Needle localization and biopsy of nonpalpable lesions of the breast

Two hundred and three consecutive needle hookwire guided biopsies for nonpalpable lesions of the breast were performed upon 174 patients over a three year period. Patients ranged in age from 25 to 83 years (a mean of 55.4 years). Malignant growths of the breast were found in 44 of 203 specimens taken for biopsy. Sixty-six per cent of malignant lesions were in situ and 34 per cent were invasive carcinoma. The chance of a biopsy containing a malignant lesion was 17.5 per cent if the biopsy was done because of a discrete density on mammography, 22.1 per cent for microcalcifications and 29.6 per cent if both were present. The incidence of Stage I disease in 24 patients undergoing dissection of the axillary lymph node was 79.2 per cent. Specimen roentgenography was done in 165 biopsies. Anesthesia time was increased an average of 5.8 minutes by specimen roentgenography. In 198 instances, the mammographic lesion was present in the specimen taken for biopsy intended to remove it. Minor complications of needle hookwire insertion occurred in two patients. The mortality rate was nil.