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Sample records for primary breast lesion

  1. FDG PET and other imaging modalities in the primary diagnosis of suspicious breast lesions

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    Scheidhauer, K.; Seemann, M.D. [Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Ismaninger Strasse 22, 81675, Munich (Germany); Walter, C. [Department of Diagnostic Radiology, Krankenhaus der Barmherzigen Brueder, Trier (Germany)

    2004-06-01

    Mammography is the primary imaging modality for screening of breast cancer and evaluation of breast lesions (T staging). Ultrasonography is an adjunctive tool for mammographically suspicious lesions, in patients with mastopathy and as guidance for reliable histological diagnosis with percutaneous biopsy. Dynamic enhanced magnetic resonance mammography (MRM) has a high sensitivity for the detection of breast cancer, but also a high false positive diagnosis rate. In the literature, MRM is reported to have a sensitivity of 86-96%, a specificity of 64-91%, an accuracy of 79-93%, a positive predictive value (PPV) of 77-92% and a negative predictive value (NPV) of 75-94%. In unclarified cases, metabolic imaging using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) can be performed. In the literature, FDG PET is reported to have a sensitivity of 64-96%, a specificity of 73-100%, an accuracy of 70-97%, a PPV of 81-100% and an NPV of 52-89%. Furthermore, PET or PET/CT using FDG has an important role in the assessment of N and M staging of breast cancer, the prediction of tumour response in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy, and the differentiation of scar and cancer recurrence. Other functional radionuclide-based diagnostic tools, such as scintimammography with sestamibi, peptide scintigraphy or immunoscintigraphy, have a lower accuracy than FDG PET and, therefore, are appropriate only for exceptional indications. (orig.)

  2. HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.

    Science.gov (United States)

    Li, Min Hua; Hou, Chuan Ling; Wang, Cheng; Sun, Ai Jing

    2016-04-01

    To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient. In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH). In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640). This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions. Copyright © 2015 Elsevier GmbH. All rights reserved.

  3. [Identification of the primary lesion in a patient with concomitant breast and kidney cancer following fracture of the femur].

    Science.gov (United States)

    Sato, Yasufumi; Okishiro, Masatsugu; Ishida, Tomo; Morimoto, Yoshihiro; Kusama, Hiroki; Matsusita, Katsunori; Hashimoto, Tadayoshi; Kimura, Kei; Katsura, Yoshiteru; Nitta, Kanae; Kagawa, Yoshinori; Takeno, Atsushi; Sakisaka, Hideki; Nakahira, Shin; Taniguchi, Hirokazu; Egawa, Chiyomi; Takeda, Yutaka; Kato, Takeshi; Tamura, Shigeyuki; Takatsuka, Yuichi; Oku, Kazuko; Goto, Takayoshi; Nagano, Teruaki; Nakatsuka, Shinichi

    2014-11-01

    A 61-year-old woman was diagnosed with breast cancer [T3N3cM0: Stage IIIC, estrogen receptor [ER] (+), progesterone receptor [PgR] (+), human epidermal growth factor receptor 2[HER2] (-)]at the time of initial presentation. Following diagnosis, combined modality therapy including hormone therapy and chemotherapy were initiated, but hemorrhage from the primary lesion and bone metastases were observed. Priority was given to treatment of the breast cancer, and chemotherapy was administered, after which, right mastectomy and axillary lymph node sampling were performed to assess local disease control. In addition, concurrent right kidney enucleation was performed for a renal lesion. The renal neoplasm was diagnosed as T1aN0M0, Stage I. After this intervention, treatment of the breast cancer was continued, but pain of the right femoral region developed, and bone metastasis was diagnosed on close inspection. The bone metastasis was considered to derive from the breast cancer. During hospitalization, the patient fell and broke her right femur. Open reduction and internal fixation was performed immediately, and bone metastasis of kidney cancer was diagnosed via perioperative cytodiagnosis. Pulmonary metastasis, local recurrence, and metastasis to the shoulder blade have been detected. The metastases are considered to derive from the breast cancer, for which treatment has been continued. In the case of concomitant cancers, biopsy for metastatic foci can be considered essential, whenever it can be performed safely.

  4. Tc-99m-tetrofosmin scintimammography: A prospective study in primary breast lesions

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    Lind, P. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Gallowitsch, H.J. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Kogler, D. [LKH Klagenfurt (Austria). Dept. of Radiology; Kresnik, E. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Mikosch, P. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology; Gomez, I. [LKH Klagenfurt (Austria). Dept. of Nuclear Medicine and Special Endocrinology

    1996-12-01

    The purpose of our study was to evaluate prospectively the sensitivity, specificity, PPV and NPV of scintimammography with a new catonic complex Tc-99m-tetrofosmin. Methods: Fourtyeight patients in whom mammography and/or high resolution ultrasonography (10 MHz) revealed suspicious breast lesions were studied with Tc-99m-tetrofosmin scintimammography. In thirty four of them biopsy and/or surgery was performed for histological evaluation. After intravenous injection of 555 MBq Tc-99m-tetrofosmin dynamic images over three minutes planar images in anterior and lateral projections and SPECT imaging including 3-D-reconstruction (20 min. p.i.) were performed. Scintimammography was evaluated as negative, equivocal (+), probably (++) or definitely (+++) positive. Results: Scintimammography with Tc-99m-tetrofosmin was negative in 18 patients (17 t.n.; 1 f.n.) and positive in 16 patients (10 t.p., 6 f.p.). The false negative scintimammography was observed in a patient with infiltrating ductal carcinoma pT1, the false positive result in a patient with fibrocystic disease; all of the five fibroadenomas were also `false` positive. Sensitivity of Tc-99m-tetrofosmin scintimammography in this prospective study was 91%, specificity 74%, PPV 63% and NPV 94%. Scintimammographic results in patients with suspicious breast lesion show, that Tc-99m-tetrofosmin accumulates in breast cancer as well as in fibroadenoma. However the high NPV of 94% excludes breast cancer in suspicious mammographic lesions in a very high degree and therefore reduces the need of biopsy and/or surgery in most of these patients. Conclusion: Our first results show that scintimammography with Tc-99m-tetrofosmin might play a role as further diagnostic step before surgery for women in whom mammography and/or ultrasonography show suspicious lesions. [Deutsch] Ziel unserer prospektiven Studie war es, die Sensitivitaet, Spezifitaet sowie den positiven (PVW) und negativen Voraussagewert (NVW) der Mammoszintigraphie

  5. Hepatic Lesions Detected after Mastectomy, in Breast Cancer Patients with Hepatitis Background May Need to Undergo Liver Biopsy to Rule Out Second Primary Hepatocellular Carcinoma.

    Science.gov (United States)

    Chen, Qi-wen; Li, Hai-jin; Chen, Ya-nan; Ning, Zhou-yu; Gao, Song; Shen, Ye-hua; Meng, Zhi-qiang; Vargulick, Sonya; Wang, Bi-yun; Chen, Hao

    2016-01-01

    Liver metastasis is a common phenomenon in breast cancer patients. Hepatic lesions detected in breast cancer patients may be easily misdiagnosed as metastatic sites, rather than being treated as primary foci. This descriptive study aims to investigate the clinicopathological characteristics of second primary hepatocellular carcinoma in breast cancer patients and to infer in which circumstances liver biopsy is needed. Eighty-one consecutive breast cancer patients with hepatic lesions admitted to our department were retrospectively studied and analyzed from January 2009 to March 2014 according to Warren and Gates' criteria for second primary cancers. Second primary hepatocellular carcinoma was observed in sixteen of seventy eight patients with breast cancer. There was a significant difference in HBV status between the second HCC group and liver metastases group (Phistory (P = 0.1160) between second primary HCC and metastases group. Two of these patients had synchronous second primary hepatocellular carcinoma and the remaining fourteen patients had metachronous second primary HCC. All sixteen patients were infected with hepatitis, including hepatitis virus B and C, or resolved HBV infection. Breast cancer patients with either HBV infection or resolved HBV infection, regardless of an elevated AFP level, may receive liver biopsy to avoid unnecessary and inappropriate treatments for metastasis. Awareness of second primary HCC in breast cancer patients needs to be emphasized.

