The value of axillary ultrasound with fine needle aspiration as a pre-operative staging procedure in breast cancer: Northern Irish experience.

INTRODUCTION: In our unit sentinel lymph node biopsy (SLNB) is performed without intra-operative pathological nodal assessment. If node biopsies are positive the patients have to return at a later date for a complete axillary node clearance (ANC). METHODS: We conducted a retrospective study to ascertain if the use of pre-operative ultrasound assessment of the axilla with fine needle aspiration (FNA) sampling could identify patients with nodal metastases and therefore identify patients who should proceed primarily to ANC. RESULTS: Our study showed that 40 patients out of 119 had nodal metastases, and ultrasound correctly identified 19 of those patients.

The National Breast Screening Programme: the first 5,000 women screened in Northern Ireland.

The National Breast Screening Programme is an ongoing public health programme. Women between 50 and 64 years are being invited to attend for screening at three yearly intervals. The results of the first 5,000 women screened in the Eastern Health and Social Services Board's unit are presented. The breast cancer detection rate was 7.8 per thousand women screened. The malignant to benign biopsy rate was greater than 1:1.

Bile acids and the increased risk of colorectal tumours after truncal vagotomy.

An association between colorectal cancer and previous peptic ulcer surgery is reported. In a prospective screening study, 100 asymptomatic patients (80 men and 20 women) who had undergone truncal vagotomy at least 10 years previously were investigated by barium enema, colonoscopy and gallbladder ultrasonography. Control data were obtained from forensic autopsy subjects. The incidence of neoplasms greater than or equal to 1.0 cm in the vagotomized group was 14 per cent (11 adenomas, 3 carcinomas) and 3 per cent in controls (P = 0.01). Duodenal bile obtained at endoscopy from 21 vagotomized patients with normal gallbladders and from 21 control patients undergoing endoscopy was analysed by high performance liquid chromatography. The mean percentage of cholic (CA), chenodeoxycholic (CDCA), deoxycholic (DCA) and lithocholic (LCA) acids in the bile of vagotomized patients was 32.3, 45.6, 20.7 and 1.4 per cent respectively compared with 45.3, 36.2, 17.9 and 0.7 per cent respectively in controls. The increased proportions of CDCA and LCA and decreased proportions of CA in the duodenal bile of vagotomized patients were significant (P less than 0.001; P = 0.02; P = 0.007). Abnormalities in bile acid metabolism may help to explain the increased risk of colorectal neoplasia 10 years after truncal vagotomy.