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Biomedical subjects

R H Troupin

Publications and source records attributed to R H Troupin.

At least 19 recordsLinked to original sources
PubMed1994

Suspicious breast lesions: MR imaging with radiologic-pathologic correlation.

PURPOSE: To study the architecture and enhancement characteristics of breast lesions with magnetic resonance imaging. MATERIALS AND METHODS: Forty-one patients with mammographic and/or palpable lesions were imaged. T1-weighted, fat-saturated T2-weighted fast spin-echo, and gadolinium-enhanced and -unenhanced fat-saturated spoiled gradient-echo images were obtained. All patients underwent excisional biopsy or cyst aspiration. RESULTS: Fifteen of 16 carcinomas were identified and exhibited at least partially irregular borders. T2-weighted signal intensity and contrast enhancement varied. Rim enhancement was seen in five lesions. Nine of 10 fibroadenomas were visualized and showed well-defined borders. T2-weighted signal intensity and contrast enhancement varied and correlated with histologic features. Internal septations were seen in five lesions. Time-intensity curves showed no statistically significant difference between fibroadenomas and cancers. CONCLUSION: There is an overlap in the signal intensity characteristics and enhancement profiles of benign and malignant lesions. However, border characteristics, internal architecture, enhancement characteristics, and the presence of multiple tiny associated cysts may be important clues to lesion identification.

Adult↗
PubMed1993

Preoperative localization of breast lesions: tailored techniques and potential pitfalls.

Preoperative needle localization procedures can be performed using a variety of devices and tailored approaches. Success in these endeavors can be optimized through communication and coordination among the radiologist, surgeon, and pathologist. Meticulous attention to performance and radiological-pathological correlation are required to ensure the best possible results.

Biopsy↗
PubMed1993

Breast cancer recurrence after lumpectomy and radiation therapy for early-stage disease: prognostic significance of detection method.

The prognostic implications of detection mode in local recurrence after lumpectomy and radiation therapy were assessed. Seventy-two women treated with lumpectomy and irradiation for American Joint Committee on Cancer stages I and II invasive breast cancer developed recurrent cancer in the ipsilateral breast, had physical examination and mammography performed at the time of recurrence, and underwent salvage mastectomy. There was a statistically significant association between detection with mammography alone and lower T stage (P = .05), and there was a nonstatistically significant trend toward noninvasive histologic findings. No significant association was noted between detection method and site of recurrent current cancer in the breast, interval to recurrence, or patient age. There were nonstatistically significant trends toward improved relapse-free survival and overall survival for patients with recurrences detected solely with mammography. that postirradiation surveillance mammography is important for the early detection of recurrent cancer. While the trend did not reach statistical significance, detection with mammography alone had a clinically apparent impact on relapse-free and overall survival.

Actuarial Analysis↗
PubMed1992

Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection.

Between 1977 and 1989, 102 of 1,145 patients treated with lumpectomy and radiation as an alternative to mastectomy required subsequent biopsy for suspected ipsilateral recurrence. The authors reviewed the mammograms of 58 of those patients for whom at least two sets of mammograms were available, including one set obtained within 3 months of the subsequent repeated biopsy. Of 38 biopsy-proved recurrences, 13 (34%) were detected with mammography alone, 17 (45%) with palpation alone, and eight (21%) with both mammography and palpation. While standard mammographic criteria for biopsy were followed, distortions and calcifications inherent to posttreatment appearances necessitated judicious modifications. As anticipated, sensitivities and positive predictive values showed more impairment within the lumpectomy quadrant. In addition, all cases of purely in situ cancer were detected solely with mammography. Mammography plays an important complementary role to physical examination in posttreatment follow-up. On the basis of these findings, a follow-up algorithm for the ongoing evaluation of these patients was developed.

Adult↗
PubMed1992

Radial scar with microcalcifications: radiologic-pathologic correlation.

