Comparison of Sonography versus Digital Breast Tomosynthesis to Locate Intramammary Marker Clips

Abstract

Around 55 000 women develop breast cancer and 20 000 women die of it in Germany every year [1]. The individual prognosis of patients with breast cancer depends in the first instance on the extent of disease at the time of diagnosis and on the implemented treatment plan [2][3][4]. According to both European treatment recommendations and the German interdisciplinary S3 Guideline for the Diagnosis, Treatment and Follow-up of Breast Cancer, at least 70 % of all breast Abstract ! Introduction: This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Patients and Methods: Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis. Results: Sonography detected no dislocation of intrammammary marker clips in 42 of 50 patients (84 %); dislocation was reported in 8 patients (16 %) with a maximum dislocation of 7 mm along the x-, y-or z-axis. Digital breast tomosynthesis showed accurate placement without dislocation of the intramammary marker clip in 48 patients (96 %); 2 patients (4 %) had a maximum clip dislocation of 3 mm along the x-, y-or z-axis (p < 0.05). Conclusion: The use of digital breast tomosynthesis could improve the accuracy when locating intramammary marker clips compared to sonography and could, in future, be used to complement or even completely replace sonography.

Evaluation of a Marker Clip System in Sonographically Guided Core Needle Biopsy for Breast Cancer Localization Before and After Neoadjuvant Chemotherapy

“…Digital breast tomosynthesis also appears to be superior to both sonography and mammography for the determination of the size of breast tumors [24]. As shown earlier by us [16], our current findings confirm that determination of the localization of marker clips placed after sonographically guided core needle biopsy is significantly more precise using digital breast tomosynthesis compared to sonography. One reason for this could be because digital breast tomosynthesis is standardized compared to sonography, where the application is semi-subjective, irrespective of whether it is 2-D, 3-D, or 4-D imaging.…”

“…Post-procedural measurements of dislocation of the intramammary marker clips in mm (along the x-, y-and z-axis) were performed as previously published by us [16], and were also carried out by the same two radiologists to reduce inter-observer variability.…”

“…The response after neoadjuvant chemotherapy can be evaluated by different imaging techniques [12]. In the view of those imaging techniques we had investigated in a recent study the accuracy of different imaging techniques when determining the precise position of marker clips placed directly in the center of intramammary lesions [16]. In particular, we had compared the accuracy of sonography versus digital breast tomosynthesis to locate the above mentioned intramammary marker clip placed under sonographic guidance and had shown that the use of digital breast tomosynthesis could improve the accuracy when locating intramammary marker clips compared to sonography [16].…”

Evaluation of a Marker Clip System in Sonographically Guided Core Needle Biopsy for Breast Cancer Localization Before and After Neoadjuvant Chemotherapy

“…Digital breast tomosynthesis also appears to be superior to both sonography and mammography for the determination of the size of breast tumors [24]. As shown earlier by us [16], our current findings confirm that determi-nation of the localization of marker clips placed after sonographically guided core needle biopsy is significantly more precise using digital breast tomosynthesis compared to sonography. One reason for this could be because digital breast tomosynthesis is standardized compared to sonography, where the application is semi-subjective, irrespective of whether it is 2-D, 3-D, or 4-D imaging.…”

Evaluation of a Wireless Localization System for Nonpalpable Breast Lesions — Feasibility and Cost-effectiveness in Everyday Clinical Routine

“…Localizing a lesion that has disappeared from view in order to carry out definitive breast surgery is one of the most challenging problems. Several studies have been published on the use of marker clips, demonstrating the feasibility of this method during neoadjuvant treatment and for preoperative localization of breast lesions (14)(15)(16)(17). In addition, less radical approaches to axillary breast surgery are now being adopted.…”