Two-view specimen radiography in surgical biopsy of nonpalpable breast masses

Nonpalpable, low-density, noncalcified lesions sometimes can be difficult to see on an initial specimen radiograph. In 57 consecutive wire localizations, 37 patients had obvious microcalcifications and did not require a second specimen radiograph. Twenty-six patients had nonpalpable, noncalcified lesions, and a second specimen radiograph was obtained in 24 of these. In four of these cases the initial specimen radiograph failed to show the suspected lesion, and a second specimen radiograph orthogonal to the original plane of orientation of the specimen showed the lesion to be contained within the biopsied material. Although it is seldom necessary to use this technique, it may obviate a second biopsy specimen as well as reduce operative time. We found that a second orthogonal specimen radiograph provided important information in 7% of cases.