Outcome of surgery for non-palpable mammographic abnormalities

A series of 493 women underwent localization biopsies for breast abnormalities that were not palpable, but could be visualized on mammography (X-ray visualization of the soft tissue of the breast). There were 515 localization biopsies performed with small pieces of breast tissue. Localization biopsy involves the placement of guide wires, followed by mammography; the wires are used as guides in locating the abnormality seen on mammography. Using this technique, the abnormality was visible on the first piece of tissue excised in 402 cases (78.1 percent); complete excision was accomplished in 476 cases (92.4 percent). In 38 women, a palpable nodule was removed, which was malignant in 17 cases. The abnormality seen on mammography was missed during surgery in 14 cases, and was only partly removed in 13 cases. Localization biopsies were found to be malignant in 144 cases (28 percent). Testing for estrogen receptors was possible in only 71 cancers (49.3 percent); the amount of tissue removed was frequently too small for this analysis to be performed. Women with cancer underwent mastectomy (removal of the breast) or wide excision of breast tissue. Residual cancer was found in 64 (44.4 percent) of these cases. X-ray study of the removed tissue is important during localization biopsy procedure. If no abnormal tissue is visible on X-ray, and there is no palpable nodule, the biopsy may be concluded. Missed lesions are usually benign, and only rarely is it necessary to repeat the localization biopsy. (Consumer Summary produced by Reliance Medical Information, Inc.)