[Automated mammary sonography and mammography: the differentiation of benign and malignant breast lesions]. / Automatisierte Mammasonographie und Mammographie: Differenzierung benigner und maligner Mammaläsionen.

PURPOSE: A prospective study on the differentiation of breast lesions was carried out using experimental combination schemes of mammography and automatic sonography. MATERIALS AND METHODS: X-ray mammograms and a B image from automatic sonography of 39 malignant and 41 benign lesions as well as 40 cases without lesions were separately examined by four experienced diagnosticians. The observers differentiated the findings mammographically and by measurement in the B images. RESULTS: For two examiners the combination of mammography and automatic sonography gave with regard to the differentiation of breast lesions an improvement in sensitivity of 3 or 5% and in specificity of 31 and 18%, respectively, as compared to mammography alone while for the other two examiners an improved specificity of 21 and 36%, respectively, was accompanied by an 8 and 10% decrease in sensitivity as compared to mammography alone. CONCLUSIONS: The differentiating criteria from automatic sonography and mammography can, in principle, be used to evaluate the dignity of breast lesions. However, an optimization is necessary since the improvement in specificity does not compensate the loss in sensitivity.

[Possibilities and limits of diagnostic frozen section in breast carcinoma]. / Möglichkeiten und Grenzen der Schnellschnittdiagnostik beim Mammakarzinom.

A short overview is given demonstrating the possibilities and limits of the frozen section technique in mammary carcinoma. The accuracy of this method in diagnostic pathology of the mammary gland is up to 97% when applied by experienced pathologists. In case of breast cancer it may be difficult to determine the maximum of tumor size and the minimum tumor-free distance to the resection margin which are significant for a breast-conserving operation. There are further limits when an atypical ductal hyperplasia (ADH) should be differentiated from a ductal carcinoma in situ (DCIS) and when in case of DCIS microinvasion is to be proven. Nevertheless, intraoperative frozen section technique is unrenunciable for breast cancer surgery. Mistakes can be avoided in most of the cases, if surgeon and pathologist will closely cooperate and if both are fully aware of the limitations of the method.

[Surgery of breast carcinoma in the elderly woman]. / Die Chirurgie des Mammakarzinoms der alten Frau.

From our experience the age of the patient does not seen to be a contraindication to surgical therapy of breast cancer. There was no statistically significant difference in the tumor staging between patients younger than 75 years and patients older than 74 years. Although radical surgery was not possible in all cases of patients older than 74 years because of general risk factors, there was not statistical difference in the survival rates of patients younger than 75 years.