Analysis of Mammary Microcalcifications Diagnosed Using Stereotactic Vacuum-Assisted Breast Biopsies

Stereotactic vacuum-assisted breast biopsy （ ST-VAB ） could replace surgical biopsy for the diagno-sis of breast cancer with microcalcifications. The purpose of the current study was to analyze the clinicopathological characteristics and to evaluate the necessity of ST ― VAB for microcalcifications. We retrospectively reviewed 152 cases of category 3 or 4 microcalcifications without ultra-sonographic findings in patients who had undergone ST-VAB between January 2009 and December 2016. Of these patients, 42 （ 28 ％） were diagnosed as having breast cancer, and 36 had ductal carcinoma in situ. The indications for ST-VAB should be determined based on accurate mammographic categorization to avoid unnecessary tests and over-diagnosis. For category 3 calcifications, amorphous/grouped and small round/segmental calcifications were observed in cancers less frequently, with observed incidences of breast cancer of 0 ％（ 0 ／ 13 ） and 14 ％（ 2 ／ 14 ） , respectively. ST ― VAB can be postponed in such cases. Though the rate of breast cancer was 20 ％ （ 13 ／ 66 ） for patients with ＜ 10mm, small round/grouped calcifications, ST-VAB should not be delayed because these cases included not only high-grade ductal carcinoma in situ, but also invasive ductal carcinoma. From these findings, we concluded that careful follow-up care without ST-VAB might be possible for selected category ３ calcifications on the condition that informed consent is obtained.