ABSTRACT
The authors reviewed 316 cases of breast carcinoma diagnosed from January 1, 1986, to December 31, 1989. Clinical data and mammograms were available for all patients. Of the 316 carcinomas, 272 (86.1%) were invasive; 37 (13.6%) of these represented pure invasive lobular carcinoma (ILC). Twenty-five (68.5%) of the 37 patients with ILC and 161 (70.3%) of the 229 patients with invasive ductal carcinoma (IDC) presented with clinically palpable masses. Asymmetric opacities and architectural distortion were the predominant mammographic signs in 21 (57%) of the cases of ILC but only 32 (13.6%) of the cases of IDC. Malignant calcifications were not present in any of the patients with ILC but were present in 110 (47%) of those with IDC. Of the ILC lesions, 29 (85%) [corrected] had the same opacity as that of normal fibroglandular tissue, and the mammographic findings were often subtle and seen initially on one view only. There was no substantial difference in the TNM stage at diagnosis between the two study groups.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging , Carcinoma/diagnostic imaging , Mammography , Adult , Aged , Breast Neoplasms/pathology , Carcinoma/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Humans , Male , Middle AgedABSTRACT
Our early experience and frustration with needle localization biopsy of nonpalpable lesions of the breast led us to develop a protocol to improve diagnostic accuracy and management of patients with mammograms read as suspicious for malignancy. In this context and as part of the program, surgical and radiologic consultation is required prior to the decision to proceed with biopsy. In this article, our experience with that protocol is summarized and mammographic description with pathological findings is correlated. In a series of 200 consecutive patients who underwent biopsies, we have achieved a positive rate of 37 per cent. Only 2 per cent of those lesions with round, oval or lobulated borders were malignant, while irregular or spiculated lesions were malignant in 69 per cent of instances. We conclude that careful adherence to this protocol and to radiologic principles of contour analysis can substantially increase the yield of needle localization biopsy.
