Management of quality saving procedures for treatment of suspected preoperatively marked and unmarked breast leasions - our one year experience

The breast cancer incidence is increasing for all industrial countries in t he last years. Therefore the relevance of screening methods especially of m ammography for early registration of suspected lesions becomes more and mor e important. One result of using screening methods is an increased rate of patients with lesions which are suspected for cancer but non palpable. For the background of that fact we are describing our one year experience with the therapy of cancer suspected breast lesions in 136 female patients. In 4 7 cases (34.6 %) there was a palpable and in 89 cases (65.4 %) a non-palpab le lesion. The need for mammography was assured in 43 patients (48.3 %) thr ough mastopathic controls, in 23 patients (25.8 %) within the frame work of a preventive first mammography and in 15 patients (16.8 %) through control s after operative therapy for breast cancer. All non-palpable lesions were marked preoperatively through mammography 88.8 % (n = 79), sonography 6.7 % (n = 6), or through magnet resonance imaging MRI 4.7 % (n = 4). Every mamm ographic marked case was followed by an intraoperative specimen mammography . In 16.8 % (n = 15 from 89) of the non-palpable marked areas, a carcinoma was found. 16.7 % (n = 3) of the detected cancers were diagnosed in an insi tu-stage, all others in an early stage (pT1-, pN0-, M0-stage) and treated. Besides the early diagnosis of breast cancer and the resulted improvement o f prognosis also the rate of breast saving therapies can be increased. Refl ecting our datas it should be demanded a regular screening for defined risk groups. In conclusion to improve the prognosis of breast cancer patients a nd reduce the risk of ablative therapies it is necessary to release a conse quent marking of non-palpable cancer suspected breast lesions, a consequent aseptic handling before operation, an intraoperative mammography of the re sected area and a frozen section.