vacuum assisted-biopsy and mammo-guided localization and excisional biopsy in the microcalcifications sampling of breast: an experience of single institution

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.