title: A needle-localised open-breast biopsy for nonpalpable breast lesions should not be performed for diagnosis.
abstract: BACKGROUND
  The achievement of tumour-free margins on excision of nonpalpable breast lesions that have aroused only an intermediate or low level of suspicion before surgery and do turn out to be malignant is a challenge for the surgeon. The purpose of this study was to determine factors that influence the probability of obtaining tumour-free margins after needle-localised excision of a nonpalpable breast carcinoma.
  
  
  METHODS
  During a 10-year period all needle-localised breast biopsies (NLBB) carried out in the Department of Surgery were retrospectively analysed. Possible influential factors considered included: age of the patient, year of NLBB, appearance of the lesion on imaging, preoperative diagnostic index, method of localisation, surgeon's level of experience, specimen size and radiology of the specimen, and all these were analysed in a multivariate logistic regression analysis.
  
  
  RESULTS
  In all, 400 needle-localised breast biopsies had been performed. Excision with tumour-free margins was more often achieved, and the final intervention less often took the form of a mastectomy, when the lesion was classified preoperatively as malignant (P = 0.02).
  
  
  CONCLUSIONS
  The outcome of treatment of a needle-localised breast cancer excision is better when the breast lesion is known to be malignant before surgery.
authors.affiliation: Department of Surgery and Radiology, University Hospital Maastricht, PO Box 5800, NL-6202 AZ Maastricht, The Netherlands. abos@shee.azm.nl
authors.forename: A M
authors.initials: AM
authors.lastname: Bosch
authors.forename: G L
authors.initials: GL
authors.lastname: Beets
authors.forename: A G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: J M A
authors.initials: JM
authors.lastname: Van Engelshoven
authors.forename: M F
authors.initials: MF
authors.lastname: Von Meyenfeldt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000473:pathology; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity