[Localization of non-palpable breast lesions with black carbon powder (experience of the Catholic University of Louvain)]. / Repérage au noir de carbone dans les lésions mammaires non palpables (expérience de l'UCL).

PURPOSE: The authors report their experience in presurgical localization of non palpable lesions with black carbon powder. MATERIALS AND METHODS: 153 cases of primary tumorectomies and mastectomies have been reviewed. The suspension is prepared in the hospital's pharmacy, the procedure is performed days or weeks before scheduled surgery without diffusion in the surrounding tissues. RESULTS: In 92% of cases, the carbon marker was observed less than 5 mm from the target and no significant interference with the pathologic diagnosis has been observed. CONCLUSION: Patient tolerance is good and providing close collaboration between the different members of the treating team, the authors believe that this technique may be a good alternative to wire localization.

Two schwannomas presenting as lumps in the same breast.

A case of two benign schwannomas of the right breast in a 25-yr-old woman is presented, including the use of fine-needle aspiration and biopsy diagnosis. A review of the literature did not reveal any such duality in the same breast. The tumors were made of clusters of spindle cells on cytological material. The final diagnosis was established through histological examination of the excised masses.

[Breast biopsy technique]. / Techniques de cytoponction mammaire.

The authors remind the fundamental bases of a successful needle puncture, both for cytological and histological purposes. Their different methods of puncture are described and for each modality, practical advice is aiming at increasing the cellular or tissular component of the samples are given.

Breast infiltration by acute lymphoblastic leukemia during pregnancy.

A case of bilateral breast infiltration as the initial manifestation of FAB-L3 leukemia during pregnancy is reported. This rare presentation is usually associated with Burkitt's lymphoma or FAB-L3 leukemia. A high suspicion of the presence of hematologic malignancy and appropriate evaluation are indicated in the presence of this clinical manifestation.

[Systematic mammographic screening for breast cancer in asymptomatic women]. / Dépistage du cancer du sein par mammographie systématique chez des femmes asymptomatiques.

It appears that the mortality rate from breast cancer decreases in 50-year-old (and over) women submitted to mammographic screening. Since 1980, the Unit of Cancer Prevention of the UCL is proposing mammographic screening to women with normal clinical examination but belonging to a "high-risk" group. Among the 5651 mammographies which were performed on 2924 women, 24 biopsies have been proposed and 16 cases of cancer have been diagnosed. 5.5% breast cancers have been detected. This result is consistent with the average figures reported in the screening programmes abroad. Questions about the age at which cancer screening should start and about the number of views that should be taken are also discussed.

Esophageal cancer.

The authors invited eminent Belgian specialists to report on their experience in esophageal cancer. A summary is given of the most striking features of their reports.

Prebiopsy localization of non-palpable breast cancer.

Mammographic screening results in the detection of non-palpable breast lesions which demand surgical excision after careful marking by the radiologist. The main localization procedures are described as well as their preferential indications. Stereotaxic localization and harpoon technique are analysed more in detail and so are their advantages and inconvenients. Continuous research for the best compromise patient tolerance/efficiency/costs of the method remains an absolute necessity. To this regard the use of a carbon material suspension described in 1983 by Svane appears to be a really interesting and promising preoperative tracer.

Rectal cancer: a summary.

The authors summarize the most important conclusions of a multicentric multidisciplinary review on rectal cancer in Belgium.

[Selective galactophorectomy: technic and indications]. / La galactophorectomie sélective: technique et indications.

The authors describe the way of operating the selective galactophorectomy and discuss the indications. Each pathological nipple discharge may reveal a carcinoma. The clinical characteristics of the discharge, the results of the cytology, of the mammography and the galactography help to come to a diagnosis. This can only be confirmed after a thorough histological examination of the involved duct. Selective galactophorectomy is a simple operation that hardly leaves any scars. According to the authors, this method has a real advantage to find the diagnosis and to treat pathological nipple discharge.

Management to prevent high-sited recurrence of pharyngo-laryngeal cancers.

The development of reconstructional techniques in cervico-facial surgery has led to the proposal of surgical solutions, in conjunction with radiotherapy, for the extensive epidermoid carcinomas of the oropharynx and hypopharynx that were formerly rejected by the surgeon. However these stage III or IV epidermoid carcinomas carry a heavy proportion of "high" recurrences, i.e. situated in the parapharyngeal, oropharyngeal and rhinopharyngeal regions. The reasons for this are: the lymphatic continuity between the oro- and hypopharynx and the parapharyngeal regions and the base of the skull; the limitation of neck dissections higher up at the tip of the mastoid and the lower parotid border; the limitation of postoperative irradiation directed upwards. Therefore for these lesions we propose an extended therapeutic programme comprising pre-operative chemotherapy based on cisplatinum, bleomycin and methotrexate, an adequately wide surgical resection followed by reconstruction and an irradiation extending upwards by two lateral fields to the oropharynx, the rhinopharynx and the parapharynx.

[X-ray computed tomography: examination of choice in cervicofacial pathology? Radio-anatomical correlation. Imagery of the chosen cases]. / Tomodensitométrie: examen de choix en pathologie cervico-faciale? Corrélation radio-anatomique--imagerie de cas choisis.

The authors present their experience of tomodensitometry in cervico-facial pathology. Their work approaches the subject successively from three angles, first comparing 51 cases of tomodensitometric exploration to the classic techniques used in cervico-facial pathology. Next, a correlation is established between the tomodensitometric images and surgical biopsies from 28 pharyngolaryngeal cancers. From the third angle, some selected cases are used to illustrate the contribution by tomodensitometry to the radiology of cervico-facial pathology. From this study, tomodensitometry would appear to be a radiological investigation of choice in cervico-facial oncology for estimating the extent and depth of the tumour, while equalling if not being superior to the traditional radiological techniques for assessing the lesions in this region, whether they be benign or malignant.