Mammographic wire-guided biopsies in non-palpable breast lesions

The use of mammography, both for diagnostic and screening purposes, is steadily increasing. It is a very sensitive examination method; findings such as an ill-defined or spiculated mass, clustered, irregular and dense microcalcifications, asymmetric densities or architectural distortion, are suggestive of malignancy. These findings are often not specific enough to make an unequivocal diagnosis of malignancy, and they are frequently not palpable. The presence of clinically occult, but mammographically present findings warrants biopsy to determine their histological nature. In order to avoid unnecessarily large biopsies and to assure the removal of the suspicious portion of the breast, precise localization in necessary, guided by mammography. Using a needle-hookwire method, 87 biopsies were done for non-palpable breast lesions detected among 3,196 mammographies performed. Experience with this method and the results show that 17 patients, i.e. every fifth biopsy, had a malignancy. In 5 patients out of 17, the findings proved to be in situ carcinoma. In another group of 17 women the biopsy result was atypical epithelial proliferation, considered to be a transitional phase of in situ carcinoma.