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Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):508-512
DOI 10.1590/S0100-72032009001000007
PURPOSE: to check epidemiological data from a breast diagnostic clinic. METHODS: mammographies from 35,041 patients were studied, within a period of 2 years and 7 months, from 2004 to 2006, 32,049 (91.5%) of them from screening, and 2,992 from symptomatic patients (8.5%). The calculated parameters were: detection rate of the screening patients, percentage of cancer among the symptomatic patients, rate of biopsy indication, percentage of minimal, in situ, and stage 0-1 carcinomas, recall rate, and predictive value of mammographies considered as abnormal and of biopsies' indications in screening patients. RESULTS: 228 diagnoses of breast cancer were made, 111 in screening patients (0.34% detection rate) and 117 in symptomatic patients (3.91% detection rate). The number of biopsies' recommendations among screening patients was 544 (1.7% of those patients). There were 28% of minimal carcinomas, 10% of in situ carcinomas and 93% of stage 0-1 carcinomas among the screening patients. Recall rate was 19%. Positivity of mammographies considered as abnormal (VPP1) was 1.65%. The rate of biopsies' positivity (VPP2) was 21.9%. CONCLUSIONS: this study brings important epidemiological data for the audit of mammographic screening, rare among us. Data have been analyzed as compared to what is recommended by the literature, the detection rate and the percentage of minimal and in situ carcinomas found being comparable to the established values, but with the VPP value lower than the ideal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):508-512
DOI 10.1590/S0100-72032009001000007
PURPOSE: to check epidemiological data from a breast diagnostic clinic. METHODS: mammographies from 35,041 patients were studied, within a period of 2 years and 7 months, from 2004 to 2006, 32,049 (91.5%) of them from screening, and 2,992 from symptomatic patients (8.5%). The calculated parameters were: detection rate of the screening patients, percentage of cancer among the symptomatic patients, rate of biopsy indication, percentage of minimal, in situ, and stage 0-1 carcinomas, recall rate, and predictive value of mammographies considered as abnormal and of biopsies' indications in screening patients. RESULTS: 228 diagnoses of breast cancer were made, 111 in screening patients (0.34% detection rate) and 117 in symptomatic patients (3.91% detection rate). The number of biopsies' recommendations among screening patients was 544 (1.7% of those patients). There were 28% of minimal carcinomas, 10% of in situ carcinomas and 93% of stage 0-1 carcinomas among the screening patients. Recall rate was 19%. Positivity of mammographies considered as abnormal (VPP1) was 1.65%. The rate of biopsies' positivity (VPP2) was 21.9%. CONCLUSIONS: this study brings important epidemiological data for the audit of mammographic screening, rare among us. Data have been analyzed as compared to what is recommended by the literature, the detection rate and the percentage of minimal and in situ carcinomas found being comparable to the established values, but with the VPP value lower than the ideal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):518-523
DOI 10.1590/S0100-72032008001000007
Ectopic pregnancy in a cesarean scar is the rarest form of ectopic pregnancy and probably the most dangerous one because of the risk of uterine rupture and massive hemorrhage. This condition must be distinguished from cervical pregnancy and spontaneous abortion in progress, so that the appropriate treatment can be immediately offered. Since the advent of endovaginal ultrasonography, ectopic pregnancy in a cesarean scar can be diagnosed early in pregnancy if the sonographer is familiarized with the diagnostic criteria of this situation, especially in women with previous cesarean scar. Here we describe a case of ectopic pregnancy in a cesarean scar in which the diagnosis was considerably late, with presentation of spontaneous regression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):518-523
DOI 10.1590/S0100-72032008001000007
Ectopic pregnancy in a cesarean scar is the rarest form of ectopic pregnancy and probably the most dangerous one because of the risk of uterine rupture and massive hemorrhage. This condition must be distinguished from cervical pregnancy and spontaneous abortion in progress, so that the appropriate treatment can be immediately offered. Since the advent of endovaginal ultrasonography, ectopic pregnancy in a cesarean scar can be diagnosed early in pregnancy if the sonographer is familiarized with the diagnostic criteria of this situation, especially in women with previous cesarean scar. Here we describe a case of ectopic pregnancy in a cesarean scar in which the diagnosis was considerably late, with presentation of spontaneous regression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):317-323
DOI 10.1590/S0100-72032007000600007
