High-frequency ultrasound quantification of acute radiation dermatitis: pilot study of patients undergoing radiotherapy for breast cancer.

BACKGROUND: Acute radiation dermatitis (ARD) is a frequent complication after breast cancer radiotherapy and is usually assessed by semi-quantitative clinical scores, which may be subject to inter-observer variability. High-frequency ultrasound imaging of the skin can reliably quantify thickness and edema in diseased skin. We aimed to compare the relative increase in dermal thickness of the irradiated zone in breast-cancer patients undergoing radiotherapy, with clinical severity. METHODS: A consecutive series of patients undergoing treatment for breast cancer by lumpectomy and radiotherapy in a 6-month period also underwent clinical and ultrasound evaluation of ARD. RESULTS: We included 34 female patients 17 had grade 1 (group 1), 17 had grade 2 or grade 3 ARD (group 2). The mean relative increase in dermal thickness in irradiated skin (RIDTIS) was greater for group 2 than 1: 0.53 vs 0.29 mm (P=.023). On univariate analysis, ARD was associated with skin phototype, breast volume and RIDTIS, and on multivariable analysis, breast volume and age remained predictive of the disease. CONCLUSION: Patients with more severe dermatitis showed significantly increased dermal thickness. Dermal thickness is a quantitative variable that could help quantify the efficacy of drugs and improve the treatment of this disease in patients undergoing radiotherapy.

[Diagnosis of lobular neoplasia in situ on percutaneous breast biopsy: surgical indication]. / Diagnostic de néoplasie lobulaire in situ sur biopsies percutanées: considérations chirurgicales.

UNLABELLED: The arrival of modern imagery techniques has generated an increase in diagnosed lobular intra epithelial neoplasia (LIN) cases. The aim of this research is to define standards to assess the reliability of surgical action currently advised after diagnosing LIN on percutaneous breast biopsy. MATERIALS AND METHODS: This retrospective research was conducted from January 1999 to December 2008 on 24 patients. After performing of mammotome procedure on micocalcifications, each diagnosed LIN case was reviewed by two anatomopathologists. The extent and type of LIN (1 and 2) tumor was defined. A further analysis of the surgically removed material was carried out. RESULTS: The study has indicated three cases of underestimation (12.5%). It was CCIS. The analysis of mammotome procedure shown that the extent and type of LIN were inconstant. CONCLUSIONS: The rate of underestimation is low but it appears that the extend and type of LIN's tumor on mammotome procedure is not available for the surgical decision.