Mastectomies after vacuum core biopsy procedure for microcalcification clusters: Value of clip

Purpose: The study was performed to substantiate the value of detecting clips in mastectomy specimens as a guide to taking pathological samples. Material and methods: We performed a retrospective review of 4 cases of mastectomy required after biopsies of microcalcifications. In each case a metallic clip had been inserted at the end of the vacuum core biopsy procedure. Results: The study included 7 microcalcification clusters with a mean size of 6.7 mm corresponding to multifocal or relapsing ductal carcinoma in situ. Gross examination of the mastectomy specimens revealed no evidence of tumoral lesions or fibrous scar tissue. Radiographic examination of the serial slices did not detect any microcalcifications, but confirmed the presence of the clip in the 7 clusters in 4 cases. Histological examination was performed on the areas identified by the clips and detected scar tissue indicating the location of the biopsies and tumoral lesions in all the specimens. Conclusion: In the pathological management of mastectomy specimens following vacuum core biopsies, gross examination may reveal no abnormalities and slice radiography may fail to detect microcalcifications. In such cases, radiography of the serial slices allows localisation of the metallic clips inserted during the vacuum-assisted biopsy procedure and remains the only way for the pathologist to select mastectomy specimens for microscopic analysis