Patrón difuso de la mama / Diffuse pattern of the breast

Presentación que se observa con más frecuencia al realizar un estudio ultrasonográfico de la mama, en la que pueden visualizarse distintas modificaciones, denominadas displasias mamarias. Se describen las patologías que pueden presentar un patrón difuso.

Correlación citológica-anatomopatológica en patología mamaria / Cytologic anatomicopathologic correlation in breast pathology

Se realiza un análisis de 1885 estudios citológicos y 522 correlaciones con la anatomía patológica. Los valores de Sensibilidad, Especialidad y Exactitud Diagnóstica se corresponden con los de la bibliografía a pesar de haber incorporado los materiales insuficientes para el estudio citológico lo mismo que los informes sospechosos. Se acentúa la importancia, seguridad y su fácil realización

Retroareolar cysts in the adolescent.

BACKGROUND: Retroareolar cysts present in female adolescents with palpable subareolar masses that can have concomitant inflammatory changes. The purpose of this study was to report our cases of retroareolar cysts and thus to contribute to a better knowledge and understanding of this entity. METHODS: Forty-six girls were diagnosed with retroareolar cysts between December 2000 and July 2002. A retrospective chart review is presented with the clinical and ultrasonographic findings. RESULTS: Age at presentation was 10 to 20 years. The reason for consultation was acute mastalgia and inflammation in 31 cases and palpable nodule in 15 cases. Two patients had areolar discharge. Ultrasonographic imaging in the 46 girls showed retroareolar simple cysts, either multiple or bilateral. The cysts had thin walls and were round, oval, or elongated with a variable diameter always less than 20 mm. They had liquid content with an echogenic or calcific sediment. When retroareolar cysts presented with inflammatory changes, antibiotics and nonsteroidal anti-inflammatory drugs were used. Inflammatory changes disappeared in approximately seven days. All patients experienced favorable outcomes. CONCLUSIONS: Retroareolar cysts are a benign form of breast disease in the adolescent. Further investigation is needed to completely understand the pathophysiology, epidemiology, and natural history of this diagnosis.

Suspicious node found at the time of reduction mammaplasty.

A case of a patient with a suspicious glandular node found during reduction mammaplasty is described. The preoperative search for such nodes, the management of cases on which a suspicious node is found intraoperatively, and a situation on which the diagnosis of breast cancer is made during histology are discussed. When a suspicious small node (with a diameter up to 2 cm) is detected during a cosmetic breast surgery, lumpectomy can be performed. It may be a definite surgical treatment, depending on stage and tumor type. In the case presented, histology revealed intraductal papilloma, a benign tumor, therefore lumpectomy was a suitable procedure with an acceptable cosmetic result. With the increased incidence of breast cancer, this situation will happen more often and technical options for the management of such cases deserves the attention of plastic surgeons.

Technetium-99m sestamibi in the diagnosis of breast cancer. The Mayagüez Medical Center experience.

The most successful screening procedures for breast cancer are breast physical examination and mammography. However, mammography has a positive predictive value of 15-30% for nonpalpable malignancy and of 22% for palpable carcinoma; this results in a large number of biopsies on patients with benign lesions. Furthermore, the benefit of mammography in woman with dense breast tissue (< 50 years old) has been questioned. Different studies have shown that Scintimammography with Tc-99m has a high sensitivity and specificity for detecting breast cancer (average of 85% and 89%, respectively), with higher positive predictive value for palpable lesions (89%). We reviewed retrospectively 35 records of patients that had Scintimammography in our institution, and the sensitivity, specificity, positive and negative predictive values were similar to other centers (100%, 76%, 62.5% and 100%, respectively). So, Scintimammography may be a complement for current diagnostic techniques for breast malignancy in our setting.

Análisis de 218 marcaciones de lesiones mamarias no palpables con correlación anatomopatológica / Analysis of 218 marcations of clinically ocult breast lesions with pathological correlation

Se estudiaron 218 pacientes en las que se realizó localización de lesión subclínica bajo guía radiológica y/o ecografía y se pudo correlacionar con informe anatomopatológico. El 55 por ciento de las biopsias se realizó por microcalcificaciones agrupadas, el resto fue por nódulos, distorsiones, asimetría y nódulos con microcalcificaciones. Fue notorio el incremento de antecedentes familiares positivos con respecto a la población general, en este grupo 30 por ciento. La patología maligna hallada fue: carcinoma ductal 41, carcinoma lobulillar 6, carcinoma ductal in situ 20, cicatriz radiada 5, carcinoma lobulillar in situ 2 e hiperplasia atípica 12. Además se encontró un alto porcentaje de lesiones consideradas premalignas o de alto riesgo. En este estudio se analiza el valor predictivo positivo de la mamografía y ecografía en diagnóstico de patología maligna mamaria (AU)

[Radiologic visibility of breast fibroadenomas]. / Visibilidad radiológica de los fibroadenomas mamarios.

From a clinical point of view, all mammary fibroadenomas are similar. However some of them are not visible in mammograms, phenomenon probably related to glandular density. Aiming to elucidate whether the lack of visibility is caused by the glandular density or by tumor itself, a three stage study was performed. In 201 cases the mammographic visibility of fibroadenomas was determined and correlated with patient's age, the presence of fibrocystic disease and tumor histological type; after surgical excision, 18 fibroadenomas were sliced into 5 mm thick samples and X rayed to determine their visibility; finally 2 visible and 2 non visible tumors were calcinated at 550 degrees C and their ashes subjected to X-ray diffraction analysis. Twenty two percent of fibroadenomas were not visible on mammography, this percentage was higher for intracanalicular tumors, in younger women and in the presence of fibrocystic disease. Sixteen percent of excised and sliced tumors were not visible on X rays. Also, differences were found in X-ray diffraction studies between visible and invisible tumors, probably related to NaCl and KCl tumor content.

[The value of ultrasonography in benign breast diseases]. / Utilità dell'ecografia nella patologia mammaria benigna.

In recent years breast scans have been widely used for the precise diagnosis of breast cancer. However, the value of this diagnostic tool is debatable in comparison to mammography in women of a childbearing age who often present a dense youthful breast. The role of clinical examination as a screening process is also examined. In the light of these findings the Authors evaluated the role played by ultrasonography in breast cancer, and in particular benign breast tumours, in a group of outpatients attending the clinic. The technique used was relatively simple: the scan in the department used for gynecological and obstetrical ultrasonography was fitted with a 5 MHz probe and was used to perform all the scans. In addition, a Kiteco space maintainer was used for ultrasonography of soft tissue. Scans were performed at a distance of 0.5 cm. The Authors examined 107 patients with benign breast tumours using ultrasonography. They evaluated the morphology, dimensions, edges and internal echo-structure of pathological formations and adjacent areas. The value of breast ultrasonography emerges from an analysis of the results both in the study of the glandular structure and in the differentiation between cystic and solid type lesions which are not always diagnosed during clinical examination. A total of 59 fibroadenoma, 44 cysts, 2 lipoma and 2 phylloids were diagnosed. Fibroadenomas had smooth edges in 98.4% of cases and were lobulate in 1.6%. In 100% of cases the fibroadenomas diagnosed presented fine internal homogeneous echoes with a lower echogenicity than that of surrounding glandular tissue.(ABSTRACT TRUNCATED AT 250 WORDS)