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Detection of occult carcinoma in the apparently benign breast biopsy through specimen radiography

A pathologic and radiographic study of operative breast specimens revealed calcifications in 54% of carcinomas and 23% of apparently benign breast biopsies. Microscopic examination of tissue containing calcifications in biopsies deemed benign after usual gross and histologic evaluation led to the discovery of 11 occult carcinomas (5 duct, 6 lobular). Nine of these 11 patients had simultaneous bilateral biopsies, and, in 6, there was carcinoma in the opposite breast. This group represents one fifth of the patients in this series with one primary operable breast cancer who underwent contralateral biopsy and were found to have simultaneous bilateral cancer. These findings indicate an important role for specimen radiography in evaluating the apparently benign breast biopsy, particularly when the opposite breast contains cancer. Suspicious clinical mammographic findings, bulky specimens, atypia, or noninvasive carcinoma in routine sections are other indications for specimen radiography.