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To determine the predictive value of fine-wire localization (FWL) biopsy.A chart review.The Royal Columbian Hospital, New Westminster, BC.Two hundred and thirty-five women who underwent 239 biopsies for abnormal mammographic findings between Jan. 1, 1991, and Dec. 31, 1992. The average age was 58 years (range from 33 to 83 years).FWL biopsy.Positive findings of cancer on FWL biopsy.Mammographic findings were as follows: a mass only in 98 cases (41.0%), microcalcification in 90 (37.7%), a spiculated mass in 20 (7.5%), an ill-defined density in 18 (8.4%) and a mass with microcalcification in 13 (5.4%). Malignant lesions were found in 97 (40.6%) of 239 biopsies. These included 55 infiltrating ductal carcinomas, 31 in-situ carcinomas, 7 infiltrating lobular carcinomas and 4 miscellaneous carcinomas. Spiculated masses were associated with malignancy in 18 (90%) of the 20 biopsies. Also, 41 (42%) of the 98 masses and 30 (33%) of the 90 microcalcifications were malignant. Only 4 (31%) of the 13 masses with associated microcalcification and 4 (22%) of the 18 ill-defined densities were malignant.The 40.6% rate of positive findings supports the use of FWL biopsy as a valuable tool in the diagnosis of nonpalpable breast cancers.

From a budgetary viewpoint, the authors summarize the operative experience of the cardiac surgery program at the Royal Columbian Hospital during its first fiscal year of operation. The program was funded for 250 cardiopulmonary bypass (CPB) procedures: $16,800 per CPB procedure ($4.2 million for the program). The 250 CPB procedures were performed on 248 patients. The 30-day operative mortality was 2%. Thirty patients (12.1%) underwent a second operation for complications or delayed primary closure of the sternum, or both; the complications included aortic prosthetic perivalvular leaks in 2 patients. Eight patients (3.2%) required insertion of an intra-aortic balloon pump preoperatively to stabilize their condition; 10 others (4.0%) required intra-aortic balloon pump insertion at surgery to correct low-cardiac-output syndrome. Blood products were needed for 149 (59.6%) of the 250 CPB procedures. The average hospital stay was 10.4 days for noncoronary procedures and 9.0 days for coronary procedures.