Showing papers on "Breast lumps published in 1983"

Predicting nodal metastases in breast cancer by lymphoscintigraphy.

Abstract: In a prospective trial, 89 women with breast lumps underwent bilateral axillary and internal mammary lymphoscintigraphy preoperatively, using technetium-99m antimony sulfide colloid. All scans were interpreted blindly by three separate observers. Breast biopsy was then performed; if the biopsy specimen showed malignant tumour, definitive therapy was performed with axillary dissection. The interpretation of the axillary and internal mammary lymphoscintigrams was subsequently compared with the histologic assessment of the axillary nodes. Of the 89 women, 54 had benign disease and 35 had cancer. The internal mammary lymphoscintigram was considered to show abnormality in only 1 of the 54 patients with benign disease. One patient with cancer was eliminated from the review. Sixteen of the remaining 34 patients had axillary node metastases. Of these, 8 had an abnormal internal mammary lymphoscintigram. Only 2 of the 18 patients with cancer but no axillary metastases had an abnormal internal mammary lymphoscintigram. One bilateral axillary lymphoscintigram in the 54 patients with benign disease was discarded for technical reasons. The axillary lymphoscintigram was accurate in 52 of the remaining 53 patients. Two such scintigrams in the 35 patients with breast cancer were discarded for technical reasons. The axillary lymphoscintigram indicated abnormalities in 12 of 16 patients with axillary nodal metastases but appeared normal in 13 of 17 patients without axillary metastases. Lymphoscintigraphy may play a valuable role in the staging of breast cancer in the future.

Breast disease in young women. When is biopsy indicated

Abstract: The low incidence of breast cancer among women under the age of 25 years may not justify the routine excision biopsy of breast lumps in this age group. A policy of conservative management has been tested in 70 women between the ages of 17 and 25 years. Excision biopsy was eventually performed in 23 women - fewer than half of those with a palpable mass. No cancerous lesions were found; a high proportion of lumps removed were fibroadenomas. The accuracy of clinical diagnosis was high and, of 31 breast lumps diagnosed as benign mammary dysplasia, more than three-quarters resolved without surgical intervention. Indications for surgery are defined. Because breast cancer does occasionally occur in this age group, accurate clinical diagnosis and review are essential components of conservative management.

Fine-needle aspiration cytology in the management of breast disease.

Abstract: The results of a series of fine needle aspiration biopsies of breast lumps were reviewed to evaluate the accuracy of this diagnostic method and its place in the clinical management of breast lesions. A high level of diagnostic accuracy was achieved. There were no false positive diagnoses of malignancy and fewer than 3% of diagnoses were falsely negative. Eighty per cent of carcinomas could be confidently diagnosed by means of cytological investigation. The patient with a benign cytological diagnosis can either be reassured, or her surgical management planned as a day case. For the patient with a cytological diagnosis of malignancy, discussion of the nature of her surgery and subsequent care is possible before operation. In selected cases of carcinoma, mastectomy can be performed without frozen-section confirmation. Diagnostic accuracy is dependent upon experience, especially in aspiration technique, and optimum results are obtained if the pathologist/cytologist also performs the procedure.

Trucut needle biopsy in breast lumps.

Abstract: THE clinical differentiation between benign and malignant breast lumps is fraught with danger. A small proportion of cases present with classical findings but in the majority it is essential to have a histological or cytological diagnosis before surgery is undertaken. Trucut needle biopsy (TCN) of solid tumours is now established as a useful means of obtaining representative biopsy material and has been used widely in liver and kidney disease. However, its usefulness in the diagnosis of solid breast lumps remains controversial. To evaluate the technique we carried out 250 consecutive TCN biopsies and the results of the series are presented.