Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated?

Am J Surg. 2018 Apr;215(4):693-698. doi: 10.1016/j.amjsurg.2017.06.032. Epub 2017 Jul 1.

Abstract

Background: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT).

Methods: Retrospective review of stereotactic biopsies performed during 2009-2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT.

Results: 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6-20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008).

Conclusions: Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology.

Keywords: Breast cancer; Breast conservation; Calcifications; Mammography; Stereotactic biopsy.

MeSH terms

  • Adult
  • Aged
  • Biopsy / methods*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery*
  • Calcinosis / pathology*
  • Female
  • Humans
  • Mammography
  • Mastectomy, Segmental*
  • Middle Aged
  • Retrospective Studies
  • Stereotaxic Techniques
  • Time Factors