  6. Histomorphological spetrum of breast lesions.

    Science.gov (United States)

    Parajuli, S; Koirala, U; Khatri, R; Acharya, L; Suwal, A

    2011-04-01

    Cancer of the breast is the second most common cause of cancer in women. Mass in the breast, whether benign or malignant is a cause of anxiety to the patients and the family members. All breast lumps are considered to be carcinomas until proved otherwise and are the causes of concern both for the patient and surgeon. This is a retrospective study conducted in Kathmandu Model Hospital for a total duration of three years from August 2007 to August 2010. 114 sample of breast tissue sent for histopathology were studied. Peak incidence of benign lesion was in between 21-30 years and malignant lesions in between 31-50 years. No breast lesions were seen in the first decade of life. Cancer of the breast was seen in 12.28% of cases. Fibroadenoma and fibrocystic disease were the commonest benign lesion and infiltrating ductal carcinoma was the commonest malignant lesion. Specimens from 10 male breasts were received. Gynaecomastia was the most common lesion encountered in males. Infiltrating ductal carcinoma was seen in a 70 year old male. Breast cancer is one of the commonest causes of breast lump particularly in women and is growing public health problem in Nepal.

  7. Alterations in three biomarkers (estrogen receptor, progesterone receptor and human epidermal growth factor 2) and the Ki67 index between primary and metastatic breast cancer lesions.

    Science.gov (United States)

    Fujii, Kimihito; Watanabe, Rie; Ando, Takahito; Kousaka, Junko; Mouri, Yukako; Yoshida, Miwa; Imai, Tsuneo; Nakano, Shogo; Fukutomi, Takashi

    2017-12-01

    In recurrent breast cancer, the tumor phenotype, as assessed by estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) status, occasionally changes. This change, in addition to the Ki67 index were evaluated at sites of recurrence and the correlation between changes in tumor phenotype and survival were assessed in breast cancer patients. Comparisons in pathological parameters between primary and metastatic lesions were drawn between ER, PR, HER2, and the Ki67 index in 70 patients with recurrent breast cancer. The association between changes in tumor phenotype and patient survival was assessed. The hormone receptor status changed from positive, in the primary lesions, to negative, in the metastatic lesions in 19.8% (ER) and 39.5% (PR) of patients, respectively. Conversion from negative to positive status was confirmed in 27.2% (ER) and 31.2% (PR) of patients, respectively. A change in HER2 status from negative (primary lesion) to positive (metastatic lesion) occurred in seven patients (10%). The mean Ki67 index of primary lesions with positive hormone receptor status was significantly lower than at sites of recurrence with any hormone receptor status, from 10.9±9.8 standard deviation (SD) to 22.9±18.6 (P=0.031) and 12.2±10.5 SD to 27.4±20.9 (P=0.023), for ER and PR, respectively. The mean overall survival of patients with ER status conversion from positive to negative was 7.4±1.2 standard error (SE) years, and 14.8±1.4 SE years for patients who retained positive ER status (P=0.005, log-rank), with a hazard ratio of 3.44 (95% confidence interval, 1.36-8.33). This difference in survival based upon change in ER status was similarly observed in patients with PR status conversion in the same direction. Thus, ER and PR status conversion at the time of recurrence strongly impact survival, particularly if the change is from positive (primary lesion) to negative (metastatic lesion). Monitoring the biological behavior of breast

  8. How to approach breast lesions in children and adolescents

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    Gao, Yiming, E-mail: yiminggao@gmail.com [New York University Langone Medical Center, 221 Lexington Ave., New York, NY 10016 (United States); Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States); Saksena, Mansi A.; Brachtel, Elena F.; Meulen, Deborah C. ter; Rafferty, Elizabeth A. [Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States)

    2015-07-15

    Highlights: • Recognize why the diagnostic approach to the developing breast differs from that to the adult breast. • Review of embryology, early breast development, and later pubescent breast development. • Learn the spectrum of common and uncommon pediatric breast lesions. • Develop an algorithm for diagnostic evaluation and management of pediatric breast lesions. - Abstract: Assessment of a pediatric breast lesion always starts with clinical evaluation. When imaging of a pediatric breast is indicated, ultrasound is the mainstay. The vast majority of pediatric breast complaints are of benign etiology, therefore the diagnostic/management approach emphasizes “first do no harm”. Correlation with age and clinical history helps to direct diagnosis. It is essential to be familiar with the imaging appearance of the normal developing breast at various Tanner stages, in order to diagnose physiologic breast findings and to minimize unnecessary biopsies in young breasts vulnerable to injury. Normal anatomic structures, developmental conditions, benign neoplastic and non-neoplastic lesions are common causes of breast complaints in children. Uncommon benign masses and rarely, secondary more than primary malignancies may present in a pediatric breast. Chest wall masses such as Ewing's sarcoma or rhabdomyosarcoma occur in children and may involve the breast via contiguous growth or locoregional metastasis. In addition, special attention should be given to any breast lesion in a child with risk factors predisposing to breast cancer, such as known extramammary malignancy, genetic mutations, prior mantle irradiation, or strong family history of breast cancer, which usually requires biopsy to exclude the possibility of malignancy. Conclusion: The developing breast is vulnerable to injury, and because breast malignancy is uncommon in children, diagnostic and management approach emphasizes “first do no harm”. Understanding normal breast development and the

  9. Discordance of the estrogen receptor and HER-2/neu in breast cancer from primary lesion to first and second metastatic site.

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    Lower, Elyse E; Khan, Shagufta; Kennedy, Diane; Baughman, Robert P

    2017-01-01

    Hormone receptor and HER-2/neu discordance between the primary lesion and first metastasis has been reported. This study was performed to determine further biomarker discordance rates between the first and subsequent metastatic breast cancer lesions. We performed a retrospective review of paired biomarkers from primary breast cancers compared to first reported and subsequent metastases from 103 patients with breast cancer. The estrogen receptor (ER), progesterone receptor (PR), and HER-2/neu status were reported at all three time points. In addition, hormone, cytotoxic, and targeted treatments were recorded for primary and metastatic disease, and survival was determined. Between the primary and first metastases, discordance rates for ER, PR, and HER-2/neu were 15.8%, 33.7%, and 14.3%, respectively. There was discordance between the first and second metastases for the ER receptor in 18.8%, PR receptor in 19.8%, and HER-2/neu in 10.7%. Overall, there was discordance between the primary tumor and either the first or second metastases for ER in 27.7%, PR receptor in 40.7%, and HER-2/neu in 19.6% of cases. Discordance of either ER or PR affected survival, with worse survival experienced by those patients with all three hormone receptors remaining negative, and intermediate survival reported for those with discordant tumors (ER χ2=14.27, p=0.0008; PR χ2=11.31, p=0.0035). There was no difference in survival for patients whose HER-2/neu tumors were discordant. This study demonstrated that continued metastatic disease evolution may be associated with different tumor biology and that studies of metastatic lesions appear warranted, especially if targeted therapy is an option.

  10. Primary breast sarcoma: case report | Hassan | East African Medical ...

    African Journals Online (AJOL)

    Primary breast sarcoma is a rare entity occurring in 0.5% of women with breast malignancy. Like in breast carcinoma, delay in its diagnosis has important clinical and treatment implications. The subject of this report presented at our breast unit with advanced breast lesion months after she noticed a small lump in her right ...

  11. Primary Breast Leiomyosarcoma

    OpenAIRE

    Amaadour, L.; Benbrahim, Z.; Moumna, K.; Boudahna, L.; Amarti, A.; Arifi, S.; N. Mellas; El Mesbahi, O.

    2013-01-01

    Primary leiomyosarcoma of the breast is an extremely rare neoplasm. Only few cases have been reported in the literature. We report here a case of breast leiomyosarcoma in a 44-years-old female and we discuss the data of the existing literature.

  12. 21 CFR 884.2990 - Breast lesion documentation system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation... lesions identified during a clinical breast examination. (b) Classification. Class II (special controls...

  13. Benign breast lesions in Kano

    African Journals Online (AJOL)

    The breast in: Robbins pathologic basis of diseases. Saunders, Phil~ adelphia. 1994; 1093. Mann CV, Russell RCG. Williams. NS. The breast. in: Bailey and. Love's short practice of surgery. Arnold, London, 1999; 5495521. Templeton AC Tumours of the breast in Uganda; An extract of information from the cancer registry.

