Sonographically Guided Biopsy of Suspicious Microcalcifications of the Breast
A Pilot Study
Mary Scott Soo1,
Jay A. Baker1,
Eric L. Rosen1 and
Thuy T. Vo1,2
1
Department of Radiology, Breast Imaging Division, Box 3808, Duke University
Medical Center, Durham, NC 27710.
2
East Valley Diagnostic Imaging, 1125 E. Southern Ave., Ste. 300, Mesa, AZ
85212.
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Fig. 1A. —65-year-old woman with breast carcinoma. Spot compression
magnification mammogram of left breast reveals new cluster of six
microcalcifications (arrows).
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Fig. 1B. —65-year-old woman with breast carcinoma. Sonogram in radial
orientation of clustered microcalcifications shows apparent lobulated duct
(arrows) in region of mammographic abnormality.
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Fig. 1C. —65-year-old woman with breast carcinoma. Sonogram in
antiradial orientation reveals duct (arrowheads) in cross-section
with echogenic specular reflector (arrow) corresponding to
microcalcification.
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Fig. 1D. —65-year-old woman with breast carcinoma. Sonographically
guided core biopsy with needle tip located just proximal to abnormal duct
(arrowheads) and aligned to target single microcalcification
(arrow). Lesion was diagnosed as atypical hyperplasia at core biopsy,
which was upgraded to ductal carcinoma in situ at excisional biopsy.
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Fig. 2A. —69-year-old woman with benign breast mass. Magnification
mammogram of biopsy specimen with localizing wire shows irregular
multilobulated mass with innumerable microcalcifications.
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Fig. 2B. —69-year-old woman with benign breast mass. Sonogram of
multilobulated mass in A before excision shows three echogenic,
shadowing components of mass (arrows) that correspond to groups of
innumerable microcalcifications contained in different lobulated components of
mass. This lesion was localized under sonographic guidance, and excisional
biopsy yielded radial scar.
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Fig. 3A. —49-year-old woman with benign calcified breast mass. Spot
compression magnification mammogram of right breast reveals small, ill-defined
mass containing clustered microcalcifications.
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Fig. 3B. —49-year-old woman with benign calcified breast mass. Sonogram
of mass shows predominantly echogenic shadowing mass (arrows)
containing central hypoechoic component. Sonographically guided core biopsy
yielded papillary apocrine metaplasia and calcifications associated with
benign tissue.
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Fig. 4A. —52-year-old woman with breast carcinoma. Spot compression
magnification mammogram of right breast reveals fewer than 50 clustered
pleomorphic microcalcifications (arrows) within dense fibroglandular
tissue. No associated mass is identified.
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Fig. 4B. —52-year-old woman with breast carcinoma. Sonogram of region
of clustered microcalcifications shows hypoechoic mass (arrows) with
internal echogenic specular reflectors corresponding to microcalcifications.
Sonographically guided core biopsy yielded ductal carcinoma in situ.
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Fig. 5A. —57-year-old woman with breast carcinoma. Mediolateral oblique
mammogram of left breast shows more than 50 tightly clustered pleomorphic
microcalcifications with no associated mass.
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Fig. 5B. —57-year-old woman with breast carcinoma. Sonogram of
clustered microcalcifications shows oval mass (arrows) with
ill-defined posterior margin and central shadowing. Numerous echogenic
specular reflectors correlating with microcalcifications are seen centrally
within mass. Sonographically guided core biopsy yielded ductal carcinoma in
situ.
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Fig. 6A. —85-year-old woman with breast carcinoma. Magnification
mammogram of left breast reveals large region of pleomorphic
microcalcifications corresponding to carcinoma. Several benign calcifications
are also present anteriorly and inferiorly.
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Fig. 6B. —85-year-old woman with breast carcinoma. Sonogram of region
of calcifications shows apparent ductlike structure (arrows) with
internal specular reflectors corresponding to calcifications. Sonographically
guided core biopsy yielded ductal carcinoma in situ and invasive ductal
carcinoma.
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Copyright © 2002 by the American Roentgen Ray Society.
