Mammographically detectable breast cancer. An eleven year experience

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.

Breast surgery

Initial diagnostic errors are related to the presumption that symptoms or findings are due to benign causes. Physical examination augmented by mammographic study will disclose those benign-appearing lesions which may harbor a carcinoma. All palpable lesions and mammographically suspicious areas require that their identity be determined. The final resolution depends upon biopsy. Missing the tumor also causes diagnostic error. An accurate biopsy or "sample" must be obtained for study. Negative results of sampling techniques should be followed by formal biopsy. Failure to eliminate the primary disease by leaving tumor or breast tissue behind increases the incidence of recurrence. Total mastectomy reduces this risk. It is our view that removal of the axillary nodes also aids in obtaining cure, as well as providing prognostic information. Well intentioned attempts to obtain a better cosmetic appearance or to reconstruct the breast are secondary to the patient's chief need which is to achieve cure. Complications of the surgical procedures are due to improper flap dissection, desiccation and trauma to tissues, incomplete hemostasis, and inadequate drainage. Attention to operative details and adherence to well established surgical principles will minimize complications.