PURPOSE: to evaluate the diagnostic efficacy of core needle biopsy in suspicious solid breast masses (Bi-Rads™ 4 or 5) up to 10 mm. METHODS: this study was conducted on 83 women diagnosed with 90 suspicious solid lumps, all measuring up to 10 mm, identified by mammography (41), sonography (47) or palpation (two), who visited our clinic from September 2003 to January 2006. The lesions were biopsied with automatic device and 14 gauge needle (Bard, Corington, GA), all of them ultrasound guided. According to the pathological report, the biopsies were classified as true-positives, false-positives, true-negatives, and false-negatives. The sensitivity and specificity of ultrasound-guided core biopsy in breast masses up to 1 cm were calculated. RESULTS: the mean patient age was 52.5 years, and the mean diameter of the lesions was 7.3 mm, ranging from 3 to 10 mm. The results yielded by the pathologist showed 40 benign lesions (44.4%), 49 malignant lesions (54.4%) and one case (1.1%) of inconclusive material. This patient was submitted to ultrasound guided core needle biopsy once again, this time with conclusive results. There was agreement between histology and radiology in 89 cases. Sensitivity of ultrasound guided core biopsy for the diagnosis of breast cancer was 98.8 % and specificity 100%. CONCLUSIONS: the results obtained by ultrasound-guided core biopsy in suspicious breast lesions up to 10 mm are comparable to the best results of any kind of biopsy in the literature. Therefore, even solid lesions smaller or equal to 10 mm can be safely evaluated pathologically by core biopsy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):317-323
DOI 10.1590/S0100-72032007000600007
PURPOSE: to evaluate the diagnostic efficacy of core needle biopsy in suspicious solid breast masses (Bi-Rads™ 4 or 5) up to 10 mm. METHODS: this study was conducted on 83 women diagnosed with 90 suspicious solid lumps, all measuring up to 10 mm, identified by mammography (41), sonography (47) or palpation (two), who visited our clinic from September 2003 to January 2006. The lesions were biopsied with automatic device and 14 gauge needle (Bard, Corington, GA), all of them ultrasound guided. According to the pathological report, the biopsies were classified as true-positives, false-positives, true-negatives, and false-negatives. The sensitivity and specificity of ultrasound-guided core biopsy in breast masses up to 1 cm were calculated. RESULTS: the mean patient age was 52.5 years, and the mean diameter of the lesions was 7.3 mm, ranging from 3 to 10 mm. The results yielded by the pathologist showed 40 benign lesions (44.4%), 49 malignant lesions (54.4%) and one case (1.1%) of inconclusive material. This patient was submitted to ultrasound guided core needle biopsy once again, this time with conclusive results. There was agreement between histology and radiology in 89 cases. Sensitivity of ultrasound guided core biopsy for the diagnosis of breast cancer was 98.8 % and specificity 100%. CONCLUSIONS: the results obtained by ultrasound-guided core biopsy in suspicious breast lesions up to 10 mm are comparable to the best results of any kind of biopsy in the literature. Therefore, even solid lesions smaller or equal to 10 mm can be safely evaluated pathologically by core biopsy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):69-73
DOI 10.1590/S0100-72032001000200002
Purpose: to analyze the follow-up of regretful sterilized women who sought sterilization reversal at a public service. Method: a retrospective study was carried out with a population of sterilized women who attended the infertility clinic during the period from June 1983 to July 1998. The analysis of the data was descriptive. Results: among the 147 women who sought the infertility clinic, most were 20 to 30 years old and 60% were sterilized at the age of 25 years. During follow-up, 54.4% of the initial patients gave up treatment, 15% were discouraged to continue the investigation and only 31 (21%) underwent tubal anastomosis. Fourteen women became pregnant and nine (6.1%) of them had term gestation. Conclusion: women who request sterilization should be counseled and instructed about the definitive feature of this method in order to reduce regret after sterilization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(2):69-73
DOI 10.1590/S0100-72032001000200002
Purpose: to analyze the follow-up of regretful sterilized women who sought sterilization reversal at a public service. Method: a retrospective study was carried out with a population of sterilized women who attended the infertility clinic during the period from June 1983 to July 1998. The analysis of the data was descriptive. Results: among the 147 women who sought the infertility clinic, most were 20 to 30 years old and 60% were sterilized at the age of 25 years. During follow-up, 54.4% of the initial patients gave up treatment, 15% were discouraged to continue the investigation and only 31 (21%) underwent tubal anastomosis. Fourteen women became pregnant and nine (6.1%) of them had term gestation. Conclusion: women who request sterilization should be counseled and instructed about the definitive feature of this method in order to reduce regret after sterilization.