  14. Primary breast lymphomas.

    Science.gov (United States)

    Julen, Olivier; Dellacasa, Ilaria; Pelte, Marie-Françoise; Borish, Bettina; Bouchardy, Christine; Capanna, Federica; Vlastos, Georges; Dubuisson, Jean-Bernard; Vlastos, Anne-Thérèse

    2009-07-22

    The diagnosis, prognostic factors, and optimal management of primary breast lymphomas (PBL) is difficult. Seven patients recorded at the Geneva Cancer Registry between 1973-1998 were reviewed. Five patient had diffuse large B-cell lymphoma, one a follicular lymphoma and one a MALT-lymphoma. All patients had clinical and radiological findings consistent with breast cancer and underwent mastectomy, which is not indicated in PBL. Diagnosis should be established prior to operative interventions, as fine needle aspiration missed the diagnosis for one patient and intra-operative frozen sections for 3 patients in our study. Five-year and 10-year overall survivals were 57% and 15%, respectively. Of the 3 patients who died from PBL, 2 had tumors that were Bcl-2 positive but Bcl-6 negative. All 3 surviving patients have positive Bcl-2 and Bcl-6 immunostaining, which could be important prognostic factors if confirmed by a larger study.

  15. Primary breast lymphomas

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    Anne-Thérèse Vlastos

    2009-07-01

    Full Text Available The diagnosis, prognostic factors, and optimal management of primary breast lymphomas (PBL is difficult. Seven patients recorded at the Geneva Cancer Registry between 1973-1998 were reviewed. Five patient had diffuse large B-cell lymphoma, one a follicular lymphoma and one a MALT-lymphoma. All patients had clinical and radiological findings consistent with breast cancer and underwent mastectomy, which is not indicated in PBL. Diagnosis should be established prior to operative interventions, as fine needle aspiration missed the diagnosis for one patient and intra-operative frozen sections for 3 patients in our study. Five-year and 10-year overall survivals were 57% and 15%, respectively. Of the 3 patients who died from PBL, 2 had tumors that were Bcl-2 positive but Bcl-6 negative. All 3 surviving patients have positive Bcl-2 and Bcl-6 immunostaining, which could be important prognostic factors if confirmed by a larger study.

  16. Primary breast lymphomas

    Science.gov (United States)

    Julen, Olivier; Dellacasa, Ilaria; Pelte, Marie-Françoise; Borish, Bettina; Bouchardy, Christine; Capanna, Federica; Vlastos, Georges; Dubuisson, Jean-Bernard; Vlastos, Anne-Thérèse

    2009-01-01

    The diagnosis, prognostic factors, and optimal management of primary breast lymphomas (PBL) is difficult. Seven patients recorded at the Geneva Cancer Registry between 1973–1998 were reviewed. Five patient had diffuse large B-cell lymphoma, one a follicular lymphoma and one a MALT-lymphoma. All patients had clinical and radiological findings consistent with breast cancer and underwent mastectomy, which is not indicated in PBL. Diagnosis should be established prior to operative interventions, as fine needle aspiration missed the diagnosis for one patient and intra-operative frozen sections for 3 patients in our study. Five-year and 10-year overall survivals were 57% and 15%, respectively. Of the 3 patients who died from PBL, 2 had tumors that were Bcl-2 positive but Bcl-6 negative. All 3 surviving patients have positive Bcl-2 and Bcl-6 immunostaining, which could be important prognostic factors if confirmed by a larger study. PMID:21139885

  17. Primary Breast Angiosarcoma: Avoiding a Common Trap

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    Christine Desbiens

    2011-01-01

    Full Text Available Background. Primary breast angiosarcoma is a rare entity. Case. Initial diagnosis was a benign hemangioma at core biopsy. Wide local excision was performed, with positive margins. Pathology after surgery reported a moderately differentiated angiosarcoma. Tumor was finally treated using mastectomy and radiations. She developed a second angiosarcoma in contralateral breast, with an initial diagnosis on core biopsy of an atypical vascular lesion and was again treated using mastectomy and radiations. She developed bones and lung metastases. Conclusion. Primary breast angiosarcoma is a rare entity often difficult to diagnose on core biopsy, and a benign differential diagnosis is frequent. A highly vascular breast mass should always be considered malignant until proven otherwise. Surgical treatment seems to be the best course of action. There is a lack of data proving efficacy of adjuvant chemotherapy and radiation therapy.

  18. Neutrosophic segmentation of breast lesions for dedicated breast CT

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    Lee, Juhun; Nishikawa, Robert M.; Reiser, Ingrid; Boone, John M.

    2017-03-01

    We proposed the neutrosophic approach for segmenting breast lesions in breast Computer Tomography (bCT) images. The neutrosophic set (NS) considers the nature and properties of neutrality (or indeterminacy), which is neither true nor false. We considered the image noise as an indeterminate component, while treating the breast lesion and other breast areas as true and false components. We first transformed the image into the NS domain. Each voxel in the image can be described as its membership in True, Indeterminate, and False sets. Operations α-mean, β-enhancement, and γ-plateau iteratively smooth and contrast-enhance the image to reduce the noise level of the true set. Once the true image no longer changes, we applied one existing algorithm for bCT images, the RGI segmentation, on the resulting image to segment the breast lesions. We compared the segmentation performance of the proposed method (named as NS-RGI) to that of the regular RGI segmentation. We used a total of 122 breast lesions (44 benign, 78 malignant) of 123 non-contrasted bCT cases. We measured the segmentation performances of the NS-RGI and the RGI using the DICE coefficient. The average DICE value of the NS-RGI was 0.82 (STD: 0.09), while that of the RGI was 0.8 (STD: 0.12). The difference between the two DICE values was statistically significant (paired t test, p-value = 0.0007). We conducted a subsequent feature analysis on the resulting segmentations. The classifier performance for the NS-RGI (AUC = 0.8) improved over that of the RGI (AUC = 0.69, p-value = 0.006).

  19. Benign breast lesions in Kano | Ochicha | Nigerian Journal of ...

    African Journals Online (AJOL)

    Method: A five-year retrospective review of all histopathologically proven benign breast lesions in the two major hospitals in Kano was carried out. The data were analysed on the basis of the histopathological types, age and sex distribution. Results: Benign breast lesions accounted for 160 (73%) of all breast biopsies seen, ...

  20. Primary Osteosarcoma of the Breast Arising in an Intraductal Papilloma

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    Khalefa Ali Alghofaily

    2017-01-01

    Full Text Available Introduction. Primary osteosarcoma of the breast is extremely rare, and an osteosarcoma arising from an intraductal papilloma is exceptional. Case Presentation. A 72-year-old Saudi Arabian woman presented with a solid, bone-containing breast mass that was diagnosed as primary osteosarcoma of the breast on biopsy. She had a history of untreated intraductal papilloma. Treatment was completed with a modified mastectomy after excluding extramammary metastases. However, she subsequently developed multiple recurrent lesions at the same site. Conclusion. Primary osteogenic sarcomas of the breast are very rare. Although the main treatment is resection the optimal management remains uncertain and prognosis is poor.

  1. Zr-89- Bevacizumab PET Imaging in Primary Breast Cancer

    NARCIS (Netherlands)

    Gaykema, Sietske B. M.; Brouwers, Adrienne H.; Lub-de Hooge, Marjolijn N.; Pleijhuis, Rick G.; Timmer-Bosscha, Hetty; Pot, Linda; van Dam, Gooitzen M.; van der Meulen, Sibylle B.; de Jong, Johan R.; Bart, Joost; de Vries, Jakob; Jansen, Liesbeth; de Vries, Elisabeth G. E.; Schroder, Carolien P.

    2013-01-01

    Vascular endothelial growth factor (VEGF)-A is overexpressed in most malignant and premalignant breast lesions. VEGF-A can be visualized noninvasively with PET imaging and using the tracer Zr-89-labeled bevacizumab. In this clinical feasibility study, we assessed whether VEGF-A in primary breast

  2. Is routine biopsy of sonographically benign breast lesions in black ...

    African Journals Online (AJOL)

    The Breast Imaging Reporting and Data System. (BIRADS) classification has been developed for both ultrasound and mammography.[1] 'BIRADS 2 lesions are described as benign findings inclu ding intramammary nodes and breast implants. BIRADS 3 lesions are probably benign lesions including non calcified ...

  3. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Hebatallah Hassan Mamdouh Hassan

    2013-03-31

    Mar 31, 2013 ... Conclusion: DWI shows potential for improving the PPV of breast MRI for detection of malig- nant breast lesions. Recommendation: ... Radiologists who practice breast imaging have long known that the field provides ... detection of breast cancer using digital mammography, with special reflection on the ...

