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

Abstract

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.

The Clinical Utility of a Adding Lateral Approach to Conventional Vertical Approach for Prone Stereotactic Vacuum-Assisted Breast Biopsy

“…Any benign lesion from stereotactic biopsy was not confirmed by surgery. Therefore, for confident conclusions, continuous follow-ups are required (6, 18, 19). …”

“…In addition, the prone position allows an approach from all directions, including vertical and lateral approaches. Studies analyzing the utility of stereotactic breast biopsies in Asian women are scarce, and in the few published studies, only cases using the add-on stereotactic method (5) rather than the prone position have been examined, even in procedures involving core needle biopsies (6). We know of no prior articles in which the utility of prone stereotactic vacuum-assisted breast biopsies using a lateral approach has been evaluated.…”

Intermediate to highly suspicious calcification in breast lesions: a radio-pathologic correlation

“…The sampling methods include the widely practiced stereotactic needle core biopsy and mammotome, with the latter usually giving larger core size samples. In general, the retrieval of calcifications at stereotactic needle core biopsy is satisfactory, ranging from about 77% to almost 100%, with a mean value of about 86% [46][47][48][49].…”

Water Extract of Liuwei Dihuang Reduces Weight Gain and Visceral Fat in Obese Rats

“…It is not surprising to see this discrepancy as previous studies analyzed methanol extracts while the current study was focused on water extract. Several studies have demonstrated that gallic acid [44,45] and paeoniflorin [46] prevent weight gain, inhibit adipocyte proliferation, induce adipolysis, and lower blood lipids. To our knowledge, saccharides do not have weight-and lipid-lowering properties.…”