[Optimization of the indications for breast biopsy by preoperative conference]

In connection with a series of second reviews of mammographies as part of a preoperative conference, criteria are presented that allow a correct diagnosis, thus avoiding unnecessary breast surgery. In addition, it is shown that preoperatively all diagnostic findings must be reviewed as a whole, in order to make the appropriate decision for the patient. A total of 145 patients was admitted for breast surgery between 1994 and 1997. Group 1: The mammographies of 133 patients were re-evaluated and additional exams were performed. In only 17% (23 cases) could the first diagnosis be confirmed and the patients went to surgery. In 110 cases a single mammographic view sufficed to show that there was no suspicious finding in the breast. Instead there was a pseudolesion, not visible after an image had been taken with appropriate technique. Group 2: For 12 additional patients, a synopsis of different findings was presented and analysed at a preoperative conference. Even although imaging may have been performed correctly, a conference can still contribute to the optimization of indocations. Unnecessary breast surgery can can thus be avoided.