STEREOTAXIC LOCALIZATION AND CORE NEEDLE-BIOPSY OF NONPALPABLE BREAST-LESIONS - 2-YEAR FOLLOW-UP OF A PROSPECTIVE-STUDY

In August 1989, we began a prospective study of patients with abnormal mammograms to determine the clinical efficacy of stereotaxic localiza tion and needle biopsy of nonpalpable breast lesions. By August 1990, 115 patients had undergone stereotaxic localization and needle biopsy of nonpalpable breast lesions using the Mammotest II (Fischer Imaging, Denver, CO) and an 18-gauge needle in a Bard Biopty gun (Bard Urologi cal, Covington, GA). In 19 per cent (22 of 115) of the cases, the path ologist suggested open surgical biopsies of the lesions due to clinica l judgment, or atypical or cancer cells in the core biopsy specimen. O f these 22 cases, 12 (54%) were found to be cancer on open surgical bi opsy-10 per cent of all the patients. Of the remaining 93 patients wit h benign pathology, 9 were lost to follow-up by the end of the second year after closure of the study. The remaining 84 patients were follow ed by mammography and physical exam at 3 months, at 12 months, and yea rly thereafter to determine whether cancer had been missed or develope d at the biopsy site. The median follow-up was 24 months (mean, 23.3 m onths), and all 84 patients were found to have no evidence of malignan t disease at follow-up. The small group (10 cases) of patients who wer e determined to have benign disease by open surgical biopsy were also found on follow-up to have no evidence of malignant disease (median fo llow-up, 20.5 months; and mean, 18.3 months). The accuracy of this ste reotaxic procedure, combined with an approximately 80 per cent decreas e in the more expensive and more invasive open surgical biopsy procedu re, provides strong support for the use of this procedure on all nonpa lpable breast lesions that would normally proceed to open surgical bio psy.