Cosmetic results after wire-guided biopsy of benign breast lesions

Background: There are surprisingly few reports about the cosmetic results o f wire-guided biopsy of benign breast lesions as opposed to breast-conservi ng surgery and irradiation of early breast cancer (BCT). Study Design: Twenty potential perioperative risk factors for adverse cosme tic results after wire-guided breast biopsy were prospectively evaluated in 101 patients undergoing the first single biopsy after suspicion of a malig nant lesion that subsequently proved to be benign. The overall cosmetic res ult was evaluated by using 6 specific cosmetic indices individually scored 6 months after the breast biopsy. Results: The overall cosmesis was excellent, good, fair, or poor in 48.5%, 26.7%, 12.9%, and 11.9% of cases, respectively. The corresponding figures a ccording to appraisal by the patients were 22.8%, 58.4%, 17.8%, and 1.0%, r espectively. Unsatisfactory (fair or poor) overall cosmetic results were re lated to excisions extending down to the fascia (p = 0.001) and postoperati ve complications (p = 0.018) in multivariate analysis. Notably, specimen vo lume had no significant impact on overall cosmesis, as opposed to cosmesis after BCT. Conclusions: Cosmetic outcomes after wire-guided biopsy of benign breast le sions were excellent or good in at least 75% of cases. Excisions extending down to the pectoralis fascia and complications were associated with poor a esthetic outcomes. (J Am Coll Surg 1998;187:610-615. (C) 1998 by the Americ an College of Surgeons).