Abstract:

Introduction: surgical treatment of an area of accumulation of breast microcalcifications requires the surgeon to choose the optimal method of surgery. For a long time, the gold standard of surgery was the placement of a wire needle under X-ray control and subsequent removal. In our study, we want to demonstrate one of new methods, which is based on the placement of ultrasound marks in the area of accumulation of calcifications at the preoperative stage and further removal under the control of ultrasound device.

Aim: was to make comparative analysis and estimate the effectiveness of preoperative marking with ultrasound-positive (US-positive) marks in patients with non-palpable breast neoplasms.

Material and methods: the study included 165 patients (age 32 - 71 years). Patients were divided into three groups depending on the preoperative marking. The first group: installed ultrasound-positive Gel Mark UltraCor Bard marks in the region of microcalcifications at the outpatient stage.

The second group: marking with a wire needle «DuaLok» Bard immediately before the operation.

The third group: according to results of a repeated preoperative examination, which included: unilateral mammography in two projections with marker, a skin mark was established in the projection of a non-palpable formation.

Results: study showed that when choosing a surgical treatment using ultrasound-positive marks, the risk of detecting tumor cells at edges of the resection decreases, the time of surgery is shortened, and the volume of resection of healthy breast tissue is minimized.

Study proved that marking using ultrasound-positive marks has an advantage over other methods of preoperative marking and can be implemented in medical organizations that are not equipped with x-ray equipment for marking non-palpable breast formations immediately before surgery.

References

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Abstract

The clinical case that is presented, demonstrates the need to sub-specialize radiologists in the field of mammology for a qualitative examination of the breast and timely diagnosis, including breast cancer. During last 8 years, the patient regularly (once every two years) underwent mammography in general-specialization medical facilities. According to findings of surveys conducted, nodal pathology of the breast was not identified. During the physical examination in the upper inner quadrant of the left mammary gland, a movable mass that was soldered to the skin up to 2.0 cm. When conducting a survey mammography in two standard projections in the lower inner quadrant of the left mammary gland, the nodal formation of the BIRADS 5 category was visualized. In a retrospective analysis of past mammograms, described above, nodal formation was noted on all presented mammographic images, the growth and changes in semiotic signs of the pathological focus were also observed. After additional diagnostic manipulations, a highly differentiated breast cancer with low mitotic activity was verified. 

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