Breast biopsy avoidance: The value of normal mammograms and normal sonograms in the setting of a palpable lump

PURPOSE: To review the authors' experience with patients who presented with breast lumps and had normal mammograms and normal sonograms. MATERIALS AND METHODS: The findings from 600 lumps in 486 women with no foc al ultrasonographic (US) mass or mammographic finding in the area of clinic al concern were retrospectively studied. Evaluated parameters included the individual reporting the lump, qualitative descriptors for the physical fin ding, mammographic density, US characteristics in the area of concern, whet her there was a change in imaging and/or physical examination results, and whether there were diagnostic biopsy findings at follow-up. The study group included 540 lumps in 435 women who had a minimum mammographic and clinica l follow-up of 2 years, as well as 60 additional lumps in 51 patients who u nderwent biopsy. RESULTS: No patient in the nonbiopsy group developed carcinoma at the initi al site of concern during a mean mammographic and clinical follow-up period of 43 months, and all biopsy specimens were benign (negative predictive va lue, 100%). CONCLUSION: Results of this retrospective study suggest that breast biopsy may be avoided in women with palpable abnormalities when both US and mammog raphy depict normal tissue at the lump site.