NEEDLE LOCALIZATION BREAST BIOPSY - A MODEL FOR MULTIDISCIPLINARY QUALITY ASSURANCE

As part of the quality assurance role of the Cancer Committee at Barne s Hospital, an institutional audit of Needle Localization Breast Biops y (NLBB) was performed, Mammographic, operative, and surgical patholog y reports from 370 consecutive patients at our institution undergoing both mammography and needle localization biopsy over a 34-month interv al were reviewed, Carcinoma was diagnosed pathologically in 103 patien ts (28%), and 27% of these proved to be noninvasive. Sixteen patients were found to have histologic or clinical involvement of the axillary nodes; no patients with Tis lesions were found to have axillary nodal involvement. Of the patients, 73% were found to have either Stage 0 or Stage I disease, and 61% with an established malignancy had mastectom y (67% of patients with invasive carcinoma, 44% of those with carcinom a-in-situ), whereas 39% had some form of conservation therapy (33% of patients with invasive lesions, 56% of those with carcinoma-in-situ). Our results have been compared with other published studies, and impor tant clinical indicators for evaluating the results of individual cent ers performing NLBB are discussed. It is concluded that NLBB is a safe and effective method of biopsying nonpalpable breast lesions, which a llows for the identification of early stage breast carcinomas. In the present environment of concerns about the quality of care and costs, i t is the responsibility of each center performing NLBB periodically to evaluate their results with this multidisciplinary procedure and to b ring about change in those areas found to be deficient. (C) 1995 Wiley -Liss, Inc.