[Results of stereotactic breast biopsy in mammographically suspicious lesions]. / Ergebnisse der stereotaktischen Mammabiopsie bei mammographisch suspekten Läsionen.

PURPOSE: The object of this study was to evaluate the diagnostic accuracy of the stereotactic large core breast biopsy in the histological assessment of mammographically suspicious lesions. MATERIAL AND METHODS: In 106 patients with a mammographically suspicious lesion, 67 with a mass (55 non-palpable, 12 palpable and 39 with microcalcification stereotactic large core biopsies were performed. Samples were obtained in the prone position under local anesthesia with a 14-gauge needle and an automated high-speed gun. An average of 4.3 cores per lesion were acquired. In 68 patients (64%) an additional surgical biopsy was performed, 38 (36%) had clinical and mammographic follow-up. RESULTS: In 4 of the 106 stereotactic biopsies insufficient material for the histological examination was obtained. In the 68 core biopsies with surgical correlation there were no false-positive, but 2 false-negative results with regard to the malignancy of the lesion (sensitivity: 93.8%; specificity: 100%). The 2 false-negative results were obtained in lesions that were mammographically judged as malignant while histology of the stereotactic biopsy showed fibrosis. The stereotactic large core breast biopsy was well tolerated by all patients. No clinically significant complications occurred. CONCLUSION: The stereotactic large core breast biopsy of a mammographically suspicious lesion can be performed with a high diagnostic accuracy. A correlation of the mammographic and histological findings and a follow-up program are necessary in order to recognize false-negative results early and to avoid a delay in the diagnosis.

[Place of triple diagnosis in the differential diagnosis of benign and malignant breast cancers (studies of 1819 women)]. / Stellenwert der Tripeldiagnostik bei der Differentialdiagnose gut- und bösartiger Mamma-Erkrankungen (Untersuchungen an 1819 Frauen).

In 1819 female patients, the diagnostic value of clinical examination, mammography, and fine needle biopsy separately as well as in combination (so-called triple diagnosis) has been investigated. Comparing the histological findings with each of the several examination procedures, the triple diagnosis proved to have a high diagnostic validity (sensitivity 0.98; specificity 0.99). If the result of all three findings is "benign" and the diameter of the tumour does not exceed 20 mm, the diagnostic extirpation of a mammary tumour will usually not be necessary. On the other hand, if the findings unanimously read "malignant" it is to be discussed whether a primary mammary amputation should be carried out. The examinations of the triple diagnosis can be made during a consultation and the risk is insignificant. They will only affect the patients very little and will leave no scars if repeated.

[Value of sonography in assessing nodular changes of the thyroid in an endemic goiter area]. / Zur Wertigkeit der Sonographie für die Beurteilung nodöser Schilddrüsenveränderungen im Strumaendemiegebiet.

In an area of endemic goiter 304 patients with an increased thyroid gland were examined by palpation, sonographically and partly scintigraphically. The average age was 37 (12-78) years, the average age of the patients with nodular changes of the thyroid gland 38-44 years. Patients with a diffuse struma were significantly younger with an average age of 33 years. A false-positive enlargement of the thyroid gland established by palpation occurred in 16.1% (n = 49/304). In the sonographic examination 148 out of 304 patients revealed a diffuse enlargement of the thyroid gland without provable nodular change. However, in about one third already more or less clearly characterized regressive changes could be observed. In 156 of the 304 patients 109 times solitary nodes and 47 times multinodular changes were established sonographically. In more than one third of all nodular goiters or one fifth of all patients examined a cyst was demonstrated sonographically. Two thirds of the sonographically established nodular changes were, however, solid. In 53 of all 304 examined patients could sonographically be established additional, unexpected nodes which had escaped the palpation and partly also the scintigraphic investigation. In 14% the node suspected by palpation could not be ascertained sonographically. According to the echo structure echo-poor and echo-equal solid nodes dominated. The frequency of carcinomata of the solid nodes was 6.7%. Apart from 4 echo-poorly and 2 complexly structured nodes a carcinoma of the thyroid gland demonstrated itself sonographically to the same echo. Finally conclusions are drawn for the diagnostics of the thyroid gland in the endemic area of goiter.