Can the organic coating of breast tissue markers be sampled by an ultrasound-guided core cut biopsy without removing the clip marker? A proof-of-concept evaluation of two coated clip marker types in turkey breast tissue to improve representativity of ultrasound-guided core cut biopsies

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Purpose: The aim of this preclinical study was to test if the organic coating of two breast tissue clip markers (HydroMARK and UltraClip) can be sampled selectively by an ultrasound-guided core cut biopsy. Methods: Ten clip markers of each type were inserted in four turkey breasts. Sonographic visibility was graded by the performing physicians. Core cut biopsy was performed, aiming to sample only the organic coating while leaving the clip marker in situ. Mammography, specimen radiography and gross inspection of the biopsy samples were conducted to evaluate dislocation or removal of the clips. The specimens were examined histopathologically to detect fragments of the coating material. Results: HydroMARK was superior regarding biopsy feasibility and detectability of the coating. The organic coating of HydroMARK could be sampled selectively without dislocating the clip marker. Fragments of the coating material were visible macroscopically in 7 out of 10 biopsy specimens and could be detected in the histopathologic workup in 5 out of 10 specimens. The coating material of the UltraClip was not visible in any sample. Conclusion: This study showed that the organic coating could be identified in core cut biopsy samples, both on a macroscopic and microscopic level. This could potentially be used to verify representativity of minimal invasive biopsies.

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