Fibroadenoma vulvar: a propósito de un caso clínico / Vulvar fibroadenoma: about a clinical case

RESUMEN El fibroadenoma vulvar es un tumor benigno poco frecuente con muy pocos casos descritos en la literatura. Por lo general, se diagnostica entre los 20 y 70 años. Tiene un buen pronóstico y rara vez recurre después de la escisión. Presentamos un caso de fibroadenoma vulvar, en una mujer de 33 años, manifestado como un tumor localizado, bien definido de partes blandas en el labio mayor izquierdo. La lesión fue extirpada completamente y la histología confirmó un fibroadenoma con marcador de estrógeno positivo.

ABSTRACT Vulvar fibroadenoma is a rare benign tumor with few cases reported in the literature. It usually occurs between 20 and 70 years of age. It has a good prognosis and rarely recurs following excision. We present a case of vulvar fibroadenoma as a localized, well-defined soft tissue mass in the left labium majus of a 33-year-old woman. The mass was excised completely, and histology demonstrated a fibroadenoma positive for estrogen receptor.

Fibroadenoma de la vulva. A propósito de un caso / Vulvar Fibroadenoma with regards

El fibroadenoma vulvar es una lesión extremadamente rara. Se presenta como una masa unilateral, de tamaño variable, asintomático y ocasionalmente asociado a otras lesiones vulvares o extravulvares y existe gran controversia sobre su origen. Estas lesiones necesitan del examen histopatológico para llegar al diagnóstico definitivo. El comportamiento de este tumor es similar al mamario. La escisión generalmente tiene un buen pronóstico y rara vez recidiva. Presentamos un caso donde se diagnosticó histopatológicamente esta lesión en una mujer de 26 años de edad con masa tumoral en la vulva, a la que se le realizó excéresis quirúrgica.

Vulvar fibroadenoma is extremely rare. It presents as a unilateral mass of variable size, asymptomatic and occasionally associated to other vulvar and extra-vulvar lesions. There is a great controversy about their origin. These lesions need a histo-pathological exam to reach a concluding diagnosis. Its behavior is similar to the breast tumor. Its removal generally has a good prognosis and there is rarely a relapse. This is a case of a 26 year old woman who was histo-pathologically diagnosed a vulvar tumor. A surgical removal was performed.

Eccrine syringofibroadenomatosis of the reactive subtype occurring in chronic poorly-controlled psoriasis.

Eccrine syringofibroadenomatosis (ESFA) is a rare adnexal tumor with acrosyringeal differentiation. Clinically, it can be mistaken for granulomatous infections or malignancies such as squamous cell carcinoma. Despite the rarity of the condition, we recently encountered two cases of the reactive subtype, which occurred in patients with poorly controlled chronic psoriasis. Both patients presented with long‑standing, thick verrucous lesions on the lower legs. The diagnosis was made after histological examination and exclusion of infectious and neoplastic disorders. As this is a reactive disorder, management is focused on treating the underlying condition. Unfortunately, psoriasis was difficult to manage in both our patients and they defaulted further treatment. It is important to recognize ESFA as it can be confused with infectious or malignant disorders.

Evolución inusual de fibroadenomas mamarios múltiples en adolescente con metrorragia disfuncional / Unusual evolution of multiple breast fibroadenomas in adolescent with dysfunctional uterine bleeding

Se describe la inusual evolución de fibroadenomas (FA) mamarios múltiples en una adolescente de 11 años en tratamiento con progestinas cíclicas por metrorragia disfuncional. Inicialmente la ecografía mamaria mostró más de 10 lesiones sólidas en cada mama de hasta 2,6 cm, compatibles con fibroadenomas. Al cabo de 13 meses las lesiones se redujeron en número y tamaño. Se discute la historia natural de los FA, la influencia hormonal en la etiología de los FA y finalmente el diagnóstico ecográfico y manejo de este cuadro en la adolescencia. Se plantea, a modo de hipótesis, que existe un desbalance estrógeno-progesterona (E-P) dado por ciclos anovulatorios en el periodo posmenárquico, que se manifestó con metrorragia disfuncional y la presencia de FA. Al administrar progesterona cíclica se reequilibra la relación E-P explicando el control del ciclo y la involución de las lesiones mamarias.

