title: Selective nonoperative management of solid breast masses.
abstract: A prospective study evaluated the hypothesis that, following consistent clinical and mammographic guidelines, many women with breast masses can be nonoperatively managed. One hundred eighty women with solid breast masses were assigned both a clinical and mammographic diagnosis by each a surgeon and radiologist. Immediate biopsy (n = 78) was recommended when either clinician thought that the mass was malignant (52 cancers). The remainder were offered a trial of observation, with interval biopsy performed upon patient preference or for increased clinical/mammographic concern. Of the 89 who consented to this, 70 received long-term follow-up (X = 22 months) with improvement in the characteristics of the mass. The diagnosis of invasive cancer was delayed in two women initially observed, with no apparent impact on survival. It is concluded that many women with solid breast masses can be safely observed. Biopsy remains warranted for any mass suspicious for malignancy on clinical/mammographic grounds, or if follow-up cannot be assured.
authors.affiliation: Department of Surgery, University of South Alabama, Mobile 36688.
authors.forename: D L
authors.initials: DL
authors.lastname: Dyess
authors.forename: C O
authors.initials: CO
authors.lastname: Lorino
authors.forename: A
authors.initials: A
authors.lastname: Grieco
authors.forename: J J
authors.initials: JJ
authors.lastname: Ferrara
mesh_terms: D001706:Biopsy; D001941:Breast Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D016504:Breast Self-Examination; D002985:Clinical Protocols; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors