Surgery for nonpalpable breast lesions
A. E. Papatestas, D. Hermann, G. Hermann, C. Tsevdos and G. Lesnick
Department of Surgery, Mount Sinai Medical Center, New York, NY 10029.
Nonpalpable lesions detected on mammograms were localized in 475 women
between 1976 and 1988 by means of the spot method. A malignant neoplasm was
noted in 149 patients (31%), including 69 (33%) of 206 with clusters of
microcalcifications, 16 (41%) of 39 with calcifications associated with
densities and 64 (28%) of 230 with nonpalpable masses. Infiltrating lesions
were present in 89 (60%) of 149 patients. Among women with infiltrating
lesions who had axillary dissection, 14 (21%) of 67 had positive nodes. In
younger women, microcalcifications were more likely to represent neoplasms,
masses frequently represented invasive tumors. Among patients with invasive
malignant neoplasms who had calcifications, 39% had positive axillary lymph
nodes. Spot localization, rather than monitoring, seems appropriate in
young women with microcalcifications suggestive of malignant neoplasms and
older patients with nonpalpable masses to achieve earlier and more
effective treatment of biologically significant occult neoplasms.
