[Stereotactic vacuum core biopsy of clustered microcalcifications classified as B1-RADS 3].

PURPOSE: Evaluation of stereotactic vacuum core biopsy of clustered microcalcifications categorized as BI-RADS 3.

MATERIAL AND METHODS: 86 patients with microcalcifications BI-RADS 3 (probably benign, < 3% malignant) underwent a stereotactic vacuum core biopsy (Mammotome, Fa. Ethicon Endo-Surgery Breast Care) using a digital stereotactic unit (Mammotest, Fa. Fischer Imaging). The removal of the calcifications was judged by two radiologists in consensus and classified as complete (100%), major (55-99%) or incomplete (< 50%).

RESULTS: 4/86 patients could not be evaluated by vacuum core biopsy due to the localization of the microcalcifications close to the skin or lack of detection. In 40/82 cases a complete, in 38/82 a major, and in 4/82 a incomplete removal was achieved. Histology revealed 67 cases of fibrocystic changes, 4 papillomas, 4 fibroadenomas, 4 cases of atypical ductal hyperplasia (ADH), and 3 ductal carcinomas in situ (DCIS), one of these with a minimal-invasive tumor component. Patient with ADH were advised to undergo surgical biopsy. Histology revealed complete removal. 7 patients had complications or side-effects.

CONCLUSIONS: Percutaneous vacuum core biopsy is a reliable minimal-invasive diagnostic method to come to the final diagnosis in patients with clustered microcalcifications categorized BI-RADS 3. However, if malignancy is proven (about 4% of our cases) an open biopsy is necessary.