Preoperative Evaluation of Abnormal Mammographic Findings to Avoid Unnecessary Breast Biopsies

Objective: To prospectively evaluate a program of additional mammographic views, interval follow-up, and stereotactic biopsy in the management of abnormalities detected on mammograms. Methods: From June 1988 to September 1991, 267 consecutive women who were referred for surgical consultation because of an abnormal mammographic finding were evaluated. Mammographic abnormalities were assessed as benign or as requiring interval follow-up, stereotactic biopsy, open surgical biopsy, or additional views. Women having additional mammographic views were reassigned to the preceding groups. The mean follow-up for women who did not have a biopsy was 37 months. Results: Only 129 (48%) of the women who were sent for surgical consultation underwent open biopsy, and 46 (36%) of the biopsy specimens revealed carcinoma. Forty-one (89%) of the cancers were ductal carcinoma in situ or stage I lesions. Of the 117 women who were assigned to follow-up, six (5%) subsequently required biopsy and two cancers were identified. Conclusion: Rigorous mammographic evaluation and the use of stereotactic biopsy for selected lesions can prevent breast biopsy for low-suspicion mammographic abnormalities while still allowing the detection of early-stage breast cancer. (Arch Surg. 1994;129:1091-1096)