BREAST BIOPSY FOR NONPALPABLE LESIONS - A WORTHWHILE ENDEAVOR

The purpose of this study was to determine our yield of carcinoma in p atients with a nonpalpable mammographic abnormality and to identify wh ich mammographic criteria will most likely yield a positive biopsy. We conducted a review of all patients with nonpalpable mammographic abno rmality who underwent needle-localized breast biopsy at our institutio n from 1988 to 1991. Charts of 295 patients who underwent 332 needle-l ocalized breast biopsy were reviewed for age, family history, cancer h istory, mammographic findings, operative time, volume of excised breas t tissue, and histology. Mammographic abnormalities were categorized a s suspicious (clustered) microcalcification, stellate mass, ill-define d mass, well-circumscribed mass, developing density, or asymmetric den sity. The overall yield of cancer positive biopsies was 48 of 332 (14. 5%). The frequency of diagnosed cancers was DCIS (8), LCIS (1), Stage 1 (31) and Stage 11 (8). The frequency that each single mammographic c riteria resulted in a cancer diagnosis was: suspicious calcification ( 12%), stellate mass (22%), ill-defined mass (14%), well-circumscribed mass (11%), developing density (9%) and asymmetric density (0%). Howev er, patients with both a stellate mass and microcalcifications formed the highest risk subgroup, with cancer detected 66 per cent of the tim e (P = 0.03).