Localization and significance of clinically occult breast lesions: experience with 469 needle-guided biopsies.

Experience with 469 clinically occult breast lesions is presented. The overall incidence of malignancy observed was 32%, just about one in three. The technique of needle-guided biopsy is described, insuring precise localization and excision of minute radiographic findings, yet without leaving a conspicuous scar to remind the patient of her experience. Although it is too early to speculate about a possible increase in survival of these "earliest" breast cancers, the observed decreased incidence of axillary node metastasis implies a lowered death rate from breast cancer in these patients. It is not unreasonable to extrapolate the extent of patient salvage from axillary node status. Many of these cancers were uncovered in the course of screening asymptomatic patients, and this further implies the efficacy of such screening programs in the early detection of breast cancer. The surprisingly high incidence of multicentricity in these tiny cancers must not be ignored when recommending adequate and appropriate therapy for these impalpable malignancies.