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Biomedical subjects

E Azavedo

Publications and source records attributed to E Azavedo.

At least 19 recordsLinked to original sources
PubMed2000

Effect on sensitivity and specificity of mammography screening with or without comparison of old mammograms.

PURPOSE: To evaluate the effect of old mammograms on the specificity and sensitivity of radiologists in mammography screening. MATERIAL AND METHODS: One hundred and fifty sets of screening mammograms were examined by 3 experienced screeners twice: once without and once in comparison with older mammograms. The films came from a population-based screening done during the first half of 1994 and comprised all 35 cancers detected during screening in 1994, 12/24 interval cancers, 14/34 cancers detected in the following screening and 89 normal mammograms. RESULTS: Without old mammograms, the screeners detected an average of 40.3 cancers (range 37-42), with a specificity of 87% (85-88%). With old mammograms, the screeners detected 37.7 cancers (range 34-42) with a specificity of 96% (94-99%). The change in detection rate was not significant. However, the increase in specificity was significant for each screener (p = 0.0002-0.03). CONCLUSION: Mammography screening with old mammograms available for comparison decreased the false-positive recall rate. The effect on sensitivity, however, was unclear.

Adult↗
PubMed1999

Imaging breasts with silicone implants.

Over the last two decades, the use of breast implants both for breast augmentation and for breast reconstruction following mastectomy has increased substantially. It is estimated that around two million women have undergone breast augmentation, while hundreds of thousands have had breast reconstruction surgery. Different types of material have been used for breast implants, but silicone gel implants have been the dominating implant type. Many implants can lead to complications, such as hardening and rupture, and may therefore need in vivo evaluation by imaging, particularly if they lead to clinical symptoms. They can also pose problems in the assessment of surrounding breast tissue by conventional mammography. In this respect, imaging modalities such as ultrasound, computed tomography and magnetic resonance imaging offer greater possibilities to assess a failing implant, as well as surrounding breast tissue. Several factors, mainly of a psychological nature, lead to requests for breast implants. In this review article, only the imaging aspects of breasts with silicone gel implants will be dealt with. Each modality is concisely presented with its possibilities and limitations.

Breast Implantation↗
PubMed1999

Nipple discharge disorders: current diagnostic management and the role of fiber-ductoscopy.

Nipple discharge disorders is a field in which there has been both increasing awareness on the part of patients and advances in management. Today secretion from nipples can be classified according to its color, cellularity and biology. To be significant a discharge should be true, spontaneous, persistent and non-lactational. Moreover there are methods to differentiate patients who require surgical intervention from those who do not. Surgically significant nipple discharges are watery, serous (yellow), serosanguineous and bloody. Cytology smears of discharge material have helped to classify the cellular material, providing information about normality, atypia and malignancy and also about papillary formation of the exfoliated cells. Tests such as Hemoccult help to discover occult blood in the secreted fluid. Modern immunological tests can be performed on cytology smears where occurrence of high levels of carcinoembryonic antigen could indicate a latent malignancy. Galactography investigation is today the state-of-the-art approach to investigate patients with nipple discharge disorders and this examination can demonstrate the size, location and extent of an intraductal abnormality. Modern high-resolution ultrasound techniques are helpful in visualizing intraductal disorders and are becoming a good complementary approach if not an alternative to traditional radiology techniques. Recently even MR galactography has been shown to be of diagnostic value, but not as informative as regular galactography. The most sophisticated investigation method, which can also be used therapeutically, is fiber-ductoscopy of the concerned duct in a breast. This technique, although expensive and in its infancy, is a fascinating and promising approach for inspecting the intraductal lumina. In this article the background, current investigation methods and possibilities of the technique are described, as well as the most sophisticated ways to deal with nipple discharge disorders in human breasts.

Breast Diseases↗
PubMed1996

Mammographic features, predictors of early ipsilateral breast tumour recurrences?

Mammograms from 69 patients with Stage I/II breast cancer, operated on using breast-conserving surgery between 1987-1990 were blindly re-evaluated in order to predict retrospectively ipsilateral breast tumour recurrences. The study cohort was divided into two groups of 34 and 35 patients. Each group was matched according to age, the time at risk and to presence or absence of an ipsilateral breast tumour recurrence. The mammographic reinterpretation was performed by two radiologists that correctly predicted an ipsilateral breast tumour recurrence in 81%. Mammographic characteristics, such as diffuse microcalcifications, multifocality, solitary densities, especially of stellate type near the nipple and/or spicula in the vicinity of the retroareolar region were more often associated with an ipsilateral breast tumour recurrence. Data from this limited series suggest that certain mammographic features seem to correlate with the ability of the tumour to recur locally. Hence, mammography can play a prognostic role in deciding the treatment of choice in operable breast cancer.

