Management of patients with nonpalpable breast lesions

Ever-increasing use of mammography brings with it a growing number of breast biopsies. The authors describe the five radiologic findings that mandate a surgical consultation. About 30% of their biopsies for nonpalpable breast lesions prove to be invasive or in situ carcinomas. When a mammogram is ambiguous, the authors recommend a repeat mammogram in 6 months. They use needle-localization, and feel that dye marking is superfluous. The films, duly marked by the radiologist, should accompany the patient to the OR. The biopsy is an outpatient procedure, and only local anesthesia, sometimes with IV sedation, is required. It is not necessary to remove the skin over the biopsy site, nor all of the tissue traversed by the needle localizer. The authors describe their surgical procedure for biopsy, state that x-ray of the specimen is mandatory, and that frozen sections are not desirable. Their procedure takes longer, but it's better, they say.