Tuesday, January 29, 2013

MALINANT Breast Cancer 5


6. SPECIAL INVESTIGATIONS
 
6.1 MAMMOGRAPHY
 
Mammography is an X-ray examination of the breast.
 
This technique is helpful in diagnosis in cases where the mass is
ill-defined in outline.
 
This  is true mostly in large fatty breasts where tumours  cannot
be easily felt.
 
6.2 THERMOGRAPHY
 
This  techniqe  measures  the amount of  heat  in  masses,  since
tumours  are more vascular they are detected by heat scanners  as
hot spots on a film
 
It  is worth remembering that infections may also be  represented
as hot spots because of the accompanying vascularity.
To day a combination of:
Clinical examination
Ultrasound
And NMR are most depended on.
 

 
6.3 FINE NEEDLE ASPIRATION CYTOLOGY(FNAC)
 
An experienced cytologist can usually give an accurate  diagnosis
on the small amounty of cellular material made available by  fine
needle  aspiration of a breast lesion.  The level of accuracy  is
variable.
 
6.4 EXCISION BIOPSY
 
This method is perhaps the most dependable means of coming to  an
accurate tissue diagnosis.
 
In  all suspicious masses information can be obtained  by  frozen
sections  and surgery planned during the same  anaesthetic  after
obtaining results.
 
6.5 ESTROGEN RECEPTORS
 
Estrogen  sensitive  target tissues (Breast,  uterus  etc.)  have
specific protein receptors for this hormone.
 
   *  Breast  cancer  tissue can also retain ability  to  produce,
      these receptors(receptor positive cases).
   *  These  cases have a better prognosis and are responsive  to
      hormone  manipulation.  The change in hormonal  environment
      is achieved by:
      i)   Oophorectomy
      ii)  Stilbestrol therapy
      iii) Tamoxifen therapy
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