Needle-localized mammographic lesions. Results and evolving treatment strategy
H. R. Alexander, F. C. Candela, D. D. Dershaw and D. W. Kinne
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.
From January 1981 to December 1987, 932 needle-localization breast biopsies
were performed at our institution for mammographically detected
abnormalities. We reviewed 531 needle-localization breast biopsy procedures
performed during two periods (January 1981 to June 1984, n = 311; and
January to August 1987, n = 220) to compare results and treatment patterns,
and to determine the prevalence of the missed lesions. Mammographic
abnormalities detected on routine screening accounted for a larger
proportion of needle-localization breast biopsies in the later series (94
[30%] of 311 vs 94 [43%] of 220). However, the rate at which carcinoma was
identified remained constant at 29% as did the percentage of cancers that
were invasive (46% vs 51%). Overall, the rate of malignant diagnoses after
needle-localization breast biopsy was lowest in asymptomatic women
undergoing routine screening mammography (44 [24%] of 188) and
significantly higher in women undergoing mammographic follow-up of the
contralateral breast after treatment for breast cancer (28 [43%] of 65).
There were seven missed lesions in 531 needle-localization breast biopsies,
necessitating a second procedure in six and interval mammograms in one.