  4. Primary lymphoma of the breast involving both axillae with bilateral breast carcinoma

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    Rubin Gary

    2008-05-01

    Full Text Available Abstract Background Primary Non-Hodgkin's Lymphoma (PHNL of the breast is a rare entity, while secondary involvement of the breast with diffuse disease of Non-Hodgkin's lymphoma (NHL is more common. However, PNHL is the most frequent haematopoietic tumour of the breast. Diagnostic criteria for PNHL of the breast are presence of technically adequate pathologic specimens, close association of mammary tissue and lymphomatous infiltrate, no prior diagnosis of an extarammamary lymphoma, and no evidence of concurrent widespread disease, except for ipsilateral axillary lymph nodes if concomitant with the primary lesion. Case presentation A 57-year-old woman was recalled because her screening mammograms revealed three separate lesions in her right breast and one in the left. Histology of the lesions confirmed lymphoma in one breast with ductal carcinoma in the other. Conclusion Most of reported cases in literature have been involving the right breast, and almost all the patients were females. NHLs of the breast typically present as unilateral mass; the frequency of bilateral disease at first presentation ranges from 5–25%. Our objective is to report a case of primary lymphoma of the breast involving both axillae with concomitant bilateral primary breast cancer which has not been reported yet to our best of knowledge in literature.

  5. Simple mucins (T, sialosyl-T, Tn and sialosyl-Tn) are not diagnostic for malignant breast lesions

    DEFF Research Database (Denmark)

    Reed, W; Bryne, M; Clausen, H

    1994-01-01

    carcinomas (79 localized and 43 metastatic lesions). T antigen, not observed in normal breast tissue, was present in 31% of the benign lesions and in some cases of morphologically normal epithelium adjacent to tumor cells, compatible with altered glycosylation being an early event. Sialosyl-T (s-T) antigen......Immunohistochemical study of the distribution of carbohydrate core-structures on O-linked glycoproteins (T, sialosyl-T, Tn and sialosyl-Tn) was performed using specific monoclonal antibodies on 148 primary breast lesions, including 10 normal breast tissues, 16 benign lesions and 122 invasive...... was present in all cases of normal epithelium and in 81% of the benign lesions. Both Tn and sialosyl-Tn (s-Tn) antigen were present in normal breast lesions. Both Tn and sialosyl-Tn (s-Tn) antigen were present in normal breast tissue (30%) and benign lesions (31% and 19%). In the malignant lesions, 20% were...

  6. Malignant hyperechoic breast lesions at ultrasound: A pictorial essay.

    Science.gov (United States)

    Tiang, Stephen; Metcalf, Cecily; Dissanayake, Deepthi; Wylie, Elizabeth

    2016-08-01

    Malignant breast lesions are typically hypoechoic at sonography. However, a small subgroup of hyperechoic malignant breast lesions is encountered in clinical practice. We present a pictorial essay of a number of different hyperechoic breast malignancies with mammographic, sonographic and histopathologic correlation. Suspicious sonographic features in a hyperechoic lesion include inhomogeneity in echogenic pattern, an irregular margin, posterior acoustic shadowing and internal vascularity. A hyperechoic lesion at ultrasound does not discount the need to undertake histological assessment of a mammographically suspicious lesion. © 2016 The Royal Australian and New Zealand College of Radiologists.

  7. Sonographic-pathologic correlation of complex cystic breast lesions

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    Saravech Pongrattanaman

    2013-02-01

    Full Text Available Objective: To understand the pathologic basis for sonographic features of complex cystic lesions. Methods: From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42, core needle biopsy (n=6, excision (n=54 and mastectomy (n=1. Complex cystic breast masses were classified into 3 types as followings; thick outer wall and/or thick internal septa (type I; thick septation and thick wall were defined as equal or more than 0.5 cm, masses containing mixed cystic and solid components (at least 50% of cystic component (type II, predominantly solid with eccentric cystic foci (at least 50% of solid component (type III. Results: In 103 complex cystic masses, there are 27 lesions (26% classified as type I cystic breast masses, 37 lesions (36% as type II cystic breast masses and 39 lesions (38% type III cystic breast masses, 26 lesions (25.2% are proved to be malignant. All of type I cystic breast masses in our study are benign, and 14 (38% of type II cystic breast masses and 12 lesions (31% of type III cystic breast lesions are proved to be malignant. Conclusions: Type II and III lesions should suggest possibility of malignancy and biopsy should be performed in all lesions. All type I lesion in this study are benign. None of other parameters we included in this study (size or margin can effectively differentiate between benign or malignant cystic breast lesions. Also, grading of the malignant lesions by using type of cystic breast mass cannot be applied.

  8. Sonographic-pathologic correlation of complex cystic breast lesions

    Science.gov (United States)

    Pongrattanaman, Saravech; Prueksadee, Jenjeera

    2013-01-01

    Objective To understand the pathologic basis for sonographic features of complex cystic lesions. Methods From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42), core needle biopsy (n=6), excision (n=54) and mastectomy (n=1). Complex cystic breast masses were classified into 3 types as followings; thick outer wall and/or thick internal septa (type I); thick septation and thick wall were defined as equal or more than 0.5 cm, masses containing mixed cystic and solid components (at least 50% of cystic component) (type II), predominantly solid with eccentric cystic foci (at least 50% of solid component) (type III). Results In 103 complex cystic masses, there are 27 lesions (26%) classified as type I cystic breast masses, 37 lesions (36%) as type II cystic breast masses and 39 lesions (38%) type III cystic breast masses, 26 lesions (25.2%) are proved to be malignant. All of type I cystic breast masses in our study are benign, and 14 (38%) of type II cystic breast masses and 12 lesions (31%) of type III cystic breast lesions are proved to be malignant. Conclusions Type II and III lesions should suggest possibility of malignancy and biopsy should be performed in all lesions. All type I lesion in this study are benign. None of other parameters we included in this study (size or margin) can effectively differentiate between benign or malignant cystic breast lesions. Also, grading of the malignant lesions by using type of cystic breast mass cannot be applied.

  9. Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons

    Directory of Open Access Journals (Sweden)

    Deepak Jha

    2015-01-01

    Full Text Available Wire Guided Localisation has been the traditional technique for occult breast lesions. However, ROLL has emerged as a safer alternative to WGL approach. ROLL provides an improvement on margin positive rates and offers better pain and cosmetic advantages to the patient combined with a shorter learning curves for both radiologists and surgeons. SNOLL adds to the advantages of the procedure by combining SLNB with ROLL hence offering an economic advantage. The use of ROLL as primary modality for occult lesion localisation is bound to increase with potential to replace WGL as the primary modality for such lesions.

  10. Epidemiology of breast lesions in eastern Nigeria. A 10- year ...

    African Journals Online (AJOL)

    Objective: The paper aims to review the 'epidemiologic features of breast lesions in Eastern Nigeria' using a 10 year data collected from January 1998 to December 2007, and update available literature on the prevalence of common breast lesions in our environment. It simultaneously compares these with previous studies ...

  11. Simple mucins (T, sialosyl-T, Tn and sialosyl-Tn) are not diagnostic for malignant breast lesions

    DEFF Research Database (Denmark)

    Reed, W; Bryne, M; Clausen, H

    1994-01-01

    Immunohistochemical study of the distribution of carbohydrate core-structures on O-linked glycoproteins (T, sialosyl-T, Tn and sialosyl-Tn) was performed using specific monoclonal antibodies on 148 primary breast lesions, including 10 normal breast tissues, 16 benign lesions and 122 invasive carc...

  12. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Hebatallah Hassan Mamdouh Hassan

    2013-03-31

    Mar 31, 2013 ... detection of breast cancer using digital mammography, with special reflection on the ... and characterization of breast cancer.2 Additional lesions seen by MRI that are not ..... A 42 years old female with family history of breast cancer and microcalcification on follow-up (high risk) developed right axillary lump ...

