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PubMed1994

Plasma cortisol response in dairy cows to vaginoscopy, genital palpation per rectum and artificial insemination.

Response of plasma cortisol concentrations after vaginoscopic examination, palpation of the genital organs per rectum and artificial insemination were investigated in six Holstein-Friesian cows weighing between 510 to 620 kg. Blood samples were collected by indwelling jugular catheter. The experiment was begun at 09:00 hours on the day when cows came into estrus. Blood samples were collected from 30 minutes before to 60 minutes after each treatment at intervals of 5 to 10 minutes. Cows were initially blood-sampled for 90 minutes at the same intervals without giving any treatment and then were subjected to vaginoscopy for 1.5 minutes, palpation of the uterus and ovaries per rectum for 4 minutes and artificial insemination by the recto-vaginal method for 5 minutes. No significant increase in plasma cortisol was shown in cows in estrus following vaginoscopy. Palpation per rectum as well as artificial insemination caused a significant increase in plasma cortisol (P < 0.01) 5 to 10 minutes after the initiation of treatments in cows in estrus. There was a tendency for cows in the luteal phase to show higher plasma cortisol levels after the vaginoscopy than cows in estrus. Adrenal response to palpation per rectum in cows in the luteal phase was similar to that in cows in estrus. Thus, in cows in estrus, palpation per rectum as well as artificial insemination may be potential stressors for cows, causing an increase in plasma cortisol levels. However, the pathophysiological importance of the rise in plasma cortisol levels is not known.

Animals↗
PubMed2004

Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT.

PURPOSE: To compare ultrasonography (US), computed tomography (CT), and palpation for diagnosing supraclavicular lung cancer metastases and to assess the effect of proved metastases on TNM stage and diagnostic work-up. MATERIALS AND METHODS: One hundred seventeen consecutive patients (91 men and 26 women; mean age, 64.0 years) underwent palpation, US, and CT of supraclavicular regions and chest and upper abdominal CT. Fine-needle aspiration cytologic (FNAC) analysis was performed in patients with nodes with a short-axis diameter of 5 mm or greater; cytologic diagnosis was used as the standard of reference. Sensitivities of palpation, US, and CT were compared with McNemar testing. Relationship between size and palpability of nodes with metastasis was evaluated with logistic regression. RESULTS: Supraclavicular metastases were diagnosed cytologically in 30 (26%) of 117 patients: eight (31%) of 26 patients with small cell lung cancer (SCLC) and 22 (24%) of 91 patients with non-small cell lung cancer (NSCLC). Sensitivities of US (1.00; 30 of 30 patients) and CT (0.83; 25 of 30 patients) for detection of metastases were significantly higher (P <.001 and P =.001, respectively) than that of palpation (0.33; 10 of 30 patients). Palpable nodes with metastasis (mean diameter, 25.2 mm) were significantly larger than nonpalpable nodes with metastasis (mean diameter, 13.7 mm) (P =.002). To have a 50% chance of being palpable, nodes with metastasis had to have a diameter of at least 22.3 mm. TNM stage was changed in three of 91 patients with NSCLC, and further invasive diagnostic procedures were prevented in 11 of such patients because it was proved that nonpalpable nodes had metastases. CONCLUSION: Supraclavicular lung cancer metastases were cytologically proved in 26% of patients. Nodes with metastasis were only palpable when markedly enlarged. US tripled the sensitivity of palpation for detection of metastases. Results of US and US-guided FNAC analysis can change the work-up in patients with lung cancer.

Adult↗
PubMed2000

A finite element model of remote palpation of breast lesions using radiation force: factors affecting tissue displacement.

The early detection of breast cancer reduces patient mortality. The most common method of breast cancer detection is palpation. However, lesions that lie deep within the breast are difficult to palpate when they are small. Thus, a method of remote palpation, which may allow the detection of small lesions lying deep within the breast, is currently under investigation. In this method, acoustic radiation force is used to apply localized forces within tissue (to tissue volumes on the order of 2 mm3) and the resulting tissue displacements are mapped using ultrasonic correlation based methods. A volume of tissue that is stiffer than the surrounding medium (i.e., a lesion) distributes the force throughout the tissue beneath it, resulting in larger regions of displacement, and smaller maximum displacements. The resulting displacement maps may be used to image tissue stiffness. A finite-element-model (FEM) of acoustic remote palpation is presented in this paper. Using this model, a parametric analysis of the affect of varying tissue and acoustic beam characteristics on radiation force induced tissue displacements is performed. The results are used to evaluate the potential of acoustic remote palpation to provide useful diagnostic information in a clinical setting. The potential for using a single diagnostic transducer to both generate radiation force and track the resulting displacements is investigated.

