[The surgical treatment of nonpalpable breast lesions]

Non-palpable breast lesions may be defined as suspected lesions for "occult" tumours and diagnosed during the course of screening or, occasionally, in asymptomatic women. Mammography is the main diagnostic instrument owing to its high sensitivity and specificity, although an increasingly important complementary role is played by ultrasound scan. The comparison of findings obtained provides elements for further evaluation. Moreover, mammography can be used to make a dynamic study of the breast over time in order to evaluate doubtful lesions that might change, especially in women of a child-bearing age and during the various phases of the menstrual cycle. The use of the metal repere allows the lesion to be identified and surgically removed. A total of 135 operations for breast pathologies were examined from 1 January 1994 to 30 April 1996, subdivided into 26 operations for benign pathologies and 109 for malignant pathologies. Of the latter 52 (47.7%) were modified radical mastectomies, 50 (45.9%) were quadrantectomies with axillary lymphadenectomy, 1 (0.9%) quadrantectomy, and 5 (5.5%) simple mastectomies. A total of 16 needle biopsies were performed of which 8 were benign and 8 malignant. The latter were treated using 2 modified radical mastectomies owing to the presence of an extensive intraductal component, 5 quadrantectomies with lymphadenectomy, and 1 simple quadrantectomy for a lobular carcinoma in situ. Kopans needle was also used as a repere and the stiffening cannula was used for an accurate, effective but economical exeresis. One of the 8 benign cases was complicated by an hematoma (12.5%). Neither the mammary gland nor the subcutis were sutured to avoid unsightly scars and uncertain images at later mammographic controls.