THE INTEGRATION OF DIAGNOSTIC-TESTS AND THE ROLE OF OUTPATIENT SURGERY IN THE MANAGEMENT OF BREAST DISEASE

The aim of the earliest possible diagnosis of breast carcinoma achieve d through the integration of clinical, mammographic, sonographic and c ytologic data has determined an increased detection of breast lesions and a greater accuracy in their description, Nevertheless, the nature of some of these lesions cannot be well-defined because of their biolo gical characteristics and their physical, radiological or cytological aspects, The need to obtain a definitive diagnosis in any case has giv en rise to a paradoxical increase in histologic examinations: in speci fic conditions and for certain kinds of lesions, outpatient surgery un der local anesthesia could very well represent a supplementary tool in the diagnostic and therapeutic strategy for the management of breast lesions, The data here reported concern 397 breast lesions for which i t was thought appropriate to complete the diagnostic procedure with th e surgical excision on an outpatient basis under local anesthesia, Exc luding the 3 breast lymphomas and the 19 loco-regional recurrences, fo r which the purpose of outpatient surgery was therapeutic, at the hist ologic examination 35% benign lesions, of which 91 associated with an increased risk of breast cancer, were found, as well as 11 in situ and 10 invasive carcinomas (false negatives), with a therapeutic option e rror of 2.5%. Now that one of the principal aims of public management is to put a check on health expenditures, outpatient surgery would con tribute to obtaining the correct balance between proper management of breast lesions and low cost/effective ratio.