by SFM (cancer detection rate 0.406% per woman screened, n=112). The PPVs for cancer of all recalls for diagnostic work-up were significantly higher in DM (36%) than in SFM (26%). In DM women were recalled for diagnostic work-up more often for calcifications, parenchymal distortions, and asymmetries than in SFM. In the case of tumor-like masses, more women were recalled in SFM. DM detected more cancers than SFM, and the PPVs for cancer were higher in DM than in SFM in all subgroups of radiological findings.

18F-FDG PET imaging of progressive massive fibrosis

This study was to evaluate (18)F-FDG PET features of progressive massive fibrosis (PMF) and to determine the ability of FDG PET to differentiate pure PMF from PMF-associated lung cancer. (18)F-FDG PET and chest computed tomography (CT) scans were performed in 9 patients with pneumoconiosis and PMF. Patients who showed active pulmonary tuberculosis on CT scan were excluded. Pure PMF was confirmed via either fine needle aspiration biopsy (n = 6) or 12 months follow-up CT scan (n = 3). CT features and PET findings were evaluated for distribution of fibrotic masses, consolidations, and nodules on CT scan and mean and maximum standardized uptake values (SUVs) of abnormalities depicted on PET scan. 14 masses were detected from nine patients. On chest CT scan, PMF masses were noted with surrounding small nodules and distortion of parenchyma. The size of the lesions ranged from 1.2 to 6.4 cm in maximum diameter. FDG PET scans identified metabolically active lesions in all patients. Maximal SUV ranged from 3.1 to 14.6 and mean SUV ranged from 1.4 to 8.5. FDG PET can identify PMF lesions as hypermetabolic lesions even without associated malignancy or tuberculosis. Therefore, it might have a limited role in the diagnosis of PMF with possible concurrent granulomatous inflammation or lung cancer.

Nontumorous arterioportal shunts in the liver: CT and MRI findings considering mechanisms and fate

The intrahepatic non-tumorous arterioportal shunt (APS) is one of the important causes of transient hepatic enhancement differences (THED) on dynamic CT or MRI. Most small APSs are located in the peripheral portion of the liver. Because of the parenchymal distortion in the advanced cirrhotic liver, many small APSs tend to show an amorphous or nodular appearance, making them difficult to distinguish from hypervascular tumors. In addition to the use of dynamic CT or MRI, iso-attenuation densities or iso-intensities on pre-contrast and equilibrium phases, MRI using a liver-specific contrast agent can be useful to characterize the hypervascular pseudolesions. Because there is no difference in water diffusion in the hepatic parenchyma in the region of the APS, diffusion-weighted MRI also has great potential to distinguish non-tumorous shunts from true focal lesions. Larger (>2 cm) APSs of direct arterio-portal venous fistulas from extrinsic insults show typical subcapsular wedge-like THEDs that are only temporarily depicted several months after the traumatic event; most of these THEDs gradually decrease in size or vanish completely. By understanding the nature of non-tumorous APSs, radiologists will be able to provide a more accurate assessment of many THEDs during daily interpretations of CT or MR images of the liver.

Dyspnea on Exertion and Ground-Glass Infiltrates in an Ex-Smoker

Dyspnea on Exertion and Ground-Glass Infiltrates in an Ex-Smoker

O-28 Audit to set a baseline measurement for clinical breast examination

To compare the mammographic background pattern, the mammographic and the pathological features of screen-detected cancers diagnosed following arbitration of discordant double reading opinions with screen-detected cancers diagnosed following concordant double reading.Between April 2002 and December 2003, 249 patients were diagnosed with screen-detected malignancies following concordant double reading. In the same period 38 patients were diagnosed with screen-detected malignancies after their mammograms had undergone arbitration prior to recall. Mammograms of both groups of patients were reviewed retrospectively and the mammographic features documented. Histological data for both groups were also compared.Cancers detected following arbitration were more likely to manifest as parenchymal distortions (44 versus 8%, p<0.001) and less likely to manifest as spiculate masses (19 versus 42%, p=0.014). Arbitration cancers were less likely to be detected in fatty breasts (4 versus 29%, p=0.01). Arbitration cancers were smaller (p=0.045). Lobular cancers were commoner in the arbitration group, although this was of borderline significance (19 versus 8%, p=0.057) There was no significant difference in patient age, tumour grade or lymph node stage between the two groups.Cancers detected following arbitration are smaller and more likely to manifest as a parenchymal distortion compared with cancers detected by both readers. Arbitration cancers have broadly similar prognostic features to cancers detected by concordant double reading. It is estimated that approximately 11% more cancers are detected as a result of double reading with arbitration compared with single reading alone, after taking into consideration second reader bias.

