Pathologic results of stereotactic core needle biopsy in patient with malignancy suspicious to microcalcification on mammography

Due to the fact that breast cancer has a high prevalence in the society and in a significant number of patients, its initial manifestation is only in the form of microcalcification on mammography, this study was performed with aim to  evaluate the pathologic results of stereotactic core needle  biopsy to determine the prevalence of malignant and benign lesion and subtype in each group in patients with  suspicious microcalcifications on mammography based on BIRADS classification.

In this descriptive study, 59 patients referred to mammographic clinic in Mashhad city between April2017-September2019, and underwent sterotactic core biopsy because of the presence of suspicious microcalcifications (including morphology and distribution) without mass or focal asymmetry on mammography. In all patients, calcification was identified in at least one core needle specimen after performing specimen mammography. The specimens were submitted and referred to pathologic laboratory and analyzed by two pathologists. The total prevalence of benign and malignant lesions and also the prevalence of subtype lesions in each group were evaluated. The results of different mammographic appearance of suspicious microcalcifications were also compared with pathologic diagnosis. Data were analyzed using SPSS statistical software (version 16) and descriptive statistics methods and frequency distribution of variables in the form of tables. P<0.05 was considered statistically significant.

Benign lesions were seen in 42 patients (71%) and malignant lesions in 17 patients (29%) in histopathologic examination. Total prevalence of benign lesions was more than malignant lesions and the prevalence of non-proliferative lesions more than proliferative lesions. Fibrocystic change was the most common lesion in non-proliferative group (54%). In malignant group, prevalence of Dcis Carcinoma and invasive ductal carcinoma was 74% and 26%, respectively. Prevalence of malignancy was more in pleomorphic type of microcalcifications than amorphous and coarse heterogeneous types.

According to the significant prevalence of malignancy especially the prevalence of DCIS, sterotactic biopsy can be used as a noninvasive biopsy method for Microcalcifications which have a suspicious morphology and distribution to detect early breast cancer.