[Metastases of breast angiosarcoma. Apropos of 2 cases]. / Métastases d'angiosarcome mammaire. A propos de deux observations.

Two patients with breast angiosarcoma and hepatic and splenic metastases developed a hemoperitoneum confirmed by ultrasound and CT scan imaging. This complication has further adverse effects on the already extremely poor prognosis of this disease.

[Diagnostic value of clustered microcalcifications discovered by mammography (apropos of 227 cases with histological verification and without a palpable breast tumor)]. / Valeur diagnostique des microcalcifications groupées découvertes par mammographies. (a propos de 227 cas avec vérification histologique et sans tumeur du sein palpable).

UNLABELLED: Excisions with histological examination were performed in 227 cases of breast microcalcifications without palpable tumor. 99 benign lesions, 27 borderline lesions and 101 carcinomas, 58 of them in situ, were found. Different radiological parameters were studied in relation to histological results: According to the morphology of the calcifications, a classification of 5 types was made. Type 1: annular: 100 per cent were benign lesions. Type 2: regularly punctiform: 22 per cent were malignant lesions. Type 3: too fine for precizing the shape: 40 per cent were malignant lesions. Type 4: irregularly punctiform: 66 per cent were malignant lesions. Type 5: vermicular: 100 per cent of the lesions were malignant. The number of calcifications was higher in carcinomas and 56 per cent of the lesions with more than 30 calcifications were malignant. Close grouping: when there were more than 10 calcifications within a 5 mm diameter area, 57 per cent of malignant lesions were found. Several clusters: 70 per cent were correlated with malignant lesions. Uneven sizes: no signification. LOCATION: the rare retroareolar location correlated with benign lesions in 64 per cent of the cases. Furthermore, the malignant lesions were rare (24%) in women under 40 years of age. For these young women, the authors suggest to directly excise the most suspicious microcalcifications as based on the factors of suspicion and to simply follow the other cases.

[Lymphographic evaluation of cervico-uterine carcinoma (author's transl)]. / Bilan lymphographique des cancers cervico-utérins.

Bilateral pedial lymphography is a technique which has already been long employed and which had aroused great hopes in the detection of metastatic node involvement. The method has nevertheless failed to form an invariable part of the pretherapeutic assessment of cervico-uterine carcinomas. This attitude may be easily explained by the difficulties encountered in the interpretation of lymphographies as indicated in the first publications. New data nevertheless have made it possible to refine the method. Whilst false negatives remain inevitable in almost half the cases with histological evidence of involvement, false positives may be reduced to a minimum by very strict criteria of interpretation. Lymphography, a harmless technique, can then provide valuable information which enables the surgeon to confirm the success of his lymph node dissection and the radiotherapist to define areas requiring treatment. It is of major prognostic value. It may be used to guide transparietal lymph node biopsies and secondary detect lumbo-aortic nodes.

[Management following mammography revealing grouped microcalcifications without palpable tumor]. / Conduite à tenir devant une mammographie révélatrice de microcalcifications groupées, sans tumeur palpable

On the basis of a series of 60 cases, the authors report their experience of excision of grouped microcalcifications detected at mammography in the absence of any clinical sign. The breast zone in which the microcalcifications were located by the radiologist was removed surgically. Per-operatoire X-ray of the excised specimens using a mammography apparatus confirmed that the microcalcifications had been totally removed. In addition it was useful to locate aceuretaly the calcifications in view of a careful histological examination of the area. The technique led to the discovery of 27 carcinomas at a sub-clinical stage. A classification of the various types of microcalcification was established in relation to histology. It will be of assistance in suspecting malignancy on the basis of mammography findings in the majority of cases. Excision can then be reserved for cases of presumed malignancy or where a doubt exists. By detecting breast carcinomas at a sub-clinical stage, the method makes possible early and minimally mutilating treatment with the best chances of cure.