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Delayed Migration of Gel Mark Ultra Clip Within 15 Days of 11-Gauge Vacuum-Assisted Stereotactic Breast Biopsy

Jay R. Parikh1

1 Women's Diagnostic Imaging Center, Swedish Cancer Institute, 1221 Madison St., Arnold Pavilion, Suite 520, Seattle, WA 98104.



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  		Fig. 1 —Immediate postbiopsy craniocaudal film-screen mammogram in 62-year-old woman with previous history of ductal carcinoma in situ in the right breast shows Gel Mark clip (SenoRx) (solid white arrow) within biopsy site, as denoted by adjacent density from small hematoma (hollow white arrow). Air radiolucency (solid black arrow) is noted near stereotactic needle entry site in lateral breast.

 


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  		Fig. 2 —With sonogram guidance, antiradial real-time compound breast sonogram image of left breast at 12 o'clock position shows needle localization wire (solid white arrows) placed into region of Gel Mark Ultra pellets (Seno Rx) (hollow white arrows) within recent stereotactic biopsy cavity.

 


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  		Fig. 3 —Initial preoperative needle localization craniocaudal mammogram shows localization wire to be in region of biopsy cavity; minimal hematoma is present (hollow arrow). Skin entry site of hookwire is denoted by round metallic BB placed on breast. Gel Mark clip (SenoRx) (solid white arrow) has laterally migrated with respect to biopsy site. Ill-defined density (solid black arrow) is present in mammogram from injected local anesthesia.

 


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  		Fig. 4A —Mammogram specimen. Photomicrograph of localized clip (solid white arrow) and both hookwires in surgical excision. (H and E, x100)

 


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  		Fig. 4B —Mammogram specimen. Translucent material from pellets (solid black arrow) within elongated space (black S) is seen, representative of core needle biopsy cavity surrounded by fibrosis and inflammation. In region of core biopsy site, pattern consistent with infiltrating lobular carcinoma (not shown) was identified. After carefully supervised sectioning by interpreting pathologist, no malignancy was found in region of migrated clip.

 

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