Nonpalpable XXXX : needle-localized biopsy for diagnosis and considerations for treatment.

@entity1 @entity0 @entity66 @entity5 @entity189 @entity3
Screening mammography as an adjunct to physical examination led to the discovery of 237 radiographically suspicious but nonpalpable breast lesions. Needle localization of the lesion preoperatively in the mammography suite followed by breast biopsy led to the diagnosis of 64 nonpalpable @entity189 , including 25 invasive, 16 minimally invasive, and 23 noninvasive @entity5 . Noninvasive and minimally invasive @entity5 were microscopic. Of the invasive lesions, 7 were 10 mm or less in diameter and 14 were 11 to 20 mm in diameter. Noninvasive and minimally invasive @entity5 tended to occur in younger @entity1 (average age 52 and 51 years, respectively), and almost uniformly appeared as clustered calcifications mammographically. @entity3 affected an older population (average age 65 years), and the mammographic appearance was that of a mass in the majority of cases. A variety of surgical procedures were carried out subsequent to biopsy to provide definite treatment of these nonpalpable @entity0 . A review of surgical specimens available from these procedures demonstrated a 27 percent incidence of @entity66 at the biopsy site. In @entity1 who underwent mastectomy, 34 percent had an unsuspected focus of @entity5 in another quadrant of the breast and an additional 14 percent had an unsuspected focus of epithelial atypia. No @entity1 with either noninvasive or minimally invasive @entity5 was found to have axillary lymph node @entity3 . Twenty-nine percent of @entity1 with invasive @entity5 demonstrated lymph node @entity3 in the axilla. Our results demonstrate the efficacy of preoperative needle localization to assist in the biopsy of nonpalpable breast lesions and the diagnosis of a significant number of early @entity0 . The treatment plan for @entity1 with these @entity5 must address the high incidence of @entity66 at the biopsy site, multicentricity, and the proved capacity for invasive lesions to metastasize to the axillary lymph nodes, regardless of the size of the @entity5 .
