Breast biopsy marking devices
Editor: Hind Nassar, M.D., Johns Hopkins Medical Institute (see Reviewers page)
Revised: 26 September 2012, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
● Devices mark the site of radiographic biopsies for future localization and resection
● Are either pellets of resorbable polylactic acid / polyglycolic acid copolymers or plugs of bovine collagen; both contain metallic clips for long-term radiographic marking
● Pellets are placed within biopsy cavity to fix clip in place and reduce clip migration away from biopsy site (AJR Am J Roentgenol 2003;181:1295)
● Collagen plugs may also promote hemostasis
● 4% of patients experience intraoperative clip loss (AJR Am J Roentgenol 2008;190:W196)
Devices and radiographs Gel Mark Ultra ®
Lost biopsy marking clips (arrows)
Gross description (Macroscopy)
● Pellets resemble soft grains of rice
● Collagen plugs are spongiform with variable hemorrhagic changes
Biopsy clips may be much smaller than standard surgical clips
Micro description (Histopathology)
● Initially hypocellular fibrotic reaction around empty spaces (processing dissolves the polymer), then multinucleated giant cell reaction with eosinophilic material in marker core (Am J Surg Pathol 2005;29:814)
● Eosinophilic, hyalinized, acellular material with lymphocytic and eosinophilic infiltrate that gradually penetrates into the core
● No prominent multinucleated giant cell reaction
● May resemble amyloidosis
End of Breast-nonmalignant > Procedures > Breast biopsy marking devices
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