True Lateral Mammography with Stereotactic VAB in the lateral decubitus position with the breast lesion facing up (Figure 1). The scout view and 15° paired stereotactic mam- mography were performed to localize the breast lesion, which was compared with a true lateral view (Figure 2). We calculat- ed the horizontal (x) and vertical (y) distanced and the depth (z) from the zero point of the stereotactic VAB device. Local anesthesia was performed with 2 mL of a 2% lidocaine injec- tion under aseptic conditions. The incision was usually 4 mm according to the skin crease. Stereotactic 15° paired mammo- graphic views were obtained again after an 8-gauge VAB probe (Mammotome®; Ethicon-Endosurgery, Cincinnati, USA) was inserted to verify the site where the microcalcification was lo- cated. The needle position was corrected when the distance was more than 2 mm between the needle tip and the breast lesion. Stereotactic VAB was performed by one clinical physician. Each of two breast tissue specimens were collected from six clockwise directions (2, 4, 6, 8, 10, and 12 o’clock) and arranged in a regular sequence on a Petri dish containing round filter paper (Figure 3). The stereotactic VAB was concluded when Figure 1. Patient laid on the stereotactic vacuum-assisted breast biopsy table in the lateral decubitus position with the breast lesion upside. 65 the breast lesion was identified by specimen mammography in more than two breast tissues. Additional sampling was per- formed when the breast lesion was still identified on stereotac- tic mammography or was not identified in specimen mam- mography. The procedure time was determined to be from probe insertion to removal. A post-procedure mammography view was obtained after a breast marker clip (Johnson & Johnson, Ethicon-Endosurgery, Cincinnati, USA) was inserted. The breast was manually com- pressed at the procedure table. Only a piece of strip envelope (Steri-Strip; 3M, St. Paul, USA) and a compression bandage were used as a wound dressing. Microcalcifications were observed in 12 (80.0%) of the 15 cases, and the remaining three cases (20.0%) showed non-pal- pable breast masses. Eight cases (53.3%) were classified as BI- RADS category 3 and seven (46.7%) were category 4 (Table 1). The morphological characters of the microcalcifications were Table 1. Radiologic classification in fifteen stereotactic vacuum-assisted breast biopsy (VAB) cases Characteristics Breast Imaging Reporting and Data System (BI-RADS) Probably benign lesion (category 3) Suspicious abnormality (category 4) Mammographic findings Non-palpable breast lesion without microcalcification Non-palpable breast lesion with microcalcification Stereotactic VAB No. (%) 8 (53.3) 7 (46.7) 3 (20.0) 12 (80.0) Figure 2. A scout 15° paired stereotactic mammography view. The tar- geted microcalcification is seen below the probe. Figure 3. Specimen mammography shows a microcalcification in three separate specimens (yellow circles). DOI: 10.4048/jbc.2011.14.1.64 http://ejbc.kr