Aims and objectives
In France,
breast cancer mass screening is based on a reviewing process: any BIRADS 1 or 2 mammogram is reviewed by a breast specialist radiologist to assess the absence of suspicious lesion,
with additional cancer detection rate of 7%. In our center,
this principle is also applied for breast cancer lesion management.
All patients addressed to our institution for breast cancer surgery or chemotherapy whose imaging was performed out of the hospital,
have a review consultation with a specialist radiologist.
If necessary they undergo complementary...
Methods and materials
This monocentric retrospective study (December 1st 2015 to April 30th 2017) included patients addressed by a physician (gynaecologist or radiologist) from another institution for management of malignant or suspicious breast lesion.
We included every patient over 18 year-old registered during this period for review consultation and biopsy or preoperative localization.
The consultation was performed by one of the breast specialist radiologists of our institution who proceeded to systematic clinical examination and breast and axillary US. We reviewed all the previously done imaging to assess the...
Results
From 202 women eligiblefor the study,
one was excluded because of proven genetic mutation and 15 patients were excludedfor the following reasons: 9 inappropriate registrations,
5 benign lesions and 1 lost of follow up (surgery performed out of our institution without available data).
A total of 186 patients were included in the analysis (Figure 1) addressed for 163 BIRADS 6 lesions and 35 suspicious lesions (BIRADS 0,
4 or 5) which were biopsied and confirmed as malignant.
Twelve patients had bilateral lesions.
The median age...
Conclusion
In our retrospective study,
systematic imaging review of breast malignant or suspicious lesions before surgery led to the diagnosis of 38 additional BIRADS 6 lesions (with 10 atypical lesions (14,5% of all breast biopsies) and 28 carcinomas (40,6%)) corresponding to 16,1% (38/236) of all malignant breast lesions and 11 additional metastatic lymph nodes.
Surgical procedure was modified in 45 patients (24,2%).
This underlines the importance of breast specialist radiologists in management of cancer.
Several European studies such as Posso et al.
or Waldmann et al....
References
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M.,
Carles,
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Rué,
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Puig,
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Bonfill,
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Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme.
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Kapsimalakou,
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Katalinic,
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Grande-Nagel,
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