Wire localization of non-palpable breast lesions: out of date?

Autor: Ernst MF; Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands. m.f.ernst@12move.nl, Avenarius JK, Schuur KH, Roukema JA
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2002 Oct; Vol. 11 (5), pp. 408-13.
DOI: 10.1054/brst.2002.0444
Abstrakt: Aims: With the increasing use of screening mammography, more and more non-palpable lesions are found. As less invasive techniques like core needle biopsy are introduced, we evaluated our experience with the well-known standard procedure of surgical excision after wire localization.
Methods: We retrospectively evaluated the results of 479 wire localizations for non-palpable breast lesions between 1992 and 1999 in 465 patients. Feasibility and reliability of the procedure and the incidence of complications are reported.
Results: The mean age of these patients was 57 years (range 22-81 years). The mammographic finding with the highest rate of malignancy was density combined with architectural distortion (72%). The removal of the lesion was radiologically confirmed in 93%; if the lesion appeared to be not removed, after 3 months mammography was repeated, in 14 patients a second localization procedure was done and in 10 patients still a malignancy was found. In 79%, the excision after initial fine-wire localization was irradical. Twenty-five patients developed a haematoma and five patients had a wound infection. The overall malignancy rate was 50%. With a mean follow-up of 18 months in 11 patients with a diagnosis of benign disease after an adequate procedure, still a malignancy was found at the original excision site.
Conclusion: In selected cases, especially as a part of the therapeutic procedure in breast-conserving therapy, there will remain a place for wire localization and excision biopsy. However, we have to reconsider its place as a diagnostic procedure as the results of less invasive procedures are promising.
Databáze: MEDLINE
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