Data favoring biopsy of the breast under local anesthesia

Experience with 184 consecutive biopsies of the breast for 147 benign lesions and 37 carcinomas over an 18 month period has been reviewed. Local anesthesia was used in 78 per cent of the patients, and it was the method of choice whenever the preoperative diagnosis was benign. General anesthesia was used when the lesion was thought likely to be malignant. Anesthesia within these guidelines was used in 88 per cent of patients with correct preoperative diagnoses. Exceptions were made primarily, but not exclusively, because of patient preference. The preoperative diagnoses were correct in 168 patients, unstated in five, and incorrect in 11. Six women erroneously were thought to have carcinoma, and five others unexpectedly had malignant disease. Although biopsy remains mandatory, the preoperative diagnosis of carcinoma of the breast can currently be made with sufficient accuracy to justify restricting recommendation for general anesthesia to those patients thought likely to have carcinoma of the breast.