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Biomedical subjects

A Tardivon

Publications and source records attributed to A Tardivon.

At least 19 recordsLinked to original sources
PubMed2006

[Identification and management of hereditary breast-ovarian cancers (2004 update)].

BACKGROUND: Since the last recommendations, up to 2500 new references had been published on that topic. METHODOLOGY: On the behalf of the health Minister, the Ad Hoc Committee consisted of 13 experts carried out a first version revisited by five additional experts who critically analyzed the first version of the report. MAIN UPDATING: Breast and ovarian cancer seem to be associated with fewer deleterious mutations of BRCA1 and BRCA2 than previously thought. The screening of ovarian cancer is still not an attractive option while in contrast MRI may be soon for these young women with dense breast, the recommended option for breast cancer screening. The effectiveness of prophylactic surgeries is now well established. French position is to favor such surgeries with regard to a quality of life in line with the expected benefit, and providing precise and standardized process described in the recommendation. CONCLUSIONS: Due to methodological flaws, the low power and a short follow-up of the surveys, this statement cannot however aspire to a high stability.

Breast Neoplasms↗
PubMed2005

Use of radiology for the pathologist in the management of breast lesions.

Today radiology is an essential step in the pathological analysis of breast biopsies. It is determinant at each stage of the management of non palpable lesions, clusters of microcalcifications and opacities, whether this concerns the needle biopsy or the surgical excision. Firstly, an X-ray is necessary to ensure that the core needle biopsy specimen has been adequately sampled and when samples with microcalcifications are selected by the radiologist, management can be more specific and accurate. In the case of surgical specimens, the X-ray confirms the presence of the radiographic abnormality or the clip indicating the site of the surgical excision which guides sampling. Some radiographic features also provide information on underlying pathologies allowing management to be adapted accordingly. Radiographs are also important to ensure that microscopically detected microcalcifications or lesions exactly correspond to the radiographic abnormality in size and location. The paraffin block can also be X-rayed to select those containing microcalcifications for additional slicing. It is also important to identify the presence of modifications caused by the core needle biopsy (fibrosis, haemorrhage and inflammation) and to carefully recognize displacement of epithelial cells and pseudo-emboli resulting from the needle procedure. Such correlation between radiology and pathology is essential so that appropriate management of the specimen can be adapted and to avoid pitfalls arising from pre-operative procedures.

Biopsy, Needle↗
PubMed2005

Normal and pathological breast, the histological basis.

Breast tissue is heterogeneous, associating connective and glandular structures, which grow and change cyclically under hormonal regulation. Hormones are also thought to be the main determinant of the major benign and malignant pathologies encountered in the breast. Benign lesions are more frequent and fibrocystic changes are by far the most common among them. They usually associate different entities, (adenosis, fibrosis, cysts and hyperplasia) but vary in intensity and extension. Thus, their clinical and radiographic presentation is extremely different from one patient to another. Adenofibroma is the most frequent tumour. It also undergoes modifications according to hormonal conditions. About 90% of malignant tumours are primary carcinoma. The incidence of intra-ductal carcinoma has risen dramatically since the development of screening because of its ability to induce calcification. Two mechanisms could be involved in the formation of calcification: one active (tumour cell secretion of vesicles), the other passive (necrotic cell fragments are released). Invasive carcinoma comprises numerous histological types. Stromal reactions essentially determines their shape: a fibrous reaction commonly found in ductal carcinoma creates a stellate lesion while other stroma, inflammatory (medullary carcinoma), vascular (papillary carcinoma) or mucinous determine nodular lesions whose borders push the surrounding tissue. The histological features which give rise to the radiographic pattern will be emphasised.

Breast↗
PubMed2004

[New developments in breast imaging].

In 2004, breast cancer screening will be effective in France. This evolution has a strong impact on our mammographic practice that becomes a real mission of public health. Digital mammography, compared to screen-film mammography, provides the same results for the detection of breast cancer, computer-aided detection systems represent the most relevant application of this technology at this time. The setting up of a quality control will allow the introduction of this technology in screening during 2004. Percutaneous imaging-guided procedures are now currently used for the diagnosis of nonpalpable breast lesions and allow the selection of patients for surgery. These procedures have emphasized the need for a multidisciplinary approach of the patients. Indications of MRI have not changed because of its moderated specificity and no relevant development of interventional-guided procedures. Work on standardization of radiological reports and assessment categories goes on. This classification is already applied for mammography, and new classifications for lesions detected by ultrasound or MRI will be published by the American College of Radiology (Breast Imaging Reporting and Data System, 4th edition, available in 2003).

Aged↗
PubMed2003

[Interventional radiology in nonpalpable lesions of the breast].

The increasing number of nonpalpable breast lesions found at screening mammography has induced the development of percutaneous imaging-guided procedures to reduce the number of surgical biopsies. After a description of the indications (classification of the American College of Radiology), the different types of sampling procedures (fine needle aspiration, core and large-core biopsies) will be described and the material used also. Depending on the type of breast lesions (mass, clustered microcalcifications), ultrasound--guided and stereotactic--guided biopsies will be explained. Clear information to the patients, efficient quality control and multidisciplinary approach are mandatory for the success of these percutaneous diagnostic procedures.