Adult↗
PubMed1993

Dietary habits and mammographic patterns in patients with breast cancer.

Between 1983 and 1986, dietary history interviews were conducted with 238 women aged 50-65 years who had surgery for stage I-II breast cancer. Diagnostic mammograms were coded in line with Wolfe's criteria in N1, P1, P2, and Dy patterns. Women with Dy pattern reported significantly higher intake of total fat, monounsaturated fatty acids (FA), polyunsaturated FA, n-3 FA, n-6 FA in per cent of energy (E%), and alpha-tocopherol in mg/10 MJ. Fat intake was lowest in women with N1 pattern and highest in those having Dy pattern. Patients having ER-rich cancers and Dy pattern reported significantly higher intake of total fat, monounsaturated FA, polyunsaturated FA, n-6 FA (E%), and alpha-tocopherol (mg/10 MJ), as well as significantly lower intake of carbohydrate (E%) and calcium (g/10 MJ). In the stepwise multivariate analysis, the multivariate-odds ratio (OR) for having P2 + Dy patterns was 1.06 (95% confidence interval (CI), 1.02-1.12) for each increment in E% of total fat. In women with ER-rich tumors this OR was 1.09 (95% CI, 1.02-1.16). The highest self-reported body mass index (BMI) was observed in women with N1 + P1 patterns. OR for having P2 + Dy patterns was 0.91 (95% CI, 0.83-0.98) for each increment in 1 kg/m2 of BMI. The results suggest that dietary habits affect the mammographic parenchymal pattern in women with breast cancer and that a high fat intake is associated with a higher proportion of mammograms with Dy pattern in such patients.

Aged↗
PubMed1992

Expression of the c-erbB-2 proto-oncogene product and nuclear DNA content in benign and malignant human breast parenchyma.

The expression of the c-erbB-2 proto-oncogene product was investigated immunohistochemically in 474 formalin-fixed and paraffin-embedded human breast tissue samples. The series included 32 benign and 26 hyperplastic lesions, 32 carcinomas in situ and 384 invasive breast carcinomas, 107 of which were less than 1 cm in diameter. Cytometric DNA assessments were performed on histopathologically or cytodiagnostically identified cell nuclei, using image analysis. C-erbB-2 immunoreactivity was not seen in normal parenchyma or in benign and hyperplastic lesions. Mammary carcinomas in situ were more frequently immunoreactive (59%) than invasive neoplasms (23%). Invasive tumours more than 1 cm in diameter immunoreacted more often (26%) than small invasive carcinomas (16%). C-erbB-2 expression in regional lymph node metastases was the same as in the corresponding primary tumours. Significant differences were observed between the c-erbB-2 expression in DNA diploid and aneuploid lesions; for carcinomas in situ the figures were 40% and 72%, respectively. Invasive carcinomas of DNA diploid type rarely showed c-erb-B-2 expression, irrespective of tumour size and nodal status (7-11%). DNA aneuploid tumours were more frequently immunoreactive with increasing levels during progression (32-41%). Our data indicate that genetically stable invasive mammary tumours seem rarely to express the c-erbB-2 protein, even during progression, whereas genetically unstable invasive neoplasms frequently show c-erbB-2 immunoreactivity which increases during tumour progression.

Breast↗
PubMed1991

Radiological evidence of response to electrochemical treatment of breast cancer.

A non-surgical therapeutic approach is illustrated with a case report of a breast cancer. Percutaneous implantation of electrodes in a breast permitted electrochemical treatment of a clinically, radiologically and cytologically verified cancer. Electrophoresis was induced between two implanted electrodes for about 2 h. No complaints were reported and no complications were observed. Bi-annual mammographic follow up could not disclose palpable or mammographic evidence of tumour remnants 2 years later.

Adenocarcinoma↗
PubMed1990

Nuclear DNA content, histological grade, and clinical course in patients with nonpalpable mammographically detected breast adenocarcinomas.

