RESUMEN
OBJECTIVE: To asses and analyse the results of 3 years large scale mammography screening of breast cancer in Ariana state in Tunisia. MATERIALS AND METHODS: This program, managed by the Family and Population National Office, was addressing to women aged from 49 to 69 years old residing in a area with adds up a population of 459 700 inhabitants including 52,729 women in the target age population. The screening was including a breast clinical examination and a mammography with two incidences face and external profile. The women was invited at their residence or were sensitized in the reproductive health centers, care and base health centers or by a close relation which heard of the program. An enlightened assent was submitted to the women who wished to profit from the screening. RESULTS: In three years, 9093 mammography were carried out of which 8244 were retained in the analyses, that is to say a rate participation of 9.6%. The rate of women recalled for suspect test was of 18.1% and it was of 13.1% among women of more than 50 years. The rate of practiced surgical biopsies was of 0.5% and the positive predictive value was of 45.5%. The average time between the date of screening and the result of the screening was 9.7 days, more important in the event of tests requiring a complementary assessment (61.7 days). On the whole 40 cancers were detected by the program, that is to say a rough rate of detected cancers, of 4.9 per thousand, in conformity with the recommendations. The percentage of invasive cancers < or = 10 mm was of 24.3 whereas percentages of in situ cancers and of cancers without ganglionic invasion were respectively of 7.7% and of 50.0%. CONCLUSIONS: The weakness of our study lay primarily in the rate of participation which remained weak. The methodology adopted for the sensitizing of the women is proven not very effective and did not allow inviting all eligible women. Results of the study are encouraging in spite of its limited impact and made it possible to detect an important rate of cancers of which cancers infra-private clinics.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Mamografía , Tamizaje Masivo , Adulto , Anciano , Neoplasias de la Mama/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Túnez/epidemiologíaRESUMEN
We present the radiological protocol of the breast cancer screening program of Ariana state in Tunisia. Specifications of this protocol are largely inspired from the french model adapted to the socioeconomic Tunisian conditions. We explain the guidelines of the mammograph specifications, quality insurance of all the process, mammography procedure, double reading, complementary views and ultrasound indications and final results management.
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Neoplasias de la Mama/diagnóstico , Mamografía/normas , Protocolos Clínicos , Femenino , Humanos , TúnezRESUMEN
OBJECTIVE: To report the preliminary results of the feasibility of breast cancer mammographic screening among women younger than 50 years from the l'Ariana state of Tunisia. MATERIAL AND METHODS: The National office of the Family and Population (ONFP) launched a protocol on feasibility of breast cancer mammographic screening targeting asymptomatic women aged 40-69 years, from the l'Ariana state in Tunisia. We practiced two oblique and face incidences at the mammography screening unit of the ONFP, whose equipment and control system of quality answered to the European Communitiy for breast cancer screening. RESULTS: We did 5325 mammograms between April 2004 and March 2006. Our targeted population had a 48.9 years mean age (CI 95% = [48.7-49.1]), 60.3% of them younger than 50 years. There were more young women with high breast denisty (8.2%) compared to the group from 50 to 69 years (2.1%). The women arising from the 40-49 years cohort had a socio-economic and educational level higher. The complementary rate of examination/explorations was higher in this cohort (19.5%) vs 11.5% for the 50-69 years. The youngest women presented a more often positive test (7.0 vs 5.2%) than the oldest women (p<0.01). CONCLUSION: The option to screen breast cancer by mammography in women younger than 40 years in Tunisia is partially justified by the relatively high frequency of this cancer in this age group. Our feasibility poorly useful in screening will be used to sensibilise females to the problematic of breast cancer to obtain a better compliance compared to the older age group of 50-59 years.
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Neoplasias de la Mama/diagnóstico , Mamografía , Tamizaje Masivo , Adulto , Neoplasias de la Mama/epidemiología , Estudios de Factibilidad , Femenino , Humanos , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Túnez/epidemiologíaRESUMEN
OBJECTIVE: This retrospective work is related to ACR3 mammograms of the program "Feasibility of breast cancer screening by mammography in Ariana Governorate" in order to evaluate the efficiency and short-term quality control of these probably benign lesions. MATERIALS AND METHODS: Mammograms classified ACR3 raised the indication of further examination, futher mammogram (profile, expanded or compression). The monitoring and control period are explained to the patient by the radiologist. RESULTS: 6.6% mammograms were classified as ACR 3 with 71.3% under the age of 50 years. Breast is very dense in 20.5% of cases, and transparent in 6% of cases. Further exams has been performed in 94. 5% of cases with a profile in 52% of cases, enlarged in 22.1%, compression in 24.9% and ultrasound in 82.5%. The surveillance protocol was insufficient for 126 women lost to the 1st control, 32 women lost for the 2nd control and 19 women were lost to the 3rd control. After two years monitoring, 219 women were reclassified as ACR2 with a negative test. In 2 patients, we found an invasive ductal carcinoma at 4 months control. CONCLUSION: ACR 3 mammograms are the most important operator dependent category. The diagnosis of probably benign lesion dependant of the analysis of images and requires a great experience of the radiologist and a comprehensive complementary examination. In this study, this assessment was often heavy in relation to the frequency of dense breasts itself in connection with the young age of patients. In addition, for this particular category, the need of training is important and in terms of public health cost, the management of ACR3 mammograms increases difficulties and cost of screening.
