[Subclinical identification of cancer of the breast. Radiologic progress, proposition for treatment].

In the case of breast cancer with no clinical signs, radiological signs are the decisive factors to indicate surgery, histological studies or treatment. Foci of microcalcifications currently are the feature to identify as a rule. However, they reveal canalicular carcinoma in only 1 case out of 3. We propose a radiological technique allowing the selection of the microcalcifications to be operated by means of the digitization of a mammographic film and of a software-controlled morphometric analysis. 10,000 microcalcifications have been studied in this way. The most reliable of the 12 parameters that were distinguished is compacity. 100 files were studied with conventional mammography and a morphometric and histological analysis. Any microcalcification less compact than 0.35 is highly suspicious, since this parameter is the only one having a significant difference, with a confidence interval of 95%. The patients are now selected in this way. Differences in the age of the lesions, multiple foci and sometimes lesions with multiple centers lead us to automatically propose the exeresis of the gland, followed by immediate reconstruction of its shape and volume. According to a retrospective study we carried out on 111 subclinical intracanalicular carcinomas after a 5 to 20-year time interval, recurrence is observe in only 4.5% of all cases.