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Biomedical subjects

S Ciatto

Publications and source records attributed to S Ciatto.

243 records · Page 14Linked to original sources
PubMedDate not supplied

The significance of mammographic calcifications in early breast cancer detection.

3,126 medical reports on women sent to mammary biopsy following breast examination at the Florence Center for the Study and Prevention of Cancer in November 1978-July 1982 were reviewed in order to assess the diagnostic significance of mammographic microcalcifications. All mammographies were examined in order to assess the presence and morphological aspects of the microcalcifications on the bioptic site. Microcalcifications were classified on the basis of the following morphological criteria: spatial disposition (isolated, clustered, diffuse); total number; number per cm; morphological aspect (dot-like, stick-like or ramified); shape (regular or irregular); radiological density; association with mammographic opacity; maximum and average diameter. Microcalcifications were encountered in 19.7% of 157 breast cancer diagnosed in a mammographic screening programme conducted on the asymptomatic population in 19.5% of 953 breast cancers diagnosed in self-referring women (most with symptoms). Among cases where subsequent histological examination revealed a benign pathology, microcalcifications were more frequent in the cases deriving from the screening programme (14.5% of 198 cases) than among self-referred cases (4.5% of 1818 cases). The presence of microcalcifications is in itself a predictive sign of the presence of a carcinoma (positive predictive value = 66.2%) but this radiological sign is only present in 20% of breast cancers. Among the various parameters considered in assessing the diagnostic significance of microcalcifications, irregular shape was the most indicative of carcinoma with a predictive value of 80% and presence in 88% of carcinoma with microcalcifications. Other microcalcification parameters with a particular predictive significance are diffuse spatial disposition, total number (over 10) and number per cm (over 50), site contiguous with a mammographic opacity and a mean diameter of 0.6-0.9 mm. Unfortunately these latter parameters are only 24% of tumour cases with microcalcifications. The incidence of microcalcifications in cancer does not vary according to age, but is strongly correlated with the tumour stage. In particular microcalcifications are found in about 1/3 of in situ carcinomas. In invasive cancers, the presence of microcalcifications tends to increase with the diameter of the lesion. No correlation was found in breast cancers between the presence of microcalcifications, lymph node condition and histological type.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenofibroma↗
PubMedDate not supplied

The value of routine cytologic examination of breast cyst fluids.

The results of the cytologic examination of 6,782 consecutive breast cyst fluids aspirated from 4,105 women during the period 1976 to 1983 were reviewed to assess the value of the routine cytologic study of such specimens. Cases in which cancer had been suspected by physical examination and/or mammography before aspiration of the cyst were excluded from the evaluation. Five clinically and radiologically inapparent intracystic papillomas were detected overall (0.1%). All cases of intracystic papilloma produced a blood-stained fluid and showed an intracystic mass at pneumocystography. Cytology was negative in two of these cases and falsely positive in one case while correctly identifying the papilloma in two cases. One incidental case of occult in situ lobular carcinoma was also detected. Routine cytologic examination of all breast fluids is thus not recommended as a cost-effective practice. Cytology should be used only when a blood-stained fluid is obtained (2% in the present series) since its indiscriminate application to all cyst fluids does not affect the rate of detection of intracystic lesions, most of which are suspected before the aspiration.

Adult↗
PubMedDate not supplied

Significance of nipple discharge clinical patterns in the selection of cases for cytologic examination.

The cytodiagnostic significance of the clinical patterns (types and sites) of nipple discharges was studied in 5,305 cytologically examined discharges from 3,687 women in a consecutive series of 50,181 self-referred women in whom 1,062 breast cancers were detected. The clinical patterns were correlated with cytologic and histologic results in both the whole series and in 119 biopsied cases, and the relative risk of association with breast cancer was calculated for each pattern. As a whole, aside from the pattern, cases with nipple discharges showed a higher relative risk (48.5) than did asymptomatic cases, but a bloody nipple discharge was by far more frequently associated with cancer than was any other pattern, being present in 70% of the cancer cases and in almost all cancer cases with suspicious cytologic findings in the discharge smear. The presence of a nipple discharge, being associated with a higher risk of breast cancer, is an indication for a careful physical examination; systematic cytologic examination should be limited only to bloody discharges. Since cancer is rare in cases with nonbloody discharges and is difficult to detect in cytologic smears of such discharges, systematic cytologic examination of all nipple discharges would not be cost-effective.

Adult↗