We describe the unusual evolution of multiple fibroadenomas (FA) in a 11-years old adolescent during treatment of an abnormal uterine bleeding with cyclic progestins. Inicially ultrasound demonstrated more than 10 masses in each breast, up to 2,6 cm diameter, compatible with fibroadenomas. After 13 month follow up lesions decreased in number and size. We discuss the natural history of FA, the hormonal influence in FA etiology, the ultrasound diagnosis and the managment of this pathology in adolescents. We hypothesized that there is an estrogen/progestin imbalance, due to the anovulatory cycles of the post menarche period that caused the AUB and FA. Cyclic progesterone balanced the E/P relation, thus managing both AUB and causing regression of the breast masses.

Histopathological Study of Neoplastic Lesions of Breast.

Aims and Objectives: 1) To study the incidence of various neoplastic lesions of breast. 2) To study the histopathological features of neoplasms and classify them according to WHO classification (2003). 3) To compare the results of study with those of other studies. Materials and Methods: The present study was prospective as well as retrospective which include 252 cases from October 2005 to October 2010. The specimens were received in different forms such as excisional biopsies, modified radical mastectomies, simple mastectomies, tru-cut biopsies, wide local excision and quadrantectomy specimens. Detail gross examination was done for each specimen and histopathological features were studied to classify neoplasms according to WHO classification 2003. Results: Out of total 9086 biopsies, breast biopsies were 366 (4%) during this 5 year study. Total 252 breast neoplasms were studied, where, the incidence of benign neoplasms was 50.4% (127 cases) & for malignant neoplasms was 49.6% (125 cases). Among all types of specimen received, excision biopsy was most common (48%). Upper outer quadrant was most commonly involved region for breast neoplasms. Fibroadenoma, benign phyllodes neoplasm, tubular adenoma, central papilloma, peripheral papilloma, lipoma and neurofibroma were seen among benign neoplasms. While invasive ductal carcinoma not otherwise specified, mixed carcinoma, metaplastic carcinoma, mucinous carcinoma, malignant phyllodes neoplasm, invasive lobular carcinoma, invasive papillary carcinoma, medullary carcinoma, intracystic papillary carcinoma, malignant peripheral nerve sheath neoplasm and collision neoplasm were studied among malignant neoplasms. The most common benign neoplasm was fibroadenoma (87%) and invasive ductal carcinoma not otherwise specified (88%) was malignant neoplasm. Conclusions: Fibroadenoma was the most common (87%) benign breast neoplasm. Among all malignant breast neoplasms, invasive ductal carcinoma, not otherwise specified was most common (88%). In cases of benign neoplasms, the highest incidence was found in the age group of 10-20 years (37%) while in the malignant neoplasms, it was 40 - 60 years (51.2%). The incidence of malignant breast neoplasm in male was 2.4%.

Inmunodetección de FHIT y E-cadherina en fibroadenomas y cáncer ductal y lobulillar de mama / Inmunodetection of FHIT and E-cadherin in fibroadenomas and ductal and lobular human breast cancer

En Chile, el cáncer es la segunda causa de muerte después de las enfermedades cardiovasculares. Los principales cánceres asociados a muerte en mujeres fueron mama, estómago, vesícula biliar, broncopulmonar y cérvico uterino. Alteraciones de las E-cadherinas han sido relacionadas con varios tipos de cáncer, ya que uno de los principales eventos involucrados con su disfunción es el gatillar la invasión y metástasis del tumor. La inactivación del gen CDH1 ha sido demostrada en el cáncer gástrico difuso y el cáncer de mama lobulillar. Asimismo, la inactivación del gen FHIT parece estar asociado con la progresión a neoplasias más agresivas. Se realizaron determinaciones inmunohistoquímicas (IHQ) en fibroadenomas mamarios y cánceres previamente diagnosticados por RE, RPg y Her2, mostrando positividad en todos los casos. La detección (IHQ) de la expresión de FHIT y E-cadherina en tejidos con patologías benignas y malignizados, puede aportar una importante información diagnóstica y pronóstica en el cáncer de mama.

