[Calcifications after tylectomy and irradiation for breast cancer. Their symptomatic picture and diagnostic value].

In several institutions lumpectomy combined with radiation treatment is being investigated as an alternative method in the primary management of breast cancer (1-5). In 8 of 53 patients, who had undergone this treatment, new calcifications developed after therapy. In 2 of the 53 patients postoperatively persisting calcifications were encountered.

Imaging of the breast.

A multitude of techniques for imaging and evaluating the breast have been described. Based upon current evidence, thermography does not appear to have any established clinical indications. Computed tomography, ultrasonography, lightscanning, and NMR may be useful as adjuncts to mammography, and further research seems warranted.

[Initial results in the mammographic diagnosis of recurrences following tylectomy and irradiation].

In several institutions lumpectomy combined with in- and external radiation is being used as an alternative to the modified radical mastectomy. The mammographic detection of local recurrence is complicated by the fact that the changes after radiation and surgery interfere with primary and secondary signs of malignancy. The authors report about their preliminary experience in the radiographic detection of recurrence in these patients.

Sonography of the breast: findings following conservative surgery and irradiation for early carcinoma.

A dedicated-waterpath ultrasound breast scanner was used to examine 25 patients who had early breast carcinomas that were treated with conservative surgery (lumpectomy, tylectomy) and irradiation. Sonographic findings following such therapy included asymmetry in breast size, skin deformity and thickening, nipple retraction and/or distortion, and thickening of the Cooper ligaments. Disruption of the central echogenic cone of fibroglandular tissue, and general architectural distortion and internal asymmetry when the breasts were compared were also present in a large percentage of patients.

Fat necrosis of the breast: characteristic xeromammographic appearance.

Eight cases of fat necrosis of the breast were examined by xeromammography and confirmed pathologically. They showed a spectrum of mammographic appearances, from mimicking other benign diseases to suggesting a malignant lesion. Three of the eight cases showed the benign ring-like calcification associated with fat necrosis; this is a higher percentage than reported in previous series.

Mammographic and pathologic correlation of microcalcification in disease of the breast.

Fifty-five patients with isolated microcalcification clusters and no palpable tumor of the breast were studied. All patients underwent appropriate localization biopsies and had roentgenographic, specimen roentgenographic examination of histologic confirmation that the area of microcalcification was removed. Fifteen patients proved to have a malignant lesion at biopsy and in 40 patients, it proved to be benign.

Ultrasound demonstration of giant malignant breast cyst undetected by xeromammography.

The present case is unusual because, despite the underlying fatty breast pattern, the large size of the mass, and the presence of carcinoma, an essentially normal xeromammogram was obtained. This case demonstrates the necessity of performing a subsequent ultrasound examination on any patient in whom a palpable breast mass is not detected by xeromammography. The present case report clearly demonstrates that cyst aspiration plays a vital role in the evaluation of cystic breast masses.

Lymphoma with herpes zoster.

A herpes zoster infection in patients with lymphoma has been associated with subsequent metastatic disease involving the spinal cord and vertebrae of the affected dermatome segment. This correlation can be used in planning radiation therapy to avert neurologic complications secondary to spinal cord involvement.

Pectus excavatum deformities simulating mediastinal masses.

Three patients with various pectus excavatum deformities in whom radiographic findings suggested hilar and mediastinal masses are presented. Computed tomography of the chest yielded valuable diagnostic information and made it possible to exclude the existence of these masses. Compression deformity of the heart and great vessels by the pectus deformity is the most likely explanation for these findings.

Scapular defects: a normal variation.

Sharply marginated defects were observed in the scapulae of five patients. In all cases the defects were benigh in appearance and unrelated to symptoms. These patients have been observed up to 5 years without change in the radiographic appearance.

Duodenal pseudotumor with ball-valve syndrome.

Prolapse of the gastric mucosa into the duodenum must be considered when a round soft tissue mass is seen in the right upper quadrant on scout abdominal film. Gastric prolapse may mimic tumor in the duodenum when the prolapse is large. Examination with barium meal is necessary to exclude prolapse of the gastric mucosa into the duodenum as a cause of epigastric pain and vomiting.

Irregularity of Silastic breast implants mimicking a soft tissue mass.

Seven patients were identified who developed a palpable breast mass following augmentation mammoplasty. Xeromammography showed the "mass" to be a puckering or bulge in the Silastic implant.

Perforated viscus presenting with gas in the soft tissues (subcutaneous emphysema).

We have reviewed the spectrum of gaseous densities in the soft tissues secondary to a perforated viscus. All patients presented late and most were elderly. The most common surgical procedure was diversion of the fecal stream proximal to the perforation.