Silvia Jaromi MD, Presenter: Nothing to Disclose

Daniel Floery MD, Abstract Co-Author: Nothing to Disclose

Christopher C. Riedl MD, Abstract Co-Author: Nothing to Disclose

Georg Pfarl MD, Abstract Co-Author: Nothing to Disclose

Michael Weber, Abstract Co-Author: Nothing to Disclose

Thomas Hans Helbich MD, Abstract Co-Author: Nothing to Disclose

To assess a potential clip displacement of two biopsy marker clips following stereotactic 11-G vacuum assisted breast biopsy (VABB).

In a prospective randomized study 100 conventional localizing clips (Micromark II, Ethicon, USA) and 100 gelatin plellet/metallic marker clips (Gel Mark ultra, SenoRX Inc, USA) were deployed using a stereotactic system (Mammotome, Fisher Imaging, USA) following 11-G VABB. Pre- and post-interventional two-view mammograms were analyzed by two radiologists, independently. The position of the markers was assessed. In case of a displacement, defined as a clip migration more than 10mm from the target, the distance and direction of displacement was recorded. The displacement was categorized as minor dislplacement (more than 10 to 20mm), and major displacement (more than 20mm).

Post-interventional mammograms revealed a clip displacement of more than 10mm in 16/200 (8%) cases, including 3/16 (18.8%) masses and 13/16 (81.2%) calcifications. Clip displacement was seen significantly more often in conventional localizing clips (14/100; 14%) than in gelatin pellet/metallic marker clips (2/100; 2%; p20mm) was seen in conventional clips only (7% vs. 0%; p<0.05)!

Following 11-G VABB clip displacement of more than 20mm was seen significantly more often using conventional localizing clips in comparison to the gelatin pellet/metallic marker clips. Conventional localizing clips should no longer be used following stereotactic 11-G VABB.

Major displacement of a localizing clip leads to tissue excision within the subsequent surgery at the wrong location and therefore the suspicious lesion, potentially a carcinoma, is not removed.

Jaromi, S, Floery, D, Riedl, C, Pfarl, G, Weber, M, Helbich, T, Clip Displacement Following Stereotactic Breast Biopsy: A Comparison of a Gelatin Pellet/Metallic Marker Clip System with a Conventional Localizing Clip System.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5013969.html