Contribution of hook-guided breast biopsy to the pathological diagnosis ofmammographic lesions

This study was carried out to evaluate the reliability of a diagnostic appr oach with close cooperation between radiologists and surgeons for minimal b reast disease. From 1993 to 1995, 152 evaluable patients with non palpable breast lesions were examined by mammography and their lesion was localized with a hook wire before being referred to the surgeon for biopsy. Compariso n of mammography findings with pathological diagnosis indicated a good pred ictive value for benign lesions with only 8% non concordant diagnosis and a rather low predictive value in case of suspect mammograms with only 64% po sitive diagnosis. With hook-guided breast biopsy, a correct diagnosis was e stablished in 93% of the cases. The remaining breast samples were either no n contributory or necessitated a second biopsy. Several recommendations are proposed for improving accuracy of breast sampling such as securing the ho ok into the gland, orienting the limits of resection, sending specimen for X-ray study and inking the margins for the pathologist. This field experien ce revealed that some progress, are to be made in diagnosis in particular b y standardization of mammography and pathological criteria, more precise lo calization of the lesions with the hook and more refined surgical technique s for breast biopsy.