MAMMOGRAPHIC AND HISTOPATHOLOGIC CORRELATION OF NONPALPABLE LESIONS OF THE BREAST AND THE RELIABILITY OF FROZEN SECTION DIAGNOSIS

  • 1 December 1987
    • journal article
    • research article
    • Vol. 165  (6) , 523-529
Abstract
During a period of ten years, 118 (32.9 percent) instances of carcinoma were found in 359 specimens taken at biopsy for nonpalpable mammographic lesions. In recent years, the positive predictive value has increased from 68 percent due to the development of magnification mammography and the use of a mammographic grid. Correlating mammographic and histopathologic data, the rate of malignant disease was 12.7 percent for instances of a circumscribed or nodular mass, 32.4 percent for clustered microcalcifications as the only suspect finding, 28.6 percent when a mass with microcalcifications was present and 66.7 percent when a stellate-shaped mass was found. Of 188 instances of carcinoma, 40 were noninvasive: 32 instances of ductal carcinoma (27.1 percent) and eight of lobular carcinoma in situ (6.8 percent). The possibility of frozen section diagnosis was studied retrospectively by comparison with the paraffin section reports. A correct diagnosis, whether benign or malignant, was achieved in 68 percent. No frozen section examination was done in 17.3 percent and the diagnosis was deferred to results of paraffin section in 12.2 percent. False-negative results were encountered in seven patients (1.9 percent) and false-positive results in two (0.6 percent). Both of these patients had florid sclerosising adenosis. Although frozen section diagnosis is feasible in nonpalpable lesions of the breast, it is recommended that this method not be used in instances of pure microcalcifications and tiny solid masses of 5 millimeters or less.