Factors associated with one step surgery in case of non-palpable breast cancer

• Published in: European journal of radiology Vol. 64; no. 3; pp. 426 - 431
• Main Authors: Schaefer, Fritz K, Eden, I, Schaefer, P.J, Peter, D, Jonat, W, Heller, M, Schreer, I
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.12.2007; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy - methods; Breast cancer; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - surgery; Calcinosis - diagnostic imaging; Carcinoma in Situ - diagnostic imaging; Carcinoma in Situ - surgery; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - surgery; Female; Genital system. Mammary gland; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Lymph Node Excision; Mammary gland diseases; Mammography; Mammography - methods; Mastectomy; Mastectomy, Segmental; Medical sciences; Middle Aged; Palpation; Preoperative localization; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography, Interventional; Radiology; Reoperation; Retrospective Studies; Sentinel Lymph Node Biopsy; Stereotaxic Techniques; Tumors; Ultrasonography, Interventional; Ultrasonography, Mammary - methods; Ultrasound; Preoperative localization; Breast cancer; Mammography; Ultrasound; Sonography; Radiodiagnosis; Malignant tumor; Mammary gland diseases; Treatment; Surgery; Echography; Preoperative; Localization; Cancer
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2007.02.033

Abstract Purpose To examine factors associated with one step surgery in case of non-palpable breast cancer. Materials and methods Clinical data of 152 consecutively diagnosed patients with breast cancer were analyzed retrospectively. Preoperative diagnostic findings were divided in subgroups: mammographically visible mass/microcalcifications/sonographically visible mass/sonographically visible architectural distortion. Correlation between tumor-size, radiologic tumor morphology, quality of localization and number of operation was evulated. For localization exact wire position was defined less than 3 mm apart from the lesion. Results One hundred and thirty-six patients attempted breast conservation and underwent preoperative tumor localization. Fourteen of 16 patients had mastectomy without preoperative localization. Average tumor size was 12 mm for one-operation, and 17 mm for re-operation. Significant correlation ( p < 0.001) was found between one operation and masses visible in mammograms (55/62 (89%) patients) or sonography (53/64 (83%) patients). Significant correlation was found ( p < 0.001) between more re-operation and microcalcifications in mammograms (33/89 (37% patients). In 123/138 (89%) cases wire position was central, in 15/138 (11%) cases distance was maximally 10 mm. No significant correlation was found between number of operation and wire position. Re-operation was required in 38 cases. Conclusion Mammographically or sonographically visible mass, small size of tumors, preoperative percutaneous biopsy and exact preoperative localization are important for a single step procedure for definite surgical treatment, that we found in 74% of the patients.