[Most patients attitude is positive to a new, reconstructed nipple in connection with mastectomy].
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Adult↗
Biomedical subjects
H Wallberg
Publications and source records attributed to H Wallberg.
Skin circulation in the nipple after reduction mammaplasty by upper and lower glandular resections.
Avascular necrosis of the nipple is a serious complication of reduction mammaplasty with nipple transposition. A study was undertaken to measure the skin circulation in the nipple before, during and after this operation. In 14 patients undergoing a reduction mammaplasty according to the method of Strömbeck, the skin circulation was measured in 25 breasts with laser doppler flowmetry (LDF) and fluorescein flowmetry (FF). LDF showed that the skin circulation increased after de-epithelialization to 204.4 +/- 31.0% of the preoperative value (100%) (mean +/- SEM, p less than 0.01). After the upper and lower glandular resection the circulation was reduced to 90.7 +/- 12.3% of the preoperative value. The division of the lateral pedicle did not affect the circulation. After the skin had been sutured, the circulation was 71.5 +/- 9.1% of the preoperative value (p less than 0.01). One to four days postoperatively the circulation was 100.3 +/- 13.2% of the preoperative value. At FF uniform fluorescence was observed in the nipple postoperatively in all patients but two, in whom avascular necrosis later developed. Our results thus show that the circulation in the nipple after reduction mammaplasty by the Strömbeck method is adequate and that it is safe to divide the lateral dermal pedicle.
Adult↗
The thermal emission from the skin and the vascularity of the breasts in normal and scoliotic girls.
The vascularity of the breasts was examined by thermographic and diaphanographic methods in normal and scoliotic girls. The thermal emission from the skin registered with an AGA Thermovision 750 camera (Stockholm, Sweden) on black and white Polaroid film was evaluated visually by 10 independent observers. No significant differences between the thermal images of the left and the right breast were found in the control or scoliotic groups or in girls with a right convex thoracic curve, nor was there any significant difference between the groups in this respect. Image analysis of diaphanograms of the breasts using the GOP 300 system showed a significantly greater vascularity of the left breast than of the right, both in the scoliotic series as a whole and in the subgroup with a right convex thoracic curve, but not for the reference group. The vascularity of the left breast but not of the right one was significantly greater for the girls with a right convex thoracic curve than for the control group. The results of the diaphanographic study confirm earlier observations and together provide substantial evidence that unilateral stimulation of rib growth due to a greater vascularity of the left breast and the underlying costosternal junctions might be one initiating factor in the development of right convex thoracic idiopathic scoliosis in adolescent girls.
Adolescent↗
The value of diaphanography as an adjunct to mammography in breast diagnostics.
Histologically classified carcinoma and benign breast disorder was present in 100 respectively 163 cases of symptomatic women. The results of diaphanography were correlated with those obtained by clinical examination, mammography and histology. A false negative diagnosis was made in 17 cases (15.5%) using diaphanography and in 13 cases (11.8%) using mammography. A false positive diagnosis was made in 15 cases (9.2%) with diaphanography and in 33 cases (20.2%) with mammography. The use of both mammography and diaphanography reduced the number of false negatives from 11.8 per cent to 5.5 per cent. In conclusion, diaphanography has been demonstrated to be a useful adjunct to mammography.
Adult↗
Diaphanography in breast carcinoma. Correlation with clinical examination, mammography, cytology and histology.
