Upright stereotactic vacuum-assisted needle biopsy of suspicious breast microcalcifications

Stereotactic core needle biopsy is a useful technique for evaluation of suspicious breast microcalcifications. The development of the 11-G vacuum-assisted biopsy system offers another method of minimally invasive biopsy carried out on a conventional mammography unit. We evaluate its usefulness, efficacy and safety in Asian women. Vacuum-assisted biopsy was carried out through the lateral approach using an add-on stereotactic device attached to a mammography unit. One hundred and five lesions were sampled in 97 patients. Excisional biopsy was subsequently Carried out for diagnosis of atypical ductal hyperplasia or carcinoma in high-risk patients. Patients with benign diagnosis underwent mammographic follow up. The technical success rate was 97%. An average of 13.5 tissue cores were retrieved for each lesion. The histopathological result obtained from mammotome was benign in 84.8% and malignant in 15.2%. The benign microcalcifications were predominantly fibrocystic change (n = 42) whereas the malignant microcalcifications included ductal carcinoma in situ (n = 15) and invasive carcinoma (n = 1). Twenty-two patients underwent subsequent open surgical biopsy but no underestimation of disease was seen. Only two patients had vasovagal syncope and three others felt unwell during the biopsy. Nine patients had small haematomas, which resolved spontaneously. Vacuum-assisted biopsy carried out on an upright stereotactic mammography unit is a safe and effective method for evaluation of suspicious microcalcifications.