Nine years' experience of needle localized breast biopsy in a university hospital: results and evaluation of the role of the surgeon in decision making.
BACKGROUND
Needle localized breast biopsy is an effective means of detecting breast cancer in its early stages. We analysed the indications for needle localized biopsies, evaluated the results, and determined the surgeon's role in the decision-making process.


METHODS
The needle localized open biopsy results of 350 patients were assessed.


RESULTS
Malignancy was encountered in 7 of 56 patients in whom the radiologist suggested follow-up due to mammographical images, although a surgeon performed a biopsy with the assessment of the patient's historical and clinical findings (12.5%). Biopsy failure rates were higher for office-based ambulatory patients (9.1%) than for those patients who underwent biopsies in an operating theatre (1.9%; P < .05). Patients undergoing operating theatre biopsies under local anaesthesia showed statistically significant failure rates compared with those under general anaesthesia (p = .04). The rate of malignancy of micro-calcification was highest in patients younger than 40 years of age (64.3%), while spicular lesions were commonly malignant in patients over 50 years of age.


CONCLUSIONS
From our experience, we suggest that needle localized biopsies should be performed in the operating theatre with the patient under general anaesthesia. Although both micro-calcifications and spicular lesions have a high rate of malignancy in all decades, micro-calcifications are more prevalent in younger patients while spicular lesions prevail in older patients. The final decision, to follow-up or biopsy, should be based on a patient's clinical and historical perspective and not only on the guidance of the mammography report.
Parlakgumus
A
A
Baskent University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey. aparlakgumus@yahoo.com
Karakoc
D
D
Ozenc
A
A
D000328:Adult; D000367:Age Factors; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D000772:Anesthesia, Local; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis; D002114:Calcinosis / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis; D003560:Cysts / Q000175:diagnosis; D003657:Decision Making; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis; D008875:Middle Aged; D010819:Physician's Role; D012189:Retrospective Studies; D017211:Treatment Failure