Histologically classified carcinoma was present in 110 breasts of 108 symptomatic women. The results of diaphanography (DPG) were correlated with those obtained by clinical examination (CE), mammography (M) and cytology (C). A tumour was palpable in 87 cases (79.1%). A false negative diagnosis was made in 17 cases (15.5%) using DPG, in 13 cases (11.8%) using M and in 15 cases (13.6%) using C, but in 12 of the latter cases (10.9%) the specimen was not representative. The validity of the findings using DPG and M was also analysed. The calculations were based on the results obtained from the present investigation and from a study of diaphanography in 163 cases of benign breast disorders. For DPG the sensitivity was 85 per cent, the specificity 91 per cent, the positive predictive value 86 per cent and the negative predictive value 90 per cent. For M the sensitivity was 86 per cent, the specificity 80 per cent, the positive predictive value 75 per cent and the negative predictive value 91 per cent. The specificity for diaphanography was significantly different from mammography (p less than 0.05). The use of both M and DPG reduced the number of false negatives from 11.8 per cent to 5.5 per cent. In conclusion, DPG has been demonstrated to be a useful adjunct to CE and M.
Adenocarcinoma↗
Diaphanography in benign breast disorders. Correlation with clinical examination, mammography, cytology and histology.
Histologically classified benign breast disorder was present in 163 breast of 158 symptomatic women. The results of diaphanography (DPG) were correlated with those obtained by clinical examination (CE), mammography (M) and cytology (C). A tumour was palpable in 108 cases (66.3%). A false positive diagnosis, i.e. possibly malignant, probably malignant or malignant was made in 15 cases (9.2%) with DPG, and in 33 cases (20.2%) with M. Use of both M and DPG reduced the number of false positives to 1.8 per cent. In 8 cases (4.9%) false positive diagnosis was made with C. During a mean observation time of 58.5 months (range 44-72 months, one case of breast carcinoma was diagnosed.
Adenofibroma↗
Diaphanography in various breast disorders. Clinical and experimental observations.
Diaphanograms of various breast disorders were obtained and investigations were made concerning the ways in which changes in skin temperature, fine needle aspiration biopsy and surgery as well as anti-oestrogen treatment affect the findings. A lowering of the skin temperature made it impossible to detect some of the vessels in the breast and more difficult to interpret the diaphanograms. Cooling of the breast should therefore be avoided in diaphanography. Mastitis, haemorrhage after fine needle aspiration biopsy or an induced haemorrhagic cyst will result in the appearance of a shadow on the diaphanogram suggestive of malignancy. The shadow of a haemorrhagic cyst disappeared immediately after the cyst was emptied and diminished gradually in the other cases. Thus the nature of the breast disorder may be determined by diaphanography if it is repeated at short intervals. Fine needle aspiration biopsy may yield false positive findings and should therefore not be made until diaphanography has been performed.
Adult↗
Physical interpretation of diaphanograms using the computer-controlled image scanner OSIRIS.
Experiments have shown that the light recorded in diaphanography covers approximately the wavelength region of 645 to 900 nm. No significant change in image quality was noted by changing the camera distance between 10 and 25 cm and the light source aperture between 5 and 30 mm. Experiments using polarising filters indicated that the breast is optically isotropic; therefore the results cannot be improved by using polarising filters. In a comparison of various films. Kodak Ektachrome Infrared Film gave the best results. No degradation or variation in image quality was observed when different batches were compared or when the exposed film was stored for 3 weeks before processing. The exposure level is a critical factor and a series of 3 images is needed for optimum evaluation of diaphanograms. The experiments indicate that diaphanography gives consistent results.
Adult↗
Breast carcinoma and benign breast lesions. Diaphanography and quantitative evaluation using the computer-controlled image scanner OSIRIS.
A total of 110 diaphanograms from women with breast carcinoma and 154 diaphanograms from women with benign breast disorders were quantitatively evaluated using the OSIRIS image scanner. Optical density values in the green and red spectral bands were recorded. The malignant and the benign groups, were statistically evaluated using linear discriminant analysis. Correct classification was obtained in 73.5 per cent of women with breast carcinoma and in 84.6 per cent of women with benign breast disorders. Visual interpretation of the findings alone classified 84.5 per cent of the malignant lesions correctly and 90.8 per cent of the benign lesions correctly. Quantitative evaluation combined with visual interpretation improved the accuracy of classification of breast carcinoma (91.8%), but not of benign breast disorders, which was about the same (83.8%).
Analog-Digital Conversion↗