Clinical Research Of Nonpalpable Breast Lesions (Diameter≤1.0cm) In 1040 Cases

Breast tiny lesion is nonpalpable in clinical examination and detected by ultrasound which diameter≤1.0cm.It is very common when we take physical examination and in outpatient. At present there is no unified criteria of treatment to comply. In order to avoid excessive biopsy and find out malignant lesions in early stage, choosing correct treatment method seems important in particular.Objective:To discuss treatment principle of nonpalpable breast lesions (diameter≤1.0cm).Methods:1040 women aged 35-70 years old who were found nonpalpable breast lesions (diameter≤1.0cm) by ultrasound were included,admitted to the First hospital of Jilin University from April 2009 to Dec 2010. We divided into two groups,BI-RADS≤3 grade group and BI-RADS4 grade group. Immediately surgical biopsy was performed in the two groups partly.We followed the remaining with ultrasound (once per 3 months) and Mammotome biopsy or surgical biopsy was performed when the lesion progressed or patients required. Application of SPSS 18.0 was used for statistical analysis between two groups on relative factors withχ2 test.Test levelα=0.05.Incidence of malignancy in nonpalpable breast lesions was calculated by rate of descriptive statistics. Results:Of 1040 cases,1004 cases were included in BI-RADS≤3 grade group and 36 cases in BI-RADS4 grade group.(1)In BI-RADS≤3 grade group, 43(4.3%)cases were performed surgical biopsy immediately,933(93.0%) cases were followed-up with different months,4(0.4%)cases were performed biopsy during the period of following-up because the lesions progressed more than 30% with interval,28(2.8%)cases were lost. All the lesions were benign in those cases performed biopsy. In BI-RADS4 grade group,29(80.6%) cases were performed surgical biopsy immediately,7(19.4%) cases were followed-up with different months,5(13.9%)cases were performed biopsy during the period of following-up because the lesions progressed more than 30% with interval, 2(5.6%)cases were malignant. (2) Of 940 followed-up cases,the space were different from 3 months to 21 months,530(56.4%) cases were followed-up more than 12 months,931(99.0%) cases were stable.(3) When BI-RADS≤3grade group compare with BI-RADS4 grade group,breast cancer history,childbearing history and breast-feeding history was statistically significant(breast cancer historyχ2=17.634, P=0.000; childbearing historyχ2=36.378, P=0.000; breast-feeding historyχ2=10.638, P=0.000).Conclusion:(1) Preferred Treatment:The rate of malignancy in the study is 0.2% in total group.we suggest that short-term follow up is preferred treatment to nonpalpable (diameter≤1.0cm)and probably benign breast lesions detected by ultrasound.(2) Biopsy Indication In Follow-up Cases: Mammotome biopsy or surgical biopsy was performed when the lesions progressed more than 30% with interval who were followed-up or patients with extremely anxious. (3) Interval:The interval of follow-up in the study was once per 3 months. The frequency was rational and active for detecting breast cancer in early stage.(4) Immediately Biopsy Indication:We suggest biopsy was performed immediately in BI-RADS4 grade group. Besides, in BI-RADS≤3 grade group, patient were also suggested to accept biopsy who possessed two factors with following:(1) no childbearing history(2)no breast-feed history(3)having family history(4)extremely anxious.