Radiological and surgical management of nonpalpable breast leasions

In this retrospective study the results of surgical biopsy of suspected bre ast cancer in 319 outpatients are reported. In 113 cases (35.4%) the lesion was palpable, in 206 cases (64.6%) it was not. Concerning the nonpalpable lesions, mammography was performed in 98 patients (47.6%) for work-up of fi brocystic changes, in 41 patients (19.9%) for initial participation in a br east cancer prevention program,and in 33 patients (16.0%) for surveillance after breast conservation thera py. Prior to operation, 84.0% (n=173) of th e nonpalpable lesions were detected by mammography, 11.2% (n=23) by sonogra phy, and 4.8% (n=10) by magnet ic resonance imaging. Intra-operative specim en mammography was carried out in every case detected by mammography. In 19 .4% (n=40) of 206 nonpalpable lesions a malignant tumor was found. Twenty-f ive percent (n=10) of all marked tumors were diagnosed and treated as in-si tu stage tumors,while 65% (n=26) were diagnosed and treated as tumors in th e pT1 stage. As regards the nodal stage, 85% (n=34) of the tumors were diag nosed and treated as pNO tumors,and 100% (n=40) were found to be free from any distant metastases. Consequently, for improving prognosis and, at the s ame time, for reducing the rate of breast amputations as a means of curativ e therapy of breast cancer, regular screening in defined risk groups is nec essary. Surgical treatment of patients with small and nonpalpable findings should be reserved for departments with marking and quick-freezing faciliti es.