Our objective was to evaluate our experience with the Advanced Breast Biopsy Instrumentation system (ABBI) in non-palpable breast lesions in a prospective study from July 1998 to November 2000. The ABBI system was included in a protocol for BIRADS 4 non-palpable, small (<15 mm) breast lesions. Digital radiographs of both specimen and biopsy cavity were obtained to validate the procedure. A total of 255 ABBI biopsies were performed in 254 patients. In 251 cases the lesions were successfully removed (98.4%). Mammographic lesions consisted of 176 cases of microcalcifications (69%), 51 cases of architectural distortions (20%) and 28 cases of nodules (11%). Seventy-two carcinomas were diagnosed (28.2%). Affected margins were found in 41 cases (56.9%). Residual tumour was seen in 31 patients (43%). Seventeen borderline results and 33 benign architectural distortions obviated further procedures. The complication rate in 10 cases was as follows: 3 wound infections; 4 haematomas; and 3 vasovagal reactions. The main utility of the ABBI system is to allow a reliable diagnosis in complex lesions, such as small clusters of microcalcifications and especially architectural distortions. Surgery can be avoided for borderline cases if the lesion is completely removed and free margins are obtained in the pathology study. Therapeutic use is controversial and can be applied only in selected cases.
We describe a novel technique for marking non-palpable breast lesions with the aim of selecting the best approach prior to performing a biopsy. The technique employs a new coil, specifically designed for breast localization, guided by stereotaxy. This technique is reserved for selected cases in which the lesion is seen peripherally in only one mammographic view with negative or non-conclusive ultrasonographic results, and deeply seated after a stereotactic study. Once the coil is released beside the lesion, the shortest approach from the skin may be employed to perform the biopsy. To our knowledge, this is the first report of this technique.
We report an infrequent mammographic case in which a gross-calcified lipid cyst evolved spontaneously to form a cluster of pleomorphic microcalcifications which were indistinguishable from those seen in breast cancer. The biopsy performed was consistent with fat necrosis. Ultrasonography of the specimen showed a nodule with mixed echogenicity surrounded by a hypoechoic rim. To our knowledge, this behavior is extremely rare, with only one similar case reported in the literature.
En la actualidad la radiología juega un papel fundamental en la detección, estadiaje y manejo de los tumores colorrectales (CCR). El enema de Bario, la tomografía computerizada, los ultrasonidos y la Resonancia magnética son técnicas radiológicas empleadas en el diagnóstico de estos pacientes. La evolución técnica en las técnicas percutáneas ha permitido además que la Radiología contribuya al tratamiento de las lesiones hepáticas metastásicas, con una mejora en el supervivencia de estos pacientes. La aparición de los nuevos TC multicorte hace prever que se convertirán en herramientas de screening que se sumen al enema de bario actual y a la colonoscopia.
El papel de la Radiología en el CCR es por tanto amplio, y, con los continuos aveces técnicos que aparecen en este campo, puede suponerse que se amplicará aún más.
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