title: [Mammographic control after quadrantectomy and radiation therapy].
abstract: The efficacy of combined surgery and radiation therapy in the treatment of breast cancer has increased the use of mammography in the follow-up to detect early recurrences. The authors report their experience in the follow-up of 43 breast cancers after treatment with local excision, axillary dissection, and irradiation. Mammography was performed at 6.12, and 24 months. The radiological findings were: 38/43 (88.3%) breasts with abnormal mammographic patterns, skin thickening in 36/43 (83.7%) cases, breast retraction in 16/43 (37.2%), architectural distortion in 17/43 (39.5%), increased parenchymal density in 33/43 (76.7%), calcifications in 6/43 (13.9%), and a mass in 10/43 (23.2%) cases. The authors describe histologic changes, corresponding to mammographic findings, and evolution of the treated breasts. Suspicious findings were microcalcifications in one case and a mass in 6 cases (4 of them at 6 months and 2 at 12). Excisional biopsy, performed in the above 7 patients, confirmed recurrence in 4 cases. In 3 cases with negative pathology, where the malignant nature of the lesion could not be demonstrated, we observed: a cluster of microcalcifications undistinguishable from neoplasm in 1 case and spiculated nodules with architectural distortion in the extant 2 cases. Further limitations of mammography were due to radiological density of the breast in one case, and to its minimal size in another--these elements delayed both correct interpretation of mammographic findings and final diagnosis. The low agreement between mammography and histology proved the difficulty of both analysis and evaluation of abnormal post-irradiation breast tissue. The authors, in agreement with literature reports, suggest the schedule for clinical and mammographic follow-up.
authors.affiliation: U.O. Radiodiagnostica II, USL 12, Pisa.
authors.forename: V
authors.initials: V
authors.lastname: Pignatelli
authors.forename: C
authors.initials: C
authors.lastname: Campassi
authors.forename: A
authors.initials: A
authors.lastname: Calderazzi
authors.forename: S
authors.initials: S
authors.lastname: Colosimo
authors.forename: A
authors.initials: A
authors.lastname: Savino
authors.forename: L
authors.initials: L
authors.lastname: Grassi
authors.forename: S
authors.initials: S
authors.lastname: Mazzeo
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011184:Postoperative Period
vernacular_title: Il controllo mammografico dopo trattamento con quadrantectomia e terapia radiante.