Histologic-radiologic correlation of mammographically detected microcalcification in stereotactic core biopsies

Core biopsy is an alternative technique to surgical excision for assessment of nonpalpable mammographically detected suspicious lesions. The pattern of radiologic calcification is often considered to have diagnostic importance. The aim of this study was to correlate radiologic and histologic features of calcification, with respect to appearance, distribution, and size, to determine the significance, if any, of different radiologic patterns of calcification. Core biopsy samples from 124 women who had 129 mammographically suspicious areas of calcification were examined. Core biopsy samples (five cores per procedure) were obtained stereotactically using a 14-gauge needle in an automated Biopty (Bard Australia, Chatswood, NSW, Australia) gun. In 30 lesions no histologic calcification was found. In the others, there was a poor correlation between radiology and histology with respect to the appearance and distribution of calcification. In a subgroup of 53 women, radiographs of biopsy cores were available to allow correlation with the size of histologic calcification. Calcification of <100 microm assessed histologically was not visible on core biopsy specimen radiographs and may not represent the calcification seen mammographically. Thus, radiography of core biopsy samples and histologic measurement of the size of calcification in core biopsy specimens is useful to reduce false-negative diagnoses in which a biopsy has been performed to evaluate mammographically suspicious calcifications.