In Chile, cancer is the second leading cause of death after cardiovascular diseases. The major death-related cancers in women were breast, stomach, gallbladder, lung and cervical cancer. Alterations of E-cadherin have been linked to various cancers, as one of the main events involved in its dysfunction is the trigger of tumor invasion and metastasis. CDH1 gene inactivation has been demonstrated in diffuse gastric cancer and lobular breast cancer. Furthermore, inactivation of the FHIT gene to be associated with progression to more aggressive tumors. Immunohistochemistry (IHC) determinations were performed in fibroadenomas and breast cancers previously diagnosed by ER, PgR and Her2, showing positivity in all cases. Immunohistochemical detection of FHIT and E-cadherin expression in tissues with benign disease and malignant, may provide an important diagnostic and prognostic information in breast cancer.

Tumores phyllodes de mama: clínica, tratamiento y pronóstico: Hospital Universitario de Canarias, España / Phyllodes tumor of the breast

El tumor Phyllodes de mama es un tumor poco frecuente que se engloba dentro de los tumores fibroepiteliales de mama, con un amplio abanico de presentación clínica y comportamiento biológico. Se clasifican en benignos, borderline o malignos, en base a factores histológicos. Las formas menos agresivas o benignas presentan un comportamiento similar al de los fibroadenomas, sin embargo las formas malignas suelen presentar un comportamiento más agresivo. El pronóstico de este tipo de tumor es favorable, con una recurrencia local del 15 por ciento de forma global y recurrencia a distancia entre 5-10 por ciento. El tratamiento se basa en la escisión quirúrgica de la lesión, acompañada de radioterapia e incluso quimioterapia en las formas más agresivas. Presentamos la revisión de 13 casos clínicos de esta entidad diagnosticados en nuestro centro entre 2001-2009.

Phyllodes tumor of the breast is a rare tumor, which is part of fibroepithelial breast tumors with a wide range of clinical presentation and biological behavior. They are classified into benign, borderline or malignant based on histologic factors. The less aggressive or benign forms show a more behavior to that of fibroade-nomas, but malignant forms usually show a more aggressive behavior. The prognosis of this tumor is favorable, with local recurrence in 15 percent overall and distant recurrence between 5-10 percent globally. The treatment relies on surgical excision of the lesion accompanied by radiotherapy and chemotherapy even in the most aggressive. We present a review of 13 cases of this entity diagnosed in our center between 2001-2009.

Adenomastectomia bilateral com reconstrução imediata para tratamento de lesão benigna da mama / Bilateral adenomastectomy with immediate reconstruction for treatment of a benign breast lesion

Os fibroadenomas são atualmente considerados uma forma localizada de hiperplasia nodular do tecido do estroma e do componente glandular das mamas. Sua maior incidência é em pacientes jovens entre 20 e 30 anos. Geralmente, são lesões únicas, porém, em 10 a 15%, apresentam-se como lesões múltiplas, podendo ser bilaterais em 10% dos casos. A frequência de transformação maligna é muito baixa (0,1 a 0,3 % dos casos), ocorrendo em média 15 a 20 anos após a média de idade de ocorrência do fibroadenoma. Os autores relatam caso de paciente de 29 anos, solteira, técnica de enfermagem, natural de Belo Horizonte (MG) que procurou o consultório médico queixando-se de extremo desconforto e nodularidade em ambas as mamas. Ao exame apresentava incontáveis nódulos bilaterais, volumosos, móveis, de consistência fibroelástica e não aderidos a planos profundos, ocupando praticamente todo o volume de ambas as mamas. No entanto, apresentava ausência de linfonodos regionais palpáveis (ultrassonografia 1). Ao exame, constatou-se: Múltiplos nódulos bilaterais, limites precisos, dimensões variadas, sendo o maior medindo 8,0 cm no QSL mama E. Paciente submetida a tratamento cirúrgico com reconstrução.

Fibroadenomas are considered a localized form of nodular hyperplasia of breast stroma and glandular tissue. Its greater incidence is in the 20-30 year-old age range. Although lesions are generally solitary, in 10 to 15% of the cases there are multiple lesions, with bilaterality in 10%. Malignant transformation rates are very low (0.1 to 0.3 % of the cases), occurring on average 15 to 20 years after the mean age of fibroadenoma occurrence. The authors report the case of a 29-year-old single nursing technician from Belo Horizonte, Minas Gerais, Brazil, who consulted with bilateral breast discomfort and nodularity. Physical examination revealed a great number of large freely movable fibroelastic nodules, not adhered to deep planes, occupying the whole extension of both breasts. There were no palpable regional lymphnodes, though. An ultrasound scan showed multiple bilateral precisely outlined nodes, of varying sizes, the largest measuring 8.0 cm and situated in the upper lateral quadrant of the left breast. The patient underwent surgery with reconstruction.

