Management of mammographic indeterminate lesions. First place winner of the Conrad Jobst Award in the Gold Medal paper competition.

The positive predictive value of mammography in non-palpable malignancy, only 20 to 25 per cent, could be improved with better mammographic criteria for lesions not requiring biopsy. The outcomes of 89 patients with indeterminate lesions were reviewed to determine whether these lesions could be managed safely by observation rather than biopsy. Indeterminate lesions were defined as 1) tightly clustered, nonlinear calcifications (>5 within 1 cm of tissue); 2) dominant, well-circumscribed soft-tissue masses (≤1 cm 2 ); or 3) asymmetric density. Lesions not immediately undergoing biopsy were followed with frequent-interval mammography. Twenty-two lesions (26%) underwent immediate biopsy, and 2 of these demonstrated carcinoma in situ with microinvasion