Nonpalpable, circumscribed, noncalcified solid breast masses: likelihood of malignancy based on lesion size and age of patient.
OBJECTIVE
To determine whether lesion size and patient age should prompt immediate biopsy of selected nonpalpable, circumscribed, noncalcified solid (probably benign) breast masses, which otherwise would be managed with periodic mammographic surveillance.


METHODS
Consecutive cases of probably benign breast masses were studied, for which mammographic surveillance was recommended prospectively. Patient age and lesion size were recorded, but age and size thresholds were not used as eligibility criteria. Clinical outcome, determined for each patient after 3 or 3 1/2 years of surveillance, was evaluated as a function of patient age and lesion size.


RESULTS
There were 1,403 study cases, among which 19 cancers were diagnosed (positive predictive value [PPV] = 1.4%). Only small differences were found in PPV for various patient-age and lesion-size subgroups. Even the subgroup with the highest PPV, which consisted of women aged 50 years and older, contained 60 benign masses for each cancer.


CONCLUSIONS
Nonpalpable, circumscribed, noncalcified (probably benign) breast masses should be managed with periodic mammographic surveillance regardless of lesion size and patient age.
Department of Radiology, University of California School of Medicine, San Francisco 94143-0628.
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Sickles
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D011446:Prospective Studies