Increased mammographic screening and use of percutaneous image-guided core biopsy in non-palpable breast cancer: Impact on surgical treatment

Moshe Carmon, Louis Rivkin, Ribhi Abu-Dalo, Meir Goldberg, Oded Olsha, Irit Hadas, Ibrahim Zagal, Shalom Strano, Alex Fisher, Omri Lernau

Research output: Contribution to journalArticlepeer-review


Background: Major efforts are being directed at the early diagnosis of breast cancer. The diagnosis rate of non-palpable tumors is steadily growing as a result of increased screening by mammography. In most patients with non-palpable lesions, percutaneous image-guided biopsies have replaced wire localization with surgical excision for obtaining tissue diagnosis. In recent years the Israel Ministry of Health initiated a mammograpy screening program. Percutaneous image-guided biopsies have also become widely available. Objective: To assess the impact of these changes on breast cancer surgical treatment in our hospital. Methods: The charts of 483 patients operated on in our department for primary breast carcinoma during the years 1997 to mid-2001 were reviewed. Data on the mode of diagnosis, tumor stage, resection margins, and number and types of operations were recorded and analyzed. The term non-palpable tumors relates to tumors necessitating wire localization for surgical excision. Results: The percentage of patients diagnosed with non-palpable tumors rose from 16.2% in 1997 to 47.4% in 2001, with an average size of 2.6 cm for palpable and 1.7 cm for non-palpable tumors. The rate of preoperative diagnosis for non-palpable tumors rose from 6.2% in 1997 to 96.4% in 2001. The rate of involved or very close margins was reduced by 73% in the patent group diagnosed preoperatively as compared to those without a preoperative diagnosis (10.6% vs. 39.4%), Finally, the percentage of patients who had two operations fell from 56.2% in 1997 to 11.1% in 2001. Conclusions: The mammography screening program in Jerusalem in 1997-2001 was effective in increasing the relative percentage of non-palpable breast cancers with reduced tumor size at diagnosis. The improved availability of preoperative tissue diagnosis in these patients reduced the number of surgical procedures needed.

Original languageEnglish
Pages (from-to)326-328
Number of pages3
JournalIsrael Medical Association Journal
Issue number6
StatePublished - Jun 2004
Externally publishedYes


  • Image-guided core biopsy
  • Non-palpable breast cancer
  • Screening
  • Wire-guided excisional biopsy

ASJC Scopus subject areas

  • General Medicine


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