Clinically occult breast lesions: localization and significance

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Clinically occult breast lesions are often detected through screening mammography.
• The management of nonpalpable breast cancers presents unique diagnostic and therapeutic challenges.

Purpose of the Study:

• To evaluate the malignancy rate and characteristics of clinically occult breast lesions detected via needle-guided biopsy.
• To assess the incidence of axillary metastases and multicentricity in nonpalpable invasive breast cancers.

Main Methods:

• Retrospective analysis of 927 needle-guided breast biopsies performed between 1974 and 1985 for clinically occult lesions.
• Review of axillary dissection and mastectomy data for patients with confirmed invasive cancers.

Main Results:

• 29% of occult lesions biopsied were malignant, comparable to palpable lesions (20%).
• 30% of patients with nonpalpable invasive lesions had confirmed axillary metastases.
• 39% of patients undergoing mastectomy had multicentric cancer in the same breast.

Conclusions:

• Clinically occult invasive breast cancers are significant and necessitate prompt, appropriate treatment.
• Treatment planning for occult breast lesions must account for metastatic potential and multicentricity.
• A trend towards less invasive surgical approaches for early breast cancer is noted.