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Results and Evolving Treatment Strategy

H. Richard Alexander, MD; Frank C. Candela, MD; D. David Dershaw, MD; David W. Kinne, MD

Arch Surg. 1990;125(11):1441-1444.

Abstract
• 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.

(Arch Surg. 1990;125:1441-1444)

Author Affiliations
From the Departments of Surgery (Breast Service) (Drs Alexander, Candela, and Kinne) and Medical Imaging (Dr Dershaw), Memorial Sloan-Kettering Cancer Center, New York, NY.

Footnotes
Accepted for publication July 1, 1990.

Reprint requests to Surgery Branch, National Cancer Institute, National Institutes of Health, Bldg 10, Room 2B05, Bethesda, MD 20892 (Dr Alexander).

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