Processing Stereotactic Breast Biopsy Specimens: Impact of Specimen Radiography System on Workflow

To the Editor: After breast tissue cores are obtained from a patient during a stereotactic biopsy performed for suspicious calcifications with potential atypia and/or breast malignancy, the presence of target calcifications within the tissue cores must be verified before sending the tissue to pathology. At our breast imaging center, there are two commercial imaging systems being used for this, the Bioptics CoreVision System, located in the biopsy room, and the GE 2000D System, which is a free-standing mammography unit located outside the biopsy room. They are essentially equivalent in terms of specimen radiography capabilities. The only difference is the location of the equipment and the rapidity of acquiring a specimen radiograph of the core tissue samples. The Bioptics unit allows for quickly evaluating the core tissue specimens in the biopsy room and efficiently transferring them to the collection jars sent to pathology. Otherwise, the core tissue specimens must be taken out of the biopsy room to the reading room workstation for specimen radiograph evaluation and separating core samples before sending them to pathology. This is relevant for institutions where the specimen is separated into “with calcifications” and “without calcifications” collection jars, which is often standard operating procedure. This also obviates the need to “hold” another mammography unit in a separate room, in addition to the biopsy unit, for obtaining the specimen images, which is an interruption in the usual work flow and an inconvenience for scheduled screening mammography patients. Using the Bioptics CoreVision increases overall efficiency of imaging the core tissue samples, and decreases time required to determine whether target calcifications are obtained so that a biopsy clip can be placed and the procedure completed. Prior to this study, the mammographers at our institution reported that although the overall quality of the two systems is equivalent, it seemed to take less time with one system compared with the other. Although there have been reports on interpretation workflow in mammography (1–4), as well as biopsy