ABSTRACT
BACKGROUND: nonconcrete the mammary injuries are frequent in programs of detection of breast cancer, estereotaxic or ecographic marking is required to realize its split. The intrasurgical radiation control of the surgical piece is indispensable to evaluate the margins of the mammary cancer. OBJECTIVE: to determine the effectiveness of the intrasurgical radiation control of the surgical piece in nonconcrete mammary injuries to diminish the surgical reinterventions to extend margins. PATIENTS AND METHOD: women with nonconcrete mammary injuries to those who biopsy by split became, previous marking and intraoperating radiation control of the surgical piece to value margins (suitable margin the same or major of 10 mm, smaller inadequate margin of 10 mm). Intrasurgical reesicion in inadequate radiological margins became. The demographic characteristics, masto-ecographics images, histopathology of the injuries and the radiological-histopatol6gica correlation of the margins studied. Cross-sectional, prospective and descriptive study. RESULTS: 103 patients with 113 nonconcrete mammary injuries included themselves, with age average of 51,35 (32-73) years. In all the injuries the intrasurgical radiation control became of the surgical piece. The prevalence of mammary cancer was of 28.3% (32/113), that corresponds to stellar images (42.8%), suspicious microcalcifications with density (39.2%), microcalcifications (31.2%) and nodules (20%). Of the 32 cancers, 16 had inadequate radiological margins that required intraoperating reescision; suitable histopatologic margins in 100% were obtained (16/16). The 16 (62.5%) cancers without intraoperating reescisi6n by suitable radiological margins had suitable histopatologic margins and 37.5% (6/16) inadequate ones that required surgical reinterventionn to control the margins. The discrepancy between margins was related to microcalcifications in 83.3% of the injuries. CONCLUSIONS: the intrasurgical radiation control of the surgical piece is effective to evaluate margins; the intrasurgical reescisión changed inadequate margins to suitable in 50% (16/32) of the cancers; only 18.7% (6/32) of the total of cases required another surgery to control the margins.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Intraoperative Care , Cross-Sectional Studies , Diagnostic Techniques, Surgical , Female , Humans , Middle Aged , Prospective Studies , RadiographyABSTRACT
BACKGROUND: Regulations concerning the use of x-rays in medical diagnoses were published in Mexico in 1997. In this work, we evaluate technical aspects of mammography services in the Mexico City area and radiation dose and coincidence between the radiological interpretation by the institution radiologist and by a panel of experts. METHODS: Following methodology proposed by the American College of Radiology and the European Community among others, we have evaluated the performance of six mammography systems in Mexico City public and private services. The studied services carry out approximately one half of the mammography studies in the capital's metropolitan area. RESULTS: The systems comply with 53-82% of a total of 31 applied quality control tests and measurements, which include the mammography unit, x-ray generation, collimation, automatic exposure control, compression devices, grid and image receptor, film processing, darkroom, viewboxes, dose, film rejection, and image quality. The elements that most frequently fail are film processing, darkroom, and light boxes; average ACR phantom score is 11.2 (9.5, 12.0); mean average glandular dose measured with the phantom is 1.00 (0.71-1.15) mGy, and measured in patients is 1.75 (0.3, 4.9) mGy; coincidence between radiologic reports (BI-RADS) by the institution radiologist and a panel of experts is obtained in 35% of studied cases. CONCLUSIONS: Statistical analysis of results indicated that the level of equipment performance is correlated with image quality, image quality estimated by the panel of radiologists is correlated with phantom score, and coincidence in clinical mammography reports is not correlated with equipment performance and appears to depend on the radiologist's experience.
Subject(s)
Breast Neoplasms/diagnostic imaging , Mammography , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted , Breast Neoplasms/pathology , Cities , Female , Humans , Mammography/instrumentation , Mammography/methods , Mammography/standards , Mexico , Phantoms, Imaging , Quality Assurance, Health Care , Quality Control , Statistics as TopicABSTRACT
Objetivo. Demostrar la utilidad de la centelleografía con 111In-octreótido en la detección del glomus carotídeo único o múltiple comparada con los eritrocitos marcados con 99mTc. Calcular la sensibilidad, especificidad y precisión de ambas pruebas. Diseño. Encuesta comparativa (prueba diagnóstica). Lugar. Hospital Oncológico de concentración del Distrito Federal, México. Sujetos. Veinte pacientes enviados al servicio de medicina nuclear para diagnóstico de glomus carotídeo. Mediciones principales. A todos se les realizó centelleografía con eritrocitos marcados con 99mTc y con 111In-octreótido. El diagnóstico se confirmó con tomografía axial computarizada y ultrasonido, se tomó como estándar de oro la angiografía selectiva y/o histopatología. Resultados. Con eritrocitos marcados con 99mTc las verdaderas positivas fueron 13, verdaderas negativas tres, falsas positivas tres, falsas negativas una; la sensibilidad fue de 92 por ciento, especificidad 50 por ciento, exactitud 80 por ciento. Con el 111In-octreótido verdaderas positivas 14, verdaderas negativas seis, falsas positivas 0, falsas negativas 0. Se obtuvo una sensibilidad, especificidad y exactitud de 100 por ciento. El intervalo de confianza fue de 95 por ciento. Conclusiones. Consideramos que la centelleografía con 111In-octreótido debe ser la metodología de imagen de elección para detectar con certeza el glomus carotídeo previo a la cirugía o bien radioterapia en pacientes que por su edad, por el tamaño de la lesión o por su localización no son candidatos a cirugía.