Ultrasound imaging features of radial scars of the breast

Radial scars of the breast are common benign lesions, which are often radiologically occult. When they are detected by imaging, they are most often found by mammography. Radial scars are usually impalpable and have traditionally been localized for core biopsy and hookwire placement preoperatively by mammographic guidance. Stereotactic biopsy and localization is often difficult. Ultrasound-guided core biopsies and hookwire placement have the potential to provide a more accurate needle placement. The aim of this study was to determine the proportion of radial scars detectable by ultrasound and the feasibility of carrying out core biopsies and hookwire localization ultrasonographically. A retrospective review of the records of 7236 women was undertaken to determine those who had a histological diagnosis of radial scar. A total of 44 radial scars in 43 women were found, of which 40 had images that were available for analysis. Sixty-eight per cent of radial scars are visible on ultrasound, most commonly seen as hypoechoic areas/masses. Parenchymal distortion without a hypoechoic mass was seen in 22%. In 8%, the lesion was appreciably better visualized by ultrasound when compared with mammography. In one case, the lesion was detected on ultrasound and not detected by mammography. At least two-thirds of mammographically detected radial scars can be visualized on ultrasound. These should be submitted to preoperative core biopsy and hookwire localization under ultrasound control.

Granulomatous mastitis: radiological findings

To evaluate the radiological, ultrasonographic, and magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis. Between April 2002 and June 2005, the mammography, ultrasound, color Doppler ultrasound, nonenhanced MR, and dynamic MR findings of nine patients with the preliminary clinical diagnosis of malignancy and the final diagnosis of granulomatous mastitis were evaluated. On mammography, asymmetrical focal densities with no distinct margins, ill-defined masses with spiculated contours, and bilateral multiple ill-defined nodules were seen. On ultrasound, in four patients a discrete, heterogenous hypoechoic mass, in two patients multiple abscesses, in one patient bilateral multiple central hypo peripheral hyperechoic lesions, in two patients heterogeneous hypo- and hyperechoic areas together with parenchymal distortion, and in one patient irregular hypoechoic masses with tubular extensions and abscess cavities were seen. Five of the lesions were vascular on color Doppler ultrasound. On MR mammography, the most frequent finding was focal or diffuse asymmetrical signal intensity changes that were hypointense on T1W images and hyperintense on T2W images, without significant mass effect. Nodular lesions were also seen. On dynamic contrast-enhanced mammography, mass-like enhancement, ring-like enhancement, and nodular enhancement were seen. The time-intensity curves differed from patient to patient and from lesion to lesion. The imaging findings of idiopathic granulomatous mastitis have a wide spectrum, and they are inconclusive for differentiating malignant and benign lesions.

Granulomatous Lobular Mastitis: A Complex Diagnostic and Therapeutic Problem

Granulomatous lobular mastitis is a rare chronic inflammatory disease of the breast. Clinical and radiological features may mimic breast carcinoma. Since this entity was first described, several clinical and pathologic features of the disease have been reported, but diagnostic features and treatment alternatives are still unclear. The purpose of this study is to evaluate diagnostic difficulties and discuss the outcome of surgical treatment in a series of 21 patients with granulomatous lobular mastitis. A retrospective review of 21 patients with histologically confirmed granulomatous lobular mastitis treated in our center between January 1995 and May 2005 was analyzed to identify issues in the diagnosis and treatment of this rare condition. The most common presenting symptoms were a mass in the breast and pain. Four patients had no significant mammographic findings (MMG), but on ultrasound (US), 2 had irregular hypoechoic mass, and 2 hypoechoic nodular structures had abnormalities-one parenchymal distortion and 1 mass formation in 2 of these 4 patients' magnetic resonance imaging (MRI). In recurrent cases, limited excision under local anesthesia was performed, as the clinical examination suggested carcinoma. Although some findings on MMG and US are suggestive of benign breast disease, these modalities do not rule out malignancy. MRI may be helpful in patients who do not have significant pathology at MMG or US. Fine-needle aspiration cytology may be useful in some cases but diagnosis is potentially difficult because of its cytologic characteristics. Wide excision, particularly under general anesthesia, can be therapeutic as well as useful in providing an exact diagnosis.