  13. Fuzzy-based classification of breast lesions using ultrasound echography and elastography.

    Science.gov (United States)

    Selvan, Shirley; Kavitha, M; Devi, S Shenbaga; Suresh, S

    2012-09-01

    Common breast lesions have different elasticity properties. Segmentation of contours of breast lesions from elastography and B mode images by incorporating variational level set method is involved in the proposed work. After segmentation, strain and shape features, such as differences in area, perimeter, and contour and width to height difference and solidity, as well as texture features like contrast, entropy, standard deviation, dissimilarity, homogeneity and energy, are estimated. A nonlinear fuzzy inference system is applied for classifying the breast lesions as benign cyst, benign solid mass, or malignant solid mass. Detection of malignant solid masses is our primary objective. A classification accuracy of 83% is obtained. One hundred percent sensitivity is reported. It can be concluded that the proposed fuzzy-based classification technique can be used as an aid for the automated detection of breast lesions.

  14. Primary hydatid disease of breast: a case report.

    Science.gov (United States)

    Sheikh, Sheema; Akhter, Rukhsana; Bhat, Salma; Wani, Rohi

    2017-09-01

    Human hydatid disease, or echinococcosis, is a helminthic infection that leads to the formation of fluid-filled cysts in the liver, lungs and other organs. Breast, is a rare primary site of hydatid disease. We report a case of a 45 years old female who presented with a breast lump of 2 years duration. On fine needle aspiration cytology a diagnosis of fibrocystic changes of the breast was made and ultrasonography breast showed a thick walled infected cystic lesion. Intraoperatively, a diagnosis of hydatid cyst was made which was confirmed on histopathology.

  15. The Role of Scintimammography with 99mTc-MIBI in Evaluation of the Breast Lesions

    Directory of Open Access Journals (Sweden)

    A. Khancherly

    2003-07-01

    Full Text Available The breast cancer is common in females.Early detection with safe , convenient , noninvasive and accessible diagnostic tools are important. X- ray mammography is still the first choice imaging for breast cancer, but has low specificity and limited value in dense breast and surgically scarred breasts. In recent years , MIBI scintimammography has been used for this purpose. The aim of this study was to determine diagnostic value of prone lateral 99mTc-MIBI scintigraphy in detection of primary breast cancer in patients with breast lesions. We evaluated 55 patients with breast lesions and/or suspicious mammographic findings with MIBI scintimammography. In all patients , the diagnosis was established by pathology. Pattern of MIBI uptake and ratio of lesion to normal tissue uptake was recorded. All lesions with focal uptake and T/N ratio of more than 1.31 were considered as positive. Absence of focal activity or diffuse uptake either unilaterally or bilaterally were considered negative for malignancy. Focal uptake with T/N ratio of 1.01- 1.30 was equivocal in MIBI scan. Mammographic and sonographic findings were classified as negative ( normal or benign , equivocal and Positive (suspecious for malignancy or strongly malignant. Of 55 patients , 10 had cancer in pathologic examination. The MIBI scan detected all of the 10 cancerous lesions. X-mammography was positive in 6 of 10 patients and was negative or equivocal in 3 of them. In this study the MIBI breast scintimammography showed sensitivity and specificity of 100% and 95.4%. With respect to the limitations of X-ray mammography particularly in the young females , dense breasts and surgically scarred breasts , and low specificity of it , MIBI scan can be used as complementary imaging to the mammography and sonography in the evaluation of the breast lesions.

  16. Pathologic Findings of Breast Lesions Detected on Magnetic Resonance Imaging.

    Science.gov (United States)

    Jabbar, Seema B; Lynch, Beverly; Seiler, Stephen; Hwang, Helena; Sahoo, Sunati

    2017-11-01

    - Breast magnetic resonance imaging (MRI) is now used routinely for high-risk screening and in the evaluation of the extent of disease in newly diagnosed breast cancer patients. Morphologic characteristics and the kinetic pattern largely determine how suspicious a breast lesion is on MRI. Because of its high sensitivity, MRI identifies a large number of suspicious lesions. However, the low to moderate specificity and the additional cost have raised questions regarding its frequent use. - To identify the pathologic entities that frequently present as suspicious enhancing lesions and to identify specific MRI characteristics that may be predictive of malignancy. - One hundred seventy-seven MRI-guided biopsies from 152 patients were included in the study. The indication for MRI, MRI features, pathologic findings, and patient demographics were recorded. The MRI findings and the pathology slides were reviewed by a dedicated breast radiologist and breast pathologists. - Seventy-one percent (126 of 177) of MRI-guided breast biopsies were benign, 11% (20 of 177) showed epithelial atypia, and 18% (31 of 177) showed malignancy. The vast majority (84%; 62 of 74) of MRI lesions with persistent kinetics were benign. However, 57% (17 of 30) of lesions with washout kinetics and 65% (62 of 95) of mass lesions were also benign. - Magnetic resonance imaging detects malignancies undetected by other imaging modalities but also detects a wide variety of benign lesions. Benign and malignant lesions identified by MRI share similar morphologic and kinetic features, necessitating biopsy for histologic confirmation.

  17. Accuracy of diffusion kurtosis imaging in characterization of breast lesions.

    Science.gov (United States)

    Christou, Alexandra; Ghiatas, Abraham; Priovolos, Dimitrios; Veliou, Konstantia; Bougias, Haralambos

    2017-05-01

    The aim of this study was to evaluate the accuracy of diffusion kurtosis in the characterization and differentiation of breast lesions. 49 females with 53 breast lesions underwent breast MRI. The MRI magnetic field is 1.5 T, and the protocol is standard MRI sequences, dynamic sequences pre- and post-contrast agent administration and diffusion images. Diffusion kurtosis imaging (DKI) was applied as part of our standard breast MRΙ protocol. Two experienced radiologists on breast MRI, blinded to the final diagnosis, reviewed the parametric maps and placed a volume of interest on all slices including each lesion. Kurtosis [K apparent (Kapp)] and corrected apparent diffusion coefficient [D apparent (Dapp)] median values were then calculated from the whole-lesion histogram analysis. Receiver-operating characteristic analysis was used to determine the most effective cut-off values for the differentiation between benign and malignant pathologies. Histological analysis of the breast lesions was performed, and further comparative analysis of the results was performed to investigate the accuracy of the method. Benign (n = 19) and malignant lesions (n = 34) had mean diameters of 20.8 mm (10.1-31.5 mm) and 26.4 mm (10.5-42.3 mm), respectively. The lowest and the highest kurtosis values (Kapp) of malignant lesions were significantly higher than those of benign lesions. A cut-off of 0.71 provided specificity of 93.7% and sensitivity 97.1%, and the area under the curve (AUC) was 0.976 (p breast lesions with high Kapp and Dapp sensitivity and specificity rates. Advances in knowledge: DKI is able to distinguish benign from malignant breast pathologies. DKI increases the specificity of breast MRI.

  18. Comparative study between breast tomosynthesis and classic digital mammography in the evaluation of different breast lesions

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2014-09-01

    Conclusion: Three-dimensional tomosynthesis significantly enhanced the detection and characterization of breast lesions on digital mammography especially in the context of dense breast parenchyma (ACR 3&4.

  19. Benign Proliferative Breast Lesions and Risk of Cancer

    Directory of Open Access Journals (Sweden)

    Serap Erel

    2010-06-01

    Full Text Available Benign breast lesions (BBL includes a wide variety of histologic entities, which have been broadly classified into non-proliferative lesions, proliferative lesions without atypia, and hyperplasia with atypia. With the increased use of mammography, more benign lesions are being detected, and in order to estimate the risk of breast cancer for specific histologic categories is of great importance to guide clinical management. Women with proliferative lesions without atypia are at slightly increased risk of subsequent breast cancer, whereas women with proliferative lesions with atypia have a higher risk. The risk is 1.5- 2-fold in women with proliferative lesions without atypia, 4-5-fold in women with proliferative lesions with atypia, and 8-10 fold in women with ductal carcinoma in situ. Age at diagnosis of BBL, menopausal status, family history of breast cancer in a first-degree relative, and time since BBL diagnosis on risk of breast cancer are important for risk evaluation. [Archives Medical Review Journal 2010; 19(3.000: 155-167

  20. Sonographic-pathologic correlation of complex cystic breast lesions

    OpenAIRE

    Saravech Pongrattanaman; Jenjeera Prueksadee

    2013-01-01

    Objective: To understand the pathologic basis for sonographic features of complex cystic lesions. Methods: From 2 646 female patients underwent breast sonography at King Chulalongkorn Memorial Hospital from January 2005 through December 2010, 103 cystic lesions were included. Pathologic confirmation was performed by fine-needle aspiration (n=42), core needle biopsy (n=6), excision (n=54) and mastectomy (n=1). Complex cystic breast masses were classified into 3 types as followin...

