Early results of ultrasound-guided, vacuum-assisted breast biopsy for mammographic microcalcifications: combination with wire localization

Abstract

Purpose: This study examined the usefulness of ultrasound-guided vacuum-assisted breast biopsy for mammographic microcalcification.
Methods: case series from June- 2019 to June-2020 at Breast department Cho Ray hospital. The patients with BI-RADS Category 4 Mammographic microcalcification were included. Most microcalcifications were not observed on ultrasound. Sono-guided J-wire localization was first performed for the suspicious microcalcification area, and the location of the J-wire and calcification was determined with mammography in most cases. Sono-guided VABB was performed after removing the J-wire without a stereotactic device. On the other hand, Sono-guided VABB was performed directly without J-wire localization when microcalcification lesions were identified by mass on ultrasonography. In all cases, calcification was confirmed by specimen mammography and the pathology was performed. A follow-up examination was performed to confirm the presence of complications.
Results: A total of 20 lesions of 18 patients with BI-RADS Category 4 Mammographic microcalcification were included. Mean age: 49,44 ± 9,49 (35-66). Mean size of lesions 10,83 ± 3,60 mm, (4-15mm). In 20 lesions, 6 lesions (30%) were diagnosed as a malignancy (2 cases of ductal carcinoma in situ, 3 cases of ductal carcinoma invasive, 1 case of atypical ductal hyperplasia). The remaining 14 lesions (70%) were diagnosed as benign (fibroadenoma: 4; fibrocystic exchange 7, fibrocystic desease: 1, typical hyperplasia : 2). There were no significant complications during follow up after VABB.
Conclusion: Sono-guided VABB can be used effectively if combined with wire localization for microcalcification lesions.