Breast biopsy technique: a plea for cosmesis

Breast cancer is the leading cause of cancer death among American women. Early detection and treatment greatly increase long-term survival rates, but many women delay seeking treatment of suspected lesions out of fear of mutilation. Unfortunately, this fear is compounded by the fact that although 60% to 80% of all biopsies prove benign, many women are left with unsightly scars from the biopsies themselves. The great majority of these avoidable scars result from the use of radial biopsy incisions, which are unnecessary in virtually all cases. Most lesions can be reached via periareolar incisions and even those few that require incisions away from the areola can be reached through incisions that follow Langer's lines circumferential to the breast. Even total subcutaneous mastectomy and reconstruction can often be done via periareolar incisions, with minimal scarring, less likelihood of keloid formation, no deformity, and less emotional trauma for the recovered patient.