Digital imaging improves upright stereotactic core biopsy of mammographic microcalcifications

AIM: This comparative study was carried out to assess the effect of using d igital images compared to conventional film-screen mammography on the accur acy of core biopsy of microcalcifications using upright stereotactic equipm ent. MATERIALS AND METHODS: The biopsy results from a consecutive series of 104 upright stereotactic 14-gauge core biopsies performed with conventional X-r ay (Group A) were compared with 40 biopsies carried out using stereotaxis w ith digital imaging (Group B). In all cases specimen radiography was perfor med and analysed for the presence of calcifications, Pathological correlati on was then carried out with needle and surgical histology. RESULTS: The use of digital add-on equipment increased the radiographic cal cification retrieval rate from 55 to 85% (P < 0.005). The absolute sensitiv ity of core biopsy in pure ductal carcinoma in situ (DCIS) cases rose from 34 to 69% (P < 0.03), with the complete sensitivity increasing from 52 to 9 4% (P< 0.005). For DCIS with or without an invasive component the absolute sensitivity rose from 41 to 67% (P = 0.052, while the complete sensitivity was 59% before and 86% after the introduction of digital imaging (P < 0.04) . CONCLUSION: Digital equipment improves the performance of upright stereotac tic core biopsy of microcalcifications, giving a significantly increased su ccess rate in accurately obtaining calcifications. This leads to an improve ment in absolute and complete sensitivity of core biopsy when diagnosing DC IS, Whitlock, J. P. L. er al. (2000). Clinical Radiology 55, 374-377. (C) 2 000 The Royal College of Radiologists.