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Clip migration after stereotactic vacuum-assisted breast biopsy with the patient in the decubitus position

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Abstract

Objective

To investigate the factors contributing to clip migration in stereotactic vacuum-assisted biopsy (VAB) of the breast using an upright unit with the patient in the decubitus position.

Methods

This retrospective study included 176 women with microcalcifications on mammograms undergoing stereotactic VAB with clip marking for analysis. The prebiopsy mammograms, stereotactic VAB images, immediate postbiopsy mammograms, and follow-up mammograms were reviewed. All VAB procedures were performed using an add-on upright unit with the patient in the decubitus position. The clip-to-lesion distance on the orthogonal view (craniocaudal view) on immediate postbiopsy mammography was estimated for each biopsy. Two cutoff points of clip-to-lesion distance of > 1 cm or > 2 cm were set for clip migration. The possible factors for clip migration based on clinical and imaging findings were then analyzed by Fisher’s exact test.

Results

When the cutoff for clip migration was set at > 1 cm, thin breast (p = 0.013) and more superficial lesion (lesion closer to the skin along the line perpendicular to the posterior nipple line, p = 0.004) were associated with clip migration. When the cutoff was set at > 2 cm, thin breast (p = 0.019), high specimen number (p = 0.030), and posterior depth (p = 0.021) were associated with clip migration.

Conclusions

Thin breasts, superficial lesion location, posterior lesion depth, and high specimen number were the factors associated with clip migration.

Key Points

• We reported clip migration after ST VAB using an upright unit with the patient in the decubitus position.

• The occurrence of clinically significant clip migration (> 2 cm) in our study was 8.5%, which was within the range of the other reports with the patient undergoing ST VAB in the prone position.

• Thin breasts, high specimen number, and more posterior depth were the factors associated with significant clip migration.

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Abbreviations

ΔCC:

Clip-to-lesion distance on craniocaudal view

ΔMLO:

Clip-to-lesion distance on mediolateral oblique view

BI-RADS:

Breast Imaging-Reporting and Data System

CC:

Craniocaudal

Lat:

Lateral

LM:

Lateromedial

Med:

Medial

ML:

Mediolateral

MLO:

Mediolateral oblique

PNL:

Posterior nipple line

SD:

Standard deviation

ST VAB:

Stereotactic vacuum-assisted biopsy

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Taipei Veterans General Hospital, 201, Section 2, Shipai Road, Taipei, 11217, Taiwan

    Jane Wang

  2. Department of Radiology, National Taiwan University College of Medicine, Taipei, 10016, Taiwan

    Jane Wang

  3. Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

    Jane Wang

  4. School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

    Jane Wang

  5. Department of Medical Imaging, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 10016, Taiwan

    Ning Chien & Hsiao-Tung Lee

  6. Department of Radiology, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Shin Lin District, Taipei, 11101, Taiwan

    Hsiao-Tung Lee

Authors
  1. Jane Wang
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Corresponding author

Correspondence to Hsiao-Tung Lee.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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• retrospective

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• performed at one institution

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Wang, J., Chien, N. & Lee, HT. Clip migration after stereotactic vacuum-assisted breast biopsy with the patient in the decubitus position. Eur Radiol 30, 6080–6088 (2020). https://doi.org/10.1007/s00330-020-07015-0

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  • DOI: https://doi.org/10.1007/s00330-020-07015-0

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