Stereotactic Fine-needle Biopsy Research Articles

293 The first in Bulgaria single institution experience with nipple-sparing mastectomy – preliminary results

To assess the accuracy of detection of breast cancers by mammography and stereotactic fine-needle biopsy (SFNB) 2594 mammographically detected non-palpable lesions were sampled. On the basis of combined evaluation by mammography and cytology of these samples, 2005 (77·3%) of the cases were judged as benign lesions without need of surgery and only 1 of these turned out to be a cancer 14 months later. In 567 (21·9%) patients diagnostic and/or therapeutic surgery was done. Breast cancer was confirmed by histopathology in 429 (75·7%) of the patients operated on and a further 60 (10·6%) had non-malignant pathological changes (eg, sclerosing adenosis, epitheliosis, fibroadenoma, or papilloma). Thus, surgery was justified in 86·3% (489) of the patients. In addition to the histopathologically verified cancers, another 22 (0·8%) breast cancers were diagnosed by mammography and cytology but these patients were not subjected to surgery for various reasons. A combination of mammography and SFNB offers a procedure of high sensitivity for early diagnosis of breast cancer.

Secreting germ cell tumors of the central nervous system (CNS). First results of the cooperative German/Italian pilot study (CNS sGCT).

Secreting germ cell tumors are an invariably fatal subgroup within the malignant pediatric brain tumors. Thus in 1993, an international working group was initiated to establish a cooperative study for diagnostic and treatment of intracranial secreting germ cell tumors of the CNS. To pilot this protocol, since 1994 German and Italian patients are treated in accordance with the established guidelines. Regarding to the achieved consensus within the international protocol committee a characteristical diagnostic imaging (CT/MRI scan) of head and spine and a significant increase of tumor markers beta-HCG (> 50 IU/l) and/or AFP (> 25 ng/ml) are defined as sufficient diagnostic criteria. Additionally staging procedures include an initial CSF cytology. Treatment consists of 4 courses PEI: platinum (20 mg/m2 day 1-5), VP16 (100 mg/ m2 day 1-3), and ifosfamide (1.5 g/m2 day 1-5). Surgery of the residual tumor is administered after chemotherapy, if resection is possible, followed by craniospinal irradiation (30 Gy with tumor boost 24 Gy). Until September 96, 19 patients (16 boys and 3 girls) aged 8 to 19 years are registered and have finished their treatment. Seven children are diagnosed by elevated tumor markers. Six of 7 children with stereotactic fine needle biopsy and histology of germinoma have a significant marker increase as a specific characteristic for secreting non-germinomatous germ cell tumors. In 6 patients, the tumor is primarily resected, 2 children are biopsied. In 2 children spinal metastases are diagnosed initially. Tumor marker response is evaluated in 16 children. Thirteen of 16 patients show a clear marker normalization after 2 courses of PEI. One boy with a slight increase of the tumor marker after the 4th course developed an early spinal relapse and died. One girl showed a spinal recurrence during focal radiotherapy. She is still under relapse treatment. A significant decrease of tumor volume after chemotherapy is documented in 10/13 children, who have a definite signal tumor at start of therapy. In 3 children tumor volume does not change despite of marker normalization. Histology of these tumors is teratoma. One of these children died postoperatively because of tumor bleeding. 17/19 patients are alive, 16 of them are in complete remission with a median follow-up of 11 months. These results show a further significant increase of event-free survival (EFS 81%). The piloted chemotherapy is proven to be effective and the protocol is now open as an international SIOP CNS GCT study that is started in October 1996.

