The mammographic and histologic findings were reviewed in 41 consecutive cases of isolated lobular carcinoma in situ (LCIS) unassociated with any malignant diagnosis. Thirty-one needle-directed breast biopsies were performed to evaluate clustered microcalcifications. In 24 of the 31 cases, the calcifications were found in areas of benign breast disease, with LCIS representing a separate process. In the few cases in which microcalcifications were seen in association with LCIS, a greater number of similar calcifications were present in adjacent benign disease. Soft-tissue abnormalities necessitating the performance of a biopsy represented benign foci, except in one patient with LCIS in and adjacent to a fibroadenoma. The authors conclude that LCIS has no characteristic mammographic features. LCIS is detected as an incidental finding at breast biopsy, with the mammographic abnormality predominantly reflecting a benign process.
The authors performed 601 preoperative needle localization procedures for occult breast abnormalities in 1987. Whereas most previous series have been based on mammograms obtained and interpreted at the reporting institutions, this study population includes a large number of patients (79%) examined and referred from other facilities. One hundred nine cancers were diagnosed in the 601 cases (18%). Biopsies performed for masses yielded a 23% (64 of 278) frequency of cancer and those for calcification, 14% (45 of 323). The benign to malignant ratio (4.5:1) in this mixed group of patients is higher than that cited in reports of other large series. An analysis of the factors that might influence these statistics is presented.
Voice entry has been successfully employed to generate radiology reports with a word recognizer with a 1,000-word lexicon capacity. About 50% of reports were able to be dictated with a single 900-word lexicon. This was split into five sections by anatomic or subspecialty application. Each was augmented to 900 words. By switching from one lexicon to another, it was possible to dictate more than 70% of reports. With exclusive use of three lexicons in subspecialty areas (gastrointestinal radiology, neuroradiology, and mammography), and with further modification of the respective vocabulary, it has been possible to employ the system 88% of the time. Twelve percent of cases included wording that was beyond the scope of the lexicon. Computer subsets that allow different translations of some words when used in different contexts have been used. Some of these are used as triggers that will print whole lines, sentences, or even complete reports. Dictation times with voice entry take about 20% longer. Recognition reliability has been greater than 95%.
From January 1990 through December 1992, 1,585 preoperative wire localization procedures of occult breast lesions were performed at the authors' institution. Of these, 739 (47%) were masses, and ultrasound (US) guidance was performed to localize 30 lesions. In five of the 30 lesions, no mass was seen at radiography of the specimen, but US of the specimen helped confirm complete excision.
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