Radiologic and Clinical Features of Idiopathic Granulomatous Lobular Mastitis Mimicking Advanced Breast Cancer

Idiopathic granulomatous lobular mastitis (IGLM), also known as idiopathic granulomatous mastitis, is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The aim of this study was to describe the radiological imaging and clinical features of IGLM in order to better differentiate this disorder from breast cancer. We performed a retrospective analysis of the clinical and radiographic features of 11 women with a total of 12 IGLM lesions. The ages of these women ranged between 29 and 42 years, with a mean age of 34.8 years. Ten patients were examined by both mammography and sonography and one by sonography alone. The sites that were the most frequently involved were the peripheral (6/12), diffuse, (3/12), and subareolar (3/12) regions of the breast. The patient mammograms showed irregular ill-defined masses (7/11), diffuse increased densities (3/11), and one oval obscured mass. In addition, patient sonograms showed irregular tubular lesions (7/12) or lobulated masses with minimal parenchymal distortion (2/12), parenchymal distortion without definite mass lesions (2/12), and one oval mass. Subcutaneous fat obliteration (12/12) and skin thickening (11/12) were also observed in these patients. Contrary to previous reports, skin changes and subareolar involvement were not rare occurrences in IGLM. In conclusion, the sonographic features of IGLM show irregular or tubular hypoechoic masses with minimal parenchymal distortion. Both clinical information and the description of radiographic features of IGLM may aid in the differentiation between IGLM and breast cancer, however histological confirmation is still required for the proper diagnosis and treatment of the disorder.

Utility of high resolution computed tomography (HRCT) in diagnosis and management of idiopathic pulmonary fibrosis - a study of 10 cases".

Objective / Aim The aim of our article is to present our early experience to evaluate High Resolution CT (HRCT) findings in Idiopathic Pulmonary Fibrosis (IPF) and to stress upon its clinical utility. Materials & Methods A prospective study of ten patients was done at and tertiary care government hospital. Study population comprises seven women and three men. Patients with chronic respiratory symptoms, chest radiograph showing typical reticular pattern or with clinical suspicion of IPF were selected. All patients underwent HRCT examination. Chest radiograph findings were compared with the HRCT findings in all patients. HRCT findings of our study were compared with the other studies. Results From the study it was seen that IPF is most commonly manifested by the combination of HRCT findings, which includes peripheral (100%) and lower lobe predominance (80%) of the distribution of the lesions, evidences of intralobular septal thickening (100%), honeycombing (90%), traction bronchiectasis (90%) and parenchymal distortion (100%). Conclusion In conclusion, HRCT is accurate and superior in the confident diagnosis of IPF. HRCT findings in advance stage of IPF are characteristic. HRCT determines the disease activity and extent of IPF better than chest radiograph. When HRCT findings are characteristic in appropriate clinical settings, HRCT may obviate a need for open lung biopsy.

Localización radioguiada de lesiones ocultas de mama (ROLL)

To obtain correct location of occult breast lesions by radiopharmaceutical methods. Sixty-one patients whose ages ranged from 32 to 83 years (average: 57), with non-palpable breast lesions detected by mammography were studied. Six of them had a background of previous breast cancer. Sixty-three lesions were found. The lesions were classified into 34 clusters of microcalcifications, 25 nodules and 4 others parenchymal distortions. All patients received one dose of 0.3-0.5 mCi (11.1-18.5 MBq) of macroaggregates of 99mTc-labelled human serum albumin (99mTc-MAA) into the lesion under stereotactic mammographic or ultrasonography guidance. Anterior and lateral scintigraphic images were acquired in order to verify the correct location of the radiopharmaceutical. Intraoperative location of the lesion was performed using a gammaprobe. In case of microcalcifications, the entire removal of the lesion was verified by X-ray of the specimen. Placement of the radiotracer was good in 60 of 63 (95.2%) cases. Sixty-one lesions were completely removed. Pathological examination revealed 29 (47.6%) breast cancers and 32 (52.4%) benign lesions. Radioguided occult breast lesion location by radiopharmaceutical methods is a simple, safe and well-tolerated method by patients.

