Digital Breast Tomosynthesis-Guided Wire Localization: Assessment of Feasibility and Effectiveness for Breast Lesions Manifested with Calcifications

Abstract

Objective: To evaluate the feasibility and effectiveness of digital breast tomosynthesis (DBT) guided wire localization for breast lesions manifested with calcifications.

Methods: Between December 2017 and August 2019, a total of 36 patients who had suspicious calcifications and underwent surgery after DBT-guided wire localization were enrolled to the study. Characteristics and extension of calcifications, approaching direction, depths of the targeted calcifications, distance from tip of wire to the targeted calcifications, number of exposures, total radiation doses, complication rates for all cases, and reoperation rates of malignant cases were noted. Mean, maximum and minimum values were used as descriptive statistics of the data. Mann-Whitney U test was used to compare differences between subgroups.

Results: The mean age of the patients was 50.81 ± 9.12 (33-68 years) Of 36 patients, histopathologic assessment verified calcifications of 14 (38.9%)  lesions as benign, and 22 (61.1%) lesions as malignant. All suspicious calcifications (100%) were excised adequately. The mean extension of the calcifications were 19.61 ± 17.37 mm (3 - 67 mm). There was a statistically significant difference in the extension of calcifications between benign and malignant subgroups (P = 0.014). The mean of radiation doses for the procedures was 8.65 ± 2.77 mGy (3.51 – 14.14 mGy). Reoperation rate was 40.9% for malignant patients.

Conclusion: Our study revealed that DBT-guided wire localization is a feasible technique for surgical excision of lesions manifested with calcifications. However, the relatively high reoperation rates for malignant cases require future studies with comparison to other techniques.