Retrieval Rate and Accuracy of Ultrasound-Guided 14-G Semi-Automated Core Needle Biopsy of Breast Microcalcifications

Abstract

ObjectiveTo evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast.Materials and MethodsUS-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared.ResultsThirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05).ConclusionUS-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography.

Breast Microcalcifications: Diagnostic Outcomes According to Image-Guided Biopsy Method

“…The microcalcification retrieval rates in our study were 92.9% for US-CNB and 100% for US-VAB and S-VAB, which were within the range of previous studies ( 5 10 11 15 ). Among the seven biopsy failure cases (2.8%) in S-VAB, biopsy was technically infeasible in five lesions (2.0%) due to inadequate breast thickness under compression, and two patients (0.8%) developed vasovagal reactions.…”

“…In addition, no ionizing radiation is used, the needle insertion site is more flexible, and real-time observations can be made ( 7 8 ). For these reasons, if microcalcifications are detected on US, US-guided core biopsy (US-CNB) or US-guided vacuum-assisted biopsy (US-VAB) is conducted for the diagnosis ( 5 9 10 11 ).…”

Troubleshooting to Overcome Technical Challenges in Image-guided Breast Biopsy

“…Although calcifications are usually biopsied with stereotactic guidance, sometimes this method cannot be safely used for biopsy. US guidance is an alternative, especially in the subareolar location, where calcifications visible with a high-frequency US probe have been retrieved with 91% accuracy (25). A BB can be placed on the skin overlying the calcifications seen at US and imaged in tangent to confirm that the calcifications seen at mammography are the same as those seen at US (Fig 12).…”

Meme Biyopsisi: Hasta ve Yöntem Seçimi; Hangi Lezyonda Ne Yapalım?

“…Bunun yanında US rehberliği, gerçek zamanlı örnekleme, konfor, kısa işlem zamanı ve iyonizan radyasyon maruziyetinin olmaması gibi avantajları da beraberinde getirir. Mikrokalsifikasyon örneklemesinde US rehberliğinde yapılan KİB'lerin etkinliği oldukça yüksektir [29]. Ancak belirtilen eşlik bulgularının seçile-mediği durumlarda vakum destekli iğnelerle bile, US rehberlikli örneklemenin verimliliği stereotaksiye göre daha düşüktür [29].…”