# Core Versus Vacuum-Assisted Postbiopsy Breast Clip Migration Rates

## TL;DR

This study found that vacuum-assisted breast biopsies have a higher risk of clip migration compared to core-needle biopsies, which could affect patient care.

## Contribution

The study provides a direct comparison of clip migration rates between core-needle and vacuum-assisted breast biopsies.

## Key findings

- Vacuum-assisted biopsies had a 24% clip migration rate compared to 5.8% for core-needle biopsies.
- The difference in migration rates was statistically significant (p = 0.00265).
- Optimizing clip deployment in VAB procedures may reduce migration risk.

## Abstract

Background: Biopsy clip migration is a well-known complication that can occur after breast biopsies with potentially devastating effects on patient care and treatment. The purpose of this study is to compare the rates of postbiopsy clip migration after the two most common methods of biopsy: core-needle biopsy (Core) and vacuum-assisted biopsy (VAB).

Methodology: A retrospective review of 153 postbiopsy mammograms (103 Core and 50 VAB) was conducted from March 2024 to March 2025 at three breast imaging centers in southeastern Florida. Only postbiopsy mammograms from a single, randomly selected radiologist will be evaluated to serve as a self-control for any differences in techniques between radiologists. Mammographically occult lesions were excluded from evaluation. Rates of clip migration (with clinically significant migration being defined as 5 mm or greater) were evaluated between the two biopsy techniques while controlling for age and breast density (as defined by Breast Imaging Reporting and Data System nomenclature).

Results: Of the 153 biopsies examined, 18 (11.76%) demonstrated clinically significant clip migration (≥5 mm). Of these, VAB demonstrated a significantly higher migration rate of 24% (12 cases) compared to Core biopsies (5.8%, six cases) (p = 0.00265).

Conclusions: The findings indicate that VAB is associated with a significantly increased risk of clip migration compared to Core biopsies. Optimization of clip deployment strategies in VAB procedures may mitigate migration risk. Further prospective studies are warranted to refine procedural techniques, materials and enhance clip stability to improve localization accuracy in subsequent interventions.