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Breast conservation for mammographically occult carcinoma
M Morrow1, R A Schmidt, C Bucci
1Department of Surgery, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Annals of Surgery
|May 1, 1998
Summary
Mammographically occult tumors (MO) are not a contraindication for breast conserving therapy. Detailed clinical evaluation supports breast conserving surgery for MO tumors, even with modern mammography.
Area of Science:
- Oncology
- Radiology
- Breast Surgery
Background:
- Preoperative mammography is crucial for breast conserving therapy eligibility.
- Uncertainty exists regarding whether mammogram nonvisualization of carcinoma indicates mastectomy.
Purpose of the Study:
- To determine if failure to identify clinically evident carcinoma on mammography contraindicates breast conserving therapy.
Main Methods:
- Analysis of 268 women with 269 clinically evident carcinomas (June 1988-September 1993).
- Contraindications for breast preservation included multicentric tumors, diffuse microcalcifications, pregnancy, prior irradiation, inability to achieve negative margins, and large tumor-to-breast ratio.
Main Results:
- Mammographically occult tumors (MO) were found in 19% of patients.
- MO tumors were associated with younger age and more frequent special histologic types.
- Candidate rates for breast preservation were similar for MO (67%) and mammographically evident (ME) tumors (70%).
- Large tumor-to-breast ratio was the most common contraindication in both groups.
Conclusions:
- Mammographically occult tumors remain a challenge despite modern technology.
- No association found between MO tumors and factors precluding breast conserving therapy (size, histology, multicentricity).
- Results support breast conserving surgery for MO tumors following detailed clinical evaluation.