Breast-nonmalignant - Breast biopsy marking devices

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Breast-nonmalignant

Procedures

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

General

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● 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

Clinical features

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● 4% of patients experience intraoperative clip loss (AJR Am J Roentgenol 2008;190:W196)

Clinical images

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Devices and radiographs Gel Mark Ultra ®

Lost biopsy marking clips (arrows)

Gross description (Macroscopy)

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● Pellets resemble soft grains of rice

● Collagen plugs are spongiform with variable hemorrhagic changes

Gross images

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Biopsy clips may be much smaller than standard surgical clips

Micro description (Histopathology)

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Pellets:

● 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)

Collagen plugs:

● 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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