Sonographic evaluation of mammographically detected microcalcifications without a mass prior to stereotactic core needle biopsy

Cheung, Yun‐Chung; Wan, Yung-Liang; Chen, Shih-Cheh; Lui, Kar‐Wai; Ng, Shu‐Hang; Yeow, Kee‐Min; Lee, Kam-Fai; Hsueh, Swei

doi:10.1002/jcu.10074

Cited by 34 publications

(14 citation statements)

References 22 publications

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“…If calcifications are identified at US, US-guided core biopsy may, of course, be possible; its advantages over SCNB include a shorter procedure time and less patient discomfort, particularly in Asian women with small breasts, in whom positioning and compression during stereotactic biopsy are difficult. However, the reported success rate of pre-SCNB US in identifying calcifications is 35.8% (10), and although the success rate of US-guided core biopsy of calcifications identifiable at US has been reported to be up to 100% (11), the difficulty of accurately targeting the tiny specular reflectors, as well as interference in the multipass technique by introduced air, is well recognized. Accordingly, the biopsy of non-mass calcifications requires the use of stereotactic equipment.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Core-Needle Biopsy of Non-Mass Calcifications: Outcome and Accuracy at Long-Term Follow-Up

Han

Choe

et al. 2003

Korean J Radiol

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ObjectiveTo determine, by means of long-term follow-up evaluation, the outcome and accuracy of stereotactic core-needle biopsy (SCNB) of non-mass calcifications observed at mammography, and to analyze the factors contributing to false-negative findings.Materials and MethodsUsing a 14-gauge needle, SCNB was performed in cases involving 271 non-mass calcified lesions observed at mammography in 267 patients aged 23-72 (mean, 47) years. We compared the SCNB results with those of long-term follow-up which included surgery, mammography performed for at least six months, and reference to Korean Cancer Registry listings. We investigated the retrieval rate for calcifications observed at specimen mammography and histologic evaluation, and determined the incidence rate of cancer, sensitivity, and the underestimation rate for SCNB. False-negative cases were evaluated in terms of their mammographic findings, the effect of the operators' experience, and the retrieval rate for calcifications.ResultsFor specimen mammography and histologic evaluation of SCNB, the retrieval rate for calcifications was, respectively, 84% and 77%. At SCNB, 54 of 271 lesions (19.9%) were malignant [carcinoma in situ, 45/54 (83%)], 16 were borderline, and 201 were benign. SCNB showed that the incidence of cancer was 5.0% (6/120) in the benign mammographic category and 31.8% (48/151) in the malignant category. The findings revealed by immediate surgery and by long-term follow-up showed, respectively, that the sensitivity of SCNB was 90% and 82%. For borderline lesions, the underestimation rate was 10%. For false-negative cases, which were more frequent among the first ten cases we studied (p = 0.01), the most frequent mammographic finding was clustered amorphous calcifications. For true-negative and false-negative cases, the retrieval rate for calcifications was similar at specimen mammography (83% and 67%, respectively; p = 0.14) and histologic evaluation (79% and 75%, respectively; p = 0.47).ConclusionIn this study group, most diagnosed cancers were in-situ lesions, and long-term follow-up showed that the sensitivity of SCNB was 82%. False-negative findings were frequent during the operators' learning period.

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Section: Discussionmentioning

confidence: 99%

Stereotactic Core-Needle Biopsy of Non-Mass Calcifications: Outcome and Accuracy at Long-Term Follow-Up

Han

Choe

et al. 2003

Korean J Radiol

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“…More frequently, 3D postprocessing has become important in assessment of vasculature. CHI US is already used to distinguish scars from recurrent tumours as well as in the optimisation of US-guided biopsies [14, 15, 20, 32]. …”

Section: Discussionmentioning

confidence: 99%

Value of tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) in detection and characterisation of breast tumours

Clevert

Jung

Jungius³

et al. 2006

Eur Radiol

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“…Several studies have reported that handheld breast US (HHUS) is useful in identifying malignant microcalcifications and provides effective guidance for percutaneous biopsy [789101112]. US-guided breast biopsy has several advantages over stereotactic biopsy, which include improved patient comfort, real-time visualization of needle placement, absence of radiation exposure, shorter duration of the procedure, and relatively low cost.…”

Section: Introductionmentioning

confidence: 99%

Detectability and Usefulness of Automated Whole Breast Ultrasound in Patients with Suspicious Microcalcifications on Mammography: Comparison with Handheld Breast Ultrasound

et al. 2016

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PurposeThe purpose of this study was to prospectively evaluate the detectability and usefulness of automated whole breast ultrasound (AWUS) and to compare it with handheld breast ultrasound (HHUS) in cases with suspicious microcalcifications identified by mammography.MethodsForty-two patients with 43 suspicious microcalcifications (25 malignant and 18 benign) detected by mammography underwent AWUS, HHUS, and histol-ogic examination. With knowledge of the mammographic findings, HHUS was performed to assess the visibility of the microcalcifications and the presence of associated masses or ductal changes. Two radiologists reviewed the AWUS images in consensus using the same methods employed for HHUS. Detectability of AWUS was compared with that of HHUS and was correlated with histologic and mammographic findings.ResultsOf the 43 lesions, 32 (74.4%) were detectable by AWUS and 31 (72.1%) by HHUS. No significant differences in sensitivity were found between the two methods (p=0.998). AWUS detected 96% (24/25) of malignant microcalcifications and 44.4% (8/18) of benign microcalcifications. AWUS was more successful in the detection of malignant vs. benign lesions (96.0% vs. 44.4%, p=0.002), lesions >10 mm vs. ≤10 mm in size (86.7% [26/30] vs. 46.2% [6/13], p=0.009), lesions with a fine pleomorphic or linear shape vs. a round or amorphous or coarse heterogeneous shape (94.7% [18/19] vs. 58.3% [14/24], p=0.021), and lesions associated with a mass or architectural distortion vs. without obvious changes on mammography (100% [19/19] vs. 54.2% [13/24], p=0.022).ConclusionDetectability of AWUS was comparable to that of HHUS in cases where suspicious microcalcifications were identified on mammography. Therefore, AWUS might be helpful in the performance of ultrasound-guided percutaneous procedures for highly suspicious microcalcifications.

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Sonographic evaluation of mammographically detected microcalcifications without a mass prior to stereotactic core needle biopsy

Cited by 34 publications

References 22 publications

Stereotactic Core-Needle Biopsy of Non-Mass Calcifications: Outcome and Accuracy at Long-Term Follow-Up

Stereotactic Core-Needle Biopsy of Non-Mass Calcifications: Outcome and Accuracy at Long-Term Follow-Up

Value of tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) in detection and characterisation of breast tumours

Detectability and Usefulness of Automated Whole Breast Ultrasound in Patients with Suspicious Microcalcifications on Mammography: Comparison with Handheld Breast Ultrasound

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