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  1. Preoperative diagnosis of carcinoma of the breast : Is a "cost-cutter" algorithm tenable ?

    Article - En anglais


    Decision making in favor of conservative breast surgery is dependent upon the accuracy of preoperative evaluation of tumor stage, of which imaging modalities occupy a pivotal role.

    Systematic studies correlating the relative accuracy of various evaluating strategies are few, but remain vital means of making the optimal selection of diagnosis and subsequent treatment option.

    In this study, we evaluated the relative efficacy of : (I) palpation (P), (2) ultrasonography (US), and (3) bilateral mammography (MG) of the breast and axilla.


    In a prospective study, 109 female patients undergoing a modified radical mastectomy were subjected to a preoperative diagnostic assessment protocol involving palpation, ultrasonography, and bilateral mammography of the breast and axilla.

    Subsequently the preoperative findings were correlated to the postoperative histopathological reports.

    Cancer-specific criteria evaluated were tumor size, location, histologic type, histoarchitecture, and calcification, as well as status of regional nodes.

    Patient-specific criteria included age, size, and density of the breast and presence of associated benign breast disease.

    Percentage sensitivity, specificity, and positive and negative predictive values were determined for MG, US, and P as well as MG+P and US+P. Results :

    • In assessment of the primary tumor,

    • P,

    • MG, and US showed an overall sensitivity of 88%, 92%, and 90%, respectively ;

    • MG+P and US+P had a sensitivity of 99% each. (...)

    Mots-clés Pascal : Carcinome, Glande mammaire, Diagnostic, Préopératoire, Chirurgie conservatrice, Evaluation performance, Echographie, Exploration clinique, Palpation, Mammographie, Ganglion lymphatique, Axillaire, Résultat, Homme, Femelle, Tumeur maligne, Glande mammaire pathologie, Chirurgie, Exploration ultrason, Radiodiagnostic

    Mots-clés Pascal anglais : Carcinoma, Mammary gland, Diagnosis, Preoperative, Conservative surgery, Performance evaluation, Echography, Clinical investigation, Palpation, Mammography, Lymph node, Axillary, Result, Human, Female, Malignant tumor, Mammary gland diseases, Surgery, Sonography, Radiodiagnosis

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0210874

    Code Inist : 002B20E02. Création : 21/05/1997.