  1. Lobular neoplasia: frequency and association with other breast lesions

    OpenAIRE

    Gobbi Helenice; Porto Simone S; Balabram Débora; Gomes Douglas S

    2011-01-01

    Abstract Background Using new molecular biology techniques, recent studies have implicated a common evolutionary pathway between lobular neoplasia, lobular carcinomas, and columnar cell lesions. Our aims were to assess the frequency of lobular neoplasia in a series of breast biopsies that were performed and examined in the same institution and to analyze the association between subtypes of lobular neoplasia and benign and malignant breast lesions. Methods Cases were selected after reviewing a...

  2. US findings of bilateral primary breast cancer: Retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Lou Li [Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324 Jing 5 Road, Jinan 250021 (China)]. E-mail: luckylouli@eyou.com; Cong Xinli [Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324 Jing 5 Road, Jinan 250021 (China); Yu Guofang [Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324 Jing 5 Road, Jinan 250021 (China); Li Jichang [Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324 Jing 5 Road, Jinan 250021 (China); Ma Yuxiang [Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324 Jing 5 Road, Jinan 250021 (China)

    2007-01-15

    Background: For women with breast cancer, the contralateral breast is at high risk. The bilateral cancers may be synchronous or metachronous. If the bilateral breast cancers have similar ultrasonography (US) appearances, the US findings of the first breast cancer (index cancer) might lead to early detection of the contralateral cancer. The purpose of this study was to identify the US characteristics of bilateral breast cancer and to determine whether bilateral breast cancers have similar US appearances and whether the US findings for one breast cancer might be predictive of the contralateral breast cancer. Methods: We retrospectively reviewed the US manifestations of 58 patients with surgically proven bilateral primary breast cancer and compared the contralateral cancer with the index cancer by evaluation the margin, shape, inside echoes, posterior attenuation, calcification and color flow signals of 58 lesion pairs to investigate whether the bilateral breast cancers have similar US appearances. Results: Bilateral primary breast cancers were more located in upper outer quadrant, frequently spiculation, taller than wide shape, with irregular margin, heterogeneous internal echo and acoustic shadowing, containing microcalcification and abundant color flow signals. The most common US appearances were taller than wide shape (75.0%, 87/116), irregular margins (79.3%, 92/116) and heterogeneous internal echo (86.2%, 100/116). Of the total 58 lesion pairs, 18 (31.0%) pairs had similar US characteristics, whereas 40 (69.0%) pairs had different US characteristics. Conclusions: US signs of the index cancer do not indicate the most likely appearance of the second cancer in the contralateral breast. Evaluation of the contralateral cancer should be performed without regard for the US findings for the index cancer.

  3. Diffusion magnetic resonance imaging of breast lesions: Initial ...

    African Journals Online (AJOL)

    Objective: The purpose of our study was to investigate whether adding diffusion weighted imaging (DWI) to dynamic contrast-enhanced MRI (DCE-MRI) could improve specificity and the positive predictive value (PPV) of breast MRI in differentiating benign and malignant focal breast mass lesions. Materials and methods: ...

  4. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    Cite as: Nwadike UI, Eze CU, Agwuna K, Mouka C. Mammographic classification of breast lesions amongst women in Enugu, South East. Nigeria. Afri Health ... It has the ability to detect micro-calcification which can- not be delineated by ... estimated 246,660 new cases of the invasive breast cancer are expected to be ...

  5. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    BA, Teresa LF and Sonia IS. Screening of Breast Lesions: a Comparative Study between Mammography, B-mode. Ultrasonography, Sonoelastography and histological re- sults. Radiologia Brasileira 2013; 46(4): 78-99. 21. Frank NG Jnr, Akwasi A, Sebastian E, Saanid MA,. Samuel D. Pattern of Breast Cancer Distribution in ...

  6. Mammographic classification of breast lesions amongst women in ...

    African Journals Online (AJOL)

    Objectives: The study was to classify lesions identified on mammograms using Breast Imaging Reporting and Data System (BIRADS) grading method. This was in view of ascertaining the rate of occurrence of breast malignancy of the studied population. Methods: A retrospective cohort study of 416 mammographic reports of ...

  7. PROSPECTIVE STUDY OF CYTO HISTOPATHOLOGICAL CORRELATION OF BREAST LESIONS

    Directory of Open Access Journals (Sweden)

    Vijayabharathi

    2015-06-01

    Full Text Available INTRODUCTION: Cancer of breast is the second most common cause of cancer in women. In the present era, late marriage, late child birth, shorter period of breast feeding and nulliparity or low parity have contributed to increase in the number of cases. Fine needle aspiration cytology (FNAC is a useful method for initial evaluation and diagnosis of breast cancers and it has the ability of providing necessary prognostic predictive information. AIMS AND OBJECTIVES: The aim of the present study is to evaluate t he accuracy of FNAC of breast lesions with histopathological correlation. To study the cytomorphological features of palpable breast lumps. To study the various cytological patterns in aspirates from breast lesions and to classify them into non - neoplastic, benign and malignant lesions. To correlate the cytology findings with subsequent histopathological diagnosis wherever possible. To establish accuracy and efficacy of aspiration cytology as an early and preoperative diagnostic aid. To compare the statistic al analysis of present study with other contemporary studies. MATERIALS AND METHODS: The present study includes the study of aspiration smears of all cases referred to the Department of Pathology, Andhra medical college, Visakhapatnam from various outpatient departments from King George Hospital, with a palpable breast lesion. True cut Biopsy and Mastectomy specimens for Histopathological correlation RESULTS: Out of 952 analyzed cases benign lesions were 691 (72.58%, malignant lesions were 146 (15. 33%,non - neoplastic lesions were common in the age group of 21 - 30 years, benign lesions in 21 - 30 years, and malignant lesions were common in the age group of 41 - 50 years. Majority of the patients were female with 913 (95.90% and male patents are 39 (4 .09%.The results of sensitivity (97.18%, specificity (98.74%, positive predictive value (97.18% and negative predictive value (98.74% with diagnostic accuracy of 98.26%. CONCLUSION: FNAC

  8. Radiologic appearance of primary jaw lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Malini; Kaste, Sue C. [Department of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Hopkins, Kenneth P. [Department of Surgery, Division of Dentistry, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2002-03-01

    Background: The jaw (an unusual site of primary tumors in children and adolescents) has lesions often found incidentally by dentists on routine panoramic radiographs or during examination of a child who has swelling or tooth pain. Objective: This pictorial seeks to familiarize pediatric radiologists with the radiographic appearance of a variety of primary jaw lesions. Materials and methods: We retrospectively searched institutional records for cases of primary jaw lesions in children and adolescents. Jaw lesions were characterized as: I, well-circumscribed radiolucent lesions; II, lesions with mixed or variable appearance; III, poorly circumscribed radiolucent lesions; and IV, radiopaque lesions. Results: Although most oral and maxillofacial lesions in children are benign, a broad spectrum of tumors was identified; lesions may occur in patients with unrelated prior malignancy. Conclusion: Because radiologic studies may identify jaw lesions and direct further care, familiarity with the appearance of these entities is prudent. (orig.)

  9. Characterization of lesions in dense breasts: Does tomosynthesis help?

    Directory of Open Access Journals (Sweden)

    Krithika Rangarajan

    2016-01-01

    Full Text Available Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS categories 0, 3, 4, or 5 on two-dimensional (2D mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR. Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging. Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85. Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

  10. Is routine biopsy of sonographically benign breast lesions in black ...

    African Journals Online (AJOL)

    Introduction. Breast lesions that appear benign on ultrasound examination continue to be biopsied, and no relevant data from Africa exist. Objective. To determine the histological spectrum of sonographically benign lesions measuring >3 cm in women in Johannesburg, South Africa, by age and population group, and ...

  11. Optical discrimination between malignant and benign breast lesions

    Science.gov (United States)

    Quarto, Giovanna; Pifferi, Antonio; Cubeddu, Rinaldo; Ieva, Francesca; Paganoni, Anna Maria; Abbate, Francesca; Cassano, Enrico; Taroni, Paola

    2015-07-01

    Time domain multi-wavelength (635 to 1060 nm) optical mammography was performed on 82 subjects with breast lesions (45 malignant and 38 benign lesions). A perturbative approach based on the high-order calculation of the pathlength of photons inside the lesion was applied to estimate differences between lesion and average healthy tissue of the same breast in terms of: i) absorption properties, and ii) concentration of the major tissue constituents (oxy- and deoxy-hemoglobin, water, lipid and collagen). The absorption difference Δμa between lesion and healthy tissue is significantly different for malignant vs. benign lesions at all wavelengths. Logistic regression fitted to the absorption data identifies 975 nm as the key wavelength to discriminate malignant from benign lesions. When the difference in tissue composition between lesion and healthy tissue is considered, malignant lesions are characterized by significantly higher collagen content than benign lesions. Also the best model for the discrimination of malignant lesions obtained applying regression logistic to tissue composition is based only on collagen. Including demographic information into the model improves its specificity.