Increased and Prolonged Pulmonary Fibrosis in Surfactant Protein C-Deficient Mice Following Intratracheal Bleomycin

Recent reports have linked mutations in the surfactant protein C gene (SFTPC) to familial forms of pulmonary fibrosis, but it is uncertain whether deficiency of mature SP-C contributes to disease pathogenesis. In this study, we evaluated bleomycin-induced lung fibrosis in mice with genetic deletion of SFTPC. Compared with wild-type (SFTPC+/+) controls, mice lacking surfactant protein C (SFTPC-/-) had greater lung neutrophil influx at 1 week after intratracheal bleomycin, greater weight loss during the first 2 weeks, and increased mortality. At 3 and 6 weeks after bleomycin, lungs from SFTPC-/- mice had increased fibroblast numbers, augmented collagen accumulation, and greater parenchymal distortion. Furthermore, resolution of fibrosis was delayed. Although remodeling was near complete in SFTPC+/+ mice by 6 weeks, SFTPC-/- mice did not return to baseline until 9 weeks after bleomycin. By terminal dUTP nick-end labeling staining, widespread cell injury was observed in SFTPC-/- and SFTPC+/+ mice 1 week after bleomycin; however, ongoing apoptosis of epithelial and interstitial cells occurred in lungs of SFTPC-/- mice, but not SFTPC+/+ mice, 6 weeks after bleomycin. Thus, SP-C functions to limit lung inflammation, inhibit collagen accumulation, and restore normal lung structure after bleomycin.

The pathological and radiological features of screen-detected breast cancers diagnosed following arbitration of discordant double reading opinions

To compare the mammographic background pattern, the mammographic and the pathological features of screen-detected cancers diagnosed following arbitration of discordant double reading opinions with screen-detected cancers diagnosed following concordant double reading. Between April 2002 and December 2003, 249 patients were diagnosed with screen-detected malignancies following concordant double reading. In the same period 38 patients were diagnosed with screen-detected malignancies after their mammograms had undergone arbitration prior to recall. Mammograms of both groups of patients were reviewed retrospectively and the mammographic features documented. Histological data for both groups were also compared. Cancers detected following arbitration were more likely to manifest as parenchymal distortions (44 versus 8%, p<0.001) and less likely to manifest as spiculate masses (19 versus 42%, p=0.014). Arbitration cancers were less likely to be detected in fatty breasts (4 versus 29%, p=0.01). Arbitration cancers were smaller (p=0.045). Lobular cancers were commoner in the arbitration group, although this was of borderline significance (19 versus 8%, p=0.057) There was no significant difference in patient age, tumour grade or lymph node stage between the two groups. Cancers detected following arbitration are smaller and more likely to manifest as a parenchymal distortion compared with cancers detected by both readers. Arbitration cancers have broadly similar prognostic features to cancers detected by concordant double reading. It is estimated that approximately 11% more cancers are detected as a result of double reading with arbitration compared with single reading alone, after taking into consideration second reader bias.

Avaliação da tomografia de alta resolução versus radiografia de tórax na doença intersticial pulmonar na esclerose sistêmica

OBJETIVO: Avaliar a acurácia da tomografia de alta resolução (TCAR) do tórax em relação à radiografia simples (RX) do tórax no diagnóstico de doença intersticial pulmonar relacionada à esclerose sistêmica (ES). MATERIAIS E MÉTODOS: Foram realizados TCAR e RX de tórax em póstero-anterior e perfil em 34 pacientes com diagnóstico de ES, segundo critérios do Colégio Americano de Reumatologia, e feita comparação entre as prevalências dos achados radiológicos sugestivos de doença intersticial pulmonar encontradas com estes dois métodos de imagem. RESULTADOS: Foram observadas alterações em 31 (91%) das TCAR, enquanto 16 (47%) dos RX de tórax se apresentavam alterados. Os achados mais freqüentes à TCAR foram: linhas septais (74%), faveolamento (56%) e bandas parenquimatosas (26%), localizados predominantemente nas bases pulmonares. Os RX de tórax demonstraram áreas de infiltrado reticular em 32% dos casos e distorção parenquimatosa em 12% dos pacientes. Em 18 (53%) pacientes com RX de tórax normal a TCAR revelou espessamento septal em 55%, vidro fosco em 44%, faveolamento em 38,5% e cistos em 33%. CONCLUSÃO: A TCAR é mais sensível que o RX de tórax para a investigação de envolvimento intersticial pulmonar inicial em pacientes com ES, justificando, em casos incipientes, tratamento com terapia imunossupressora.

