Objectives: Stereotactic vacuum assisted breast biopsy (SVAB) is the most efficient and habitual method for the management of suspicious calcifications. However, it's a not perfect method: false negatives cases can be observed, and some malignant lesions may be underestimated. Our purpose is to evaluate the diagnostic value of stereotactic vacuum-assisted breast biopsy (SVAB) in the management of suspicious calcifications, without associated mass.Materials and methods: Retrospective review of 1,106 procedures of SVAB performed on a prone digital table on calcifications without associated mass classified as BI-RADS 3, 4 or 5. The samples were analysed in the same laboratory of pathology. In situ lobular carcinomas have been considered malignant lesions. The "gold standard" has been the pathological analysis after surgery, and/or the follow-up for a minimum of 2 years. The following variables were evaluated: age, diagnostic category, size of lesions, number of samples extracted and diagnostic parameters: Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Accuracy. Results:The average age has been 52.75 years. According to the diagnostic category, 28.03% of cases corresponded to category 3, 57.32% to category 4 and 14.65% to category 5. The PPV was 14.84%, 35.80% and 93.21%, for category 3, 4 and 5, respectively, with an average PPV of 38.34%. A sensitivity of 96.81%, specificity of 100%, VPP of 100%, VPN of 98.28% and an accuracy of 98.87% were obtained. 1.47% of false negatives and 4.76% of underestimation have been observed. Conclusion:A high indication for category 3 calcifications cluster is observed, since most patients prefer to undergo the procedure, rather than radiological follow-up. The PPV observed in category 3 (14.84%) is higher than that reported "officially" (2%), probably due to the great inter-observer variability.