The importance of stabilizing the specimen taken at needle localized biopsy of the breast for microcalcifications.

The specimen from a needle localized biopsy of the breast must be compared with its roentgenogram to locate the area of microcalcification within the specimen. Any errors in aligning the specimen to its roentgenogram could result in failure to sample and microscopically examine the area of the microcalcifications. The results of the current study show the importance of maintaining the orientation and position of the specimen from the time the roentgenogram is taken until it is examined by the pathologist. Each of 45 consecutive specimens taken at biopsy were secured to a square of cardboard immediately after excision from the breast to maintain the orientation of the specimen during the process of roentgenography. The histologic findings of this group (group 2) were compared with the preceding 87 biopsies (group 1) in which no effort had been made to immobilize the specimen for a roentgenogram. The presence of microcalcifications was confirmed roentgenographically in all the specimens of each group. Histologic confirmation of the presence of microcalcifications was obtained in 42 of 45 specimens in group 2 and only 71 of 87 in group 1 (p = 0.035). Thirty-one per cent of specimens in group 2 contained a carcinoma compared with 10 per cent in group 1. We conclude that fixing the position of the specimen after excision improves the ability of the pathologist to locate the suspicious area of microcalcifications within the specimen. This may lead to an increase in the yield of these biopsies and the identification of occult carcinomas that might otherwise be missed.