RESUMO
There is a general consensus that earlier detection of breast cancer should result in improved survival. Current breast imaging relies primarily on mammography. Despite better equipement and regulation, variability in interpretation and tissue density still affect accuracy. A number of adjuvant imaging techniques are currently being used, including doppler ultrasound and gadolinium-enhanced MRI, which can detect cancer-induced neovascularity. In order to assess the potential contribution of currently available high-resolution digital infrared technology capable of recognizing minute regional vascular flow related temperature variation, we retrospecitively reviewed the relative ability of our preoperative clinical exam, mammography, and infrared imaging to detect 100 new cases of ductal carcinoma in situ, stage I and II breast cancer. While the false-negative rate of infrared imaging was 17%, at least one abnormal infrared sign was detected in the remaining 83 cases, including 10 of the 15 patients, a slightly younger cohort, who had nonspecific mammograms. The 85% sensitivity rate of mammography alone thus increased to 95% when combining both imaging modalities. Access to infrared information was also pertinent when confronted with the relatively frequent contributory but equivocal clinical exam (34%) and mammography (19%). The average size of those tumors undetected by mammography or infrared imaging was 1.66 cm and 1.28 cm, respectively, while the false-positive rate of infrared imaging in a concurrent series of 100 successive benign open breast biopsies was 19%. Our initial experience would suggest that, when done concomitantly with clinical exam and mammography, high-resolution digital infrared imaging can provide additional safe, practical, and objective information. Further evaluation, preferably in controlled prospective multicenter trials, would provide valuable data.
RESUMO
Between January 1971 and December 1978, 117 consecutive patients with unilateral early stage carcinoma of the breast were treated with limited surgery, with or without the addition of postoperative radiotherapy. Local excision alone was found to be inadequate treatment for T1 and T2 carcinoma of the breast. Local recurrence rates were also high in patients with T1 and T2 lesions treated by local excision plus relatively low dose radiotherapy. Local recurrence was, however, infrequent after partial mastectomy, and no local failures were observed after partial mastectomy plus postoperative radiotherapy to a dose of 5000 rad in 5 weeks. Morbidity with such treatment is minimal and cosmetic results are generally excellent.