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Neoplasias de la Mama/patología , Mamografía , Tamizaje Masivo , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , TúnezRESUMEN
OBJECTIVE: To report the results of breast ultrasonographically-guided fine needle aspirations and needle biopsies within the breast cancer screening program of L'Ariana state in Tunisia. MATERIAL AND METHODS: Our retrospective study include 143 patients, with mammographically detected lesions, which underwent a diagnostic percutanous ultrasonographically guided procedures. 57 patients underwent a fine needle aspiration, 25 underwent a needle biopsy and 61 patients underwent both procedures. RESULTS: Sensitivity and specificity of fine needle aspiration are of 84.2% and 98.5%. We report 13.5% of non contributive results. The needle biopsy have a sensitivity of 97.3% and a specificity of 100% with one false negative corresponding to an atypical ductal hyperplasia at the excisional biopsy. CONCLUSION: Fine needle aspiration is a reliable method of accurately establishing a diagnosis. Needle biopsy is recommended for a preoperative lesion characterisation before adequate treatment.
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Biopsia con Aguja Fina , Neoplasias de la Mama/diagnóstico , Mama/patología , Ultrasonografía Intervencional , Adulto , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , TúnezRESUMEN
We describe the case of a 38-year-old woman with breast tuberculosis associated with a second localization in the lumber spine. These features simulated breast cancer with vertebral metastasis. Clinical and imaging findings are described herein.
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Enfermedades de la Mama/diagnóstico , Vértebras Lumbares , Tuberculosis de la Columna Vertebral/diagnóstico , Tuberculosis/diagnóstico , Adulto , Antituberculosos/uso terapéutico , Enfermedades de la Mama/diagnóstico por imagen , Enfermedades de la Mama/patología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Mamografía , Neoplasias de la Columna Vertebral/diagnóstico , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/secundario , Tuberculosis/diagnóstico por imagen , Tuberculosis/patología , Tuberculosis de la Columna Vertebral/diagnóstico por imagen , Tuberculosis de la Columna Vertebral/patología , Ultrasonografía MamariaRESUMEN
INTRODUCTION: Carotid body tumors are rare hypervascular lesions arising from neural crest paraganglion cells. MATERIALS AND METHODS: We retrospectively analyzed the imaging features of six patients with carotid body tumors to precise their imaging characteristics in order to find specific signs and elaborate a strategy for diagnosis. RESULTS: Imaging features detect the vascular nature of these tumors of the carotid space causing characteristic widening of the carotid bifurcation. Two patients had multiple (two or more) localizations and one had a family history of glomus tumor. CONCLUSION: MRI with MRA is considered as the gold standard imaging technique for the evaluation of glomus tumors as it allows a multiplanar approach which is important in the preoperative study.
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Tumor del Cuerpo Carotídeo/diagnóstico , Diagnóstico por Imagen , Adulto , Anciano , Arterias Carótidas/patología , Tumor del Cuerpo Carotídeo/irrigación sanguínea , Medios de Contraste , Femenino , Tumor Glómico/genética , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Ultrasonografía DopplerRESUMEN
Ganglioneuroma is a neurogenic tumor originating from autonomic ganglia. It most commonly occurs in patients younger than 20 years with a slight predominance of females. The pelvic localization is rare. Imaging can lead to diagnosis but it is not specific. The diagnosis can only be confirmed by the pathologic study. The authors report one case of pelvic ganglioneuroma diagnosed in an 11-year-old child who also had hypertension and renal failure.
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Ganglioneuroma/diagnóstico , Neoplasias Pélvicas/diagnóstico , Lesión Renal Aguda/diagnóstico , Niño , Diagnóstico por Imagen , Humanos , Hipertensión/diagnóstico , MasculinoRESUMEN
Diabetic fibrous mastopathy was first described in 1984. This mastopathy usually occurs in patients with autoimmune disorders and often occurs in patients with insulin-dependent diabetes. Little is known about this benign condition. Clinically and radiologically, this entity may simulate malignancy. The presence of an underlying auto-immune disorder or diabetes may suggest the correct diagnosis. The authors report two cases of fibrous mastopathy and suggest that core biopsy could replace surgical biopsy for diagnosis.