Abstract
In the absence of any suspicious mammographic findings, lesions that appear benign with ultrasound yield benign pathology [1-5]. This retrospective study investigated the outcome of needle biopsy of ultrasonically benign appearing masses. The sample group included patients attending a symptomatic breast clinic at a busy London teaching hospital, from 2000 to 2003. Eight hundred and seventy-two cases fulfilled the following criteria: a solid mass graded U2, and an absence of any suspicious mammographic findings (M1/M2), if mammogram performed. A definitive pathological result had been obtained from fine needle aspiration cytology (FNA) or wide-bore needle biopsy (WBN). Cases also had a follow-up period of 18 months following FNA or WBN; 872 cases fulfilled this inclusion criteria. The results demonstrated 865 cases (99.2%) were true negatives and seven cases (0.8%) were false negatives. This revealed that there is a strong positive correlation with benign appearing breast masses seen with ultrasound and their respective pathological findings. The recommendations are to continue with further study to include all cases (not just benign). Also to develop a standardised reporting system, particularly for the training of junior staff members.
Highlights
Axillary lymph node dissection has been standard practice for staging invasive breast cancer
Best estimates for where to credit this dramatic drop in death rate place approximately 50% of the credit with improved adjuvant chemotherapy and 50% with mammography
Full field digital mammography (FFDM) had a higher detection rate for ductal carcinoma in situ (DCIS) but no difference was observed for invasive tumours
Summary
Axillary lymph node dissection has been standard practice for staging invasive breast cancer. Aim To assess the feasibility of surgeons performing breast US in symptomatic breast clinics either as an adjunct to triple assessment or on their own for diagnostic and therapeutic purposes. The performance of individual units is monitored to ensure all women have access to an excellent service Aim This project aims to demonstrate how the Liverpool Breast Unit addressed failure to meet the national quality standard for the benign. Method A retrospective review of the records of patients who had undergone benign biopsy (2001–2002) was conducted to establish reasons for surgical referral and suggest corrective measures to enable the unit to meet the standard in the future. Columnar cell change (CCC) is diagnosed on core biopsies performed for indeterminate microcalcification. Method Mammograms of 33 cases with established CCC on core biopsy were reviewed and the radiological features, follow-up imaging and surgical excision histology (if performed) were collated. The results were completed when all units were undergoing assimilation onto the new banding procedures
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