BIOPSIES OF OCCULT LESIONS DETECTED BY MA MMOGRAPHY IN DISTRICT HOSPITAL

Most series of biopsies of mammographically identified breast lesions are performed in specialized units following mass screening and report an 11% to 36% rate of carcinoma. The results of such biopsies in a di strict hospital setting are analysed. Seventy-nine consecutive needle localisation biopsies were performed over a 2.5-year period by 15 surg eons and retrospectively reviewed. 13 lesions (16%) were referred by t he National Breast Screening Programme. Carcinomas were found on 24 bi opsies (30%): 8 were in situ and 16 were infiltrative, 5 of whom were less than 0.5 cm. Thus half of them met the criteria of ''minimal'' ca rcinoma as described by GALLAGHER. 40% of women 50 years and older and 13% of women less than 50 years had carcinoma. 6% of the lesions read on mammogram as ''probably'' benign and 47% of those considered as '' probably'' malignant were cancer. There was no significant correlation between the mammographic appearance and the occurrence of cancer but all ''minimal'' invasive carcinomas were associated with calcification s. Complete removal of the lesion failed in 3 cases. Localisation biop sy can be performed in a district hospital by general surgeons with a similar yield of malignancies as in specialized unit and with a high i ncidence of early detected cancers.