Sixty-five consecutive female patients, age 35-83, with nonpalpable breast carcinomas detected by mammography were classified with both morphological and cytochemical malignancy grading. Cytochemically, the tumors were divided into euploid and aneuploid types indicating low and high malignancy potential, respectively. The mean follow-up time in the euploid group was 6.7 years and in the aneuploid group 8.0 years. No significant difference in mortality was observed in the two groups comprising 65% euploid and 35% aneuploid tumors. Our results here indicate that an early detection of breast cancer at a clinically occult and nonpalpable level leads to better prognosis even in patients with aneuploid tumors whose tumors otherwise are considered to be highly malignant.

Adenocarcinoma↗
PubMed1990

Preoperative immunocytochemical analysis of the estradiol receptor in nonpalpable human breast tumors.

An immunocytochemical technique employing a monoclonal antibody to the estrogen receptor was used to analyze the receptor content in tumor biopsy material from nonpalpable breast carcinomas. Fine needle biopsies were obtained from 12 such tumors using a stereotaxic biopsy technique. The smears were used for cytomorphological diagnosis and receptor analysis. The results show that estrogen receptor status can be determined preoperatively in nonpalpable human breast tumors.

Aged↗
PubMed1990

DNA ploidy in screening-detected non-palpable mammary carcinomas.

Non-palpable breast cancers detected by mammography in women participating in the ongoing screening project at Södersjukhuset, Stockholm, Sweden, were classified by morphological and cytochemical malignancy grading. The women's age ranged between 40 and 64 years, and the clinical course was followed for a minimum of 5 years after primary treatment. No significant difference in disease-free survival was observed in the 66 cases studied (mean age 58 years) where 28% of the tumors were aneuploid and 72% euploid. Our results indicate that prognosis, even for patients with potentially highly malignant tumors, can be altered when their tumors are detected and treated at an early stage.

Adult↗
PubMed1989

Stereotactic fine-needle biopsy in 2594 mammographically detected non-palpable lesions.

To assess the accuracy of detection of breast cancers by mammography and stereotactic fine-needle biopsy (SFNB) 2594 mammographically detected non-palpable lesions were sampled. On the basis of combined evaluation by mammography and cytology of these samples, 2005 (77.3%) of the cases were judged as benign lesions without need of surgery and only 1 of these turned out to be a cancer 14 months later. In 567 (21.9%) patients diagnostic and/or therapeutic surgery was done. Breast cancer was confirmed by histopathology in 429 (75.7%) of the patients operated on and a further 60(10.6%) had non-malignant pathological changes (eg, sclerosing adenosis, epitheliosis, fibroadenoma, or papilloma). Thus, surgery was justified in 86.3% (489) of the patients. In addition to the histopathologically verified cancers, another 22 (0.8%) breast cancers were diagnosed by mammography and cytology but these patients were not subjected to surgery for various reasons. A combination of mammography and SFNB offers a procedure of high sensitivity for early diagnosis of breast cancer.

Adult↗
PubMed1986

Nuclear DNA content and behavior of oxyphil thyroid tumors.

Microspectrophotometric measurement of nuclear DNA content was made on archival smears of fine-needle aspirates from 23 oxyphil thyroid neoplasms. Fourteen tumors were considered benign as judged from the histologic picture as well as follow-up for 7 to 18 years after the operation. Nine tumors were malignant; five of these showed capsular penetration and/or blood vessel invasion as the only signs of malignancy, whereas the remaining four in addition had histologically verified metastases and were the cause of death. The DNA patterns found--diploid, polyploid or aneuploid--appeared to have a limited diagnostic value, since malignancy could not be excluded on this basis. A practically useful finding was, however, that aneuploidy appeared to be associated with a high probability of invasive growth. As regards prognostic information, it was found that euploid patterns occurred in tumors from patients with long survival after surgical treatment, while tumors with aneuploid patterns showed a variable clinical course.

Adenoma↗
PubMed1986

Receptors for EGF and oestradiol and thymidinekinase activity in different histological subgroups of human mammary carcinomas.

The cellular content of receptors for epidermal growth factor (EGF) was measured in different histological subgroups of human mammary carcinomas. EGF receptors were detected in 36% of the ductal and all the medullary carcinomas. In contrast lobular and pure colloid tumours did not contain measurable amounts of the receptor. The receptor was found both among tumours with an euploid and aneuploid DNA pattern. The EGF receptor is thus found in carcinomas with a varying degree of differentiation as judged by the cellular DNA pattern. There was no correlation between the proliferative activity of the tumours as measured by thymidinekinase activity and the amount of EGF receptors in the tumour. Tumours with detectable EGF receptor often had low levels of oestrogen receptor. This finding could only partly be explained by the menstrual status of the patients.

Breast Neoplasms↗