Tissue compression to enhance lesion visibility on radiography of needle-localized breast biopsy specimens is widely used. We hypothesized that compression is not necessary for detection of lesions on specimen radiography.

Forty-nine consecutive patients underwent needle-localization biopsies of 59 mammographic targets. All specimens were radiographed without and with compression. The films were later independently reviewed and compared with preoperative mammograms by 2 surgeons and a breast-imaging radiologist. The primary end point was identification of mammographic targets in noncompressed specimen radiographs.

Twenty-nine targets were masses, 36 contained calcifications, and 14 contained previously placed clips. All mammographically localized lesions were identified on noncompressed views. Overall concordance for the 2 images was 100% for all 3 reviewers and 98% among reviewers.

Tissue compression before specimen radiography is not routinely necessary for target lesion identification.