Acoustics↗
PubMed1985

Carotid palpation at two exercise intensities.

It remains unclear whether carotid palpation (CP) should be used to count post-exercise heart rate (HR). We hypothesized that the carotid sinus, when stretched or compressed by external pressure, results in an increased nerve activity to the cardiovascular areas in the brain stem, with a resultant increase in parasympathetic activity and a decrease in sympathetic activity. The primary purpose of this study was to investigate the effects of CP and no CP on post-exercise HR determination at two exercise intensities. The secondary purposes were to investigate whether CP during exercise would elicit a decrease in HR and the effects of CP on post-exercise blood pressure. Twenty-one healthy females served as subjects. During the final min of each exercise intensity, two 10-s HRs were recorded by continuous ECG (i.e., 10 s without palpation and 10 s with palpation). Immediately post-exercise at each intensity, the carotid artery was either palpated (Phase I) or not palpated (Phase II). At 60 and 80% intensity, with 10-s CP, post-exercise HR decreased 12.4 and 7 beats . min-1, respectively (both were significant: P less than 0.05). At 60 and 80% intensity, without CP, post-exercise HR decreased 6.1 and 3.3 beats . min-1 in 10-s, respectively (both were significant; P less than 0.05). CP during exercise did not elicit a carotid sinus reflex, and post-exercise CP did not alter blood pressure readings. These findings were generally contrary to previous research on CP and were determined to be important in that the correct technique was used by the investigators.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Histopathologic study of the so called 'palpation thyroiditis'.

We have reviewed 1066 thyroid lesions and compared the relative incidence of the so called 'palpation thyroiditis' between autoimmune thyroiditis and normal thyroid parenchyme surrounding the nodular thyroid lesion and also discussed the pathogenesis of palpation thyroiditis. The typical histopathologic features of 'palpation thyroiditis' were seen in 275 cases among 467 adenomatous goiters and in none of the autoimmune thyroiditis. We here in this paper suggest that the so called 'palpation thyroiditis' is not merely a secondary phenomenon to mechanical follicular damage by vigorous palpation, but this lesion more likely develops in conditions where certain types of physiologic alteration has occurred in follicular basement membrane, just like a pathogenesis of subacute granulomatous thyroiditis.

Adenocarcinoma↗
PubMed1992

Diagnosis of luteal and follicular ovarian cysts by palpation per rectum and linear-array ultrasonography in dairy cows.

The purpose of this study was to determine and compare the accuracy of palpation per rectum and linear-array ultrasonography for diagnosing follicular vs luteal ovarian cysts in cows. Forty-seven examinations of ovarian cysts from 28 cows were diagnosed by palpation per rectum as either a firm, thick-walled structure (luteal cyst) or a soft, thin-walled structure (follicular cyst) during weekly herd examinations. The ovaries of each cow were then examined by ultrasonography. Ultrasonograms of cysts greater than 25 mm in diameter were diagnosed as luteal or follicular cysts and were recorded on videotape for evaluation by a second clinician. Serum progesterone concentrations at the time of examination were determined by radioimmunoassay and used to classify luteal (greater than 0.5 ng/ml) or follicular (less than or equal to 0.5 ng/ml) cysts. Selection of this discriminatory level was based on response of a proportion of cows with luteal cysts that were given 25 mg of prostaglandin F2 alpha at the time of diagnosis by ultrasonography. Sensitivity and specificity of palpation per rectum for diagnosis of type of ovarian cyst were low (43.3 and 64.7%, respectively). In contrast, sensitivity and specificity of ultrasonography were considerably higher (86.7 and 82.3%, respectively). Agreement between the 2 methods of diagnosis was 57.4%. Overall agreement between the 2 clinicians' diagnoses by ultrasonography was 85.1%. On the basis of our findings, we confirm that luteal and follicular cysts cannot be accurately differentiated by palpation per rectum alone. These data suggest that linear-array ultrasonography is more effective than palpation per rectum for diagnosing type of ovarian cyst in cows.

