[Lesion localization and surgical resection for non-palpable breast cancer].
OBJECTIVE
To investigate the methods of lesion localization and surgical treatment for non-palpable breast cancer, presented with only small calcification lesion on the images.


METHODS
From November 2003 to August 2007, 61 patients with non-palpable lesion were finally pathologically diagnosed as early breast cancer (T1-2N0M0), based on the small calcification lesions shown by full field digital mammography (FFDM) through molybdenum target, and the rich blood supply shown by type-B ultrasonic examination. Accurate lesion-localization prior to surgical resection was conducted, and sample re-examination by FFDM was done after resection. Patients with single lesion underwent breast-conserving surgery, precise excision with the aid of image-guided wire localization, and stage I breast reconstruction was performed simultaneously using wide-based gland-tissue flap. Patients with multiple lesions received modified radical mastectomy.


RESULTS
Among the 50 patients treated with breast-conserving surgery, the accuracy of localization for lesions was 100% (50/50), and all lesions were excised completely with a negative margin proven by FFDM re-examination and pathological examination. The superior rate of mammaplasty was 86.0% (43/50) according to JCRT criteria, with a compliance difference of 1.5 cm. Modified radical mastectomy was performed in 11 patients. The follow-up period in this series was from 6 to 58 months with a mean follow-up time of 39 months. Distant metastases were detected in only one patient and local recurrence was not observed yet.


CONCLUSIONS
Lesion localization by FFDM in patients with non-palpable breast cancer is accurate and practical. In patients with single lesion, breast-conserving resection followed by synchronous stage I breast reconstruction with wide-based gland-tissue flap is appropriate.
Tang
Jin-hai
JH
Department of General Surgery, Jiangsu Cancer Hospital, Nanjin 210009, China.
Xu
Xiao-ming
XM
Zheng
Kai-er
KE
Qin
Jian-wei
JW
Zhao
Xiang-sheng
XS
Zhang
Tong
T
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008327:Mammography / Q000379:methods*; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D010173:Palpation