title: Diagnostic strategies in non-palpable breast lesions.
abstract: The number of non-palpable breast lesions is growing. Needle-localised breast biopsy (NLBB) is the gold standard for evaluating these lesions. Cost-saving techniques and less invasive alternatives such as core-needle biopsy (LCNB) and fine-needle aspiration (FNA) have emerged. The aim of this study was to find out if the lesions of patients who were sent directly for surgery to undergo a NLBB differed from lesions of patients who were send for a non-operative procedure. Furthermore, if a benign result was obtained, we assessed the total and kind of subsequent diagnostic procedures that were undertaken. A retrospective study on 718 women with 749 non-palpable breast lesions was performed. In 58% of women with non-palpable breast lesion, a non-surgical procedure was chosen. Lesions sent directly for surgery were more frequently not visible on ultrasound (62%) and mainly consisted of microcalcifications only (56%). In 45%, this primary surgical approach could have been avoided. If the non-operative procedure showed a non-malignant result, 41% of these women received an additional surgical diagnostic procedure. These figures obtained from routine daily practice show the importance of protocols in order to standardise diagnostic procedures and prevent unnecessary surgery.
authors.affiliation: Department of Radiology, Martini Hospital, Locatie van Swieten, PO Box 30033, 9700 RM, Groningen, The Netherlands. r.pijnappel@mzh.nl
authors.forename: R M
authors.initials: RM
authors.lastname: Pijnappel
authors.forename: P H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: M
authors.initials: M
authors.lastname: van den Donk
authors.forename: R
authors.initials: R
authors.lastname: Holland
authors.forename: J H C L
authors.initials: JH
authors.lastname: Hendriks
authors.forename: E E
authors.initials: EE
authors.lastname: Deurloo
authors.forename: W P Th M
authors.initials: WP
authors.lastname: Mali
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014463:Ultrasonography