A 4-year retrospective analysis of screen-detected and stereotactically biopsied microcalcification with emphasis on ways to reduce the number of benign surgical biopsies

One hundred and twelve women with high and intermediate risk impalpable screen-detected microcalcification were referred for surgery following stereotactic fine needle aspiration cytology between June 1990 and June 1994. Histologically 89 were malignant and 23 benign. The cytology report and the presence or absence of calcium in the cytologic specimen were recorded. In a separate, more detailed, analysis for the first year of the study, the 69 screen-detected and stereotactically biopsied low risk microcalcifications which were not surgically biopsied were similarly analysed. There were significantly fewer acellular cytology results (C1; 4.5%) from cancers than from histologically benign lesions (P<0.001), and only one C2 result from a cancer. In contrast, 44.9% of the low risk 1990-1991 cases had C1 cytology. Cytologically seen calcium was most frequently observed in frankly malignant (C5) smears. There was no significant difference between histologically malignant and benign cases in the frequency of cytologically seen calcium in C1 to C4 cytological reports.