Triage for the breast biopsy.

A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a period of 114 months shows local anesthesia biopsy to be efficient and accurate. Five year survival for all mastectomy-treated patients whose cancers were diagnosed under local anesthesia is 72 per cent. Use of a triage method for selecting biopsy procedures has resulted in a thirteen-fold decrease in the number of patients subjected to general anesthesia.