The early detection of nonpalpable breast carcinoma with needle localization. Experience with 500 patients in a community hospital.

During a 5-year interval, 500 women underwent 530 needle localizations (NL) for nonpalpable, mammographically suspicious breast lesions. These lesions were localized using the Homer Mammalok Breast Needle/Wire Localizer (Namic; Glens Falls, NY). Almost one half the NL (260/530) were performed for suspicious calcifications; 19 per cent (49/260) proved to be cancerous. Cancer (CA) was identified 90 times in 88 patients (17%); 64 per cent (58/90) were invasive and 36 per cent (32/90) were noninvasive carcinomas. Eighty per cent of the lesions were 1 cm or smaller. Eighty-four axillary dissections were done and only 7 patients (8%) had axillary metastasis. During the same time interval, 277 women underwent axillary dissection, with or without mastectomy, for palpable breast cancer. Ninety-one per cent (252/277) had invasive carcinomas and 38 per cent (104/277) had axillary metastasis. Estrogen receptor assays (ERA) and progesterone receptor assays (PRA) were similar for both patient populations. The authors conclude that NL is an effective, safe method of detecting highly curable, occult breast cancer. It can be done effectively at a community hospital with results very similar to large university studies.