The role of wire guided localization excisional biopsy in the diagnosis and managament of nonpalpable breast lesions


Thesis Type: Expertise In Medicine

Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey

Approval Date: 2013

Student: ORHAN ASLAN

Supervisor: ÖMER ŞAKRAK

Abstract:

Breast cancer is the most common malignant tumor among women worldwide, and accounts for 30% of all cancers in women. After widespread usage of screening mammography, detection rate of nonpalpable breast lesions has increased. Nowadays, excisional biopsy after wire guided localization is widely practiced for nonpalpable breast lesions, which are detected with mammography and/or ultrasonography. The aim of this retrospective study is primarily to calculate the prediction rate of wire localization method in non palpable breast lesions, Age, lesion size family history, radiomorphologic type, BIRADS category, to examine the diagnostic importance of the method, compared with the histopathological features. In addition, to determine the benefits of the technique in the management of breast cancer, by detection of reexicison rates and types according to insitu-invasive properties and surgical margins of malignant lesions. All lesions, 58 '(25.4%) were diagnosed malignant 170 (74.6%) were composed of benign pathologies. Method to predict the cancer rate was calculated as 25.4%. There is no significant relationship between age and malignancy. Rate of malignancy increases with increasing age (p = 0.006). Between malignant and benign lesions, size, location, statistically significant differences were found in terms of family history. In terms of type of the lesion was no significant difference between benign and malignant pathologies. The incidence of malignancy is higher than the set of microcalcification lesions (p = 0.005). With respect to BIRADS, BIRADS category 4b (OR: 6.06) and BIRADS 4c (OR: 6.77) group were significantly higher malignancy rate than other groups. Malignant cases with a positive surgical margin (28/58) as reexcision MRM ratios were significantly higher than those with negative surgical margins (p = 0.0001). All malignant lesions, 79.3% in stage 0 or 1 is composed of cancer. Wire localization excisional biopsy of nonpalpable breast cancer is an early detection and identification of suspicious lesions and is still an effective method. The better localization of nonpalpable suspicious lesions will lower rates of positive surgical margins and will help pathology, radiology and surgery departments to develop new techniques in the field of battle with breast cancer easier.