Fine-wire localization for nonpalpable mammographic abnormalities.

OBJECTIVE

To determine the predictive value of fine-wire localization (FWL) biopsy.

DESIGN

A chart review.

SETTING

The Royal Columbian Hospital, New Westminster, BC.

PATIENTS

Two hundred and thirty-five women who underwent 239 biopsies for abnormal mammographic findings between Jan. 1, 1991, and Dec. 31, 1992. The average age was 58 years (range from 33 to 83 years).

INTERVENTION

FWL biopsy.

MAIN OUTCOME MEASURE

Positive findings of cancer on FWL biopsy.

RESULTS

Mammographic findings were as follows: a mass only in 98 cases (41.0%), microcalcification in 90 (37.7%), a spiculated mass in 20 (7.5%), an ill-defined density in 18 (8.4%) and a mass with microcalcification in 13 (5.4%). Malignant lesions were found in 97 (40.6%) of 239 biopsies. These included 55 infiltrating ductal carcinomas, 31 in-situ carcinomas, 7 infiltrating lobular carcinomas and 4 miscellaneous carcinomas. Spiculated masses were associated with malignancy in 18 (90%) of the 20 biopsies. Also, 41 (42%) of the 98 masses and 30 (33%) of the 90 microcalcifications were malignant. Only 4 (31%) of the 13 masses with associated microcalcification and 4 (22%) of the 18 ill-defined densities were malignant.

CONCLUSION

The 40.6% rate of positive findings supports the use of FWL biopsy as a valuable tool in the diagnosis of nonpalpable breast cancers.