  12. Molecular Concordance Between Primary Breast Cancer and Matched Metastases

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Thomassen, Mads

    2016-01-01

    . The purpose of this review is to illuminate the extent of cancer genome evolution through disease progression and the degree of molecular concordance between primary breast cancers and matched metastases. We present an overview of the most prominent studies investigating the expression of endocrine receptors......Clinical management of breast cancer is increasingly personalized and based on molecular profiling. Often, primary tumors are used as proxies for systemic disease at the time of recurrence. However, recent studies have revealed substantial discordances between primary tumors and metastases, both......, transcriptomics, and genome aberrations in primary tumors and metastases. In conclusion, biopsy of metastatic lesions at recurrence of breast cancer is encouraged to provide optimal treatment of the disease. Furthermore, molecular profiling of metastatic tissue provides invaluable mechanistic insight...

  13. Ultrasonography-guided mammotome biopsy of breast lesions : early experience

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Mi; Yun, Ji Young; Yoon, CHil Suk; Gong, Gyung Yub; Ahn, Sei Hyun [Ulsan Univ. College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2001-04-01

    To report some early experiences of ultrasonography-guided mammotome biopsy for solid breast lesions. Sixty seven solid breast lesions in 59 patients aged 25-77 (mean, 44.5) years were biopsied under ultrasound-guidance using an 11 gauge mammotome. The size and depth of the lesions, diagnostic accuracy achieved, complications, and merits and demerits of the device were evaluated. The lesions ranged in size from 0.5 to 8 (mean, 1.6)cm, and at their center the mean depth was 1.4cm. for every lesion at least seven biopsies were performed, and the mean weight of extracted tissue was 0.44gm. The lesions were located mainly at the at 12o'clock area and upper inner quadrant of the left breast(n=10 for each area); they were also found in other regions for both breasts, including subareloar areas. The histopathologic diagnosis was malignant in 26 lesions and benign in 39, and in one case, atypical ductal hyperplasia was diagnosed. One lesion contained no tumor cells. Twenty-four malignant lesions were surgically excised, and in 21 invasive ductal/lobular carcinomas and one ductal carcinoma in situ (DCIS) (91.7%) the initial and subsequent diagnosis correlated. One lesion diagnosed as DCIS and one whose invasiveness could not be initially determined were confirmed as invasive ductal carcinomas (8.3%). Follow-up ultrasonography involved six benign lesion and showed that five of these had become smaller. The complications noted were severe pain in three patients and a moderate amount of bleeding in two, but in all cases good control was achieved by interrupting the procedure or applying compression. The merits of the mammotome biopsy compared with the conventional core biopsy technique are higher diagnostic accuracy due to the larger amount of tissue extracted by suction and the large caliber of the needle, multiple biopsies achieved by one needle insertion, and less possibility of server complications such as pneumothorax. Dry-tapping was a demerit of the device. Very

  14. Simple mucins (T, sialosyl-T, Tn and sialosyl-Tn) are not diagnostic for malignant breast lesions.

    Science.gov (United States)

    Reed, W; Bryne, M; Clausen, H; Dabelsteen, E; Nesland, J M

    1994-01-01

    Immunohistochemical study of the distribution of carbohydrate core-structures on O-linked glycoproteins (T, sialosyl-T, Tn and sialosyl-Tn) was performed using specific monoclonal antibodies on 148 primary breast lesions, including 10 normal breast tissues, 16 benign lesions and 122 invasive carcinomas (79 localized and 43 metastatic lesions). T antigen, not observed in normal breast tissue, was present in 31% of the benign lesions and in some cases of morphologically normal epithelium adjacent to tumor cells, compatible with altered glycosylation being an early event. Sialosyl-T (s-T) antigen was present in all cases of normal epithelium and in 81% of the benign lesions. Both Tn and sialosyl-Tn (s-Tn) antigen were present in normal breast lesions. Both Tn and sialosyl-Tn (s-Tn) antigen were present in normal breast tissue (30%) and benign lesions (31% and 19%). In the malignant lesions, 20% were positive for T antigen, 82% for s-T antigen, 66% for Tn antigen and 22% for s-Tn antigen. The staining pattern was nearly identical for carcinomas with and without lymph node metastases. In conclusion, immunostaining for simple mucins does not permit a clear distinction between benign and malignant breast lesions.

  15. Preoperative localization of non-palpable breast lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H. M.; Lee, K. S.; Kim, Y. H.; Choi, H. J.; Cho, B. J. [Cheil General Hospital, Seoul (Korea, Republic of); Lee, D. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    As film-screen mammography became to be used widely, more mammographic abnormalities without palpable masses were detected and the need for surgical biopsied increases. We intended to study the mammographic findings and pathologic diagnosis together with the preoperative localization procedures used in these cases. From Feb. 1987 to Mar. 1993 localization of breast lesion using Breast Needle/Wire Localizer was done in 179 cases. All cases were proven pathologically though surgical biopsy. In these cases, microcalcification(52.0%), mass(29.6%) architectural distortion(2.2%), or combination of the above(16.2%) was observed on film mammogram. Most frequent lesion site was upper outer quadrant(53.1%), followed by upper inner quadrant(25.7%), subareolar area(7.8%), lower outer quadrant(6.7%) and lower inner quadrant(6.7%) in decreasing order of frequency. Cranial(85.5%) approach for needle localization was mostly used but other approaches such as caudal(5.6%), lateral(5.0%) and medial(3.9%) were also used. A total of 24 cases was malignant(13.4%), and among them there were 14 cases of intraductal carcinoma, 1 intralobular carcinoma, 8 invasive ductal carcinoma and 1 invasive lobular carcinoma. With the use of Breast Needle/Wire Localizer, safe, simple and precise localization of non-palpable breast lesion can be achieved. It makes breast biopsy possible with minimal resection of breast tissue therefore minimizing disfigurement of the breast resulting from operation.

  16. Grey zone lesions of breast: Potential areas of error in cytology

    Directory of Open Access Journals (Sweden)

    Suvradeep Mitra

    2015-01-01

    Full Text Available Fine-needle aspiration cytology (FNAC of the breast is a rapid, cost-effective, and sensitive procedure to diagnose breast lesions, and was widely employed to diagnose breast lesions in the past. However, in recent times, core needle biopsy of the breast is gaining popularity and acceptability, although FNAC still looms large. There are some intrinsic disadvantages to FNAC, of which the most important is probably difficulty in classification of a significant percentage of breast lesions. Such lesions are usually denoted by the rubric "grey zone lesions of the breast." This article attempts to review these grey zone lesions and highlight the difficulties in diagnosing them.

  17. Genomics and premalignant breast lesions: clues to the development and progression of lobular breast cancer.

    Science.gov (United States)

    Mastracci, Teresa L; Boulos, Fouad I; Andrulis, Irene L; Lam, Wan L

    2007-01-01

    Advances in genomic technology have improved our understanding of the genetic events that parallel breast cancer development. Because almost all mammary carcinomas develop in the terminal duct lobular units of the breast, understanding the events involved in mammary gland development make it possible to recognize those events that, when altered, contribute to breast neoplasia. In this review we focus on lobular carcinomas, discussing the pathology, development, and progression of premalignant lobular lesions from a genomic point of view. We highlight studies utilizing genomic approaches and describe how these investigations have furthered our understanding of the complexity of premalignant breast lesions.

  18. Primary glandular melanoma of male breast with nodal metastasis

    OpenAIRE

    Jayabal Pandiaraja

    2016-01-01

    Malignant melanoma is a malignancy that develops from melanocytes. Breast is an uncommon site for malignant melanoma. Melanoma of the breast occurs in various situations such as primary melanoma of breast skin, metastatic melanoma of breast, in-transit metastasis to the breast, and primary glandular breast melanoma. Most of the melanoma breast either cutaneous melanoma or metastatic melanoma. Primary glandular melanoma of male breast with nodal involvement is rarely reported compared to prima...

