Volume 13 Supplement 1
© Powell and Bayley. 2011
Published: 4 November 2011
It is accepted that a proportion of patients treated by breast-conservation surgery for unifocal malignancy will undergo further surgery for residual disease. Preoperative planning for impalpable lesions involves a radiological prediction of the extent of disease. The optimal outcome is disease clearance achieved by one operation only. We have revisited our cases which required a subsequent theatre visit in order to facilitate an understanding of the factors involved in accurate lesion sizing and thereby reduce re-excision rates.
All women screened through the Wrexham centre with a positive diagnosis of in situ or invasive disease going on to have operative treatment over a 1-year period have been included. The lesions were double-read by experienced film readers to obtain a maximal dimension on two-view mammography and ultrasound where applicable. Each case was attributed a grading, 1 to 3, for ease of measurement. This was compared with the postoperative histology, reported by a specialist breast histopathologist. The size, type, grade, receptor status and nodal status were recorded for each case.
A total of 61 cases were selected. The preoperative prediction of size was closest to the mammographic measurement in 74% of cases, and to the ultrasound dimension in 21%. The remainder showed equal measurements on both.
The mammogram provides a more accurate prediction of lesion size when compared with ultrasound images. It should be borne in mind that a certain proportion of women will choose mastectomy over conservation regardless of the available option of conservation.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.