Evaluation of Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications VASB for isolated BI-RADS 4 microcalcifications

Aim: The aim of this study was to evaluate the long-term results of vacuum-assisted stereotactic biopsy (VASB) for microcalcifications with isolated Breast Imaging Reporting and Data System (BI-RADS 4). Material and Methods: Three hundred sixty-seven patients who underwent VASB due to microcalcifications between June 2011 and October 2017 were screened. VASB was performed in all patients using stereotaxy in the lateral decubitus position. VASB, surgical pathology results and long-term follow-up findings were evaluated. Statistical analysis was evaluated with mean values and underestimation rates. Results: Among 76 patients and 78 microcalcifications, 20 were defined as ductal carcinoma in-situ (DC15), two were defined as atypical lobular hyperplasia (ALH), one as atypical ductal hyperplasia (ADH) and 56 as benign. The two cases reported as ALH in VASB refused the operation and were followed up, and no progression was detected in their follow-up. The DCIS underestimation rate was 20% (4/20). The mean follow-up time was 55.46 months, and the mean follow-up time in benign lesions was 53.4 months. No conversion to malignancy was detected in any of the patients whose VASB results were found benign (false negative rate 0%). Discussion: In our study, no conversion to malignancy was detected in the long-term follow-up results of patients with isolated BI-RADS 4 microcalcification and having benign VASB results (false negative rate 0%). This method eliminated the necessity of surgical excision in 71.7% (56/78) of the cases with isolated BI-RADS 4 microcalcification in our study. VASB may be the standard method for BI-RADS 4 microcalcifications.