Preoperative evaluation of abnormal mammographic findings to avoid unnecessary breast biopsies
M. Morrow, R. Schmidt, B. Cregger, C. Hassett and S. Cox
Department of Surgery, University of Chicago, Ill.
OBJECTIVE: To prospectively evaluate a program of additional mammographic
views, interval follow-up, and stereotactic biopsy in the management of
abnormalities detected on mammograms. METHODS: From June 1988 to September
1991, 267 consecutive women who were referred for surgical consultation
because of an abnormal mammographic finding were evaluated. Mammographic
abnormalities were assessed as benign or as requiring interval follow-up,
stereotactic biopsy, open surgical biopsy, or additional views. Women
having additional mammographic views were reassigned to the preceding
groups. The mean follow-up for women who did not have a biopsy was 37
months. RESULTS: Only 129 (48%) of the women who were sent for surgical
consultation underwent open biopsy, and 46 (36%) of the biopsy specimens
revealed carcinoma. Forty-one (89%) of the cancers were ductal carcinoma in
situ or stage I lesions. Of the 117 women who were assigned to follow-up,
six (5%) subsequently required biopsy and two cancers were identified.
CONCLUSION: Rigorous mammographic evaluation and the use of stereotactic
biopsy for selected lesions can prevent breast biopsy for low-suspicion
mammographic abnormalities while still allowing the detection of
early-stage breast cancer.
