An assessment of the value of Stereotactic Mammotomy Biopsy (SMB) in the diagnosis of impalpable breast lesions

Abstract

Background

Breast cancer is the most common malignancy for women in Poland and represents 19.7% of all neoplasms diagnosed in this group. It is also the most frequent cause of cancer related deaths among women (14.1% of total).

An improvement in these results has been achieved by the popularisation of prophylactic mammography. An increase in awareness among women, of the dangers of breast cancer, and an increase in the availability of mammography testing has resulted in impalpable breast lesions being diagnosed increasingly frequently. These diagnoses require histopathological verification.

Aim

To demonstrate the usefulness of stereotactic mammotomy biopsy (SMB)in the diagnosis of impalpable breast lesions, and its effects on the processes of diagnosis, classification and treatment of pre-invasive growths within the breast.

Materials/Methods

Stereotactic mammotomy biopsy is a minimally invasive method for the collection of tissue from impalpable changes in the breast which are visible in mammography images and require histopathological diagnosis. The procedure may be carried out on an ambulant patients, under a local anaesthetic.

Between April, 2000, and August, 2003, the First Surgical Department carried out 2000 SMB procedures. Changes suitable for biopsy fall into three groups: clusters and areas of microcalcification – 929 (46.45%), small tumours and soft tissue density – 975 (48.75%), radial structures – 96 (4.80%).

Results

365 patients (18.25%)required surgery for the purpose of obtaining a histopathological diagnosis, including 150 (7.50%)with invasive cancer, 120 (6.00%)with preinvasive cancer – DCIS and 95 (4.75%)with atypical ductal hyperplasia – ADH.

Among the remaining 1635 patients (81.75%)changes were found to be benign and the patients avoided surgery.

Conclusions

It is demonstrated that stereotactic mammotomy biopsy is the method of choice for the diagnosis of mammographically detected, inpalpable lesions of the breast, and furthermore, contributes to the process of diagnosis, classification and treatment of pre-invasive growths in the breast.