ABSTRACT
OBJECTIVES: To evaluate the underestimation rate and clinical relevance of lobular neoplasia in vacuum-assisted breast biopsy (VABB). METHODS: A total of 161 cases of LN were retrieved from 6,435 VABB. The histological diagnosis was ALH (atypical lobular hyperplasia) in 80 patients, LCIS (lobular carcinoma in situ) in 69 patients and PLCIS (pleomorphic lobular carcinoma in situ) in 12 patients. Seventy-six patients were operated on within 2 years after VABB and 85 were clinically and radiologically monitored. The mean follow-up was 5.2 years, and the prevalence of malignancy was evaluated in the group of 85 patients. RESULTS: The clinico-pathological characteristics significantly favouring surgery were larger lesions, occurrence of a residual lesion following VABB and histological LCIS and PLCIS subtypes. The VABB underestimation rate as compared to surgery was 7.1% for ALH, 12% for LCIS and 50% for PLCIS. Overall, 11 of the 148 patients included in this survival analysis developed an ipsilateral tumour. CONCLUSION: Although obtained retrospectively in a relatively small series of patients, our data suggest that only patients with a diagnosis of PLCIS in VABB should be treated with surgery, whereas patients with ALH and LCIS could be monitored by clinical and radiological examinations. KEY POINTS: ⢠The treatment of ALH and LCIS in VABB is still debated ⢠Some authors favour radical treatment and others a more conservative approach ⢠Only patients with PLCIS in VABB should be treated by surgery.
Subject(s)
Adenocarcinoma in Situ/diagnosis , Biopsy, Needle/methods , Breast Neoplasms/diagnosis , Breast/pathology , Carcinoma, Lobular/diagnosis , Adenocarcinoma in Situ/epidemiology , Adult , Aged , Breast Neoplasms/epidemiology , Carcinoma, Lobular/epidemiology , Equipment Design , Female , Follow-Up Studies , Humans , Incidence , Italy/epidemiology , Middle Aged , Neoplasm Staging/methods , Retrospective Studies , VacuumSubject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/diagnosis , Breast Neoplasms/secondary , Hemangiosarcoma/diagnostic imaging , Hemangiosarcoma/diagnosis , Hemangiosarcoma/secondary , Breast Neoplasms/pathology , Breast Neoplasms/radiotherapy , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/radiotherapy , Carcinoma, Ductal, Breast/surgery , Female , Humans , Lipoma/diagnosis , Lipoma/diagnostic imaging , Magnetic Resonance Imaging , Middle Aged , UltrasonographyABSTRACT
BACKGROUND: The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy. MATERIAL/METHODS: This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a "hot spot" corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy. RESULTS: Preoperative sentinel node identification was successful in all patients. CONCLUSIONS: The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks.
Subject(s)
Biopsy, Needle/methods , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Image-Guided Biopsy/methods , Neoplasm Staging/methods , Ultrasonography/methods , Female , Humans , Pilot Projects , Prospective Studies , Radioactive Tracers , Sentinel Lymph Node Biopsy/methodsABSTRACT
OBJECTIVE: To study whether there is an epidemiological association between liver hemangiomas and oral contraception use, as may be suggested by clinical observations of liver hemangioma growth during pregnancy and under estrogen administration. METHODS: A case-control study of 40 women with liver hemangiomas, as diagnosed by imaging studies [ultrasonography (US) or computed tomography (CT) and nuclear scan], and 109 age-matched control with normal studies. The women were interviewed with respect to their menstrual, reproductive and oral contraception use history. RESULTS: The liver hemangioma and control groups did not differ significantly with regard to their menstrual or reproductive history. Ever oral contraception use was reported by 30% of the cases and 27% of controls. The odds ratio (OR) was 1.1 [95% confidence interval (CI) 0.52-2.60] for ever use, 1.64 (95% CI 0.37-7.13) for initiation before the age of 20, and 0.62 (95% CI 0.16-2.42) for use duration of less than 1 year. On the multivariate analysis only the women's age emerged as a predictor for liver hemangiomas (OR 3.1; 95% CI 1.16-8.96). CONCLUSIONS: In this study liver hemangiomas were not associated with menstrual, reproductive and oral contraception use history.
