Needle-guided breast biopsy for mammographic abnormalities in 561 patients.

Between 1977 and 1983, 561 consecutive patients underwent 595 surgical biopsies for suspicious mammographic lesions with negative clinical correlation. The procedure consisted of preoperative needle localization, with or without immediate radiologic examination of the biopsy specimen, depending on the presence or absence of microcalcifications in the mammographic lesion. Eighty-four carcinomas were found. Of these, 60 (71%) were infiltrating carcinoma and 24 (29%) were noninvasive carcinoma. The carcinoma yield was 24.2% in the patients with lesions involving foci of microcalcifications and 9% in those lesions without calcifications. Surgical treatment of infiltrating carcinoma consisted of 39 modified radical mastectomies, 10 (25.6%) of which were associated with positive nodes, 16 partial mastectomies with axillary dissection, 3 (18.7%) of which were associated with positive nodes, and 5 wedge resections. Treatment of noninvasive carcinoma consisted of 19 partial mastectomies with axillary dissection and 5 modified radical mastectomies. None of these were associated with positive nodes. Modified radical mastectomy was used with decreasing frequency. Of the 10 patients with infiltrating carcinoma and positive axillary nodes treated by modified radical mastectomy, 7 had one to three involved nodes and 3 had four or more; of those with positive nodes treated by partial mastectomy, 1 had one to three involved nodes and 2 had four or more. These results confirm the correlation between suspicious mammographic non-clinical lesions and breast carcinoma.