Stereotactic core needle breast biopsy marker migration: An analysis of factors contributing to immediate marker migration

Eur Radiol. 2017 Nov;27(11):4797-4803. doi: 10.1007/s00330-017-4851-7. Epub 2017 May 19.

Abstract

Objectives: To evaluate breast biopsy marker migration in stereotactic core needle biopsy procedures and identify contributing factors.

Methods: This retrospective study analyzed 268 stereotactic biopsy markers placed in 263 consecutive patients undergoing stereotactic biopsies using 9G vacuum-assisted devices from August 2010-July 2013. Mammograms were reviewed and factors contributing to marker migration were evaluated. Basic descriptive statistics were calculated and comparisons were performed based on radiographically-confirmed marker migration.

Results: Of the 268 placed stereotactic biopsy markers, 35 (13.1%) migrated ≥1 cm from their biopsy cavity. Range: 1-6 cm; mean (± SD): 2.35 ± 1.22 cm. Of the 35 migrated biopsy markers, 9 (25.7%) migrated ≥3.5 cm. Patient age, biopsy pathology, number of cores, and left versus right breast were not associated with migration status (P> 0.10). Global fatty breast density (P= 0.025) and biopsy in the inner region of breast (P = 0.031) were associated with marker migration. Superior biopsy approach (P= 0.025), locally heterogeneous breast density, and t-shaped biopsy markers (P= 0.035) were significant for no marker migration.

Conclusions: Multiple factors were found to influence marker migration. An overall migration rate of 13% supports endeavors of research groups actively developing new biopsy marker designs for improved resistance to migration.

Key points: • Breast biopsy marker migration is documented in 13% of 268 procedures. • Marker migration is affected by physical, biological, and pathological factors. • Breast density, marker shape, needle approach etc. affect migration. • Study demonstrates marker migration prevalence; marker design improvements are needed.

Keywords: Breast biopsy; Breast cancer; Core-needle biopsy; Image-guided biopsy; Marker migration.

MeSH terms

  • Biopsy, Large-Core Needle / instrumentation*
  • Biopsy, Large-Core Needle / methods
  • Breast / diagnostic imaging*
  • Breast / pathology
  • Breast Density
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Female
  • Foreign-Body Migration / diagnostic imaging*
  • Humans
  • Imaging, Three-Dimensional
  • Mammography*
  • Middle Aged
  • Retrospective Studies