Preoperative
Needle
Calcifications:
Localization
Magnification
Joan E. Berkowitz, Paula M. Horan,
MD
magnification
technique,
preoperative
ing
needle
facilitat-
localization
subtle
breast
nique needle
has been successfully used localization procedures.
Index
calcifications.
terms:
Breast,
calcifications, sis, 00.31,
00.81
biopsy,
neoplasms,
of
tech-
00.12986 neoplasms,
#{149} Breast
#{149} Breast
00.32
The
in 20
#{149} Breast,
diagno-
localization,
00.125
Materials
T
1992;
and
in
radiologists’
knowl-
edge and experience in mammography has resulted in identification of more subtle breast abnormalities and in earlier diagnosis of breast cancer. After detection, some subtle abnormalities are appropriately followed mammographically, whereas in other cases, patients may be referred for biopsy. Extremely subtle calcifications can be difficult to see on localization mammograms ob-
tamed
with
than used can make
dure
less breast
compression
with standard views, the needle localization
challenging
ful at worst.
at best
and
To address
this
which proce-
unsuccessproblem,
we developed a simple method to perform preoperative needle localization of
compression
work
space
and
ease
needle
into
the
breast.
the Mammography
21117
(J.E.B.,
timore, 1992;
P.M.H.),
Baltimore revision
0
RSNA,
Volume
and
Sinai
1; accepted
February
Hospital
2,
3; revision
re-
insertion
1
The windowed compression unscrewed from its arm and
of the
arm used
Twenty
needle
localization
that for
usually holds magnification.
the
plate
has been
screwed compression
to the plate
proceable to confidently and accurately perform preoperative needle localization to ensure surgical excision. The procedure we describe allows this and gives the mammographer an additional tool in the search to detect early breast cancer. #{149}
Discussion
References
benefits of mammography of occult breast cancer
(1,2). Modern not
contributed breast
the
identification
but
their
careful
of
greatly sign
1.
Tabar L, Gad A, Holmberg LH, et al. Reduction in mortality from breast cancer after mass screening with mammography. Lancet
2.
Feig S.
specifichas
in the work-up which
of breast
1985;
analysis,
sensitivity and spot magnification
microcalcifications,
ten the earliest
in deare well
mammography
just
To identify and characterize breast calcificalions is not ever, for the mammographer
to J.E.B.
#{149} Number
of Bal-
January
with
dures with magnification were performed during a 4-month period between August and December 1991. All procedures were performed without complication. Radiography of the specimen confirmed excision of calcifications in all cases.
to help increase ity. Microfocal
Mills, MD
June 22. Address
1992
185
Ultrasound
(J.E.B.). Received
requested
received June print requests
and
Dr. Owings
fitted
localization routine manner (Figure). the breast at then removing to maximize
Results
abnormalities 23 Crossroads
plate
magnification tower, be performed in the with images magnified We recommend marking the appropriate site and the cross-hair apparatus
demands From
mammogtower is atunit (Se-
arm and attached to the arm that usually holds the compression plate for magnification. With the modified win-
known
I
Methods
Systems, Milwaukee). With this in place, there is not enough room to attach the windowed compression plate used in localizalion. This compression plate, however, can be easily unscrewed from its
The tecion
Center,
by using
the can but
185:277
HE increase
abnormalities
To perform magnification raphy (x 1.5), a 24-cm-high tached to the mammography nographe 600T; GE Medical
dowed Radiology
Breast
Technique’
subtle breast magnification.
RT
The authors adapted a windowed fleedle localization compression plate to allow performance of mammography with
of Subtle
of are
cancer
subtle enough, must
of-
(3).
3.
1:829-832.
Decreased breast cancer mortality through mammographic screening: results of clinical trials. Radiology 1988; 167:659665. Sickles E. Further experience with microfocal spot magnification mammography in the assessment of clustered breast microcalcifications. Radiology 1980; 137:9-14.
howbe
Radiology
#{149} 277