Mammographic follow-up of apparently benign nonpalpable breast nodules

To study the incidence of apparently bening, nonpalpable nodular breast lesion in our region, on the basis of the radiological findings. The radiological follow-up is assessed and compared with surgical biopsy in terms of cost-effectiveness. One hundred seventy apparently bening, nonpalpable breast masses were studied in a series out 152 women. The means follow-up time was 18 months, starting with a study performed 3 to 6 months after the initial diagnosis and repeated 6 to 12 months later. Monitoring consisted of conventional mammography of both breast which was compared with previous mammograms whenever available. The lesions remained nonpalpable and showed no radiologically detectable changes suggestive of malignant transformation throughout the follow-up period. The incidence of apparently benign, nonpalpable breast masses in this series was 1.3%. The majority were solitary, round lesions in the upper outer quadrant of the left breast measuring less that 1 cm, with perfectly defined borders. None of the lesions presented radiological signs of malignant transformation throughout the entire follow-up period. The cost of radiological follow-up in the present series was 6 to 7-fold less than that of surgical biopsy. In many cases, mammographic follow-up of probably benign, nonpalpable breast masses makes biopsy unnecessary, thus greatly reducing costs. Moreover, the elevated morbidity and psychological impact of surgical biopsy is avoided. Thus periodical mammography is a reasonable and safe alternative to biopsy in the management of lesions of this type. (Author) 15 refs