Ultrasonographically-Guided Biopsy after Digital Mammographically Guided Two-Dimensional Localization of Breast Microcalcifications

Department of Radiology, Samsung Medical Center, Sunkyunkwan University, School of Medicine Department of Radiology and Medical Research Institute, Ewha Womans University, College of Medicine, Ewha University Mokdong Hospital Department of General Surgery and Medical Research Institute, Ewha Womans University, College of Medicine, Ewha University Mokdong Hospital Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea Received January 8, 2007 ; Accepted July 23, 2007 Address reprint requests to : Hye-Young Choi, M.D., Department of Radiology and Medical Research Institute, Ewha Womans University, College of Medicine, Ewha University Mokdong Hospital 911-1, Mok-dong, Yangcheon-gu, Seoul 158-710, Republic of Korea. Tel. 82-2-2650-5038 Fax. 82-2-2650-5302 E-mail: [email protected] Purpose: To investigate the efficacy of ultrasound (US)-guided core biopsies after digital mammography-guided two-dimensional localization (DM-2DL) of breast microcalcifications. Materials and Methods: Twenty-two patients with 23 suspicious microcalcifications underwent US-guided core biopsies after DM-2DL, to mark the sites on the skin where microcalcifications had been found (craniocaudal and mediolateral (or lateromedial) views). Of the 23 lesions, 4 were sampled using a 14-gauge automated gun and the other 19 were sampled using an 8-gauge vacuum-assisted device. The lesions were categorized into two groups: those with and those without microcalcifications observed on US. The success rate for correctly sampling microcalcifications on the specimen radiograph in the two groups was assessed and their pathologic outcomes were investigated. Results: Of the 23 lesions, 16 were invisible and 7 were visible to ultrasonographic microcalcifications. The sampling success rate for the specimen radiographs was 100% for ultrasonographic visible microcalcifications and 88% (14/16) for lesions invisible to ultrasonography after DM-2DL (p = 1.000). The cancer rate of individuals with microcalcifications observed on US (57%, 4/7) was greater than in individuals without visible microcalcifications (13%, 2/16) (p=0.045). Conclusion: Although some microcalcifications are invisible on US, a US-guided biopsy after DM-2DL is a useful method for the successful sampling of the microcalcifications.