title: Breast conservation surgery without pre-operative mammography--a definite feasibility.
abstract: Mammography is mandatory before breast conservation. Its limited availability in developing countries has discouraged surgeons in rural areas from practicing breast conservation. We analyzed the database of breast surgeries at our institute to investigate whether breast conservation could be safely performed if clinically feasible without the use of mammography. If mammography had not been performed in the 735 patients undergoing surgery, breast conservation could have been erroneously performed in 38 (5.17%) patients; 13 had impalpable mammographic multicentricity and 25 had extensive microcalcifications. A detailed analysis showed that this error in decision would have been detected and rectified in each of the above patients before commencement of radiotherapy. We conclude that although mammography cannot be totally excluded from the treatment algorithm for palpable breast cancer, conservative surgery can be offered in clinically suitable cases even if pre-operative mammography is not available due to limited resources in the developing world.
authors.affiliation: Department of Surgical Oncology, Tata Memorial Hospital, Ernest Borges Marg, Parel, Mumbai-400 012, India. drmandar@gmail.com
authors.forename: Mandar S
authors.initials: MS
authors.lastname: Nadkarni
authors.forename: Piyush B
authors.initials: PB
authors.lastname: Gupta
authors.forename: Vani V
authors.initials: VV
authors.lastname: Parmar
authors.forename: Rajendra A
authors.initials: RA
authors.lastname: Badwe
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003663:Decision Trees; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India / Q000453:epidemiology; D008327:Mammography / Q000706:statistics & numerical data*; D015412:Mastectomy, Segmental / Q000379:methods*; D008499:Medical Records; D008507:Medically Underserved Area; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019035:Rural Health Services