[Surgical treatment of infraclinical breast lesions: preliminary results of the screening program of L'Ariana state]

To report clinical, radiological and histological characteristics of the infraclinical breast lesions patients recruited via the large scale mammography breast cancer screening of l'Ariana state in Tunisia. Retrospective study over a period of 2 years. The recruitment of patients made on the occasion of the program of breast cancer screening. During this period, 22 patients in our unity had a surgical excision after wire localization. Ten patients were recruited by means of systematic breast cancer screening. In these cases, the mammographic findings were classified B.I.R.A.D.S 4 in 7 cases and BIRADS type 5 in 3 cases. Definitive histology concluded to benign disease in 4 cases and malignancy 6 cases. This collaboration enables the diagnosis an invasive ductal carcinoma in three cases. The surgical excision after wire localization for non palpable breast lesions allows diagnosis of high-risk benign lesions and low-stage breast cancer. It is a reliable technique which indications have to be based on clinical and radiological strict criteria. This procedure is at present, and in developed countries, widely outstripped with the stereotactic core needle biopsy

[Placenta percreta: a rare aetiology of metrorrhagies in the first and second trimesters of pregnancy about two cases and review literature]

The placenta percreta is an abnormal placentar adhesion with invasion of all the uterine wall with sometimes an extension to the organs bordering the womb by chorial villiosities. It is a pathology rarely diagnosed during the first trimester of pregnancy. We report in this work two cases of placenta percreta diagnosed in the first trimester of pregnancy in the A service of the centre of maternity and of neonatology of Tunis. After a review of the literature we tried to make lignt on risk factors inherent to this pathology and to propose a practical behaviour. The first patient of the study was 28 years old, with bicicatricial uterus. She was admitted in urgency for abundant metrorragies in the tenth week of pregnancy, A molar pregnancy was suspected and an attempt of uterin evacuation failed. In front of the importance of bleeding an haemostais hysterctomy was made. The second patient was 39 years old, and had as antecedents of cures of uterine synechy. She was admitted in the 19[th] week of pregnancy, for a late abortion. In front of the complete placentar retention and the aggravation of bleeding, the diagnosis of placenta accreta was evoked and a haemostasis hysterectomy was realized. In both cases histological exam confirmed peroperative discoveries and concluded the diagnosis of placenta percreta. The difficulty of the management of the placenta percreta is due to the fact that this pathology is almost always met in a unexpected way in an urgent context. Antenatal diagnosis is recently described as possible in the first trimester of pregnancy