CT and MRI of Hepatic Contour Abnormalities

Lipson JA, Qayyum A, Avrin DE, Westphalen A, Yeh BM, Coakley FV epatic contour abnormalities are seen commonly on CT or MRI but have received relatively little attention in the radiology literature compared with parenchymal hepatic disease. The objective of this pictorial essay is to provide a concise pictorial review of the causes and appearances of hepatic contour abnormalities on CT and MRI with an emphasis on clinical and imaging features that facilitate a correct diagnosis. Such a review is timely because new causes of liver contour abnormalities have been described recently [1], and the interpretation of such findings remains controversial. Intrinsic disorders of the liver that may cause contour abnormalities consist of hepatic tumors, cirrhosis, infarction, and vascular occlusion; treatment change also may cause contour abnormalities. Perihepatic diseases also may cause extrinsic alteration of the liver contour. Depending on the nature and extent of these disorders, the contour abnormality may be unifocal, multifocal, or diffuse. The mechanism of contour change also varies and may reflect focal expansion of the liver, capsular retraction, parenchymal distortion, capsular indentation, or some combination of these factors. All of

Radiological results of the Age Trial

Almost 500 cancers occurring within the study arm of the Age Trial have had their radiological features reviewed. The commonest radiological features of screen-detected cancers in this age group are granular microcalcification (28%), spiculate mass (22%), poorly defined mass (20%) and comedo calcification and parenchymal distortion both at 18%. Of the 254 cancers detected at screening that had a previous screen, 52% showed some mammographic feature on the previous screen. The most frequent abnormality in such cases was granular microcalcification 44%, parenchymal deformity 17% and poorly defined mass 17%. Of the 138 interval cancers reviewed, 30% had abnormalities visible on previous screens. The commonest features present on previous screens were microcalcification, asymmetric density and ill-defined mass. The radiological features of cancers arising in younger women who are being screened are different to those occurring in older women. Spiculate masses are less common and microcalcification is more common in this age group. Microcalcification is also a common feature of screen-detected cancers visible on previous screens. False negative interval cancers show a more varied distribution of radiological features, with asymmetric density, parenchymal deformity and microcalcification all being important features.

18‐Fluorodeoxyglucose‐Positron Emission Tomography in Inflammatory Breast Cancer

Inflammatory breast cancer (IBC) is the most aggressive form of locally advanced breast cancer. It can be diagnosed based on a clinical or pathologic basis. We evaluated the usefulness of (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scans for diagnosing and staging IBC. We retrospectively reviewed the medical records of seven consecutive patients with IBC who underwent FDG-PET scanning for the initial staging. Four patients had follow-up PET scans after chemotherapy. All seven patients presented with diffuse breast enlargement, redness, and peau d'orange for 1 to 5 months' duration. In addition, four patients had a palpable breast mass, and three had axillary lymph node enlargement. Mammography showed diffuse, increased parenchymal density and skin thickening in 85% and parenchymal distortion in 43%. There was no evidence of distant metastasis on computed tomography of the chest or abdomen. Pathologic examination of breast biopsy specimens showed infiltrating ductal carcinoma in six patients, and one had lobular carcinoma. All patients had prechemotherapy whole-body PET scans that showed diffuse FDG uptake in the breast with superimposed intense foci in the primary tumor. Furthermore, there was skin enhancement in 100%, axillary lymph node in 85%, and skeletal metastases in 14% of the patients, confirmed by bone scintigraphy. Postchemotherapy FDG-PET scans performed in four patients showed response in the primary tumor, axillary lymph nodes, and skeletal metastases. The FDG-PET scan is thus useful for displaying the pattern of FDG breast uptake that reflects the extent of the pathologic involvement in IBC (i.e., diffuse breast involvement and dermal lymphatic spread). It can also detect the presence of lymph node and skeletal metastases, demarcating the extent of the disease locally as well as distally.

Digital stereotactic biopsies for nonpalpable breast lesion.

Percutaneous biopsy (BP) is a valid alternative to open surgical biopsy. The aim of our study was to evaluate the results and diagnostic value of vacuum-assisted core biopsy (VACB; Mammotome) and advanced breast biopsy instrumentation (ABBI). From June 1999 to December 2001, 360 BPs were performed: all patients had dubious mammography lesions not confirmed by ultrasonography. Indications were as follows 264 (73.3%) microcalcifications, 64 (17.8%) nodular opacities, and 32 (8.8%) parenchymal distortions. All BPs were performed with a digital stereotactic table with a vacuum suction aspiration system for VACB and a cutting cannula for ABBI. All BPs were correctly performed. Seventy-one (19.7%) lesions were malignant, whereas 258 (71.6%) were benign: 31 (8.6%) of the lesions removed with VACB were atypical ductal hyperplasia. BP is a valid method for the diagnosis of nonpalpable breast lesions. In our experience, VACB is the method of choice because it is easy to perform and has high adaptability.