Animals↗
PubMed1991

Rectal palpation and transmission of bovine leukemia virus in dairy cattle.

To determine whether rectal palpation, using common obstetrical sleeves, serves as a mode of transmission of bovine leukemia virus in dairy cattle, field studies were conducted at 2 dairies. At a commercial dairy, significant difference was not observed in rate of seroconversion in heifers and cows in which the same sleeve or new sleeves were used for palpations. At a university dairy, where cattle were used to teach dairy husbandry and veterinary procedures, significantly (P less than 0.02) greater rate of seroconversion was observed in heifers and cows palpated with unwashed common sleeves than that observed in heifers and cows palpated with sleeves washed between use. Although rectal transmission of bovine leukemia virus under field conditions was documented, it was related to frequency of palpation and age of cattle.

Animals↗
PubMed1989

[Relationship between muscular palpation and three dimensional incisal path at border movement of mandible].

Temporomandibular arthrosis was diversified phases of its development as well as complicated mode of its crisis, due to which no concrete clinical diagnostic procedure has been established yet. However, a close relation of occlusal disturbance with the crisis factor is suggested, and assessments have been made in the prosthetic dentistry, setting a viewpoint at the phases of mandibular movement. Particularly, incisal path at border movement of mandible is made the object for basic assessment since it exhibits intensified condition. On the other hand, importance is attached to Krogh-Poulsen's muscular palpation for diagnosis of the pain and contraction of the masticatory muscle which occur in temporomandibular arthrosis. However, though there is a close relation between the pain or abnormal contraction of the masticatory muscle and the phases of mandibular movement, these diagnostic procedures have been the studies which have dealt with the subjects separately. And no report is seen on the study made of the relation between the phases of incisal path at border movement of the mandible and Krogh-Poulsen's muscular palpation. Accordingly, with the purpose of investigating these relationships, the author has made assessment of the relationship between the result by Krogh-Poulsen's muscular palpation and the form (analogue form) of three-dimensional incisal path at border movement of the mandible summarized and standardized by TMJ gnathological instrument which is evaluated as a recording method with high clinical efficiency as a method with excellent reproducibility of mandibular movement and favorable manipulability. The subjects enrolled were patients with temporomandibular arthrosis and the so-called normal healthy subjects with normally functioning occlusion who are not conscious clinically of the abnormality of the stomatognathic system nor had similar anamnesis. And the following results have been obtained. 1. Results by Krogh-Poulsen's muscular palpation; 1) The 59 so-called normal healthy subjects were classified into 2 groups by Krogh-Poulsen's muscular palpation, and of these, the cases in whom no abnormality was observed were only 5, being 8.5%, and the cases in whom single or multiple test items showed abnormality were 54, being so high rate as 91.5%. The occurring frequency of 5 test symptoms in the 54 cases were; 22 cases with trismus-40.7%; 34 cases with temporomandibular sounds -63.0%; 20 cases with pain -37.0%; 36 cases with tenderness of the lateral pterygoid muscle -66.7%; and 25 cases with disturbance of lateral mandibular movement -46.3%.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1989

Interrater reliability in masticatory muscle palpation.

Muscle palpation is an important procedure in screening for TM disorders and assessing results of treatment outcome studies, but interpretation of response may be subjective and vulnerable to examiner bias. Masticatory muscle palpation scoring was evaluated with respect to interrater agreement on 31 myofascial pain-dysfunction patients participating in a medication study. Two clinicians independently palpated the temporomandibular joints, muscles of mastication, and related head and neck musculature on three different occasions over the 6-week period of the study. Standardization of palpation technique and initial protocol for interpretation of subject response were discussed prior to the first examination. Further clarification and reinforcement of examination methodology and scoring were carried out prior to the second examination, 1 week later. Another 5 weeks passed, with no further standardization, before the third and last examination. A behaviorally anchored scoring system (0 to 3) was used to rate response to palpation. Results indicate that two investigators can achieve a fair degree of reliability when carefully standardized, further interrater standardization can result in higher reliability, and reliability can be maintained over at least a 5-week period of time.

Humans↗
PubMed1981

Carotid palpation, coronary heart disease and exercise rehabilitation.

