Radiographic, gross, and histopathologic studies on 158 whole breasts with primary operable carcinoma revealed intramammary lymph nodes in 28%, and of these breasts, 10% contained a metastatic deposit of carcinoma. Cancerous and noncancerous nodes were found in all quadrants of the breast with the positive ones being in the same quadrant as the carcinoma only 50% of the time. There was no demonstrable connection with the usual lymphatic drainage of the breast. With Stage II carcinoma, positive intramammary lymph nodes had no direct effect on prognosis, merely representing advanced disease and indicating a greater likelihood of axillary metastatic disease. There was a trend toward poorer prognosis in Stage I lesions with positive intramammary lymph nodes. This may indicate the Stage I carcinomas that have a similar prognosis as Stage II tumors. Conceivably, a Stage Ia, positive intramammary lymph node(s) but normal axillary lymph nodes, could be defined and used.

No abstract

During a 16-year period, 42,888 clinical and radiographic breast studies were performed on 8,000 women. Of this number, 1,161 malignant and 5,270 benign lesions were histologically confirmed. Biopsy of 468 of the 721 breasts that had clustered calcifications not associated with a mass and that were subject to a five- to 16-year follow-up demonstrated 353 benign and 115 malignant lesions. Radiography of the biopsy specimen assured removal and proper study of the area of concern. Radiographic characteristics of the calcifications provide clues to estimate the risk of carcinoma. However, these signs are so nonspecific that all radiographically demonstrable clusters of stippled calcification require histopathologic study. Treatment prior to the formation of a mass provides an excellent prognosis.

The ability of magnetic resonance imaging (MR) to demonstrate breast carcinoma depends upon significantly different relaxation times in benign and malignant tissues. The authors conducted an in vitro study of transverse relaxation times (T2) of 393 breast tissue samples in order to establish a range of values for normal tissue, benign lesions, and carcinoma. All T2 values were multiexponential. Benign lesions were readily distinguished from both invasive and noninvasive carcinoma in samples containing fat or a mixture of fat and fibrous tissue; however, in purely fibrous samples there was some overlap of T2 values in benign and malignant tissues. Although the data acquisition and analysis requirements involved in this in vitro study exceed the capabilities of present whole-body MR imagers, the added understanding gained through efforts of this type may aid both interpretation of current images and future developments.