Evaluation of mammography based upon correlation of specimen mammograms and histopathologic findings.

The incidence of calcification and appearance of opacities in specimen roentgenograms of 228 consecutive breast specimens representing a variety of disorders are presented. Although some diseases manifest distinctive roentgenographic features, overlapping is noted. This, as well as an inherent technical difficulty, appears to be reflected by the relatively high incidence of false-negative and false-positive diagnoses conveyed by clinical mammography. The detection of only 0.7% occult carcinomas (clinically and pathologically non-palpable) by specimen mammography in calcifications unassociated with a dominant mass and only 7.4% of all calcifications, including those in the latter group, tends to minimize the practical significance of clinical mamography for the detection of occult cancer of the breast. The occult carcinomas detected by specimen mammography in this study were found only in breasts with overt carcinomatous lesions, which represents an incidence of 9% multicentric cancers. Recognition of a similar incidence of such lesions by the histopathologic study of single sections from randomly selected blocks obtained from the uninvolved quadrants of breasts harboring an overt carcinoma, and the detection of such noninvasive carcinomas in benign breast disease by “extended” histopathologic study, signify the limitations of specimen mammography for the detection of these occult cancers. It is concluded that specimen mammography represents a useful but not essential adjunct to the pathologic study of mammary disease.