Radiology, Vol 170, 427-433, Copyright © 1989 by Radiological Society of North America

ARTICLES

Nonpalpable breast tumors: diagnosis with stereotaxic localization and fine-needle aspiration

K Dowlatshahi, HJ Gent, R Schmidt, PM Jokich, M Bibbo and E Sprenger
Department of General Surgery, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612.

Modern mammography is the most effective means of detecting nonpalpable breast cancers, but correct diagnosis for malignancy is made in only 20%-30% of the cases. The conventional method of lesion localization usually results in approximate placement of the hookwire in the breast. The authors report the results of stereotaxic localization, combined with fine-needle aspiration and cytologic study, performed in 528 cases. Clinically occult breast lesions were localized precisely (within 2 mm 96% of the time), sampled by means of a 23-gauge needle, and marked with either methylene blue or a hookwire for subsequent open excisional biopsy. The results indicate a sensitivity of 95%, specificity of 91%, and accuracy of 92% for the fine-needle aspiration procedure. This technique offers a significantly improved preoperative method of diagnosing small breast lesions with minimal pain, no complications, reduced cost, and no disfigurement or scar interfering with subsequent mammographic follow-up.

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