Stereoscopic digital mammogram: Usefulness in daily practice.

OBJECTIVES: To assess the benefit of stereoscopic digital mammography in daily practice. METHODS: Stereoscopic digital (SD) mammography allows a fused 3D view of mammogram. A 4-degree cranio-caudal (CC) angle view matched with a regular CC view allows generating a stereoscopic view. Three breast radiologists reviewed retrospectively 1110 stereoscopic digital mammograms (1075 women) performed between November 2011 and February 2013 with the following sequence: each evaluated firstly conventional mammogram alone, and then integrated SD mammograms. The benefit was quoted in 3-grade scale: 0 for no benefit, 1 moderate and 2 excellent. The concordance between radiologists was evaluated by the W Randall coefficient. Subgroup analysis according to the BI-RADS classification, breast density and type of abnormalities were performed by calculating odds-ratio. RESULTS: The readers had the same opinion regarding the value of stereoscopic digital mammograms in 87% of cases (962/1110). Benefit was null, moderate and excellent in 8, 52 and 26% respectively. The concordance of radiologists was excellent with a W coefficient above 0.89. CONCLUSIONS: SD mammogram improved interpretation of abnormal mammograms. This potentially interesting and promising complementary tool might be beneficial in daily breast imaging practice.

[Invasive infra centimetric breast lobular carcinoma: ultrasonographic features]. / Cancers lobulaires invasifs infracentimétriques: aspects échographiques.

PURPOSE: To evaluate the ability of breast ultrasound to detect and analyze small (less than 1 cm in size) invasive lobular carcinomas. MATERIAL: and methods. A retrospective analysis of 93 small invasive carcinomas measuring less than 10 mm in size diagnosed between 1998 and 2000 in our institution was performed. In this group, 15 invasive lobular carcinomas were identified in 12 patients. All mammograms and ultrasound examinations were reviewed. RESULTS: Twelve cases of less than 10 mm invasive lobular carcinomas were diagnosed. Two lesions in one patient and one in an other patient were not detected at ultrasound and mammogram (multifocal carcinomas). All invasive lobular carcinomas were found as hypoechogenic masses with ill-defined margins and posterior shadowing. Four lesions showed evidence of microlobulations, 6 lesions an hyperechogenic halo and only one showed a vertical axis. The sensitivity of ultrasound in this group was recorded as 80% (12/15). CONCLUSION: The study confirms a high sensitivity of ultrasound examination in detection and characterization of small infiltrative lobular carcinoma.

Unusual mammographic and ultrasonographic findings in fibromatosis of the breast.

Fibromatosis of the breast is an uncommon disease, most often appearing as an aggressive lesion mimicking carcinoma on mammography. We describe, in an asymptomatic 40-year-old woman, an unusual imaging appearance of fibromatosis of the breast mimicking a benign lesion at mammographic and sonographic studies.

[Modified subcutaneous mastectomy. Apropos of 916 cases]. / Les mammectomies sous-cutanées modifiées. A propos de 916 observations.

Modified subcutaneous mastectomy was described by one of us in 1968; its approach, the dissection of the gland, plastic reconstruction of shape and volume are completely different from the subcutaneous mastectomy performed by plastic surgeons. 3 different time periods were studied to explain clearly evolution in the technic and indications. During many years retrospective studies made it possible to build a procedure according to the new diagnostic means for infraclinical breast cancer and to the constant improving prosthetic material. Therefore our indications for modified subcutaneous mastectomy are as following: suspicious mastopathies are the best indications with a performing choice of the radiologic images which require histologic control some evolutive or evoluated mastopathies some small infiltrating tumors developing in a highly dystrophic glandular surrounding. The numerous in situ cancers accompanying them argue for this choice. some big phyllod tumors or phyllod's recurrences.

[Subclinical identification of cancer of the breast. Radiologic progress, proposition for treatment]. / Reconnaissance infraclinique du cancer du sein. Progrès radiologiques, proposition de traitement.

In the case of breast cancer with no clinical signs, radiological signs are the decisive factors to indicate surgery, histological studies or treatment. Foci of microcalcifications currently are the feature to identify as a rule. However, they reveal canalicular carcinoma in only 1 case out of 3. We propose a radiological technique allowing the selection of the microcalcifications to be operated by means of the digitization of a mammographic film and of a software-controlled morphometric analysis. 10,000 microcalcifications have been studied in this way. The most reliable of the 12 parameters that were distinguished is compacity. 100 files were studied with conventional mammography and a morphometric and histological analysis. Any microcalcification less compact than 0.35 is highly suspicious, since this parameter is the only one having a significant difference, with a confidence interval of 95%. The patients are now selected in this way. Differences in the age of the lesions, multiple foci and sometimes lesions with multiple centers lead us to automatically propose the exeresis of the gland, followed by immediate reconstruction of its shape and volume. According to a retrospective study we carried out on 111 subclinical intracanalicular carcinomas after a 5 to 20-year time interval, recurrence is observe in only 4.5% of all cases.