Table 2. Characteristics of mammography in fifteen stereotactic vacu- um-assisted breast biopsy (VAB) cases Table 3. Clinical characteristics of stereotactic vacuum-assisted breast biopsy cases Stereotactic VAB 5 4 2 1 2 1 Diameter (mm)* 11.8 (9-15) 10.3 (6-13) 7.5 (7-8) 8.0 7.0 (6-8) 6.0 66 Characteristics Feature of microcalcification Scattered punctuate microcalcification Clustered punctuate microcalcification Amorphous microcalcification Pleomorphic microcalcification Feature of non-palpable mass without microcalcification Spiculated mass alone Oval shape mass alone *Median (range). Table 4. Histopathologic diagnosis in stereotactic vacuum-assisted breast biopsy (VAB) cases Histopathologic diagnosis Benign ductules Sclerotic stroma with benign breast tissue Fibroadenoma with fibrocystic change and microcalcification Microcalcification associated with stroma Microcalcification with benign ductules Fibrocystic change with microcalcification Ductal carcinoma in situ with microcalcification Stereotactic VAB, No. (%) 1 (6.7) 3 (20.0) 2 (13.3) 1 (6.7) 4 (26.7) 3 (20.0) 1 (6.7) scattered punctuate (n = 5), clustered punctuate (n = 4), amor- phous (n = 2) and pleomorphic (n = 1). Non-palpable masses without microcalcifications were spiculated (n = 2) and oval shape (n = 1). Microcalcification clusters were 6-15 mm in di- ameter (mean, 10.3 mm) and masses were 6-8 mm in diame- ter (mean, 6.7 mm) (Table 2). The mean patient age was 45.7 years (range, 33-63). Ten cases of microcalcifications were identified in the first specimen mam- mographic image, and the breast marker clip was located ac- curately in two cases of non-palpable masses after one proce- dure. The mean procedure time was approximately 30.1 min- utes, and the average number and length of obtained core tis- sues was 14.4 (range, 9-26) and 2.7 cm (range, 0.8-3.3), respec- tively. No patient developed a vasovagal reaction such as nau- sea, vertigo, or syncope during the procedure. One week after the procedure, complications were identified by a physical ex- amination and ultrasound. A minimal hematoma was observed in two cases (13.3%), which resolved spontaneously (Table 3). In the histopathologic diagnoses of the stereotactic VAB, 14 cases had benign breast lesions and 1 case was a ductal carci- noma in situ (DCIS). Additional breast conserving surgery (quadrantectomy with a local flap) was performed for the ma- lignant case. Among 12 cases of microcalcification on mam- mography, the microcalcification was confirmed in 11 (91.7%) http://ejbc.kr Youn Joo Jung, et al. Characteristics Age (yr) Mean Range No. of procedure, No. (%) 1 2 3 Procedure time (total, min) Mean Range No. of breast tissues Mean Range Length of breast tissues (cm) Mean Range Complication after procedure, No. (%) Yes (Hematoma*) No 45.7 33-63 12 (80.0) 2 (13.30) 1 (6.7) 30.1 15-50 14.4 9-26 2.7 0.8-3.3 2 (13.3) 13 (86.7) *All of cases were resolved spontaneously. by the pathological findings of normal stroma, benign duct- ules, fibrocystic changes, or DCIS. The other case of microcal- cification on mammography revealed only benign ductules. Three cases without microcalcification on mammography were confirmed as sclerotic stroma with benign breast tissue. Fibro- adenomas were identified in two cases, which were combined with fibrocystic changes and microcalcification (Table 4). DISCUSSION Stereotactic breast biopsy is a reliable procedure for localiz- ing and sampling of breast tissue using mammography. Stereo- tactic VAB has a high sensitivity (98%) and specificity (100%) and may provide a promising alternative to open breast biopsy [1,8-12]. Among various type of stereotactic breast biopsy, ste- reotactic VAB is indicated for microcalcifications or non-pal- pable breast lesions not detectable by ultrasound. BI-RADS categories 3 or 4 for non-palpable breast lesions are usually ap- plied for stereotactic breast biopsy, because category 5 or higher cases should be submitted to ultrasound-guided needle biopsy [13]. Stereotactic VAB is a very consistent and easy procedure if the needle is well located when targeting the breast lesion. Be- cause accurate targeting is key for stereotactic VAB, the needle should be inserted at the exact site of the calculated x, y, and z-axis points from the zero point, which is set in the VAB ma- chine. Furthermore, the complication rates for stereotactic VAB are relatively lower than ultrasound-guided VAB, because less DOI: 10.4048/jbc.2011.14.1.64