Surgical management of breast disease in an obstetrics and gynecology group

Article Abstract:

Breast cancer is the most common type of cancer among women in Europe and North America and the second leading cause of death from cancer among women in the US. Since early diagnosis can improve survival, the primary care obstetrician-gynecologist (OB-GYN) is in a unique position to direct women towards appropriate care and treatment of breast disease. A group of OB-GYN physicians, surgically treating breast disease, have reported on 312 biopsies taken from 212 patients from 1978 to 1988. Breast cancer can be detected by feeling the lump (palpation) or by breast X-ray (mammogram). Fifty-nine (19 percent) cancers were detected by breast biopsy. There were no complications reported in any surgical case. Almost all masses removed during the initial biopsy were considered successful (99 percent). Since chemotherapy protocols have changed over the course of the 10-year study period, survivals cannot be compared. Most cancer reoccurrences appeared within five years of initial diagnosis. Forty-one percent of the patients with palpable lumps also had positive lymph nodes compared with 17 percent of the patients diagnosed by mammogram with lymph node involvement. It is concluded that the primary care OB-GYN can best serve women by aggressively diagnosing and treating women with breast disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Surgery, Breast surgery, Gynecologic examination

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Mammographic abnormalities and the detection of carcinoma of the breast

Article Abstract:

Patients whose mammograms reveal an abnormal mass with or without calcification or an abnormal calcification without a mass should be referred for a biopsy. It may be possible to delay biopsies in the cases of patients whose mammograms reveal an asymmetric density. Mammograms are used to screen for the early stages of breast cancer. The records of 169 women who had mammography from 1989 to 1991 were reviewed. Subsequent biopsies detected cancer in 22% of the women with abnormal calcifications, 21% of the women with masses with abnormal calcification and 11% of the women with an abnormal mass. Only 2% of the women with asymmetric densities were diagnosed with cancer. Doctors should evaluate each patient's mammogram on an individual basis, especially in cases where an asymmetric density is present.

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Open surgical biopsy for nonpalpable mammographic abnormalities: still an option compared with core needle biopsy

Article Abstract:

A traditional open biopsy of the breast in women with nonpalpable abnormalities on a mammogram may have advantages over needle biopsy. Needle biopsy has been promoted as less invasive and cheaper, but a review of 461 open biopsies illustrates that this may not be the case. Inserting large needles into the breast could be quite painful and women who have a needle biopsy may require additional mammograms, an open biopsy and a lumpectomy. This could increase the ultimate cost of needle biopsy so that it would be no more cost-effective than open biopsy.

Biopsy, Breast biopsy

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