A Retrospective Comparative Study of Image-Guided Excisional Biopsy in High-Risk Non-Palpable Breast Lesions: Predictive Factors for Malignancy

Abstract

Objective: The use of mammography (MM) in breast cancer screening programs has been increasing in recent years. Thus, increasing the number of detected nonpalpable breast cancer patients, through early diagnosis and treatment also increased survival rates. In our study, we wanted to share the factors about imagingguided exicional biopsies for non-palpable breast lesions in postoperative proven breast carcinoma patients. Materials and Methods:The surgical data were reviewed for 83 patients with non-palpabl high-risk breast lesions undergoing imaging-guided surgery in our department between January, 2006 and May, 2011. Histopathologic results and age, ultrasound(US) results, MM image results, BI-RADS categorization, localization of lesion(quadrant) were assessed and factors for predicting malignity were detected.Results: Median age was 52 (age range 32-80 years). 29 (34,9%) of patients were malign in histopathologic results. In four patient, re-excision performed because of positive surgical margins. Axillary examination results were normal in 24 (82,7%) of malignant patients. In MM examination; microcalcifications and nodular opasity were diagnosed in 74,6% of patients before surgery. There were no differance about malignity in these groups after surgery (p:0,428). 59% and 32,7% of patients were BI-RADS 4 and 3, respectively. Postoperative diagnosed malignancies in BI-RADS 4 group were significantly higher than BI-RADS 3 group (p:<0,001). Conclusion:In our study; we concluded that, preoperative BI-RADS categorization (US and MM) is correlated with histopathologic findings after surgery and imaging-guided breast surgery is effective for diagnosis of early-stage breast carcinoma.