Site-select procedure for non-palpable breast lesions: feasibility study with a 15-mm cannula

As screening mammography becomes more commonplace, increasing numbers of non-palpable breast lesions are being found. The aim of this prospective study was to evaluate the feasibility, utility, and patient-perceived cosmesis and satisfaction of the Site-Select procedure in women with non-palpable breast lesions.

Thirty-two consecutive patients underwent the Site-Select procedure, performed under local anesthesia by the same surgeon. The Site-Select procedure was included in a protocol for small (<15 mm) breast imaging reporting and data system (BI-RADS) grade 3 and 4 breast lesions. The pathologic diagnosis, specimen size, length of the procedure, perioperative and postoperative complications, subsequent interventions, patient satisfaction, and esthetic results were documented.

The Site-Select procedure was successful in all 32 patients (mean age, 56 years; range, 44-79 years). Mammographic lesions corresponded to microcalcifications in 21 patients, microcalcifications with architectural distortion in 4 patients, microcalcifications with nodules in 2 patients, and architectural distortion alone in 5 patients. The Site-Select procedure was used on an outpatient basis. Carcinomas were diagnosed in five patients (15.6%). No complications occurred during the procedure. The only postoperative complication was a hematoma, which did not require surgical drainage. No missed cancers were detected by follow-up mammography (mean 8 months later; range, 1-18 months). The esthetic results and patient satisfaction were excellent.

This study demonstrates that the Site-Select procedure is an effective diagnostic method in selected cases. It has a low complication rate, high patient satisfaction, and excellent esthetic results.