PERCUTANEOUS REMOVAL OF MALIGNANT MAMMOGRAPHIC LESIONS AT STEREOTAXICVACUUM-ASSISTED BIOPSY

PURPOSE: To determine whether complete percutaneous removal of a malig nant lesion detected at mammography ensures complete excision of the c arcinoma histopathologically. MATERIALS AND METHODS: A retrospective r eview was performed of 135 lesions in which stereotactic biopsy was pe rformed with a directional, vacuum biopsy instrument and an 11-gauge p robe followed by mammography. Carcinoma was diagnosed at stereotactic biopsy in 51 (38%) lesions. In 15 (29%) carcinomas, the lesion seen at mammography was removed at stereotactic biopsy. Surgical findings wer e available for correlation with biopsy and imaging findings in all 15 cases. Mammographic and histopathologic findings were reviewed. RESUL TS: Mammographic findings were calcifications in 11 lesions and a mass in four lesions. The median lesion size was 0.7 cm (range, 0.2-1.4 cm ), and the median number of biopsy specimens was 15 (range, 10-22 spec imens). Histopathologic findings at stereotactic biopsy were ductal ca rcinoma in situ in 12 lesions and infiltrating ductal carcinoma in thr ee. Surgery revealed residual carcinoma in 11 (73%) of 15 lesions, inc luding all three infiltrating ductal carcinomas and eight of 12 ductal carcinoma in situ lesions. CONCLUSION: Complete removal of the mammog raphic lesion does not ensure complete excision of the carcinoma.