Tumor de células granulares de la mama: reporte de un caso / Granular cells tumor of the breast: a case report

Reportar un caso de tumor de células granulares de la mama, neoplasia generalmente benigna, de origen schwanniano que simula a menudo, clínica y radiológicamente un carcinoma mamario. Descripción de un caso clínico y revisión de la literatura. Paciente femenina de 33 años de edad con nódulo en mama derecha, evaluación mastológica clase V (Lesión de alta sospecha). Se propone y efectúa microbiopsia ecoguiada: Fibroadenoma mamario. Debido a la discordancia de los resultados, se realiza mastectomía parcial derecha con guía y control radiológico y corte congelado negativo para malignidad. Biopsia definitiva: Tumor de células granulares. Inmunohistoquímica: Inmunorreacción positiva en las células tumorales con proteína S100 y enolasa neuronal específica. 1. El tumor de células granulares de la mama aunque es una entidad poco frecuente y de carácter benigno, simula clínica y radiológicamente un carcinoma mamario, por tanto debe incluirse como diagnóstico diferencial. 2. La histogénesis del tumor de células granulares de la mama sigue en discusión. 3. El tumor en general es benigno y solitario, pero puede recidivar y sufrir transformación neoplásica (raro pero posible y publicado), por lo cual las pacientes deben ser estrictamente seguidas.

The objective of this work is to report a granular cells breast tumor case, generally benign neoplasia, of Schwann cells origin that often simulates a breast carcinoma. Description of a clinical case and literature revision. A 33 years old female patient, with right breast nodule attended to a mastology evaluation, which was concluded class V (Highly suspicious lesion). And ultrasound guided core biopsy was done. The pathology report was breast fibroadenoma. Due to the disagreement of the results with the suspicious images, she was offered with image guided right partial mastectomy plus preoperative frozen section which was report negative for malignancy. The definitive biopsy: Granular cells Breast Tumor. Immunohistochemical: Positive immunoreactivity in the tumor cells with protein S100 and enolase neuronal specific. 1. Granular cells breast tumors are not a frequent entity. Although is benign, it clinically and radiological simulates a breast carcinoma. 2. Histogenesis of granular cells breast tumor continues in discussion. 3. The tumor in general is benign and solitary, but it can recur and experiment malignant conversion (unusual but possible and published), for this reasons the patients should be strictly followed up.

Accuracy of triple test score in the diagnosis of palpable breast lump.

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosis helps to lessen the associated anxiety and leads to early definitive treatment. The aim of this study was to evaluate the accuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpable breast lump. This diagnostic test study was carried out in the Department of Surgery of Tribhuvan University Teaching Hospital. Of the 117 patients admitted with breast diseases from the breast clinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physical examination, mammography and fine needle aspiration cytology) and were categorized into benign, suspicious and malignant. This was later correlated with the histopathological findings. Nineteen patients with breast lumps interpreted by TTS as benign correlated with the histopathological findings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This gives TTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive value of 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age at diagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS is an accurate and least invasive diagnostic test based on which definitive treatment can be initiated.

Gigantomastia associada a fibroadenomas / Gigantomastia associated the Fibroadenomas

Gigantomastia é uma anomalia que causacomplicações sérias e nem todas as macromastias são sintomáticas. Dessa forma, uma avaliação apropriadada paciente, bem como um atendimento multidisciplinar faz-se necessário.A intervenção cirúrgica é conseqüentemente o método de escolha nesta patologia, sendo uma excelenteterapêutica na gigantomastia. O tamoxifeno pode ser um adjuvante útil e pode permitir resultados estáveis quandocombinado com a mamoplastia redutora .

Gigantomastia is a pathology that can cause serious complications but at some cases there are no symptoms. An adequate evaluation of the patient and a multidisciplinary attendance is necessary. The surgery intervention is the method of choice in this pathology, being an excellent therapeutic. TheTamoxifeno can be a good adjuvant producing stable results when combined with the cosmetic surgery .

