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Mammographically detected breast cancer. Nonpalpable is not a synonym for inconsequential.
Cancer. 1994 Mar 15; 73(6):1660-5.C

Abstract

BACKGROUND

Needle-guided breast biopsy has become a regularly recommended procedure to excise nonpalpable, questionable breast lesions detected by mammography. Whether cancers detected in this manner have a more favorable outcome than those detected by clinical examination is not clearly documented.

METHODS

To address questions about the biology of mammographically detected cancer and likelihood of axillary node metastasis, as well as the accuracy of screening mammography, data from 3752 needle-guided breast biopsies and 1175 nonpalpable breast cancers were reviewed.

RESULTS

Between 1974 and 1992, 3752 needle-guided biopsies were performed in 3441 women for nonpalpable breast lesions. Benign disease was disclosed in 2575 (68.7%) biopsies and malignancy in 1175 (31.3%). Of 1130 malignancies, 61.8% were invasive carcinomas; 4.8% were microinvasive ductal carcinomas; 28.5% were ductal carcinomas in situ; and 4.8% were lobular carcinomas in situ. Axillary dissection in 558 patients with invasive carcinoma revealed that 27.1% had at least one positive axillary node. Of patients with invasive cancers presenting as nonpalpable calcifications alone, 27.5% had at least one positive axillary node.

CONCLUSIONS

More than one fourth of patients with nonpalpable, invasive cancer in this series had axillary node metastasis. Therefore, axillary dissection is an important treatment consideration for all patients with invasive carcinoma, despite technique of detection. Ductal carcinomas in situ detected as limited calcifications do not require axillary dissection. In this study, 31% of biopsies proved the presence of malignancy, an acceptable and appropriate benign-to-malignant ratio.

Authors+Show Affiliations

Department of Surgery, Jefferson Medical College, Philadelphia, PA 19107-4305.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8156493

Citation

Schwartz, G F., et al. "Mammographically Detected Breast Cancer. Nonpalpable Is Not a Synonym for Inconsequential." Cancer, vol. 73, no. 6, 1994, pp. 1660-5.
Schwartz GF, Carter DL, Conant EF, et al. Mammographically detected breast cancer. Nonpalpable is not a synonym for inconsequential. Cancer. 1994;73(6):1660-5.
Schwartz, G. F., Carter, D. L., Conant, E. F., Gannon, F. H., Finkel, G. C., & Feig, S. A. (1994). Mammographically detected breast cancer. Nonpalpable is not a synonym for inconsequential. Cancer, 73(6), 1660-5.
Schwartz GF, et al. Mammographically Detected Breast Cancer. Nonpalpable Is Not a Synonym for Inconsequential. Cancer. 1994 Mar 15;73(6):1660-5. PubMed PMID: 8156493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mammographically detected breast cancer. Nonpalpable is not a synonym for inconsequential. AU - Schwartz,G F, AU - Carter,D L, AU - Conant,E F, AU - Gannon,F H, AU - Finkel,G C, AU - Feig,S A, PY - 1994/3/15/pubmed PY - 1994/3/15/medline PY - 1994/3/15/entrez SP - 1660 EP - 5 JF - Cancer JO - Cancer VL - 73 IS - 6 N2 - BACKGROUND: Needle-guided breast biopsy has become a regularly recommended procedure to excise nonpalpable, questionable breast lesions detected by mammography. Whether cancers detected in this manner have a more favorable outcome than those detected by clinical examination is not clearly documented. METHODS: To address questions about the biology of mammographically detected cancer and likelihood of axillary node metastasis, as well as the accuracy of screening mammography, data from 3752 needle-guided breast biopsies and 1175 nonpalpable breast cancers were reviewed. RESULTS: Between 1974 and 1992, 3752 needle-guided biopsies were performed in 3441 women for nonpalpable breast lesions. Benign disease was disclosed in 2575 (68.7%) biopsies and malignancy in 1175 (31.3%). Of 1130 malignancies, 61.8% were invasive carcinomas; 4.8% were microinvasive ductal carcinomas; 28.5% were ductal carcinomas in situ; and 4.8% were lobular carcinomas in situ. Axillary dissection in 558 patients with invasive carcinoma revealed that 27.1% had at least one positive axillary node. Of patients with invasive cancers presenting as nonpalpable calcifications alone, 27.5% had at least one positive axillary node. CONCLUSIONS: More than one fourth of patients with nonpalpable, invasive cancer in this series had axillary node metastasis. Therefore, axillary dissection is an important treatment consideration for all patients with invasive carcinoma, despite technique of detection. Ductal carcinomas in situ detected as limited calcifications do not require axillary dissection. In this study, 31% of biopsies proved the presence of malignancy, an acceptable and appropriate benign-to-malignant ratio. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/8156493/Mammographically_detected_breast_cancer__Nonpalpable_is_not_a_synonym_for_inconsequential_ L2 - http://www.diseaseinfosearch.org/result/960 DB - PRIME DP - Unbound Medicine ER -