Since it is widely recognized that a radial scar of the breast can mimic scirrhous carcinoma at mammography, criteria to differentiate the two lesions continue to be suggested. Mammographic features that have been described as occurring with radial scars include a radiolucent central core; elongated, radiating spicules; and absence of calcifications. Recent studies have documented the unreliability of the first two parameters; calcifications, however, have been reported to be unusual in mammograms of radial scar lesions. From recent case material, the authors present four cases of biopsy-proved radial scars associated with mammographically visible microcalcifications. The mammographic findings, with pathologic correlation, are reported to emphasize the occurrence of microcalcifications within radial scars. When a stellate lesion is seen at mammography in the absence of a surgical scar, biopsy should be performed promptly, since no reliable mammographic features exist to distinguish radial scars from scirrhous carcinomas.

Adult↗
PubMed1991

Lipid cyst: classic and atypical appearances.

Lipid cysts, a specific type of fat necrosis, frequently have a pathognomonic appearance on radiographs. This consists of a lucent lesion surrounded by a smooth rim that may or not be calcified. Occasionally, lipid cysts with unusual mammographic appearances are encountered. An appreciation of some of these appearances may prevent unnecessary biopsies.

Breast Diseases↗
PubMed1991

New insights into mammographic correlations in breast pathology.

Meticulous correlation of mammographic and pathologic findings is essential to improve detection and understanding of the many processes that affect the breast. A review of recent radiologic papers dealing with several breast cancer variants as well as two benign lesions, the radial scar and the breast hamartoma, is presented. Important papers from the pathologic, oncologic, and radiologic literature are reviewed. These papers described the evolving concepts of proliferative breast disease as risk markers, as well as insights into prognostic differences among the histologic subtypes of ductal carcinoma in situ.

Biopsy↗
PubMed1990

The mini-fellowship in teaching. A senior resident elective.

The residency program at the University of Pennsylvania offers a 1-month fellowship for senior residents in medical student education. Instructional philosophy, methods, and content are discussed, observed, practiced, and evaluated. Close supervision and immediate feedback provide training particularly needed by future academic radiologists, and strengthen consultative skills for clinical practice.

Fellowships and Scholarships↗
PubMed1989

Biopsy results of new calcifications in the postirradiated breast.

A breast biopsy was performed in 19 patients for the finding of new mammographic calcifications without an associated palpable or mammographic mass after breast-conserving surgery and definitive irradiation for early stage breast cancer. The interval postradiotherapy was 9 to 96 months with a median of 34 months. Eleven of the biopsy specimens (58%) were positive for recurrent breast cancer and eight (42%) were negative. The pathologic results from the positive biopsy specimens showed four with invasive ductal carcinoma, two with microinvasive ductal carcinoma, four with intraductal carcinoma, and one with lobular carcinoma in situ (LCIS). Treatment consisted of mastectomy in eight patients, mastectomy plus chemotherapy in one patient, and biopsy for the patient with LCIS. One patient refused a recommended mastectomy. All 11 patients with recurrent carcinoma are alive with no evidence of disease after salvage therapy, although follow-up is short (median, 14 months; range, 0-48 months). Calcifications which developed in a quadrant different from the initial tumor tended to be malignant with four of five having a positive biopsy result. Microcalcifications were not commonly associated with the initial tumor with only five of 19 having microcalcifications. These results show that the development of new calcifications in the postirradiated breast is associated with a positive biopsy rate of 58% and that the tumors which are found tend to be early and potentially salvageable. The positive biopsy rate of 58% in the postirradiated breast is in marked contrast to the lower positive biopsy rate for microcalcifications in the nonirradiated breast as reported in the literature.

Biopsy↗
PubMed1976

The arthropathy of hemochromatosis.

Five cases of hemochromatosis arthropathy are presented and the distinctive radiological features of the disease are described. Although the condition is typically degenerative, showing subchondral cyst formation, sclerosis, and thinning of cartilage, its distribution is characteristic. Selective degenerative changes of the second and third metacarpophalangeal joints are striking, particularly in the hands, while abnormalities in the intercarpal joints are variable and the interphalangeal joints are spared. Chondrocalcinosis involving both fibrous and hyaline cartilage is frequently seen as well, particularly in the large joints. The calcification is due to deposition of calcium pyrophosphate crystals, perhaps resulting from iron inhibition of pyrophosphatase.

Adult↗