Magnified radiographs as quality control for detection of microcalcifications in histopathology of breast biopsies

Purpose: Evaluation of specimen radiography as a quality control for the de tection of microcalcifications by the pathologist during histopathological examination of breast biopsies. Materials and Methods: 29 breast biopsy spe cimen with microcalcifications were radiographed using the magnification (x 4) mammography System DIMA Plus MI I before and after the histopathological examination. Tissue with detected microcalcifications after the histopatho logical examination was reexamined histologically. Results: In 55% (16/29) of all specimen we could identify missed microcalcifications. In 5 specimen s the microcalcifications were missed completely. The radiologically detect ed areas of residual microcalcifications were reexamined histologically and in one case invasive parts of a carcinoma were detected, which primarily h ad been diagnosed as an in-situ carcinoma. In 6 cases the radiographs of th e intraoperative specimen radiography were sent to the pathologist together with the biopsy. In these cases the rate of complete detection of the micr ocalcifications increased from 39% to 66%. Conclusion: Specimen radiography should be performed not only intraoperatively but also as part of the hist opathological examination.