[Clip migration after stereotactic macrobiopsy and presurgical localization: technical considerations and tricks]

Area of Science:

• Radiology
• Surgical Oncology
• Breast Imaging

Background:

• Clip migration is a frequent complication following breast biopsy procedures.
• Clip migration rates range from 13-20% irrespective of the surgical approach.
• Understanding the mechanisms of clip migration is crucial for improving patient outcomes.

Purpose of the Study:

• To identify strategies for reducing clip migration after breast biopsy.
• To optimize presurgical localization of biopsy targets.
• To analyze the impact of compression techniques on clip migration.

Main Methods:

• Retrospective analysis of 447 breast macrobiopsy procedures using a lateral approach.
• Evaluation of 60 clips that migrated more than 20 mm, with a focus on the accordion effect.
• Comparison of clip migration rates between craniocaudal (CC) and mediolateral oblique (MLO) compression.

Main Results:

• The accordion effect was identified as the primary cause of clip migration in 98.4% of cases.
• Clip migration was significantly higher with CC compression (16.6%) compared to MLO compression (5.2%).
• MLO compression demonstrated a statistically significant reduction in clip migration.

Conclusions:

• MLO compression during lateral approach breast biopsy is recommended to minimize clip migration.
• Accurate knowledge of clip position relative to the target is essential for quality assurance.
• The proposed technique optimizes presurgical localization, even in cases of clip displacement.