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One Operation After Percutaneous Diagnosis of Nonpalpable Breast Cancer

Frequency and Associated Factors

Laura Liberman1, Shelley L. Goodstine1, D. David Dershaw1, Elizabeth A. Morris1, Linda R. LaTrenta1, Andrea F. Abramson1 and Kimberly J. Van Zee2

1 Department of Radiology, Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.
2 Department of Surgery, Breast Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.



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  		Fig. 1A. —54-year-old asymptomatic woman who had one-stage breast conserving surgery after percutaneous diagnosis of nonpalpable breast cancer. Mediolateral oblique view mammogram of right breast shows irregular spiculated mass (arrow) measuring 1.0 cm with associated calcifications.

 


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  		Fig. 1B. —54-year-old asymptomatic woman who had one-stage breast conserving surgery after percutaneous diagnosis of nonpalpable breast cancer. Sonogram of right breast, upper outer quadrant, shows irregular hypoechoic solid mass corresponding to mammographic finding.

 


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  		Fig. 1C. —54-year-old asymptomatic woman who had one-stage breast conserving surgery after percutaneous diagnosis of nonpalpable breast cancer. Sonogram of right breast obtained during sonographically guided 14-gauge automated core biopsy shows needle (arrowheads) traversing mass (arrows). Histologic analysis showed infiltrating ductal carcinoma.

 


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  		Fig. 1D. —54-year-old asymptomatic woman who had one-stage breast conserving surgery after percutaneous diagnosis of nonpalpable breast cancer. Specimen radiograph obtained during one-stage lumpectomy and sentinel lymph node biopsy shows localizing wire and spiculated mass in specimen. Histologic analysis yielded infiltrating ductal carcinoma, 1.5 cm, and ductal carcinoma in situ with clear margins. Sentinel nodes were free of tumor.

 


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  		Fig. 2A. —79-year-old asymptomatic woman who had one-stage mastectomy after percutaneous diagnosis of nonpalpable breast cancer. Craniocaudal view mammogram of left breast shows two separate clusters of pleomorphic calcifications: in lower inner quadrant, cluster measuring up to 1.5 cm (larger arrow) and in upper outer quadrant, cluster measuring up to 0.5 cm (smaller arrow). (x1.5)

 


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  		Fig. 2B. —79-year-old asymptomatic woman who had one-stage mastectomy after percutaneous diagnosis of nonpalpable breast cancer. Craniocaudal view mammogram of left breast after stereotactic 11-gauge directional vacuum-assisted biopsy of both sites shows small hematoma adjacent to residual calcifications in left lower inner quadrant (larger arrow) and localizing clip without residual calcifications in upper outer quadrant (smaller arrow). Histologic analysis yielded ductal carcinoma in situ (DCIS) from both sites. Subsequent mastectomy and sentinel lymph node biopsy revealed multicentric DCIS with negative sentinel node.

 

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