Ability of mammography to reveal nonpalpable breast cancer in women with palpable breast masses

Citation
El. Rosen et al., Ability of mammography to reveal nonpalpable breast cancer in women with palpable breast masses, AM J ROENTG, 172(2), 1999, pp. 309-312
Citations number
29
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
AMERICAN JOURNAL OF ROENTGENOLOGY
ISSN journal
0361803X → ACNP
Volume
172
Issue
2
Year of publication
1999
Pages
309 - 312
Database
ISI
SICI code
0361-803X(199902)172:2<309:AOMTRN>2.0.ZU;2-4
Abstract
OBJECTIVE. Our goal was to determine the frequency with which mammography r eveals nonpalpable malignancies in women with benign palpable masses and to compare these nonpalpable malignancies with the palpable malignancies and nonpalpable malignancies detected in asymptomatic women. SUBJECTS AND METHO DS. This study of nominally asymptomatic women involved 85,399 consecutive mammographic examinations, of which 3459 (4.1%) examinations were performed on women who had palpable masses identified before or at the time of mammo graphy. A medical outcomes audit identified mammographic examinations after which breast cancer was diagnosed and determined selected surrogate measur es for mortality reduction for the mammographically detected malignancies. RESULTS. Of the 3459 examinations in women with palpable masses, 64 cases o f cancer were revealed by mammography. Of these, 54 cases involved palpable malignancies (15.6/1000 examinations) and 10 involved nonpalpable malignan cies (2.6/1000 examinations). Of the 81,940 examinations in asymptomatic wo men, 346 cases of nonpalpable cancer were detected (4.2/1000 examinations). Of the 10 cases of nonpalpable cancer detected in women with benign palpab le masses, median tumor size was 13.8 mm, 10% had axillary node metastasis, and 10% were stage 2 or higher. The corresponding surrogate measures for c ases of nonpalpable cancer detected in asymptomatic women were median tumor size, 13.6 mm; node metastasis, 7%; stage 2 or higher, 14%. The surrogate measures for the 54 palpable malignancies were median tumor size, 23.7 mm; node metastasis, 31%; stage 2 or higher, 63%. CONCLUSION. The surrogate measures for the nonpalpable malignancies in wome n with benign palpable lesions resemble those in asymptomatic women and are much more favorable than those of palpable malignancies. Therefore, in wom en with a palpable breast mass, it is important to use mammography to scree n the remainder of both breasts for nonpalpable cancer.