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Utility of detection of breast calcifications with integrated real-time radiography system (IRRS) during digital breast tomosynthesis (DBT)-guided vacuum assisted biopsy (VAB): initial single-center experience

  • Breast Radiology
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Abstract

Purpose

To determine whether the presence of calcifications in specimens collected during stereotactic-guided vacuum-assisted breast biopsies (VABB) is sufficient to ascertain their adequacy for final diagnosis at pathology.

Materials and methods

Digital breast tomosynthesis (DBT)-guided VABBs were performed on 74 patients with calcifications as target. Each biopsy consisted of the collection of 12 samplings with a 9-gauge needle. This technique was integrated with a real-time radiography system (IRRS) which allowed the operator to determine whether calcifications were included in the specimens at the end of each of the 12 tissue collections through the acquisition of a radiograph of every sampling. Calcified and non-calcified specimens were separately sent to pathology and evaluated.

Results

A total of 888 specimens were retrieved, 471 containing calcifications and 417 without.

In 105 (22.2%) samples out of 471 with calcifications cancer was detected, while the remaining 366 (77.7%) were non-cancerous. Out of 417 specimens without calcifications 56 (13.4%) were cancerous, whereas 361 (86.5%) were non-cancerous. Seven hundred and twenty-seven specimens out of all 888 were cancer-free (81.8%, 95%CI 79–84%).

Conclusion

Although there is a statistical significative difference between calcified and non-calcified samples and the detection of cancer (p < 0.001), our study shows that the sole presence of calcifications in the specimens is not sufficient to determine their adequacy for final diagnosis at pathology because non-calcified samples can be cancerous and vice-versa. Ending biopsies when calcifications are first detected through IRRS could lead to false negative results.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Postgraduate School in Radiodiagnostics, Università degli Studi Di Milano, Via Festa del Perdono 7, 20122, Milan, Italy

    Emilia Giambersio, Elisa D’Ascoli, Gianmarco Della Pepa & Giovanni Irmici

  2. Breast Imaging Unit, IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy

    Catherine Depretto & Gianfranco Paride Scaperrotta

  3. IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Rubina Manuela Trimboli

  4. Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese (Milan), Italy

    Giovanni Di Leo

  5. Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Lidia Rabiolo

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  1. Emilia Giambersio
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  2. Catherine Depretto
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  3. Rubina Manuela Trimboli
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  4. Giovanni Di Leo
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  9. Gianfranco Paride Scaperrotta
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Corresponding author

Correspondence to Emilia Giambersio.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective study was approved by the institutional review board. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Institution “Fondazione IRCCS Istituto Nazionale dei Tumori” of Milan and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Giambersio, E., Depretto, C., Trimboli, R.M. et al. Utility of detection of breast calcifications with integrated real-time radiography system (IRRS) during digital breast tomosynthesis (DBT)-guided vacuum assisted biopsy (VAB): initial single-center experience. Radiol med 128, 699–703 (2023). https://doi.org/10.1007/s11547-023-01636-3

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  • DOI: https://doi.org/10.1007/s11547-023-01636-3

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