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

Preoperative needle localization of subtle breast calcifications: magnification technique.

The authors adapted a windowed needle localization compression plate to allow performance of mammography with magnification technique, facilitating pr...
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