Clinicopathologic features of breast disease in Jamaica: findings of the Jamaican Breast Disease Study, 2000-2002 / Características clínico-patológicas de la enfermedad de mamas en Jamaica: hallazgos del estudio jamaicano de la enfermedad de mamas, 2000-2002

OBJECTIVE: To describe the clinicopathologic profile of breast disease in Jamaica. METHODS: The Jamaican Breast Disease Study is an ongoing prospective, multidisciplinary investigation of breast disease at the University Hospital of the West Indies (UHWI). The initial phase was a prevalence survey comprising all consenting patients referred to the Surgical Outpatient Department (SOPD) UHWI, for breast disease. Demographic, clinical, radiologic and pathologic information were recorded for each patient and the data for the first three years (2000-2002) were analyzed. RESULTS: A total of 1189 patients was enrolled for the study period (28.8% of all new SOPD patients). The age range was10 to 93 years (mean/SD = 36.5 +/- 16.4 years) with a female : male ratio of 14:1. Most patients (67.8%) presented with a palpable lump and the clinical diagnosis was benign in the majority (70.4%) of patients. Fibroadenoma was the most common benign histologic result (39.4% of all biopsies) followed by non-proliferative (fibrocystic) disease (19.3% of all biopsies). Proliferative disease without atypia, complex fibroadenoma and atypical ductal hyperplasia accounted for 6.9%, 2.6% and 0.4% of biopsies respectively. Overall, 23.4% of biopsies showed malignant histology (10.8% patients); invasive ductal carcinoma accounted for the majority of these cases (69.5%). CONCLUSIONS: The majority of patients with breast disease in Jamaica are young women with clinically benign disease. There was a low prevalence of clinically significant premalignant disease. This is the first study to prospectively describe the clinicopathologic features of breast disease in Jamaica and supports the need for advocating breast cancer screening to facilitate detection of significant premalignant disease and early stages of breast cancer.

OBJETIVO: Describir el perfil clínico-patológico de la enfermedad de mamas en Jamaica. MÉTODOS: El "Estudio jamaicano de la enfermedad de mamas" - que continua realizándose en la actualidad en el Hospital Universitario de West Indies (HUWI) - consiste en una investigación prospectiva y multidisciplinaria de la enfermedad de mamas. La fase inicial fue un estudio de prevalencia que abarcó a todos los pacientes que dieron su consentimiento, y que fueron remitidos al Departamento de Cirugía Ambulatoria (DCA) de HUWI a causa de la enfermedad de mamas. Se registró información demográfica, clínica, radiológica y patológica de cada paciente, así como los datos referidos a los primeros tres años (2000-2002). RESULTADOS: Un total de 1189 pacientes fueron captados para el periodo de estudio (28.8% de todos los pacientes nuevos del DCA). El rango de edad fue de 10 a 93 años (media/SD = 36.5 + / - 16.4 años) con una proporción hembra:varón de 14:1. La mayoría de los pacientes (67.8%) presentó un nódulo palpable y el diagnóstico clínico fue benigno en la mayoría (70.4%) de los pacientes. El fibroadenoma fue el resultado histológico benigno más común (39.4% de todas las biopsias) seguido por la enfermedad (fibrocística) no proliferativa (19.3% de todas las biopsias). La enfermedad proliferativa sin atipia, el fibroadenoma complejo y la hiperplasia ductal atípica representaron el 6.9%, 2.6% y 0.4% de las biopsias respectivamente. En general, el 23.4% de las biopsias mostraron histología maligna (10.8% de los pacientes); el carcinoma ductal invasivo representó la mayoría de estos casos (69.5%). CONCLUSIONES: La mayor parte de los pacientes con la enfermedad de mamas en Jamaica son mujeres jóvenes con enfermedades clínicamente benignas. Hubo una baja prevalencia de enfermedades premalignas clínicamente significativas. Este es el primer estudio dirigido a describir prospectivamente las características clínico-patológicas de la enfermedad de mamas en Jamaica, y respalda la necesidad de abogar por el pesquisaje del cáncer de mamas, a fin de facilitar la detección de enfermedades premalignas significativas y las fases tempranas del cáncer de mamas.

