STEREOTAXIC ASPIRATION BIOPSY IN THE EVALUATION OF MAMMOGRAPHICALLY DETECTED CLUSTERED MICROCALCIFICATION

BACKGROUND. Stereotaxic fine-needle aspiration biopsy (SFNA) of mammog raphically detected nonpalpable lesions of the breast provides accurat e diagnosis and may eliminate many unnecessary excisional biopsies of areas of microcalcification. METHODS. SFNA of microcalcification of in determinate radiologic significance was performed on 125 patients (199 1-1994), yielding 130 specimens (2 sites in 2 patients and bilateral a spirations in 3 patients). Stereotaxic localization was performed, and samples from within the area of microcalcification were obtained usin g 22-gauge needles. Smears stained with a Giemsa-type stain were prepa red and studied by a cytopathologist during the procedure to determine the adequacy of each specimen. RESULTS. Of 130 specimens, 104 (80%) w ere cytologically benign, 13 (10%) were atypical, 6 (4.6%) were suspic ious, and 7 (5.3%) were malignant. All malignant diagnoses were confir med by subsequent operative biopsy. Follow-up was wail able in 74 of 1 04 benign cases (71%): surgical excisions (all benign) in 8 cases and follow-up mammograms at 6 months to 5.8 years in 66 cases (no radiolog ic change in 64 cases and 2 [1.9%] cases with new radiologic findings [SFNAs of the new radiographic abnormality revealed adenocarcinoma in both]). CONCLUSIONS. SFNA is a reliable and cost-effective method of e valuating indeterminate microcalcification; however, mammographic foll ow-up is indicated because of the possibility of subsequent and indepe ndent cancers, [See editorial on pages 197-9, this issue.] Cancer (Can cer Cytopathol) 1998;84:226-30. (C) 1998 American Cancer Society.