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Biomedical subjects

B Barreau

Publications and source records attributed to B Barreau.

4 recordsLinked to original sources

The debate over mass mammography: is it beneficial for women?

The authors discuss the controversy about mass screening for breast cancer in order to assess the soundness of a nationwide expansion of such programmes. Mass screening is second best because of the failure of prevention, therapeutic progress or ability to target high risk populations, but its efficacy reducing mortality is not clearly demonstrated and the chances of one woman being saved from participating are very low. Detrimental side-effects such as anxiety, false alarms, unnecessary biopsies, overdiagnosis and overtreatment and deficiency of psychological approach are reported. On the other hand, mass screening may save lives and if no recent study can provide absolute proof of efficacy, inefficacy of systematic mammography cannot be proven either, even concerning 40 49 years old women. Moreover, screening trials have allowed an improvement in medical practice, especially concerning quality and dose in mammography and radiographer's performance. Many questions remain unanswered about mass screening for breast cancer and the best way to achieve it.

Adult

Measuring image texture to separate "difficult" from "easy" mammograms.

We are investigating computerized techniques for sorting mammograms according to whether the breast tissue is fatty or dense. The hypothesis is that areas of dense tissue are a major factor in making certain mammograms harder for both radiologists and computers to interpret. Being able to identify dense mammograms automatically could permit better use of the time and skills of expert radiologists by allowing the difficult mammograms to be examined by the most experienced readers. In addition, the scope for computer-aided detection of abnormalities might be increased by concentrating on the easier, fatty mammograms. The mammograms used in the experiment were classified independently by two radiologists, who agreed in almost all cases. A number of local statistical and texture measures were then computed for patches from digitizations of these mammograms. One of the measures (local skewness in tiles) gives a good separation between fatty and dense patches. This measure has been incorporated into an automated procedure that separates off approximately two thirds of the fatty mammograms. This finding has been replicated on mammograms taken from a UK screening programme. The relationship between the fatty/dense distinction and the classification proposed by Wolfe is discussed.

Adipose Tissue

[Breast microcalcifications].

Microcalcifications of the breast are better recognized as the quality of mammographs is improving. The clinical examination and complementary modalities are often essential to evaluate their significance and point out to an indication for surgery. However, especially when the microcalcifications are detected during a systematic examination, a strict analysis of mammographs is essential. The number of useless punctures must be reduced, as their psychological impact and socioeconomic weight are already demonstrated. Although there is no consensus, most recent publications contain ideas converging on the selection of the indications for a histological control on the basis of an accurate semiological study.

Breast Diseases

[Extramammary carcinoid tumor metastatic to the breast. Apropos of a case].

We report the case of a 42-year-woman treated for an appendicular carcinoid tumor with bilateral ovary metastases and mesenteric node involvement. After a systematic mammography, an infraclinical lesion of the breast was detected. Mammographic and echographic images revealed nodular mass with possibly malignant features. Fine-needle aspiration biopsy indicated malignancy. The definitive diagnosis of breast metastasis of a carcinoid tumor was made by biopsy. This case is related to 14 previously published cases. The authors emphasize the importance of making a precise histological diagnosis to avoid overtreatment of a metastatic lesion.

Adult