Patologia benigna da mama / Mammary benign patology

A patologia benigna da mama é responsável por cerca de 80% das massas palpáveis. Seu diagnóstico diferencial é amplo, envolvendo distúrbios no desenvolvimento, doenças inflamatórias, alterações fobrocísticas, tumores benignos e doença mamária proliferativa, entre outros. O fibroadenoma, tumor benigno da mama, é a neoplasia mamária mais comum em pacientes menores de 35 anos, já os cistos são mais freqüentes na perimenopausa. O diagnóstico diferencial entre nódulos sólidos ou císticos poderá ser feito por meio da punção aspirativa com agulha fina ou pela ultra-sonografia. Nos nódulos císticos a punção por agulha fina além de diagnóstica, é conduta terapêutica. Neste artigo serão revisados aspectos dos diagnósticos diferenciados entre estes tumores, as abordagens terapêuticas e a associação entre tais patologias e câncer de mama.

Carcinoma within a fibroadenoma: a case report.

Carcinoma within a fibroadenoma is an extremely rare occurrence with a reported incidence of 0.1% and is most often diagnosed incidentally on post-operative examination of excision biopsy specimens. One such case is reported here for its rarity and also for stressing upon the need for compulsory excision of all breast masses clinically diagnosed as fibroadenoma and for highlighting the importance of histopathological evaluation of all breast masses irrespective of their clinical diagnosis as benign.

Fibroadenoma in axillary supernumerary breast: case report

CONTEXTO: O tecido mamário supranumerário pode ser acometido pelas mesmas doenças e alterações que comprometem o tecido mamário tópico. Porém, o relato de fibroadenoma em mama acessória axilar é raro. OBJETIVO: Descrever um caso de fibroadenoma de mama supranumerária axilar. TIPO DE ESTUDO: Relato de caso. RELATO DE CASO: Mulher de 39 anos, encaminhada ao Ambulatório de Ginecologia e Obstetrícia do Hospital Estadual Sumaré, com queixa de massa axilar bilateral. Paciente referia problemas cosméticos, dor e desconforto local. No exame físico, observaram-se alterações compatíveis com mamas acessórias axilares bilaterais, sem nódulos palpáveis. Os exames complementares (mamografia e ultra-sonografia) demonstraram nódulo de 1.1 cm em mama axilar direita. Paciente foi submetida à ressecção de mamas supranumerárias, com exame histopatológico revelando fibroadenoma de tecido mamário axilar direito.

Eficacia del ultrasonido intraoperatorio en el tratamiento quirúrgico de lesiones mamarias / Efficacy of intraoperative ultrasound in the surgical treatment of breast lesions

Demostrar en forma prospectiva la eficacia del ultrasonido intraoperatorio efectuado por el cirujano para localizar lesiones subclínicas de la mama o poco delimitadas a la palpación, tanto benigna como maligna, realizar su extirpación y además, en las malignas, palpables o no lograr tumorectomía con márgenes libres. Veintiuna lesiones mamarias, de las cuáles 80,9 por ciento (17/21) fueron subclínicas, se extirparon bajo guía ultrasonográfica intraoperatoria realizada por el cirujano. Se evaluó con ultrasonido ex vivo la completa excisión de las lesiones; así como la presencia de márgenes negativos en los casos malignos. En este último grupo se realizó además, comprobación intraoperatoria mediante impronta de bordes de resección. A todas las lesiones se le practicaron estudios anatopatológicos definitivos. Quirófano del Centro Clínico Familia. El ultrasonido intraoperatorio localizó 100 por ciento de las lesiones. Todos los cánceres subclínicos que representaron 29 por ciento de la muestra y los palpables, fueron extirpados con márgenes adecuados sin necesidad de re-excisiones. Tanto las lesiones benignas de riesgo; hiperplasia ductal atípica, adenosis esclerosante y papiloma intraquístico (29 por ciento) como las lesiones benignas sin riesgo: fibroadenoma, adenosis microglandular y fibrosis (33 por ciento), fueron eficazmente extirpadas. El ultrasonido intraoperatorio tanto en la localización de lesiones mamarias, especialmente subclínicas, como su exéresis eficaz es un método preciso y eficiente. Las ventajas son: mayor comodidad para la paciente, elimina las complicaciones de las localizaciones preoperatorias, menor costo, simplifica el acto operatorio y en los casos malignos provee adecuados márgenes de resección.