Abstract
Use of mammography for breast cancer screening has resulted in a significantly increased number of patients with nonpalpable radiological findings that need histopathological study for better management. The present study evaluated an alternative to excision of nonpalpable breast lesions, using injection of patent blue (CAS 3536-49-0) dye and air. Cohort study of 64 consecutive patients at a private clinic in the city of Teresina (Piauí), between January 2009 and December 2010. The patients had received mammographic diagnoses of nonpalpable breast lesions classified as BI-RADS 3, 4 and 5, with indication of histopathological study. They underwent stereotaxy and/or ultrasound-guided injection of patent blue, for marking and subsequent excision of the lesion. The patients' mean age was 47.7 years. Nodes accounted for 53.1% of the breast abnormalities; microcalcifications, 37.5%; and complex cysts, 9.4%. In 89.1% of cases, the lesions were BI-RADS 4; 7.8% were BI-RADS 5 and 3.1% were BI-RADS 3. The histopathological findings were benign in 70.3% of the cases; atypical hyperplasia, 9.4%; and malignant, 20.3%. Among the malignant cases, 53.8% were carcinoma in situ and 46.2%, invasive carcinoma. The percentage of malignancy was 0% in BI-RADS 3 lesions; 14.3% in BI-RADS 4 and 100% in BI-RADS 5. In the cases of malignancy, the margins were clear in 92.3%. Reoperation to widen the margins was required in one patient. Excision of nonpalpable breast lesions marked with patent blue and air was possible in all cases.
Highlights
The dissemination of breast cancer screening associated with better imaging techniques has resulted in increased incidence of nonpalpable breast lesions, as classified according to the Breast Imaging Reporting and Data System (BI-RADS), published by the American College of Radiology (ACR) and recommended by the Brazilian College of Radiology (CBR).[1]
Nodes accounted for 53.1% of the abnormalities, microcalcifications for 37.5% and complex cysts for 9.4% (Table 2)
We considered that the lesions classified as BI-RADS 4C or 5, in which biopsies did not reveal malignancy due to possible sampling error, were inconclusive
Summary
The dissemination of breast cancer screening associated with better imaging techniques has resulted in increased incidence of nonpalpable breast lesions, as classified according to the Breast Imaging Reporting and Data System (BI-RADS), published by the American College of Radiology (ACR) and recommended by the Brazilian College of Radiology (CBR).[1]The initial approach is to perform core biopsy or complete excision of the lesion by means of mammotomy. In a literature review conducted by the authors of the present study, only nine studies used dye for localization of nonpalpable breast lesions.[3,4,5,6,7,8,9,10,11] Among these studies, two used a dye in association with ROLL6,7 and one used a dye in association with a metal wire.[8] Of these nine, only two studies were Brazilian.[3,10] The aim of the present study was to evaluate the resection of nonpalpable breast lesions stained with patent blue dye and air
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