Heart rate, determined by palpation of the carotid, radial, or temporal artery, is commonly used to monitor exercise intensity. It is known that massage of the carotid artery has a baroreceptor reflex effect on the heart rate. The heart rate, monitored with and without carotid palpation, at rest, during exercise, and immediately post-exercise was determined in 60 male cardiac patients (39-65 years of age) following either myocardial infarction (n=52), bypass surgery (n=6), or those with angina pectoris (n=2). The mean changes in heart rate with carotid palpation in the testing group were -3.5 bpm at rest and -2.2 bpm during exercise; in the training group the changes were +0.8 bpm at rest -3.1 bpm post exercise. While the mean decrease at rest in the testing group was statistically significant, each of the decreases in resting, during, and post-exercise heart rates were too small to be accurately monitored by palpation over a 10- or 15-sec count, a usual procedure in exercise rehabilitation programs. Provided the patients are correctly instructed and technique regularly checked, there appears to be no reason why carotid palpation should not be used in cardiac exercise rehabilitation programs to determine resting, exercise, or post-exercise heart rates.

Adult↗
PubMed1996

[Prostate cancer: palpation versus ultrasonography].

The authors compared in a group of 273 symptomatic patients the effectiveness of palpation and transabdominal USG of the prostate and in a group of 162 patients palpation and transrectal USG of the prostate in diagnosing of prostate carcinoma. Histopathological correlation was available in 203 (74.4%) patients, all of them examined by transrectal USG. From the whole group of 273 patients prostate carcinoma was confirmed in 69 (25.3%). Based on USG examination alone prostate cancer was proved by histopathological methods in three (4.3%) patients with a negative finding on palpation. A disappointment of the USG method was that it did not prove possible to diagnose before operation incidental cancer in 14 (20.3%) patients with BPH. USG made it possible to define more accurately the stage of cancer in groups T2 and T3. The effectiveness was assessed as follows: sensitivity, specificity and total accuracy during palpation was 75.4%, 88.8%, 84.2%, in transabdominal USG: 78.3%, 91.8%, 87.2% and in transrectal USG of the prostated 97.7%, 90.7% and the overall accuracy 92.6%. Despite these results for screening of patients with prostate cancer USG of the prostate can be recommended only after palpation and PSA examination.

Adolescent↗
PubMed1997

Accuracy of palpation and percussion manoeuvres in the diagnosis of splenomegaly.

A study was conducted on 80 patients admitted in a teaching hospital to see the accuracy of two palpatory methods (Supine palpation and Middleton's manoeuvre) and three percussion methods (Traube's space percussion, Castell's and Nixon's manoeuvres) in the diagnosis of splenomegaly. Ultrasonographic findings were considered as gold standard for diagnosing splenomegaly. Mean age of study subjects was 31.5 years and mean Quetelet's index was 17.8 +/- 2.6 kg/m2. Sensitivity of Middleton's and Castell's manoeuvres was similar (85.7%) and higher than other manoeuvres. Nixon's manoeuvre had the least sensitivity (66.7%). Specificity was highest (92.1%) with supine palpation and least (31.6%) with Castell's manoeuvre. Supine palpation showed highest positive predictive value (91.7%). Receiver Operating Characteristics curves showed greater area with middleton's manoeuvre (0.93) followed by supine palpation (0.92), Castell's manoeuvre (0.75) and Traube's space percussion (0.74), the findings of the study suggests that palpatory methods like Middeton's manoeuvre and Supine palpation should be routinely used for diagnosing splenomegaly among non-obese individuals.

Adolescent↗
PubMed2006

Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidance.

PURPOSE: To compare the effectiveness of sonographically guided and palpation-guided steroid injection for the treatment of proximal plantar fasciitis. PATIENTS AND METHODS: Twenty-five consecutive patients with unilateral proximal plantar fasciitis were recruited and randomly divided into a sonographically guided group (n = 12) and palpation-guided group (n = 13). Proximal plantar fascia was assessed with a 5- to 12-MHz linear-array transducer. Pain intensity was quantified using a "tenderness threshold" (TT) and a visual analog scale (VAS). Injection of 7 mg (1 ml) of betamethasone and 0.5 ml of 1% lidocaine into the inflamed proximal plantar fascia was performed under the guidance of sonography or palpation. Patients were evaluated clinically and sonographically before injection and at 2 weeks, 2 months, and 1 year after injection. VAS- and TT-measured pain intensity, thickness, and echogenicity of the proximal plantar fascia, as well as the recurrence of heel pain, were assessed. RESULTS: Both VAS- and TT-measured levels of pain improved significantly after steroid injection in both groups (p < 0.001). Also, the thickness decreased significantly after injection (p < 0.01 in the palpation-guided group; p < 0.001 in the sonographically guided group). The number of patients with hypoechogenicity at the proximal plantar fascia decreased after steroid injection in both groups (p < 0.01 for both groups). The recurrence rate of plantar fasciitis in patients of the palpation-guided group (6/13) was significantly higher than that of the sonographically guided group (1/12) (p < 0.05). CONCLUSIONS: Steroid injection can be an effective way to treat plantar fasciitis, and injection under sonographic guidance is associated with lower recurrence of heel pain.

