[The problems of breast-conserving surgery for calcification undetected by ultrasonography]

The patient was a 58-year-old woman. Mammography showed grouped heterogeneous calcifications in the M area of the right breast. The area of the grouped heterogeneous calcifications was 1 cm in diameter. A vacuum-assisted biopsy (VAB) of the area led to a diagnosis of invasive ductal carcinoma positive for estrogen receptor and progesterone receptor, and negative for human epidermal growth factor receptor type 2/neu protein expression. A micro mark was made by VAB enforcement in the lesion. At operation, we performed ultrasonography to detect the cancer lesion, but we could not detect the micro mark. It was difficult to determine the resection area. We detected architectural distortion after VAB and determined the resection area. Breast-conserving surgery and a sentinel lymph node biopsy was performed. Histopathologically, the surgical margins were negative and the sentinel lymph node was negative for cancer. This case suggested that it was necessary to make a new micro mark.