[Neddle-guided biopsy in the diagnosis of non-palpable breast cancer]

To estimate the diagnostic accuracy of the spearfishing or neddle-guided biopsy to breast cancer and no palpable mammography and ultrasound findings suspicious for malignancy.

Observational, transversal, prolective, and descriptive study was made. A histopathological diagnosis were conducted from August 2004 to December 2011 in the Radiology and Image Departmen of Centro Médico La Raza to patients sent by the service of Surgical Oncology-with non-palpable breast findings identified by mammography and/or ultrasound with any suspicion of malignancy. Radiographic and ultrasonographic images of the specimen were obtained after the surgical procedure.

Harpoon 532 placements with histopathological report. Malignancies were 4.0% of the biopsies were performed in negative mammograms (ACR BI-RADS® 3) and 34.3% (p ≤ 0.05) of which were performed in positive mammography: 19.5% of mammograms ACR BI-4 and RADS® 89.7% (p < 0.0001) of mammograms ACR BI-RADS® 5. The negative mammography (ACR BI-RADS® 3) which resulted in cancer occurred in a patient with a personal history of breast cancer who had a solid nodule in one breast. In the evaluation of mammography studies and placing seven harpoons participated certified radiologists and additional qualification in breast imaging, and five radiology technicians trained in mammography.

The positive cases in the evaluation of mammography studies and placing seven harpoons participated certified radiologists and additional qualification in breast imaging, and five radiology technicians trained in mammography. (sum of the ACR BI-RADS® cases 4 and ACR BI-RADS® 5) and individual cases ACR BI-RADS® 4 had a PPV within recommended ranges ACR BI-RADS®; PPV ACR BI-RADS® may was lower than recommended by the literature, although most recommended by other series, which forces us to emphasize adherence to the semiotics suggested by ACR BI-RADS® and avoid unnecessary surgery. Patients with a personal history of breast cancer and finding a new ACR BI-RADS® 3 should have an individual assessment and consider biopsy before the short-term monitoring.