Five-year survival of 100 women with carcinoma of the breast diagnosed by screening mammography and needle-localization biopsy.

Carcinoma of the breast was studied in 100 women who underwent needle localization and open breast biopsy for lesions found by screening mammography from January 1980 to May 1987. The average age of the patients found to have carcinoma was 59.2 years, and 16 percent of patients were younger than 50 years of age. Pathologic examination revealed 62 patients with infiltrating ductal carcinoma, 31 patients with ductal carcinoma in situ, and seven patients with infiltrating lobular carcinoma. In 34 patients the carcinoma was microscopic. Thirty-six patients had carcinomas less than or equal to 1 centimeter, and 30 patients had carcinomas greater than 1 centimeter. Eighty-four patients were treated with total mastectomy and axillary dissection. Seven patients were treated with wide excision, axillary dissection and radiation therapy. Nine patients underwent lesser treatments. Among the 91 patients undergoing axillary dissection, 82 were node negative, eight had one to three positive nodes, and one had four or more positive nodes. One hundred percent of patients with ductal carcinoma in situ who underwent axillary dissections (24 of 31) were node negative. Only two patients received adjuvant hormonal therapy, and one woman received adjuvant chemotherapy. All patients were under observation for at least five years or to the time of death (mean follow-up period, 5.8 years). Of the 100 patients with complete follow-up, 92 are alive and disease free. Four patients with carcinoma that metastasized have died. Three patients are alive with known recurrence. One patient died of other causes six months after carcinoma was diagnosed. Widespread use of screening mammography coupled with judicious use of needle-localization biopsy will lead to the early diagnosis of carcinoma of the breast. Such early diagnosis of carcinoma does lead to an excellent (95 percent) five-year survival rate.