Pippa Mills
Maidstone Hospital
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Publication
Featured researches published by Pippa Mills.
Breast Journal | 2010
Pippa Mills; Ali Sever; Jenny Weeks; David Fish; S. Jones; Peter Jones
Abstract: Axillary lymph node status is an important factor in determining the prognosis and treatment in patients with invasive breast cancer. The introduction of the sentinel lymph node biopsy technique in the axilla has significantly reduced the number of patients requiring an axillary clearance procedure. However, a proportion of patients will be found to have axillary metastases after a sentinel node biopsy and will then require a second axillary surgical procedure. A retrospective audit of 653 consecutive patients presenting with invasive breast cancer showed a preoperative diagnosis rate of axillary disease of 23% using axillary ultrasound and fine‐needle aspiration (FNA) together. We performed 232 axillary FNAs to diagnose 150 positive axillae. This avoided the need for a second operation in 150 women. The negative predictive value for axillary metastases using this technique was 79%. Overall accuracy was 84%.
Journal of Ultrasound in Medicine | 2010
Ali Sever; Anne Broillet; Michel Schneider; Karina Cox; Sue Jones; Jenny Weeks; Pippa Mills; David Fish; Peter Jones
Objective. Sentinel lymph node (SLN) identification using intradermal micro‐bubbles and contrast‐enhanced ultrasound (CEUS) has been recently reported in swine models and patients with breast cancer. The objective of this study was to investigate the dynamics of intradermally administered microbubbles as they travel to draining SLNs in pigs. We also performed a detailed study of the passage of microbubbles through breast lymphatic channels in a small group of patients with breast cancer. Methods. Nine anesthetized healthy pigs were used for the study, and 5 female patients with primary breast cancer were recruited. Pigs received intradermal injections of a microbubble contrast agent in several territories to access lymphatic drainage to regional lymph nodes. Patients had periareolar intradermal injection of the microbubble contrast agent. Ultrasound examination was performed in the real‐time contrast pulse sequencing mode with a commercial scanner. Results. Sentinel lymph nodes were identified rapidly (<1 minute) and consistently in pigs. Intradermal microbubble injection and CEUS were found to have perfect concordance with the Evans blue dye method in locating swine SLNs. In all 5 patients with breast cancer, the microbubble contrast agent entered breast lymphatic channels and traveled to draining ipsilateral axillary SLNs within 3 minutes. Conclusions. Intradermally injected microbubbles traverse readily though lymphatic channels in pigs and human breast tissue. The ability to rapidly identify SLNs in the diagnostic period would enable targeted biopsy and may facilitate preoperative axillary staging in patients with early breast cancer.
Breast Journal | 2013
Hatice Gümüş; Pippa Mills; David Fish; Metehan Gümüş; Haresh Devalia; Sue Jones; Ali Sever
To determine if the specimen without calcification, as depicted on specimen radiography, made any contribution to the final histopathological diagnosis in comparison to the specimen with calcification. The records of 1312 stereotactic vacuum‐assisted biopsies for breast microcalcifications between February 2000 and December 2010 were reviewed retrospectively. Following specimen x‐ray the biopsy tissues with and without microcalcifications were sent in two separate pots (pot 1 and pot 2 respectively). The number of cores in each pot and the number of calcium specks within the cores were recorded. In 1135 of the 1312 (86%) cases the histopathological findings were similar for pot 1 and pot 2. In 165 cases (13%) the diagnosis was made solely on pot 1 while cores in pot 2 did not reveal any additional pathology. In 12 biopsies (1%) the significant pathology was only present in the specimen without any calcification. For “microcalcification only” breast lesions the specimen containing calcium will yield a correct diagnosis in 99% of cases. Cores containing no calcification rarely contribute to the diagnosis on their own, but in 87% of cases an accurate diagnosis would still have been made even if the targeted calcification had been missed.
Breast Cancer Research | 2015
Nicky Dineen; Jennifer Weeks; Ruxandra Pietrosanu; Karina Cox; Pippa Mills
Breast MRI can be performed in the preoperative workup of patients with biopsy-proven breast cancer to size lesions, if there is discrepancy regarding the extent of disease from clinical, mammography or ultrasound assessment, and to identify multicentric or multifocal disease. The purpose of breast MRI is to plan the optimum surgical procedure, thus reducing the local tumour recurrence rate and the need for the patient to undergo additional surgery.
Breast Cancer Research | 2014
Ar Sever; Ruxandra Pietrosanu; Jennifer Weeks; Pippa Mills
The accuracy of prospectively categorised screening mammograms prior to assessment was evaluated and the individual recall and cancer detection rates for each category were studied.
Clinical Radiology | 2012
Ali Sever; Pippa Mills; Sue Jones; Willem P. Th. M. Mali; Peter Jones
Clinical Radiology | 2006
B. Yazici; Ali Sever; Pippa Mills; David Fish; Sue Jones; Peter Jones
Clinical Radiology | 2005
S. Villan; Ali Sever; Pippa Mills; N.A. Mounter; A.R. Sever
Clinical Radiology | 2012
Hatice Gümüş; Metehan Gümüş; Pippa Mills; David Fish; Haresh Devalia; Sue Jones; Peter Jones; Ali Sever
Ejso | 2012
Karina Cox; Ali Sever; Pippa Mills; Jenny Weeks; Sue Jones; Haresh Devalia; David Fish; Peter Jones