FINE-WIRE LOCALIZATION FOR NONPALPABLE MAMMOGRAPHIC ABNORMALITIES

Objective: To determine the predictive value of fine-wire localization (FWL) biopsy. Design: A chart review. Setting: The Royal Columbian Ho spital, New Westminster, BC. Patients: Two hundred and thirty-five wom en who underwent 239 biopsies for abnormal mammographic findings betwe en Jan. 1, 1991, and Dec. 31, 1992. The average age was 58 years (rang e from 33 to 83 years). Intervention: FWL biopsy. Main Outcome Measure : Positive findings of cancer on FWL biopsy. Results: Mammographic fin dings were as follows: a mass only in 98 cases (41.0%), microcalcifica tion in 90 (37.7%), a spiculated mass in 20 (7.5%), an ill-defined den sity in 18 (8.4%) and a mass with microcalcification in 13 (5.4%). Mal ignant lesions were found in 97 (40.6%) of 239 biopsies. These include d 55 infiltrating ductal carcinomas, 31 in-situ carcinomas, 7 infiltra ting lobular carcinomas and 4 miscellaneous carcinomas. Spiculated mas ses were associated with malignancy in 18 (90%) of the 20 biopsies. Al so, 41 (42%) of the 98 masses and 30 (33%) of the 90 microcalcificatio ns were malignant. Only 4 (31%) of the 13 masses with associated micro calcification and 4 (22%) of the 18 ill-defined densities were maligna nt. Conclusion: The 40.6% rate of positive findings supports the use o f FWL biopsy as a valuable tool in the diagnosis of nonpalpable breast cancers.