Use of stereotaxic aspiration macrobiopsies in managing breast microcalcifications: first series of 115 prospective cases

• Published in: Gynécologie, obstétrique & fertilité Vol. 28; no. 11; pp. 806 - 819
• Main Authors: Seror, J Y, Antoine, M, Scetbon, F, Chopier, J, Sananes, S, Ghenassia, C, Uzan, S
• Format: Journal Article
• Language: French
• Published: France 01.11.2000
• Subjects: Biopsy, Needle - methods; Breast Diseases - diagnostic imaging; Breast Diseases - pathology; Breast Neoplasms - diagnosis; Calcinosis - diagnostic imaging; Calcinosis - pathology; Female; Humans; Mammography; Middle Aged; Prospective Studies; Stereotaxic Techniques
• ISSN: 1297-9589

The objective of this prospective study of a 115-case series cases was to delineate the specific usefulness of this technique for the diagnosis and management of patients with microcalcifications. Patients with probably benign ACRII and III (n = 87) or suspicious ACRIV (n = 14) and high suspicious lesion ACRV (n = 7) lesions. The microcalcification sites were blopsied with a dedicated table and a vacuum assisted aspiration system (Mammotome). The results were correlated either with the results of any surgery or, for the lesions with benign histology findings, with the results of the six-month follow-up mammography. These results concern a series with a follow-up longer than one year. The patients' mean age was 53 years. The procedure was possible in 108 of 115 cases (feasibility). There were two failures. We studied 87 patients with ACRII or III findings; the mean size of the microcalcification cluster was 8.3 +/- 6 mm. For 67, it was less than or equal to 10 mm. The mean size for the 21 patients initially staged as ACRIV or V was 18 +/- 9 mm, and for 15 of them, it was less than or equal to 10 mm. Microcalcifications were found on the radiographs of 96% of the biopsies specimens. Excision was complete in 59 of 73 cases for the clusters less than or equal to 10 mm and in only 12 of 35 cases for the larger clusters. The correlation between the ACR staging and the histology results was excellent. Vacuum-aspirated biopsies are indicated especially among patients with an ACRIII finding and a cluster smaller than 10 mm. Surgery was avoided in more than 60% of these cases. When surgery was performed, it most often resulted in the discovery of malignant lesions. This procedure was also useful for the very small ACRIV clusters, which were totally benign and completely excised. Finally it can be useful for obtaining a preoperative diagnosis in the case of extensive ACRIV or ACRV lesions (strategic biopsies).