[Show abstract][Hide abstract] ABSTRACT: The evaluation of patients with a palpable breast lump includes physical examination, mammography, and fine needle aspiration cytology. Combined use of these diagnostic procedures (triple diagnostic) gives nearly the same degree of accuracy as excisional biopsy with a sensitivity of 97-99% in patients with palpable breast carcinomas. Ultrasonography is a valuable adjunct when mammography is normal or nonconclusive and should be the primary imaging modality in patients under 35 years of age with benign findings on physical examination. Ongoing quality assessment of mammography and ultrasonography is mandatory, since the imaging modalities play a central role in the evaluation of patients with lumps in the breast. There are considerable practical problems associated with the medical audit of the triple diagnostic procedure. Aspects of the evaluation of breast lumps and organization of breast imaging centres are discussed in the light of our own experiences.
No preview · Article · Jul 1995 · Tidsskrift for Den norske legeforening
[Show abstract][Hide abstract] ABSTRACT: Next to tumour and pain, discharge from the nipples is the most common reason for remitting women to a breast clinic, and comprises 3-6% of the total cause of remittance. We describe a technique for localizing a duct system, where a defect is found by galactography by injection of methylenblue/Isopaque Amin 1:1 in the duct system prior to operation. Ultrasonography can be used to localize the ectatic ducts in cases where there is no secretion on the day of the scheduled operation. The blue colour enables the surgeon to excise the defect duct very precisely. Such a microductectomy preserves breast tissue and gives a better cosmetic result than with complete central ductectomy. We discuss examination and treatment of women with discharge from the nipple.
No preview · Article · May 1993 · Tidsskrift for Den norske legeforening
[Show abstract][Hide abstract] ABSTRACT: The mean nuclear area (MNA) of mammary gland epithelium was measured in 403 breast specimens, comprising 239 invasive carcinomas, 49 carcinomas in situ, 45 cases of fibrocystic disease (f.c.d.) with intraductal epithelial hyperplasia, and 60 cases of f.c.d. without intraductal hyperplasia. Normal breast tissue adjacent to other benign or malignant lesions was measured in 170 specimens. Statistical analysis revealed no difference between the MNA of invasive ductal carcinoma and ductal carcinoma in situ. The MNA of lobular and ductal carcinomas were significantly different. Significant differences were also found between ductal carcinoma and the two classes of f.c.d. The MNA of f.c.d. with and without intraductal hyperplasia were also significantly different, the former having the highest MNA. All breast lesions showed MNA significantly higher than that of normal breast epithelium. These findings show that there is a gradual increase in MNA from the baseline value of normal breast epithelium, via fibrocystic disease without and with intraductal proliferation to invasive carcinomas. Measurement of MNA may aid in pinpointing cases of intraductal epithelial hyperplasia with malignant potential.
No preview · Article · Sep 1991 · European Journal of Surgical Oncology
[Show abstract][Hide abstract] ABSTRACT: An histological study of 227 non-palpable breast lesions detected by clinical mammography revealed 64 invasive carcinomas at a mean patient age of 60.5 years. There were 10 carcinomas in situ, mean age 57.2 years. Fibrocystic disease with intraductal epithelial hyperplasia was found in 41 specimens, mean age 54.3 years. Fibrocystic disease without intraductal hyperplasia was found in 57 biopsies, mean age 50.7 years. Histological microcalcifications were found in 113 biopsies, and were considered to be a marker for epithelial proliferation of both benign and malignant kinds. Microcalcifications detectable in histological sections and by mammography differ in size by a factor of 10 or more. This difference has to be considered when comparing histological and mammographic findings.
No preview · Article · Jan 1991 · European Journal of Surgical Oncology
[Show abstract][Hide abstract] ABSTRACT: In 1982, a total of 250 breasts were removed for cancer in the surgical departments of the Oslo City Health Department, comprising 81% of all new breast cancers reported in Oslo in 1982. Invasive ductal carcinoma (68%) and invasive lobular carcinoma (12.4%) were the predominant types. Special attention was given to the presence of occult in situ or invasive carcinomas more than 1 cm from the periphery of the main carcinoma. In 24.8% of the specimens, carcinoma in situ was found in such locations, and an additional 6.9% showed a second, occult invasive carcinoma. Carcinoma in situ was equally common in invasive ductal and invasive lobular carcinoma. Occult invasive carcinoma was predominantly found in specimens with invasive lobular carcinoma. There was a significantly increased number of lymph node metastases in patients with carcinoma in situ or second, occult primary carcinoma more than 1 cm from the periphery of the main carcinoma.
No preview · Article · Jul 1986 · European Journal of Surgical Oncology