CORE BIOPSY FOR MICROCALCIFICATIONS IN THE BREAST

Background: The conventional method of dealing with clustered mammogra phic microcalcification in the breast when it is of uncertain aetiolog y is to undertake either a short-term mammographic review or to surgic ally excise the abnormal area and submit it for histological examinati on. Stereotactic wide-bore needle biopsy (core biopsy) of microcalcifi cations is a suitable alternative to surgical biopsy and experience wi th this technique forms the basis of the present study. Methods: Percu taneous core biopsy has been used at the Wesley Breast Clinic as a mea ns of assessing clustered calcification in 297 cases from November 199 2 to October 1995. The procedure is done under local anaesthesia as an outpatient procedure using a stereotactic attachment to a standard ma mmography unit. Results: A diagnosis of frank malignancy was made on c ore samples in 22 cases (7.4%), and in all of these malignancy was con firmed at open surgical biopsy. Ln a further six women in whom the cor e biopsy was reported as 'suspicious of malignancy', open surgical bio psy confirmed malignancy in three women, lobular in situ carcinoma was found in two women, and atypical ductal hyperplasia in one woman. In two instances the core sample was reported as showing atypical ductal hyperplasia and in those cases, this was confirmed at open surgical bi opsy. In 265 cases (89%) thr histology of the core revealed appearance s of benign breast tissue. Open surgical biopsy has been undertaken in only six of these cases, but in all instances the histology has confi rmed a benign profess. In the two remaining cases,the procedure was co nsidered to be technically unsatisfactory, and open surgical biopsy wa s recommended because of doubt about the appearance of the microcalcif ication. In both instances, malignancy was demonstrated. Conclusions: Core biopsy of clustered mammographic microcalcification of uncertain aetiology is recommended as a satisfactory and reliable alternative to open surgical biopsy. it is less expensive, can be done quickly, prod uces few complications, and does not produce subsequent mammographic d istortion.