Adult↗
PubMed2004

Ultrasonography or palpation for detection of melanoma nodal invasion: a meta-analysis.

Because treatment of distant melanoma metastases is not very effective, nodal spread should be diagnosed early so that therapeutic lymphadenectomy can be started as early as possible. Physical examination alone often does not detect nodal metastases and palpable nodes cannot be clasified unambiguously. Whether lymph-node ultrasonography-an inexpensive procedure-improves detection of nodal invasion during the initial staging and follow-up of patients with melanoma is controversial. We used meta-analysis techniques for diagnostic tests to assess the merit of ultrasonography and palpation in detection of nodal invasion in patients with melanoma. Five databases were screened until December, 2003. 12 studies, including 6642 patients and 18?610 paired palpation and ultrasound examinations, were eligible. The main limitations were variations in the definition of false negatives, and verification bias. Ultrasonography had a higher discriminatory power (odds ratio 1755; 95% CI 726-4238) than did palpation (21 [4-111]; p=0.0001). Furthermore, positive-likelihood ratios were 41.9 (95% CI 29-75) for ultrasonography and 4.55 (2-18) for palpation; negative-likelihood ratios were 0.024 (0.01-0.03) and 0.22 (0.06-0.31), respectively. Our results showed clearly that ultrasonography detects lymph-node invasion more accurately than palpation, and should therefore probably be used routinely in patients with melanoma.

Adolescent↗
PubMed1996

Is manual palpation of uterine contractions accurate?

OBJECTIVE: The aims of this study were to assess the accuracy of uterine contraction palpation, determine whether the accuracy of palpation improves with experience, determine clinical factors that affect the accuracy of palpation, and evaluate the range of intrauterine pressure present when an observer notes the contraction to be mild, moderate, or strong. STUDY DESIGN: A total of 236 observations were obtained by use of intrauterine pressure catheters on 46 laboring patients in the first stage of labor. The blinded observers (obstetrics and gynecology residents, maternal-fetal medicine fellows and faculty, and labor and delivery nurses) were asked to label a contraction as mild, moderate, or strong. Patient's height, weight, parity, and gestational age, use of oxytocin, use of epidural anesthesia, and laboring position, and the level of training of the observer were noted. RESULTS: Mild, moderate, and strong contractions had intrauterine pressures of 35.2 +/- 33.8 mm Hg (+/- 2 SD), 44.9 +/- 35.4 mm Hg, and 55.5 +/- 28.0 mm Hg, respectively. The observers were accurate in predicting contraction strength 49% of the time. There was no improvement in accuracy with increased physician experience. All physicians as a group were more accurate than nurses (p < 0.05). Accuracy was not affected by clinical variables. CONCLUSION: Manual palpation of uterine contractions is an inaccurate means of determining contraction strength.

Female↗
PubMed1994

Adverse effect of helicopter flight on the ability to palpate carotid pulses.

STUDY OBJECTIVE: To determine if the air medical helicopter environment compromises the ability to palpate carotid pulses. DESIGN: Using a carotid pulse model, flight nurses were tested for their ability to palpate the simulated carotid pulse at normal (120/80 mm Hg) and low (80/60 mm Hg) blood pressures on the ground and during helicopter flight. SETTING: Palpation tests were performed during flight in an MBB BO-105 twin-turbine engine, single-rotor air medical helicopter; control palpation tests were performed on the ground. TYPE OF PARTICIPANTS: Ten flight nurses. MEASUREMENTS AND MAIN RESULTS: Tracings of pulsatile pressure from the carotid pulse model verified its ability to simulate a wide range of arterial pressures. Analyses of variance for repeated measures, including polynomial contrasts, were performed to compare the number of correct detections of the presence or absence of pulse pressures in flight with the number of correct detections in the two control conditions for both carotid pulse pressures. The mean in-flight number of correct detections was lower than both the preflight and postflight control tests, which were themselves nearly equal, at each simulated carotid pulse pressure. The quadratic terms for both the 120/80 mm Hg trial (F1,14 = 9.28; P = .0087) and the 80/60 mm Hg trial (F1,18 = 5.69; P = .0283) were statistically significant. CONCLUSION: Factors associated with transport of patients in an MBB BO-105 helicopter impair the ability of flight nurses to detect carotid pulses in a simulated physiologic model.