Mammography screening for breast cancer

CancerVolume 72, Issue 6 p. 1809-1812 EditorialFree Access Mammography screening for breast cancer Daniel B. Kopans M.D., Corresponding Author Daniel B. Kopans M.D. Department of Radiology, Massachusetts General Hospital, Boston, MassachusettsDepartment of Radiology, Massachusetts General Hospital, Boston, MA 02114===Search for more papers by this author Daniel B. Kopans M.D., Corresponding Author Daniel B. Kopans M.D. Department of Radiology, Massachusetts General Hospital, Boston, MassachusettsDepartment of Radiology, Massachusetts General Hospital, Boston, MA 02114===Search for more papers by this author First published: 15 September 1993 https://doi.org/10.1002/1097-0142(19930915)72:6<1809::AID-CNCR2820720603>3.0.CO;2-DCitations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Nystrom L, Rutqvist LE, Wall S, Lindgren A, Lindqvist M, Ryden S, et al. Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet 1993; 341: 973– 8. 2 van Dijck JAAM, Verbeek ALM, Hendriks JHCL, Holland R. The current detectability of breast cancer in a mammographic screening program: a review of the previous mammograms of interval and screen-detected cancers. Cancer 1993; 72: 1933– 8. 3 Tabar L, Gad A, Holmberg L, Ljungquist U. Significant reduction in advanced breast cancer: results of the first seven years of mammography screening in Kopparberg, Sweden. Diag Imag Clin Med 1985; 54: 158– 64. 4 Yaffe MJ, Correction: Canada study [letter to the editor]. J Natl Cancer Inst 1993; 85: 94. 5 Muir BB, Kirkpatrick A, Roberts MM, Duffy SW. Oblique-view mammography: adequacy for screening. Radiology 1984; 151: 39– 41. 6 Moskowitz M, Breast cancer: age-specific growth rates and screening strategies. Radiology 1986; 161: 37– 41. 7 Tabar L, Faberberg G, Day NE, Holmberg L. What is the optimum interval between screening examinations?: an analysis based on the latest results of the Swedish Two-County Breast Cancer Screening Trial. Br J Cancer 1987; 55: 547– 51. 8 Tabar L, Fagerberg G, Duffy S, Day N, Gad A, Grontoft O. Update of the Swedish Two-County Program of Mammographic Screening for Breast Cancer. Rad Clin North Am 1992; 30: 187– 210. 9 Bird RE, Professional quality assurance for mammographic screening programs. Radiology 1990; 177: 587. 10 Bassett LW, Liu TH, Giuliano ARE, Gold RH. The prevalence of carcinoma in palpable vs impalpable mammographically detected lesions. AJR 1991; 157: 21– 4. 11 Sickles EA, Mammographic features of 300 consecutive nonpalpable breast cancers. AJR 1986; 146: 661– 3. 12 D'Orsi CJ, To follow or not to follow, that is the question. Radiology 1992; 184: 306. 13 Gallagher WJ, Cardenosa G, Rubens JR, McCarthy KA, Kopans DB. Minimal-volume excision of nonpalpable breast lesions AJR 1989; 153: 957– 61. 14 Azevado E, Svane G, Auer G. Stereotactic fine-needle biopsy in 2594 mammographically detected non-palpable lesions. Lancet 1989; 1: 1033– 6. Citing Literature Volume72, Issue615 September 1993Pages 1809-1812 ReferencesRelatedInformation

Stereotactic fine needle biopsy of the breast.

The experience of the use of the TRC-Mammotest machine for stereotactic fine needle biopsy (SFNB) of the breast in Perth is presented. During the period 20 October 1988 to 10 January 1990, 404 SFNB were performed on 389 women with impalpable, mammographically detected lesions of the breast. Surgical biopsy was performed in 73 cases, of which 38 were malignant, giving a benign to malignant ratio in less than 1:1. The sensitivity for detecting cancer was 95%, with a positive predictive value of 100%. Using a combination of the mammographic and cytologic rating for the likelihood of cancer, all the cancers were detected and no cancers have developed in those considered mammographically and cytologically benign. The importance of a combined assessment of mammography and cytology in the management of patients with mammographically detected abnormalities is stressed.

STEREOTACTIC FINE-NEEDLE BIOPSY IN 2594 MAMMOGRAPHICALLY DETECTED NON-PALPABLE LESIONS

To assess the accuracy of detection of breast cancers by mammography and stereotactic fine-needle biopsy (SFNB) 2594 mammographically detected non-palpable lesions were sampled. On the basis of combined evaluation by mammography and cytology of these samples, 2005 (77·3%) of the cases were judged as benign lesions without need of surgery and only 1 of these turned out to be a cancer 14 months later. In 567 (21·9%) patients diagnostic and/or therapeutic surgery was done. Breast cancer was confirmed by histopathology in 429 (75·7%) of the patients operated on and a further 60 (10·6%) had non-malignant pathological changes (eg, sclerosing adenosis, epitheliosis, fibroadenoma, or papilloma). Thus, surgery was justified in 86·3% (489) of the patients. In addition to the histopathologically verified cancers, another 22 (0·8%) breast cancers were diagnosed by mammography and cytology but these patients were not subjected to surgery for various reasons. A combination of mammography and SFNB offers a procedure of high sensitivity for early diagnosis of breast cancer.

FINE-NEEDLE BIOPSY OF NONPALPABLE BREAST LESIONS.

A simple, reliable diagnostic technique would avert the need for surgical biopsy of all nonpalpable breast lesions discovered by mammography. Azavedo and colleagues report using stereotactic fine-needle biopsy (SFNB) to evaluate 2594 such lesions in 2510 women. SFNB allows sampling …