Pre-operative histological diagnosis of breast cancer.
Aust N Z J Surg
; 67(6): 325-9, 1997 Jun.
Article
en En
| MEDLINE
| ID: mdl-9193264
ABSTRACT
BACKGROUND:
A concordant triple assessment (clinical, mammographic and cytological) diagnosis of breast malignancy allows for pre-operative planning of surgery and may also allow for one-stage surgery. However, while the accuracy of cytology is high, it is unable to distinguish invasive cancer from ductal carcinoma in situ (DCIS). A malignant mass may be due to pure in situ cancer and hence axillary dissection may be avoided if pre-operative histology is available.METHODS:
A consecutive series of 300 cases of breast cancer treated over the last 5 years by the two authors was analysed to determine the method of achieving pre-definitive operation histology; the number of stages of surgery required; and the number of cases of mass-forming DCIS which could be susceptible to over-treatment.RESULTS:
Of 289 patients undergoing local definitive surgery for breast cancer, 12 (42%) had clinical masses predominantly due to DCIS and in most of these patients axillary dissection was avoided. Histology was obtained prior to definitive surgery in 272 (94.1%) patients, by intra-operative frozen section in 159 (55.0%), incisional biopsy in 37 (12.8%), needle localization biopsy in 62 (21.5%) and core biopsy in 14 (4.8%). A total of 189 patients (65.4%) underwent one-stage surgery only. Breast conservation was achieved in 210 (72.7%) patients. Those requiring mastectomy were significantly more likely to have required two stages of surgery as were those with lesions detected by screening.CONCLUSIONS:
Mass-forming DCIS cannot be predicted pre-operatively by triple assessment alone; and therefore pre-operative histology is required to avoid axillary dissection. Pre-operative histology may be obtained by core biopsy or intra-operative frozen section to identify DCIS and distinguish it from invasive disease, but both allow a one-stage surgical procedure in the majority of cases.
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Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_muertes_prematuras_enfermedades_notrasmisibles
Asunto principal:
Biopsia
/
Neoplasias de la Mama
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Cuidados Preoperatorios
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Mamografía
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Tamizaje Masivo
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Aust N Z J Surg
Año:
1997
Tipo del documento:
Article
País de afiliación:
Australia