HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text All Versions of this Article: 2331031680v1 233/1/251    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Margolin, F. R. Articles by Schrumpf, J. D. Search for Related Content PubMed PubMed Citation Articles by Margolin, F. R. Articles by Schrumpf, J. D.

Stereotactic Core Breast Biopsy of Malignant Calcifications: Diagnostic Yield of Cores with and Cores without Calcifications on Specimen Radiographs¹

¹ From the Breast Health Center, California Pacific Medical Center, 3698 California St, Suite 2F, San Francisco, CA 94118. Received October 10, 2003; revision requested December 10; revision received January 5, 2004; accepted February 2. Address correspondence to F.R.M. (e-mail: liue@sutterhealth.org).

PURPOSE: To retrospectively compare core biopsy diagnosis with final diagnosis at surgical excision in cores with and cores without calcification on specimen radiographs.

MATERIALS AND METHODS: One hundred thirteen consecutive patients underwent vacuum-assisted 11- or 14-gauge needle stereotactic core biopsy for calcifications with malignant histologic results in core samples from 116 lesions. For each lesion, calcification was identified in at least one core at specimen radiography. Cores with and those without calcification seen on magnified specimen radiographs were separately submitted to and reported on by pathologists, who obtained additional levels in cores with calcification. All patients underwent surgical excision of the lesion area within 7 weeks. The pathologic diagnosis in core samples with and those without calcification on specimen radiographs was compared with final diagnosis at surgical excision. Fisher exact test was used for all ² determinations of statistical significance.

RESULTS: Cores with calcification on specimen radiographs were more likely to enable a final diagnosis of malignancy than were cores without calcification (98 [84%] vs 82 [71%] of 116; P = .02). Cores without calcification were significantly more likely to cause a diagnosis of cancer to be missed than were those with calcification on specimen radiographs (13 [11%] vs one [1%] of 116; P < .001). Underestimates of malignancy were more frequent in 14- than in 11-gauge specimens (11 [18%] of 60 vs six [10%] of 56; P = .30). Regardless of needle size, there was no significant difference in underestimation of malignancy between cores with and without radiographically evident calcification (17 [15%] vs 21 [18%] of 116; P = .60).

CONCLUSION: Specimen radiography is essential to document calcification retrieval. Cores without radiographically demonstrated calcification may fail to show a malignant lesion. Separate identification of calcium-containing cores may assist the pathologist, who can more thoroughly evaluate these cores with additional levels of section.

© RSNA, 2004

Index terms: Breast, biopsy, 00.1261 • Breast neoplasms, calcification, 00.812 • Specimens, radiography, 00.128 • Stereotaxis, 00.1267

This article has been cited by other articles:

				E A Rakha and I O Ellis An overview of assessment of prognostic and predictive factors in breast cancer needle core biopsy specimens J. Clin. Pathol., December 1, 2007; 60(12): 1300 - 1306. [Abstract] [Full Text] [PDF]