부산대학교 도서관

The aim of this study was to evaluate the pathological diagnostic results of stereotactic vacuum-assisted breast biopsy （ST-VAB） in patients with category ３（C-３） calcifications appearing on mammography. Methods and materials: We retrospectively reviewed ２８９ category ３ calcifications in # patients who underwent ST-VAB from January２００５to April２０１７at our hospital. Results: Overall,１９４lesions in１９３patients were diagnosed as benign, while６９patients were identified as having malignant lesions. Of the ６９ patients with malignant lesions, ５８ had carcinoma in situ and １１ had invasive carcinoma. The lesions in the remaining ２６ patients were classified as “difficult to differentiate.” No significant differences in morphology or distribution were seen between the benign and malignant lesions. The rate of malignancy was higher among patients with an age?of ５５ years or older（P=０.０２, compared with younger patients）and among cases with a positive MRI diagnosis（P=０.０００１, compared with negative MRI diagnosis）. Pathological examinations after surgery revealed１３cases of invasive ductal carcinoma among the ５５cases who were diagnosed as having carcinoma in situ based on ST-VAB; therefore, the under-estimation rate was ２４％. Fifty-one patients underwent sentinel lymph node biopsy, but lymph node metastasis was not found in any of these patients. Conclusions: ST-VAB in patients with C-３ calcifications resulted in a diagnosis of benign lesions in the majority of cases. Malignant cases were observed in２４％ of the patients, and more than ８０％ of these lesions were diagnosed as carcinoma in situ. ST-VAB may be indicated in patients who are５５years or older and have a positive MRI diagnosis. Follow-up is reasonable in premenopausal patients with a negative MRI diagnosis, rather than immediate ST-VAB.