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  • Open Access

PB.37: Screen-detected, noncalcified, mammographic lesions with normal or benign ultrasound findings: is stereotactic biopsy necessary?

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Breast Cancer Research201315 (Suppl 1) :P37

  • Published:


  • Mammographic Density
  • Ultrasound Finding
  • Stereotactic Biopsy
  • Request Form
  • Mammographic Finding


Ultrasound has long been used in the symptomatic service, not only to distinguish cystic from solid masses but also to help in the differentiation of benign from malignant lesions. The ability to correlate a benign ultrasound mass with a mammographic mass eliminates the need for further intervention. We evaluate the need for stereotactic biopsy in screen-detected, nonpalpable lesions without calcification, which have either benign or normal sonographic findings.


Patients who had stereotactic biopsy for mammographic lesions from January 2011 to January 2013 were retrospectively identified from our screening database. Clinical examination and ultrasound findings, presence of calcification and pathological diagnosis were recorded. Final imaging opinion was also recorded from the pathology request forms.


Of 4,339 patients recalled for assessment, 1,860 had a biopsy (853 stereotactic and 1,007 ultrasound guided). Stereotactic biopsies were for microcalcification (n = 748) and for 105 impalpable, noncalcified densities with normal (n = 73) or benign (n = 32) ultrasound findings. Malignancy was detected in eight (8%) noncalcified lesions and 169 (23%) microcalcifications (P < 0.0002, Fischer exact test). Simple cysts were detected in 28/32 (88%) of cases with benign ultrasound findings. Suspicion of malignancy was mentioned in 38/105 (36%) final imaging opinions. Asymmetry (n = 4) and distortion (n = 2) were the commonest lesion features associated with a positive biopsy result.


Stereotactic biopsy for screen-detected mammographic densities with normal or benign ultrasound findings has a low yield of malignancy. Careful analysis of mammographic findings, ultrasound correlation and further multidisciplinary discussion could help reduce unnecessary biopsies.

Authors’ Affiliations

St George's Hospital and South West London Breast Screening Service, London, UK


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© Tzias et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.