[Experience with more than 200 cases of breast biopsy after preoperative spatial localization without...

The use of mammography as a screening examination has considerably increased our ability to detect non-palpable breast lesions less than 1 cm phi. A conclusive diagnosis frequently requires surgical biopsy. However, breast lesions can be localized prior to surgical biopsy by placing a wire in the lesion, with/without the use of stereotaxic equipment. Our method for lesion localization consisted in acquiring two orthogonal radiographs (cranio-caudal and latero-lateral) centered on the nipple. We used 20-21 G needles, 6-10 cm long, with curved-end wire. Mammographic findings possibly suggesting cancer were: microcalcifications, nodules, spiculated opacities, and architectural distortions. From January 1987 to January 1990, 223 patients were submitted to needle localization of breast lesions under mammographic guidance and without stereotaxic equipment. Sixty-seven cases (30%) were positive for malignancy, with a 2.3:1 benign/malignant ratio. Patients' age ranged 30-70 years, but most of them were 50-60 years old. No significant complications were observed: in one case only the hook wire broke, within breast parenchyma, which was at any rate resected together with the surgical specimen.