Localisation and excision of occult breast lesions : the early experience of a district general hospital

Abstract EN

During 18 months period (April 1989-Septeniber 29 ,(90ول female patients, with mean age of 53 (range 34-80 years), were found to have occult (clinically impalpable) breast lesions, suspicious of malignancy on mammographie examination.

In four cases, the occult abnormalities have disappeared at the time of localisation.

The remaining 25 patients underwent localisation and excision of the occult lesions.

The histological diagnoses of the excised lesions were 20 (80%) benign and 5 (20%) malignant, giving a pre-dictive positive value (FFV) of 20%.

All the malignant lesions were invasive ductal carcinomas, three <١!:)؛١١ ٠٢١١ were inpatients under the age of 50 years.

Two of the five patients with malignant lesions (40%) developed axillary lymph node métastasés within و months of excision of the occult breast lesions.

We concluded that localisation and excision of impalpable breast lesions can he performed in district general hospitals with results comparable to those from larger, specialised centres.

The increasing use of mammography in management of breast disease and recent implementation of breast cancer screening programme, have resulted in an increase in detection of occult breast lesions that are otherwise clini-cally impalpable.

Detection of such lesions warrants ex-cision biopsy to exclude malignancy.

This requires x-ray localisation prior to excision which demands close col-laboration between surgeons, radiologists and pathologists and may pose problems to the surgeon especially in dis-trict general hospitals where resources are limited.

We report our early experience with localisation and excision of occult breast lesions and discuss the problems