Abstract
Focus on early diagnosis of non-palpable breast cancers has frequently led to expensive interventions that are more challenging in low-resource environments. We examined the use of a simple, inexpensive technique more suited for these environments, presenting preliminary data on its applicability. In 10 consecutive patients with radiologically suspicious non-palpable breast lesions, we used skin markers and breast reference points generated through ultrasound images and clinical orientation to guide location of surgical incisions for excising these lesions in the operating room. This resulted in accurate localisation and complete excision of these lesions without the need for more sophisticated, expensive interventions, making this technique potentially more applicable in low-resource environments, such as ours.
Highlights
Breast cancer is among the leading causes of cancer related deaths in women internationally and especially in the Caribbean.[1, 2]
In all 10 patients the previously noted lesion was no longer present on the follow-up ultrasound or mammogram in the one patient with microcalcification. Our aim in this project was to test the feasibility of resecting non-palpable breast lesions using skin markers and ultrasound with precise radiologic reporting as a guide for the surgical procedure, location of the incisions
BIRADS is a system of classifying the radiologic abnormality to guide treatment based on the degree of suspicion of malignancy with a grading of BIRADS 0 to 6
Summary
Breast cancer is among the leading causes of cancer related deaths in women internationally and especially in the Caribbean.[1, 2] The major determinant of outcome is early diagnosis 3 with the emphasis on screening strategies and increased awareness This approach has resulted in the desired earlier diagnosis but the identification of ‘occult’ smaller frequently non-palpable lesions that are more challenging to identify, biopsy and treat definitively. The non-palpable lesion is usually identified on a previous ultrasound or mammographic study and, if it is considered suspicious enough to warrant excision, the patient is invited to participate in the study. In all 10 patients the previously noted lesion was no longer present on the follow-up ultrasound or mammogram in the one patient with microcalcification
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