Management of nonpalpable, mammographically detectable breast lesions

A series of 151 women underwent 156 preoperative localizations of nonpalpable, mammographically detected breast lesions. Indications for biopsy were (1) a cluster of more than five fine microcalcifications; (2) a solid lump found by ultrasound investigation; and (3) a radiologic abnormality of the breast parenchyma. The lesions were localized preoperatively using the hook-wire method (Frank needle), and all biopsies were performed under general anesthesia. Carcinoma was discovered in 34 (21.8%) cases; in 22 (64.7%) it was a noninvasive cancer (9 with microinvasions) and in 12 (35.3%) an invasive carcinoma with a mean tumor diameter of 0.8 cm. The highest malignancy rate was found among those with microcalcifications (21 of 81 cancers, or 25.9%). Lymph node involvement was seen in 25% of patients with invasive carcinomas. In conclusion, the needle localization of nonpalpable breast lesions is a simple, accurate method for early detection of small cancers with favorable prognosis.