The authors have reviewed 308 localisation biopsies performed on nonpalpable breast lesions between 1986 and 1990. The initiating mammogram, specimen radiograph, radiologists' reports and histology reports have been analysed with respect to the nature of the mammographic lesion, patient age, breast parenchymal pattern and histologic diagnosis. The overall malignant biopsy rate was 28%. Malignancy was found in 67% of biopsies for architectural distortion, 27% for calcification and 25% for a mass lesion. Masses if malignant proved to have an invasive component in the majority of cases (29/33). Calcification if malignant was more often in situ carcinoma (25/44). 29% of malignant biopsies were in women under the age of 50 and approximately half of these had an invasive component. The histologic nature of benign lesions is presented with identification of those with proliferative breast disease. The results are compared with those of other recently published series. Implications are discussed for the management of minimally suspicious lesions and for screening mammography.
INTRODUCITONBreast cancer is uncommon under the age of 30 and rare under age 25.Mammography is seldom helpful in the young patient but galactography can assist in diagnosis and surgical planning when a patient presents with an abnormal nipple discharge.A case of ductal carcinoma in situ (intraduct carcinoma) in a 24 year old woman is described. The radiological features are discussed and correlated with the histology of the surgical specimen. CASE REPORTA 24 year old woman with a five month history of intermittent uniductal discharge of brown and bloodstained secretion from the left nipple was referred for mammography. No mass lesion or abnormal density was detected in the affected breast but a magnification view of the subareolar area revealed a single group of microcalciThe radiologist recommended galactography for further evaluation of the region and following referral to a surgical clinic the patieat presented at our department for this examination.ficatims. (Figure 1). New ZealandFIGURE 1 -Spot magnification view done at the time of the original mammogram showing micmcalcifications in the region later shown (0 contain DCIS.The galactogram (Figure 2) showed a nondilated duct system. Within one of the major duct branches a 9mm mass lesion with an irregular surface was clearly outlined by the injected contrast medium. The lesion lay approximately 4cm deep to the nipple. The lining of the remainder of the visualised ducts was smooth and no other filling defects were shown. As far as could be determined the microcalcifications seen on the mammogram lay in the region of this intraductal mass.
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