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Invited Critique |

Is Specimen Mammography Beneficial?—Invited Critique

Douglas Reintgen, MD
Arch Surg. 2000;135(9):1089. doi:10.1001/archsurg.135.9.1089.
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One hundred sixty-four patients underwent 165 needle/dye-localization biopsies in the reported series from the City of Hope Cancer Center (Duarte, Calif). The authors estimate that specimen mammography (SM) was only beneficial in 1.8% of the patients and no cancer was missed. On the other hand, SM was incorrect in 24.8% of patients and added $60,522 in costs to the institution with an additional 55 hours of operating time.

The main reason given in support of SM is that it allows the surgeon to judge the adequacy of the excision and perhaps avoid reexcisions for negative margins and for medical-legal purposes. Specimen mammography is incorrect in up to 44% of cases, resulting in the unnecessary excision of tissue, missed tumors, and a false sense of security for the surgeon. Specimen mammography is considered wrong when there is a discordance between its outcome and the pathological and postoperative mammographic finding. The American College of Radiology (Reston, Va) judge it to be the standard of care for needle-localization biopsy.

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mammography

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