This paper is only available as a PDF. To read, Please Download here.
Background. One of the more frustrating complications after breast biopsy with needle localization is a missed lesion. To reduce the number of missed lesions, radiographs of the surgical specimen are usually obtained. In this study we determined the accuracy of specimen x-ray, the incidence of missed lesions, and the management of patients with this complication.
Methods. The result of specimen x-ray was compared with that of a postoperative mammogram in 192 patients who underwent breast biopsy with needle localization. The incidence of missed lesions was also determined from postoperative mammogram, and the management of patients with this complication was analyzed.
Results. The incidence of false-positive specimen x-ray was 7.8% and that of false-negative 55%. The sensitivity, specificity, and accuracy of specimen x-ray were 96%, 28%, and 89%, respectively. The incidence of missed lesions was 3.2% and of incompletely excised lesions 6.4%. Eighteen of 24 patients with a missed or incompletely excised lesion were treated expectantly because postoperative mammogram showed the lesion to be stable. None of these patients has required a subsequent biopsy.
Conclusions. Specimen x-ray can be false positive or false negative. An important implication of this finding is that a postoperative mammography should always be performed after biopsy with needle localization, regardless of the result of the specimen x-ray, to make certain the lesion has not been missed.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Specimen xeroradiography after needle localization and biopsy of non-calcified, non-palpable breast lesions.Am Surg. 1985; 51: 50-57
- Non-palpable breast lesions. Wire localization and excisional biopsy.Am Surg. 1986; 52: 117-122
- X-ray calcifications as the only basis for breast biopsy.Ann Surg. 1983; 197: 555-559
- Accuracy and cost of needle localization breast biopsy.Arch Surg. 1988; 123: 947-950
- An alternative approach to non-palpable breast biopsies.J Surg Oncol. 1990; 44: 93-96
- Breast biopsy with needle localization: influence of age and mammographic features on the rate of malignancy in 350 nonpalpable breast lesions.Surgery. 1991; 110: 623-628
- Non-palpable breast lesions: recommendations for biopsy based on suspicion for carcinoma at mammography.Radiology. 1988; 167: 353-358
- Needle-localized mammographic lesions. Results and evolving treatment strategy.Arch Surg. 1990; 125: 1441-1444
- Selective nonoperative management of patients referred with abnormal mammograms.Am J Surg. 1990; 160: 659-663
- Localization and excision of occult breast lesions.Br J Surg. 1983; 70: 607-617
- Mammographic identification and biopsy of occult breast cancer.Ann Coll Surg. 1986; 68: 188-190
- Localization and excision of non-palpable breast lesions.Arch Surg. 1987; 122: 802-806
- Role of needle localization of non-palpable breast lesions.Am J Surg. 1987; 154: 593-596
- Non-palpable breast lesions detected by mammography and confirmed by specimen radiography: recent experience.Breast Dis. 1977; 3: 13-16
- Outcome of Surgery for non-palpable mammographic abnormalities.Br J Surg. 1990; 77: 673-676
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
© 1993 Published by Elsevier Inc.