Stereotactic tomosynthesis biospy of malignant breast calcifications

Case contributed by Craig Hacking

Presentation

Screening mammogram shows malignant calcifications in the left breast.

Patient Data

Age: 55 years
Gender: Female

Inhomogeneously dense breast tissue.

Left upper outer quadrant polymorphous microcalcifications with crushed stone appearance highly suspicious of malignancy (BIRADS 5).

Bilateral vascular calcification.

Tomosynthesis vacuum assisted breast biopsy

mammography

Posterior position of the calcifications made positioning difficult. Multiple passes made with a 9G vacuum needle.

Post biopsy specimen mamogram

mammography

The specimen contains several microcalcification clusters.

Case Discussion

Biopsy histology = intermediate grade DCIS with comedo necrosis, no invasive carcinoma.

Wide location excision performed, histology = intermediate grade DCIS, solid and cribriform types, clear of margins.

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