Biopsy, Fine-Needle↗
PubMed2002

[Radiologic-pathologic correlations in breast diseases].

The objective of this article is to explain radiologic patterns of benign and malignant breast lesions (masses, microcalcifications) based on histological correlations. The stromal fibrous reaction associated to infiltrating carcinomas is responsible of focal increased density, and architectural distorsion, ultrasound acoustic shadowing; abnormal neoangiogenesis can be detected by Doppler, CT or MR imaging. Invasive carcinomas without spiculated margins are poorly differentiated tumors. Mammographic patterns of microcalcifications depend on their physiopathological process (necrosis, secretion), and the shape of clusters (round, triangular) typifies their anatomical site of origin (lobular, ductal). Less frequent lesions (invasive lobular, mucinous, and medullary carcinomas, radial scar) will be also explained based on radiopathological correlations. Knowledge of radiopathological correlations in breast diseases helps the radiologists to analyze and characterize breast lesions.

Breast Diseases↗
PubMed2000

MRI of bone marrow disorders.

Four factors can be used in MR of bone marrow: fat-water distribution, artifacts induced by bone trabeculae, diffusion, and uptake of contrast media. Fat-water is imaged using T1-weighted spin-echo, short tau inversion recovery (STIR), and fast STIR, in- and out-of-phase gradient echo, and fat pre-saturation sequences; bone trabeculae by gradient echo with long TE; diffusion by single-shot spin-echo. The injection of contrast media is a more easy and efficient way to improve the specificity. The value and limitations of those sequences are discussed in marrow replacements (metastases, lymphoma, leukemia) and in myeloid hyperplasia or depletion.

Bone Marrow↗
PubMed1999

Gallium scan in the evaluation of post chemotherapy mediastinal residual masses of aggressive non-Hodgkin's lymphoma.

Optimal evaluation of residual masses of non Hodgkin's lymphomas (NHL) after chemotherapy is of major importance, and gallium scan (GS) is routinely used for this purpose, particularly for mediastinal sites. However, sensitivity and specificity of GS in this setting has been diversely appreciated and needs to be more accurately defined especially if radiotherapy is not planned. A retrospective analysis selected all the patients treated in a single institution for aggressive NHL who presented a residual mass in the mediastinum after chemotherapy and who were evaluated by GS. The value of GS for distinguishing true complete responses (CR) from partial responses (PR) was analyzed in patients who were either submitted to resection of their residual mass or followed up without further treatment after GS. A residual mass with mean perpendicular diameters measuring 4.1 cm x 2.8 cm was found in 42 patients and was GS positive in 8 cases and negative in 34 cases. After GS, radiotherapy was delivered to 10 patients, but 12 patients underwent resection of their residual mass and 20 were followed up without further treatment. In the patients who did not receive radiotherapy, 3 false positive and 6 false negative GS results were disclosed. The specificity and the sensitivity of GS were 88% and 25%, and its positive predictive value and negative predictive value 40% and 78%, respectively. GS was not sufficiently reliable to evaluate post chemotherapy residual masses. Surgical resection of residual masses should be considered particularly in young patients. Patients in true CR should be spared pointless radiotherapy and its late side effects, while patients in PR may benefit from further intensified chemotherapy followed by radiotherapy.

Adolescent↗
PubMed1998

Dynamic contrast-enhanced MRI with subtraction of aggressive soft tissue tumors after resection.

OBJECTIVE: To report the application of dynamic contrast-enhanced subtraction MRI for detecting recurrences in aggressive or malignant soft tissue tumors. DESIGN: The imaging studies consisted of static (T1- and T2-weighted spin-echo) acquisitions, followed by dynamic conventional spin-echo short TR/TE images (at 45 s, 1 min 30 s and 5 min) after a bolus of intravenous contrast medium. Contrast images were subtracted from the precontrast scan on the console. PATIENTS: Ninety-eight patients were studied who had had aggressive or malignant soft tissue tumors treated by surgery, and were followed up to assess recurrences. RESULTS: Subtraction MRI characterized recurrences better than routine sequences in 10 patients (1 lesion was seen only with this technique, 6 were better delineated, and 3 inflammatory pseudotumors were identified), and less well in 4 cases. CONCLUSION: As the number of levels studied on dynamic images is limited, and all but one recurrence were detected on T2-weighted images, it remains logical to start the examination with T2-weighted spin-echo images, and to use the dynamic study only if contrast injection is required.

Adult↗
PubMed1998

MRI of bone metastases.

Some knowledge of MR theory is required to be able to achieve high contrast between bone metastases and normal marrow. Three factors are used in MR to diagnose bone metastases; fat-water distribution, artifacts induced by bone trabeculae, and uptake of contrast medium. Using MR-histological correlations based on specimens of the lumbar spine, and studies of patients, we explain the advantages and limitations of sequences studying fat and water (spin-echo T1, STIR, in- and out-of-phase gradient echo, fat presaturation), bone trabeculae (gradient echo with long TE), and the injection of contrast medium.

Adipose Tissue↗