Radiographer technique: Does it contribute to the question of clip migration?

Madeley, Carolyn; Kessell, Meredith; Madeley, Chris; Taylor, Donna; Wylie, Elizabeth

doi:10.1111/1754-9485.12327

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Evaluating the accuracy of the BBM position on mammography can, however, be challenging. A study by Madeley et al 10 reviewed a series of mammograms from the same patient and found that fixed immobile objects in the breast appeared to move a distance of >15 mm in up to 30% of cases. This suggests some of what has previously been called marker ‘migration’ may be spurious and due to differences in radiographic positioning techniques.…”

Section: Discussionmentioning

confidence: 99%

Are breast biopsy markers underused?

2020

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Introduction To evaluate current use of breast biopsy markers (BBM) amongst Australian and New Zealand radiologists. Methods Radiologists attending a national breast conference were invited to complete an online survey addressing demographics, BBM use following ultrasound, stereotactic, tomosynthesis and MRI‐guided biopsy, frequency of early BBM displacement, preoperative lesion localisation (PLL) and axillary BBM use. Results Overall response rate was 52% (60/115). The majority (n = 45) 75% practiced in Australia. 98% had BBMs available in their practice, 40% reported BBM costs weren’t covered by insurance. 27% would use BBMs more often if they were, with some utilising smaller gauge devices for lesion sampling to minimise need for BBM use and patient out‐of‐pocket costs. Ultrasound‐guided procedures were associated with lower rates of clinically significant BBM displacement (P = 0.001). Considering PLL, 44% were able to perform US‐guided PLL in <25% of cases. Poor sonographic visibility was the commonest reason why this wasn’t possible. In the axilla, BBMs were mainly used to mark positive nodes in pre‐neoadjuvant chemotherapy patients. Conclusion This survey is the first to provide data on BBM use amongst a sample of predominantly Australian and New Zealand radiologists, and provides compelling evidence of significantly lower incidence of BBM displacement with US‐guided procedures. Our results suggest some radiologists may hesitate to use BBMs due to cost, and this can influence their choice of biopsy technique. Provision of a Medicare item Number for BBMs may lead to increased adoption of best practice guidelines for preoperative diagnosis of breast lesions.

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Section: Discussionmentioning

confidence: 99%

Are breast biopsy markers underused?

2020

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“…Mask [9] and superimposed [11] measurement systems have been used for assessment of clip placement, but these systems have limited accuracy due to differences in breast shapes in different mammograms [9]. Consequently, calcifications and clips are not visualized at the same point [12] and it is difficult to overlap a calcification and a clip in different mammograms or to align them visually. Several studies have reported direct measurement of the distance from a clip to a residual calcification and hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…In those with complete resection of targeted calcifications, the resection point was estimated and the distance from the point to the clip was measured. However, mammography cannot image at exactly the same position every time, and calcifications and a clip in a mammogram are not displayed at the same point [12]. Therefore, estimation of the position at which targeted calcifications were removed using a mammogram and measurement of the target-to-clip distance may not be accurate.…”

Section: Introductionmentioning

confidence: 99%

Accuracy assessment methods of tissue marker clip placement after 11-gauge vacuum-assisted stereotactic breast biopsy: comparison of measurements using direct and conventional methods

et al. 2016

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“…Studies of the precision of clip placement show that 2-28% of clips [7] are more than 1 cm from the target [1,2,[8][9][10]. Migration of the clip following ST-VABB is an accepted risk of the procedure [8,[11][12][13][14][15][16][17][18][19][20]. The accurate placement of a tissue marker is of utmost importance for patients requiring neoadjuvant chemotherapy and undergoing complete tumor remission [21].…”

Section: Introductionmentioning

confidence: 99%

“…The accurate placement of a tissue marker is of utmost importance for patients requiring neoadjuvant chemotherapy and undergoing complete tumor remission [21]. Another aspect is the additional cost of tissue markers [3, 12, 22, 23]. It is assumed that about two-thirds of all cases with coil marking could be avoided (in case of a negative biopsy) [24].…”

Section: Introductionmentioning

confidence: 99%

Subsequent Marking under Ultrasound Guidance of Vacuum-Assisted Breast Biopsy Areas after Receipt of Histology: A Feasibility Study of a New Technique

Park

Chevalier²,

Möbus³

et al. 2020

Breast Care

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The aim of this study was to evaluate the feasibility and the accuracy of a secondary, metachronous ultrasound (US)-guided marking of the stereotactic vacuum-assisted breast biopsy (ST-VABB) area. Materials and Methods: The institutional ethics committee approved the study. The retrospective study included 98 patients. In ST-VABB of 45 women, no tissue markers were deployed at the biopsy site, even if no residual calcifications remained. After histology proved the necessity for a subsequent operation, the biopsy site was marked under US guidance using a coil marker. All interventions were technically successful. No complications occurred. Mammography was done to visualize the coil deployment. The distances from the center of the lesion and the biopsy cavity to the coil location were measured in both planes to evaluate the accuracy of the marking procedure. Results: In 24 of the 46 cases, the whole lesion was biopsied without residual elements. The mean time between ST-VABB and sonographic marking of the lesion was 9.7 days (median 6.5). The biopsy cavity could be detected in 40 (87%) cases and thus marked exactly. The mean time of US-guided marking was 12.5 min. The mean distance between the coil and the target lesion was 0.6 ± 1.5 cm in the craniocaudal (cc) view and 0.5 ± 1.5 cm in the mediolateral (ml) view for all markings. The mean delta value from the distance nippleoriginal lesion and from the distance nipple-coil was 0.85 ± 1.2 cm (median 0.5) in the cc view and 0.88 ± 1.2 cm (median 0.6) in the ml view for all cases. Clip migration was not observed. Conclusion: Our study demonstrates the feasibility and the technical success of secondary metachronous coil marking of the biopsy site under US guidance after receipt of histology. This approach seems to be a cost-effective alternative to the standard procedure of the primary coil marking especially in all completely removed lesions. It may offer advantages for allergic patients.

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Radiographer technique: Does it contribute to the question of clip migration?

Abstract: Fixed immobile objects in the breast can appear to move a distance of >15 mm in up to 30% of cases. Clinically, some of what has previously been called marker 'migration' may be spurious and accounted for by differences in radiographic positioning techniques.

Cited by 9 publications

References 15 publications

Are breast biopsy markers underused?

Are breast biopsy markers underused?

Accuracy assessment methods of tissue marker clip placement after 11-gauge vacuum-assisted stereotactic breast biopsy: comparison of measurements using direct and conventional methods

Subsequent Marking under Ultrasound Guidance of Vacuum-Assisted Breast Biopsy Areas after Receipt of Histology: A Feasibility Study of a New Technique

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