The detection of local recurrence after definitive irradiation for early stage carcinoma of the breast an analysis of the results of breast biopsies performed in previously irradiated breasts

Abstract

One hundred forty-five breast biopsies were performed in 139 treated breasts to evaluate for potential recurrent carcinoma of the breast in women previously treated with definitive breast irradiation for early stage carcinoma of the breast. One hundred thirty-four patients had undergone one breast biopsy, four patients had undergone two breast biopsies, and one patient had undergone three breast biopsies. The median interval from completion of definitive irradiation to breast biopsy was 28 months (range, 2 to 117 months). Of the 145 breast biopsies, 52% (76 of 145) were positive, and 48% (69 of 145) were negative. The positive biopsy rate was related to the type of biopsy, the location of the biopsy, and the findings on physical examination and mammography. In patients with a negative physical examination but mammographic findings of a mass, microcalcifications, or both, the positive biopsy rate was 66% (25 of 38). For patients with a mass on physical examination but a negative mammogram, the positive biopsy rate was 28% (nine of 32). For patients with a mass on physical examination and a positive mammogram, the positive biopsy rate was 72% (13 of 18). For patients undergoing an incisional or Tru-Cut (Travenol Laboratories, Deerfield, IL) needle biopsy, the positive biopsy rates were 94% (15 of 16) and 75% (three of four), respectively, whereas the positive biopsy rate for an aspiration cytology was 25% (five of 20). Of the 76 positive biopsies, 64% (49 of 76) were from an in field or marginal location. The rate of detection of a subsequent local recurrence after an initial negative biopsy was 5% (three of 66). Of the evaluable patients, the complication rate was 9% (seven of 81). This study has documented the results of breast biopsies after definitive irradiation for early stage carcinoma of the breast.