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Objective: The purpose of our report was to describe patients in whom calcifications in the breast that were unequivocally removed during stereotactic core biopsy using the Mammotome device were not detected on the initial specimen radiograph. The lost calcifications in each instance were subsequently found when the tubing and contents of the debris canister were strained through a nonadhering dressing and radiographed. Additional situations in which calcifications are not seen on the initial specimen radiograph are described and recommendations are made., Conclusion: When vacuum-assisted core biopsy procedures are performed, it is important to be aware of the possibility that calcifications may be aspirated into the debris canister, thus compromising the accuracy of the histopathologic diagnosis. We recommend changing the tubing and the debris canister after each procedure and, in certain situations, sending the strained canister contents to pathology for evaluation.

Objective: The objective of this study was to describe the mammographic appearance with pathologic correlation of solitary peripheral papillomas of the breast., Conclusion: Solitary peripheral papillomas of the breast are benign lesions that may present mammographic features suggestive of carcinoma. Solitary peripheral papilloma is a variant related to the solitary central duct papilloma but has a different mammographic appearance because of its location and histologic architecture. The associated risk of malignancy is unclear.

Lobular carcinoma in situ (LCIS) was diagnosed in 165 surgical specimens (119 patients) at our institution between 1974 and 1987. LCIS was seen more often in younger women (mean age, 49 years) than other breast carcinomas were (mean age, 58 years). Sampling of a single breast revealed multifocal disease in 70% (96/138). When both breasts were sampled, bilateral foci were found in 50% (41/82). Of 165 breasts with foci of LCIS, 37% (61/165) had simultaneously occurring invasive cancers in the same breast. Direct mammographic-pathologic correlation of foci of LCIS was possible in 73 breasts (67 patients). Microcalcifications were an indication for biopsy in 49% (20/41) of breasts with a mammographic abnormality, but were a nonspecific finding often found in tissues adjacent to foci of LCIS. The mammogram was normal in 44% (32/73) of breasts with foci of LCIS. The mammograms of patients with LCIS and those from a group of age-matched control subjects were compared by using a modified form of Wolfe's criteria and the percentage of fibroglandular elements. LCIS was seldom found in an N1 breast (1% vs 29%) or in a breast with less than 25% of its parenchymal area occupied by fibroglandular density (3% vs 33%). Compared with the control group, breasts with LCIS had more than 50% fibroglandular density (85% vs 45%) and a much higher frequency of the DY pattern (56% vs 36%). More fibroglandular density was seen in the LCIS group at all ages. Postmenopausally, the frequencies of the DY pattern and fibroglandular density greater than 50% in LCIS patients were nearly double those in the control group. LCIS patients have disease of the entire breast parenchyma, characterized by multifocality and bilaterality of various forms of lobular disease. Their mammograms reveal a higher rate of the DY pattern and higher percentages of fibroglandular or parenchymal density than those of age-matched controls. In LCIS patients, persistence of the DY pattern, or large amounts of fibroglandular density postmenopausally supports the concept that mammographically dense breasts are a marker for increased cancer risk in women 50 years old and older.

The mammographic features of hidradenitis suppurativa axillaris, a common clinical entity, are described for the first time in this report. Lucent axillary masses with a small central density appear to be a pathognomonic radiographic finding. Other entities seen on mammography such as lipomas, lucent galactoceles, traumatic oil cysts, axillary hibernomas and benign lymph nodes, should not be confused with hidradenitis suppurative axillaris.

A patient with an epithelial inclusion cyst of the distal phalanx has been presented. The radiographic and clinical findings have been described and are felt to be pathognomonic. The importance of recognizing its benign nature has been stressed.

Xeroradiographic evaluation of the axilla is useful in the presence of mammary carcinoma, as radiographic examination of this area can be highly accurate in predicting its malignant involvement if certain strict criteria are employed. The ability to diagnose nodal metastases with near certainty has important implications for treatment planning and prognostication.

Two cases of Paget's disease of bone with radiographic manifestation of extramedullary hematopoiesis are described. While extramedullary hematopoiesis usually occurs as compensatory phenomenon in response to anemia, this was not the case in our patients. We believe pathologic fractures led to extrusion of hematopoietic marrow and resultant tumorous extramedullary hematopoiesis.

Xeromammographic false negatives were analyzed to ascertain the cause of the errors and determine what corrective measures could be taken. Of 52 cancers miscalled, 52% were not visualized and 48% were categorized as misinterpretations. The causes of these errors are discussed. The error rate in all but 8% of the former group appears to be irreducible, yet errors discussed in the latter group are thought to be correctable in a high percentage of cases. Recommendations to reduce the number of false negatives in this group are presented.

Radiographic manifestation of intracystic papillary male carcinoma is presented along with its histopathological correlation. The prognosis, differential diagnosis, and natural history as well as possible sites of origin are discussed.

The author describes an inexpensive 22-gauge flat head needle which permits rapid and virtually painless preoperative localization of nonpalpable breast lesions. The lesion is transfixed and anchored by the needle to the skin after a mammogram is obtained.

Galactography is a quick effective means of evaluating nipple discharge. It is especially indicated when the effluent is bloody. A description of the procedure is discussed. The radiographic findings in both normal and abnormal studies are presented. Abnormal findings include filling defects, duct cut-off, duct encasement, extravasation, and duct ectasia. The radiographic diagnosis corresponded with pathologic findings in 12 of 16 cases (75%), although in two cases no radiographic or pathologic abnormality was found to explain the bloody discharge.

Stress fractures of the proximal fibula are uncommon, but do occur in the distal fibula in long-distance runners. A case is presented of a 71-year-old jogger who presented with a 2-month history of left knee pain. Radiographs showed an apparent destructive lesion of the proximal fibula which resembled a malignant bone lesion. Excision revealed a healing fracture.

Previous studies suggest that single-view lateral mammography alone results in a small decrease in detection of malignancies. Detection rates for lateral view only and two-view examinations in 200 cases (100 malignant, 100 nonmalignant) were compared. Four to six per cent of cases originally found positive were reinterpreted as negative in both situations. Preliminary findings suggest that the lateral view alone is sufficient, provided a second view is requested in suspicious cases.

A simple, inexpensive local cooling system for thermal evaluation of breast disease is described. Skin temperature measured during a 10-minute cooling process averaged 1.2degrees C higher over 31 proved cancers and 0.6degrees C lower over 18 benign masses. Forty-nine masses averaged 1.7 cm in diameter and were 1.5 cm deep; 23 of 31 malignancies (74%), 16 of 18 benign growths (88%), and 46 of 52 "normals" (88%) would have been correctly diagnosed, while results for 10 of 22 women (45%) with asymmetrical diffuse non-malignant disease would have been falsely classified positive.

The evaluation of maxillofacial pathology was undertaken using xeroradiography. The edge enhancement and wide image latitude were shown to give additional information, especially in areas of bony overlap, such as the temporomandibular joint, without resorting to tomography. Other areas of possible utilization are also discussed, including sialography.

The normal axial relationship of 360 wrists was measured. The results differ from those previously published in the radiological literature. The difference may be explained by the small series' size or inadequate technical criteria used in previous studies.