Gu Gary Tianyu, Tham Sarah Zhuling, Moey Tammy Hui Lin, Ching Boon Chye, Tay Ian Wei Ming
Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, 169608, Singapore.
Department of General Surgery, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
Clin Imaging. 2025 May;121:110466. doi: 10.1016/j.clinimag.2025.110466. Epub 2025 Apr 1.
Stereotactic-guided vacuum-assisted biopsy (STVAB) is the standard of care to biopsy mammographically detected breast lesions without a sonographic correlate. It can be performed using the conventional (CBA) or lateral-arm biopsy approach (LABA). Tissue marker (clip) placement is routinely done post-biopsy. Clip migration is frequently encountered in STVAB and can result in higher rates of positive margins and re-excision in subsequent surgery. We sought to compare clip migration rates between CBA and LABA.
We performed a retrospective review of 347 cases performed at an Asian institution from 2021 to 2024, on predominantly dense breasts. We compared clip migration rates between CBA and LABA. Other factors that were known to contribute to clip migration were also studied, including breast density and hematoma size. Statistical analysis was done using Fisher's exact test, Mann-Whitney U test and linear regression models.
A total of 347 biopsies were performed in 347 patients. CBA was performed for 297 (85.6 %) patients and LABA was performed for 50 (14.4 %). LABA was found to significantly reduce clip migration rates compared to CBA (4 % versus 25.9 %, p < 0.001). Breast density (p = 0.55) andhematoma size (p = 0.662) were not found to significantly affect clip migration rates.
We recommend utilizing LABA over CBA whenever technically possible if we wish to minimize clip migration.
