PREOPERATIVE EVALUATION OF ABNORMAL MAMMOGRAPHIC FINDINGS TO AVOID UNNECESSARY BREAST BIOPSIES

Objective: To prospectively evaluate a program of additional mammograp hic views, interval follow-up, and stereotactic biopsy in the manageme nt of abnormalities detected on mammograms. Methods: From June 1988 to September 1991, 267 consecutive women who were referred for surgical consultation because of an abnormal mammographic finding were evaluate d. Mammographic abnormalities were assessed as benign or as requiring interval follow-up, stereotactic biopsy, open surgical biopsy, or addi tional views. Women having additional mammographic views were reassign ed to the preceding groups. The mean follow-up for women who did not h ave a biopsy was 37 months. Results: Only 129 (48%) of the women who w ere sent for surgical consultation underwent open biopsy, and 46 (36%) of the biopsy specimens revealed carcinoma. Forty-one (89%) of the ca ncers were ductal carcinoma in situ or stage I lesions. Of the 117 wom en who were assigned to follow-up, six (5%) subsequently required biop sy and two cancers were identified. Conclusion: Rigorous mammographic evaluation and the use of stereotactic biopsy for selected lesions can prevent breast biopsy for low-suspicion mammographic abnormalities wh ile still allowing the detection of early-stage breast cancer.