Aircraft↗
PubMed1997

The intraoperative assessment of ascending aortic atheroma: epiaortic imaging is superior to both transesophageal echocardiography and direct palpation.

OBJECTIVES: To determine the optimal method for detecting ascending aortic atheroma intraoperatively by comparing manual palpation by the operating surgeon, intraoperative transesophageal echocardiography, and epiaortic ultrasound (linear and phased-array imaging); and to assess risk factors for severe aortic atheroma. DESIGN: A longitudinal prospective study. Assessment of the atheroma by manual palpation was blinded to the results of the ultrasound images. SETTING: The study was performed in a single university tertiary referral hospital. PARTICIPANTS: One hundred consecutive patients undergoing coronary bypass or valve surgery were studied after their written, informed consent. INTERVENTIONS: Potential risk factors were evaluated by both a patient questionnaire and examination of prior hospital records. The ascending aorta was assessed by the following methods: manual palpation by the operating surgeon, intraoperative transesophageal echocardiography, and epiaortic ultrasound (linear and phased-array imaging) performed by an echocardiologist. For analysis, the ascending aorta was divided into three equal segments: proximal, mid, and distal, corresponding to regions of different operative manipulations. MEASUREMENTS AND MAIN RESULTS: Age older than 70 years and hypertension were significant risk factors for severe ascending aortic atheroma with adjusted odds ratios of 3.3 (95% CI, 1.2 to 9.3) and 3.9 (95% CI, 1.3 to 12.0), respectively. There was no significant difference in atheroma detection between the two ultrasonic epiaortic probes in any segment; however, epiaortic probes were superior to manual palpation in all segments and also superior to transesophageal echocardiography in the mid and distal segments of the ascending aorta. CONCLUSIONS: Age older than 70 years and hypertension are significant risk factors for severe ascending aortic atheroma. Intraoperative detection of ascending aortic atheroma is best achieved by epiaortic ultrasound with either a linear or phased array transducer. Transesophageal echocardiography is an insensitive technique for evaluation of mid and distal ascending aortic atheroma and, therefore, of little value in guiding surgical manipulations such as cross-clamping.

Age Factors↗
PubMed2004

Magnetic resonance imaging in comparison to clinical palpation in assessing the response of breast cancer to epirubicin primary chemotherapy.

PURPOSE: To investigate whether magnetic resonance imaging (MRI) is superior to clinical palpation in the assessment of response of breast cancer to primary chemotherapy (PC). PATIENTS AND METHODS: Seventy-three patients with T2-4, N0, M0 breast cancer were treated with 3-4 cycles of single agent epirubicin before definitive surgery. MRI was performed at baseline condition and at the end of chemotherapy. RESULTS: According to the WHO criteria, 20 (27.4%) patients attained a complete response (CR) by clinical palpation and 41 (56.2%) a partial response. The corresponding response rate by MRI was 11 (15.1%) and 34 (46.6%), respectively. Residual tumor assessed by MRI better correlated with pathologic measurements (Spearman r : 0.72) than residual tumor assessed by clinical palpation (Spearman r : 0.58). Post-chemotherapy histology evaluation revealed pathologic CR in three cases, only one of them was considered as complete responder by MRI. Residual disease consisted in in situ carcinoma in four cases, one of them was complete responder at MRI, the remaining three showed residual abnormal contrast enhancement indistinguishable from that of invasive tumors. CONCLUSIONS: As compared to pathology specimens, MRI is able to represent the extent of cancer more accurately than clinical palpation. It constitutes a promising technique in assessing the BC response to PC. The current limit of MRI is the scarce specificity in predicting the nature of residual disease.

Adult↗