Management of nonpalpable, mammographically detectable breast lesions

A series of 151 women underwent 156 preoperative localizations of nonpalpab le, mammographically detected breast lesions. Indications for biopsy were ( 1) a cluster of more than five fine microcalcifications; (2) a solid lump f ound by ultrasound investigation; and (3) a radiologic abnormality of the b reast parenchyma. The lesions were localized preoperatively using the hook- wire method (Frank needle), and all biopsies were performed under general a nesthesia. Carcinoma was discovered in 34 (21.8%) cases; in 22 (61.7%) it w as a noninvasive cancer (9 with microinvasions) and in 12 (35.3%) an invasi ve carcinoma with a mean tumor diameter of 0.8 cm. The highest malignancy r ate was found among those with microcalcifications (21 of 81 cancers, or 25 .9%). Lymph node involvement was seen in 25% of patients with invasive carc inomas. In conclusion, the needle localization of nonpalpable breast lesion s is a simple, accurate method for early detection of small cancers with fa vorable prognosis.