Out With the Old and in With the New? Factors Involved in Migration of Older and Newer Generation Stereotactic Breast Biopsy Markers

Objective The purpose of this study was to investigate four commonly used stereotactic biopsy markers, two older and two newer generation, assessing percentage migration and factors influencing migration distance. Methods This was an IRB–approved retrospective review of upright stereotactic breast biopsies from May 2018 to May 2020 involving either older (Cork, Hourglass) or newer (Vision, X-shaped) generation markers. Markers were assessed for migration rate by two-sample Z-test and migration distance by analysis of variance. Univariate analysis was used to assess relationships between marker type and generation, patient characteristics, breast composition and thickness, procedure techniques, trainee involvement, and complications, correlating with migration distance. Multivariable analysis was performed for variables with P-value < 0.1 on univariate analysis. Tukey’s test was used to compare all groups (P < 0.05). Results A total of 732 stereotactic biopsies were performed with 508 using a Cork, Hourglass, Vision, or X-shaped marker. Overall migration rate was 181/508 (35.6%) with no difference between markers. Breast thickness and density were negatively associated with migration distance in univariate analysis. Older marker migration distance was greater than newer (2.6 cm vs 1.9 cm, respectively), which was significant after adjusting for breast thickness and density (P = 0.037). Density was a significant factor in migration distance, comparing fatty to nonfatty breasts (P < 0.05) in univariate analysis. Conclusion No difference in migration rate was seen between the four biopsy markers. Vision and X-shaped markers demonstrate lower migration distance than Cork and Hourglass in multivariate analysis. There is an inverse relationship between breast density and marker migration distance.