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Biomedical subjects

A Isnard

Publications and source records attributed to A Isnard.

8 recordsLinked to original sources

[Non-palpable breast lesions and core needle biopsy with Mammotome 11G: is surgery required in patients with atypical ductal hyperplasia?].

Atypical ductal hyperplasia (ADH) of the breast is a difficult histologic diagnosis. It is usually found, but not always, on clusters of microcalcifications. The subsequent risk of breast carcinoma is 4 to 5 times more important and the carcinoma can arise in the same breast or in the contralateral breast. Diagnosis can be establish on core needle biopsy with Mammotome 11G. The risk of under-estimation (ductal carcinoma in situ or invasive carcinoma) is about 20%. This risk is drastically decreased if the target (the calcifications) is completely removed by the Mammotome. This study includes 62 cases of ADH found on 633 calcifications biopsied by Mammotome 11G. In 31 cases, surgery was performed and ADH was confirmed in 25 cases (6 cases was under-estimated). In the other 31 cases, all calcifications were removed, there was no other risk factor and follow-up was suggested. Like after surgery, yearly bilateral mammography during about 20 years is recommended. In this last group, there was no false-negative result, median follow-up: 35,5 months (22-62).

Adult↗

[Malignancy in ACR 3 category mammographic lesions, masses and calcifications].

At screening mammography, lesions must be assigned to BI-RADS classification. Category 3 is used for nonpalpable probably benign lesions. This category is defined either by a subset of lesions that are so likely to be benign that follow-up is a reasonable alternative to immediate biopsy, or by a less than 2% malignancy rate for American BI-RADS, or than 5% for French ANAES. The initial work-up to analyze the lesion must be complete, not only with four screening standard views but with magnification views and sonography if necessary. The risk of malignancy is very low and the pronostic factors are the same as in screening detected carcinomas.

Breast Diseases↗

[Stereotactic 11-gauge directional vacuum-assisted breast biopsy: experience with 249 patients].

PURPOSE: To assess the value of percutaneous vacuum-assisted core biopsy to improve the diagnosis of non palpable mammographic abnormalities. MATERIALS AND METHODS: A total of 252 core biopsies using an 11G Mammotome((R))were performed in 249 patients. Stereotactic localization was performed in the prone position on a dedicated digital Fischer table. RESULTS: Fifty-one, or 25%, of 200 clusters of microcalcifications corresponded to carcinomas: 126 benign lesions, 23 atypical hyperplasia and LCIS, 31 DCIS, 15 invasive ductal carcinomas, and 4 false negative biopsies. In these 4 last cases, surgery was performed because radiographs of the core biopsy showed no microcalcifications; carcinoma was confirmed at histology of the surgical specimen. Using the BI-RADS system, 7 lesions were category 3, 175 lesions were category 4, and 18 lesions were category 5. From a total of 52 masses, 31 were benign lesions, 2 were borderline lesions, and 19 were invasive carcinomas. From these, 5 lesions were category 3, 31 were category 4, and 16 were category 5. Diagnostic surgical biopsy was avoided in 161 cases (63%), in 152 cases for benign lesions including 151 lesions classified as category 4 lesions and in 9 cases for multifocal or recurrent malignant lesions. CONCLUSION: When technical pitfalls are avoided and when presence of microcalcifications in the core biopsy sample is verified, vacuum assisted core biopsy with Mammotome((R)) 11G provides accurate diagnosis of non-palpable mammographic abnormalities.

Biopsy, Needle↗

[Impalpable breast abnormalities. Contribution of cytologic puncture under stereotaxic guidance. Apropos of 159 cases].

The authors report the results of a cooperative study of X ray guided fine needle aspiration for the cytologic diagnosis of non palpable breast lesions. They discuss the limits of this method. In 60% of 159 cases cytologic examination was diagnosis. In their series, no false positive was reported but in 64 cases no sufficient material was obtained.

Biopsy, Needle↗