RESUMEN
BACKGROUND: Our objective was to determine whether colposcopy can be performed with surgical-type loupes. METHODS: Sixty-one patients with abnormal Papanicolaou (Pap) smear test reports were examined with 6× loupes supplied by Designs For Vision, Inc. (Ronkonkoma, NY) and with a standard Zeiss Colposcope (Model OM-1). Comparisons between the two instruments were made for colposcopic impression and final histological analysis. Statistical analysis was performed by using the Kappa test. RESULTS: Comparison of the two methods of examination demonstrated excellent agreement (κ = .86) with Pap smear and biopsy results. CONCLUSIONS: We decided that surgical loupes are adequate for colposcopic examination.
RESUMEN
BACKGROUND: Our objective was to describe our experience in using a newly designed surgical loupe as a substitute device for colposcopy. METHODS: Eighty-two patients were examined with a prototype surgical loupe. The instrument has a self-contained halogen light source, allows for 6× and 10× magnification, and has a green filter. Colposcopic impression within one degree of the histological diagnosis was considered in agreement. The colposcopic impression using the new instrument was compared to biopsy diagnoses. RESULTS: Colposcopic impressions with this new instrument agreed with final histological diagnoses in 93% of cases. The instrument was easy to use. CONCLUSION: The 6× to 10× surgical loupe is comfortable to use. Correlation with final pathological evaluation is comparable to standard colposcopic instruments. A trial of this instrument against a standard colposcope is ongoing.
RESUMEN
A case-control study based on a screened population in New York City examined epidemiologic risk factor differences between minimal breast cancer (in situ and small invasive carcinomas) and all other breast carcinomas, referred to as clinical breast cancer. Histopathologic re-review of the original slides identified 113 minimal and 792 clinical breast cancers among 1,290 eligible cases; 2,173 randomly selected screenees served as controls. Among those who developed cancer, black women were twice as likely to develop minimal, as compared to clinical, breast cancer. Women who were less than 20 years of age at first live birth had more than double the probability of being diagnosed with minimal breast cancer, whereas women with first live birth at age 30 years or greater and nulliparous women were at 1.5 times the risk of clinical breast cancer. The relative proportion of minimal breast cancer increased with increasing number of children breast fed, being twofold among women who nursed 2 children or more. Unlike clinical breast cancer, minimal breast cancer was not associated with either family history of breast cancer or obesity. Meaningful histologic differences were not apparent between the case subgroups. Except possibly for obesity, these results could not be explained by any plausible diagnostic bias.