ABSTRACT
OBJECTIVE: The major objectives of this prospective study were to compare pathologic findings from stereotaxic core and excisional biopsies performed on patients with impalpable breast lesions and to compare the initial mammographic impression with the final histologic diagnosis. SUBJECTS AND METHODS: All patients referred for preoperative localization of impalpable breast lesions between October 29, 1991, and January 15, 1993, were eligible for the study. If the patient and the lesion, on the basis of mammography, were considered suitable for core biopsy, the patient was asked to participate. Four hundred forty-five excisional biopsies were performed. One hundred sixty lesions were evaluated by core biopsy; for 104 of these lesions, five or more core samples were removed. Core biopsies were done with 14-gauge biopsy needles and were followed by a localization procedure. The pathologic features of core and excisional specimens were compared. RESULTS: Biopsy results were compared for 93 (58%) benign and 67 (42%) malignant lesions. Of 104 lesions evaluated with at least five core specimens, 56 (54%) were benign and 48 (46%) were malignant. Results of core biopsy corresponded to those of excisional biopsy for 96% of benign lesions, 83% of malignant lesions, and 90% overall; sensitivity of core biopsy for malignant lesions was 85%. Of 56 lesions for which fewer than five core specimens were obtained, 37 (66%) were benign and 19 (34%) were malignant. Results of core biopsy corresponded to those of excisional biopsy for 81% of benign lesions, 79% of malignant lesions, and 80% overall; sensitivity of core biopsy for malignant lesions was 84%. Specificity of core biopsy for the entire series of benign lesions was 100%. CONCLUSION: For mammographic lesions that are believed to be not malignant or not very likely malignant, stereotaxic core biopsy decreases the need for excisional biopsy.
Subject(s)
Biopsy, Needle/methods , Breast Diseases/pathology , Breast Neoplasms/pathology , Breast/pathology , Stereotaxic Techniques , Breast Diseases/diagnostic imaging , Breast Diseases/epidemiology , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/epidemiology , Female , Humans , Mammography , Middle Aged , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
Portable chest radiography is an essential component of clinical patient management in the intensive-care unit. With routine use of this procedure, unexpected cardiopulmonary abnormalities are frequently detected, and malposition or complications of intravascular devices and endotracheal, thoracostomy, or nasogastric tubes are also commonly found. The pulmonary parenchyma may be assessed for changes of acute lung injury, cardiogenic edema, areas of pneumonitis, atelectasis, or other abnormal collections of fluid or air. In mechanically ventilated patients, barotrauma occurs frequently and may be manifested by subtle intrathoracic collections of air. Technical factors may limit the resolution of the anteroposterior chest radiograph obtained at the bedside, but crucial clinical information is often gained. Portable chest radiographic findings, the role of computed tomography and ultrasonography, and interventional radiologic procedures pertinent to patients in the intensive-care unit are reviewed.
Subject(s)
Critical Care , Intensive Care Units , Radiography, Thoracic , Equipment and Supplies, Hospital , Heart Failure/diagnostic imaging , Humans , Lung Diseases/diagnostic imaging , Pneumothorax/diagnostic imaging , Pulmonary Edema/diagnostic imagingABSTRACT
Intravenous digital subtraction angiography demonstrated a polypoid carcinosarcoma invading the left main pulmonary artery, The angiographic criteria of inoperability of patients with central pulmonary tumors are discussed.