Postexcision mammography is indicated after resection of ductal carcinoma-in-situ of the breast

Background: The adequacy of excision of ductal carcinoma-in-situ (DCIS) usu ally is confirmed with specimen mammography and histopathological assessmen t of specimen margins. Postexcision mammography of the involved breast is u sed at some centers. The objective of this study was to evaluate the impact of postexcision mammography in DCIS. Methods: We conducted a retrospective chart review of all patients treated for DCIS at our institution from 1995 to 1998. Results: Sixty-seven patients had postexcision mammography performed. Resid ual microcalcifications were identified in 16 patients (24%). Further surge ry was precluded by precise mammographic-pathological correlation by using sliced-specimen mammography in two patients. Twelve patients had repeat wid e excision, and two patients underwent mastectomy. Residual DCIS was identi fied at re-excision in 9 of 14 patients (64%). The margin status of the ini tial resection was negative in three of nine patients (33%) and positive or unknown in six of nine patients (67%). Conclusions: Postexcision mammography is a valuable technique that compleme nts specimen mammography and histopathological margin assessment in confirm ing that an adequate excision of DCIS has been performed. Postexcision mamm ography should be performed in all patients with DCIS associated with mammo graphic calcifications who are treated with breast-conserving therapy.