Volume 6 Supplement 1

Symposium Mammographicum 2004

Open Access

Screening-mammography-detected lesions undergoing benign surgical excision: review of mammography features and preoperative needle biopsy results

  • DD Manuel1,
  • S Bose1,
  • DR Evans1,
  • RK Wasan1,
  • G Ralleigh1 and
  • MJ Michell1
Breast Cancer Research20046(Suppl 1):P64

https://doi.org/10.1186/bcr883

Published: 14 July 2004

Introduction

The aim of assessment of screen-detected lesions is to achieve a definitive diagnosis and thereby avoid diagnostic surgery.

Aim

To analyse the needle biopsy results and mammography features of cases undergoing surgical excision for benign screen-detected lesions.

Methods

A total of 155,621 women were screened by SouthEast London Breast screening programme from April 1998 to March 2003; 8836 (5.7%) were assessed. The study group consisted of 182 lesions that were benign on final surgical histology (0.1% of women screened). Needle biopsy results and mammography features were recorded on a database.

Results

Final surgical histology of the lesion: fibrocystic change (26%), radial scar (24%), fibroadenoma (14%), papilloma (11%) and atypical ductal hyperplasia (7%) and miscellaneous other (15%). The mammography features of benign lesions excised were: well-defined mass (38%), microcalcifications (28%), stellate distortion (28%), asymmetry density (3%), and 4% other signs.

All 182 cases underwent biopsy, either ultrasound 14 G core biopsy or stereo 14 G core biopsy or 11 G vacuum biopsy. Core needle biopsy results: 13% (24/182) had inadequate, 27% (50/182) benign, 42% (76/182) suspicious, 18% (32/182) no biopsy performed; 21% (39/182) underwent cytology. Out of the 39 cytology aspirates performed: 41% (16/39) suspicious, 28% (11/39) benign, 31% (12/39) inadequate.

Discussion

The most common benign lesions requiring surgical excision are mass and microcalcifications due to fibrocystic change and distortion due to radial scar. Forty-two per cent (76/182) of core biopsy results showed atypia/ suspicious findings. More accurate nonoperative diagnosis obtained by excising large volume biopsy techniques such as vacuum biopsy should decrease the need for surgical excision in these cases.

Authors’ Affiliations

(1)
King's College Hospital NHS Trust

Copyright

© BioMed Central 2004

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