Clinical Experience of Ultrasound-Guided, Vacuum-Assisted Breast Biopsy for Mammographic Microcalcifications: Combination with Wire Localization

Received July 9, 2018 Revised August 16, 2018 Accepted October 1, 2018 Purpose: This study examined the usefulness of ultrasound-guided vacuum-assisted breast biopsy (Sono-guided VABB) for mammographic microcalcification. Methods: A total of 1,399 lesions of 1,364 patients with BI-RADS Category 4 Mammographic microcalcification were included. Most microcalcifications were not observed on ultrasound (99.4%). Sono-guided (or Mammo-guided) J-wire localization was first performed for the suspicious microcalcification area, and the location of the J-wire and calcification was determined with mammography in most cases (98.5%). Sono-guided VABB was performed after removing the J-wire without a stereotactic device. On the other hand, Sono-guided VABB was performed directly without J-wire localization when microcalcification lesions were identified by mass on ultrasonography (21 cases, 1.5%). In all cases, calcification was confirmed by specimen mammography and the pathology was performed. A follow-up examination was performed to confirm the presence of complications. Results: In 1,399 cases, 188 cases (13.4%) were diagnosed as a malignancy (153 cases of ductal carcinoma in situ, 32 cases of IDC and 3 cases of other cases). The remaining 1,211 cases (86.6%) were diagnosed as benign. There were no significant complications during follow up after VABB. Conclusion: Sono-guided VABB can be used effectively if combined with wire localization, even if mammographic microcalcification lesions are not fully identified by ultrasonography.