Ute Kettritz1, Günter Morack, Thomas Decker. 1. Department of Radiology, Berlin-Buch Breast Unit, HELIOS Klinikum Berlin Medical Center, Wiltbergstrasse 50, HS 120, 13125 Berlin, Germany. ukettritz@berlin.helios-kliniken.de
Abstract
AIM: We compared radiological assessment with pathological diagnoses in 500 consecutive vacuum-assisted breast biopsies performed for microcalcifications. METHODS: Lesions were biopsied using a 11-gauge mammotome device. Before biopsy, microcalcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Histopathological and radiological diagnosis were compared. RESULTS: Histopathology revealed 333 (67%) benign lesions. Benign lesions were classified as BI-RADS 3 in 19%, and as suspicious in 35%. 167 lesions (33%) were malignant. Malignant lesions were classified as suspicious or highly suggestive of malignancy in 63%. Frequency of malignancy in BI-RADS categories 4 and 5 was 35% and 100%, respectively. In BI-RADS 3 microcalcifications, the malignancy frequency was 19%. The mammographic features with the highest positive predictive value for malignancies were pleomorphic morphology (42%) and a linear or segmental distribution (51%). The microcalcification morphology was not reliably able to predict malignancy. CONCLUSION: In this study, BI-RADS 3 microcalcification lesions had a malignancy rate that is higher than previously reported. Vacuum-assisted biopsy is useful in any indeterminate and suspicious microcalcifications and provides maximum information before any operative intervention.
AIM: We compared radiological assessment with pathological diagnoses in 500 consecutive vacuum-assisted breast biopsies performed for microcalcifications. METHODS: Lesions were biopsied using a 11-gauge mammotome device. Before biopsy, microcalcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Histopathological and radiological diagnosis were compared. RESULTS: Histopathology revealed 333 (67%) benign lesions. Benign lesions were classified as BI-RADS 3 in 19%, and as suspicious in 35%. 167 lesions (33%) were malignant. Malignant lesions were classified as suspicious or highly suggestive of malignancy in 63%. Frequency of malignancy in BI-RADS categories 4 and 5 was 35% and 100%, respectively. In BI-RADS 3 microcalcifications, the malignancy frequency was 19%. The mammographic features with the highest positive predictive value for malignancies were pleomorphic morphology (42%) and a linear or segmental distribution (51%). The microcalcification morphology was not reliably able to predict malignancy. CONCLUSION: In this study, BI-RADS 3 microcalcification lesions had a malignancy rate that is higher than previously reported. Vacuum-assisted biopsy is useful in any indeterminate and suspicious microcalcifications and provides maximum information before any operative intervention.
Authors: A Luparia; M Durando; P Campanino; E Regini; D Lucarelli; A Talenti; G Mattone; G Mariscotti; A Sapino; G Gandini Journal: Radiol Med Date: 2011-01-12 Impact factor: 3.469
Authors: Anna Linda; Chiara Zuiani; Viviana Londero; Eleonora Di Gaetano; Anna Dal Col; Rossano Girometti; Massimo Bazzocchi Journal: Radiol Med Date: 2013-12-03 Impact factor: 3.469