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
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.