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Open breast biopsy. A critical analysis.

J H Shroff1, L R Lloyd, D M Schroder

  • 1Department of Surgery, St. John Hospital and Medical Center, Detroit, Michigan 48236.

The American Surgeon
|August 1, 1991
PubMed
Summary

Biopsying nonpalpable breast lesions detected by mammography leads to earlier cancer detection. Older age, mammogram findings, and palpable lesions are key predictors of malignancy.

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Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Assessing breast cancer malignancy rates is crucial for early detection and improved patient outcomes.
  • Understanding factors influencing malignancy risk aids in diagnostic strategies.

Purpose of the Study:

  • To compare the malignancy rate of open breast biopsies with literature data.
  • To evaluate the impact of biopsying nonpalpable mammographically detected lesions on cancer staging.
  • To identify predictors of malignancy in breast lesions.

Main Methods:

  • Retrospective review of 518 open breast biopsies performed between January 1, 1988, and December 31, 1988.
  • Analysis of patient demographics, lesion characteristics (palpable vs. nonpalpable, mammographic findings), and malignancy rates.
  • Comparison of cancer staging for palpable and nonpalpable lesions.

Main Results:

  • Overall malignancy rate was 23.6% (122/518).
  • Nonpalpable lesions had a 17.5% malignancy rate, with a higher proportion of early-stage cancers (28% tumor in situ, 60% stage 1).
  • Palpable lesions showed a higher malignancy rate (29.0%) and included more advanced stages.
  • Malignancy rates were significantly higher in patients over 40 (28.6% vs. 6.7%) and for lesions visible on mammography (25.3% vs. 14.2%).

Conclusions:

  • Biopsy of nonpalpable mammographically detected lesions facilitates earlier breast cancer diagnosis.
  • Age over 40, mammographic evidence of a lesion, and palpable lesions are significant predictors of malignancy.
  • No single factor definitively ruled out malignancy, underscoring the importance of biopsy.

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