  19. Magnetic resonance imaging texture analysis classification of primary breast cancer.

    Science.gov (United States)

    Waugh, S A; Purdie, C A; Jordan, L B; Vinnicombe, S; Lerski, R A; Martin, P; Thompson, A M

    2016-02-01

    Patient-tailored treatments for breast cancer are based on histological and immunohistochemical (IHC) subtypes. Magnetic Resonance Imaging (MRI) texture analysis (TA) may be useful in non-invasive lesion subtype classification. Women with newly diagnosed primary breast cancer underwent pre-treatment dynamic contrast-enhanced breast MRI. TA was performed using co-occurrence matrix (COM) features, by creating a model on retrospective training data, then prospectively applying to a test set. Analyses were blinded to breast pathology. Subtype classifications were performed using a cross-validated k-nearest-neighbour (k = 3) technique, with accuracy relative to pathology assessed and receiver operator curve (AUROC) calculated. Mann-Whitney U and Kruskal-Wallis tests were used to assess raw entropy feature values. Histological subtype classifications were similar across training (n = 148 cancers) and test sets (n = 73 lesions) using all COM features (training: 75%, AUROC = 0.816; test: 72.5%, AUROC = 0.823). Entropy features were significantly different between lobular and ductal cancers (p cancers demonstrated significantly different entropy features. Entropy features alone were unable to create a robust classification model. Textural differences on contrast-enhanced MR images may reflect underlying lesion subtypes, which merits testing against treatment response. • MR-derived entropy features, representing heterogeneity, provide important information on tissue composition. • Entropy features can differentiate between histological and immunohistochemical subtypes of breast cancer. • Differing entropy features between breast cancer subtypes implies differences in lesion heterogeneity. • Texture analysis of breast cancer potentially provides added information for decision making.

  20. Lobular neoplasia: frequency and association with other breast lesions

    Science.gov (United States)

    2011-01-01

    Background Using new molecular biology techniques, recent studies have implicated a common evolutionary pathway between lobular neoplasia, lobular carcinomas, and columnar cell lesions. Our aims were to assess the frequency of lobular neoplasia in a series of breast biopsies that were performed and examined in the same institution and to analyze the association between subtypes of lobular neoplasia and benign and malignant breast lesions. Methods Cases were selected after reviewing archived pathological reports in the Breast Pathology Laboratory, School of Medicine of Federal University of Minas Gerais (1999-2008). Cases of lobular neoplasia were reviewed and classified as atypical lobular hyperplasia, ductal involvement by cells of atypical lobular hyperplasia, lobular carcinoma in situ, and pleomorphic lobular carcinoma in situ. Coexistence of lobular neoplasia with other breast lesions, including columnar cell lesions, invasive ductal carcinoma and invasive lobular carcinoma, was evaluated. The association between lobular neoplasia and breast lesions was analyzed by Fisher's exact test and chi-square test for linear trend. Results We analyzed 5650 breast specimens, selecting 135 breast specimens (2.4%) that had a diagnosis of lobular neoplasia, corresponding to 106 patients. Hematoxylin and eosin-stained slides were available for 84 cases, 5 of which were excluded because they contained only "indeterminate" in situ lesions. Of the 79 remaining cases, columnar cell lesions were present in 78.5%, primarily with columnar cell changes without atypia (67.7%). Invasive carcinoma was present in 45.6% of cases of lobular neoplasia--a similar frequency (47.2%) as invasive ductal carcinoma and invasive lobular carcinoma. We noted a significant linear trend (p invasive carcinomas that were concomitant with lobular carcinoma in situ compared with atypical lobular hyperplasia. Invasive lobular carcinomas were associated with lobular carcinoma in situ in 33% of cases

  1. Lobular neoplasia: frequency and association with other breast lesions

    Directory of Open Access Journals (Sweden)

    Gobbi Helenice

    2011-08-01

    Full Text Available Abstract Background Using new molecular biology techniques, recent studies have implicated a common evolutionary pathway between lobular neoplasia, lobular carcinomas, and columnar cell lesions. Our aims were to assess the frequency of lobular neoplasia in a series of breast biopsies that were performed and examined in the same institution and to analyze the association between subtypes of lobular neoplasia and benign and malignant breast lesions. Methods Cases were selected after reviewing archived pathological reports in the Breast Pathology Laboratory, School of Medicine of Federal University of Minas Gerais (1999-2008. Cases of lobular neoplasia were reviewed and classified as atypical lobular hyperplasia, ductal involvement by cells of atypical lobular hyperplasia, lobular carcinoma in situ, and pleomorphic lobular carcinoma in situ. Coexistence of lobular neoplasia with other breast lesions, including columnar cell lesions, invasive ductal carcinoma and invasive lobular carcinoma, was evaluated. The association between lobular neoplasia and breast lesions was analyzed by Fisher's exact test and chi-square test for linear trend. Results We analyzed 5650 breast specimens, selecting 135 breast specimens (2.4% that had a diagnosis of lobular neoplasia, corresponding to 106 patients. Hematoxylin and eosin-stained slides were available for 84 cases, 5 of which were excluded because they contained only "indeterminate" in situ lesions. Of the 79 remaining cases, columnar cell lesions were present in 78.5%, primarily with columnar cell changes without atypia (67.7%. Invasive carcinoma was present in 45.6% of cases of lobular neoplasia--a similar frequency (47.2% as invasive ductal carcinoma and invasive lobular carcinoma. We noted a significant linear trend (p in situ compared with atypical lobular hyperplasia. Invasive lobular carcinomas were associated with lobular carcinoma in situ in 33% of cases, compared with 2.8% of atypical lobular

  2. Primary Leiomyosarcoma of the Breast: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Pallavi Agrawal

    2015-08-01

    Full Text Available Background: Primary leiomyosarcoma (LMS of the breast is a very rare neoplasm of the breast arising from the mesenchymal tissue. The clinical presentation of this entity simulates other benign and malignant lesions of mesenchymal tissue of the breast.Case presentation: Case 1: A 40-year-old female presented with a right-sided breast lump, which was suspected to be a malignant spindle cell tumor on needle core biopsy (NCB. A multi-disciplinary team performed modified radical mastectomy (MRM with axillary node dissection on the patient with no post-operative chemo-radiation. Case 2: A 70-year-old female presented with a left sided breast lump and a palpable axillary node. Needle core biopsy diagnosed it as malignant spindle cell tumor. The patient underwent MRM with axillary node dissection. It was confirmed to be a case of breast LMS with axillary nodal metastasis. Both patients were followed up for one year with no evidence of recurrence.Conclusion: Both cases underwent MRM with axillary node dissection in our study. However, the role of axillary dissection in the prognosis and disease-free survival of the patients with primary LMS of the breast with axillary metastasis has not been studied yet. The optimal management of this entity remains to be tumor excision with clear margins.

  3. Risk-benefit analysis of preoperative breast MRI in patients with primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Siegmann, K.C. [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen (Germany)], E-mail: katja.siegmann@med.uni-tuebingen.de; Baur, A. [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen (Germany); Vogel, U. [Institute of Pathology, University Hospital Tuebingen, Tuebingen (Germany); Kraemer, B.; Hahn, M. [Department of Obstetrics and Gynecology, University Hospital Tuebingen, Tuebingen (Germany); Claussen, C.D. [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen (Germany)

    2009-04-15

    Aim: To analyse and compare the risks and benefits of preoperative breast MRI (BMRI) in patients with primary breast cancer (PBC), and to determine the influence of mammographic breast density (BD) and histological tumour type (TT). Materials and Methods: One hundred and nineteen patients who underwent preoperative bilateral breast MRI for staging of PBC during a 1-year period from July 2005 to August 2006 were prospectively evaluated. Changes in clinical management due to BMRI findings were recorded. MRI-detected lesions were correlated with histology. Additional MRI-detected malignant lesions and spared additional biopsies because of negative MRI in case of unclear ultrasound findings were determined as beneficial for the patient. Biopsies of benign MRI detected lesions were defined as disadvantageous. The influence of BD (ACR 1-4) and TT on the change in clinical management and patient benefit was evaluated. Results: The findings of the BMRI examinations changed the clinical management in 48 patients (40.3%). Seventeen women underwent mastectomy instead of breast conservation, eight patients underwent extended excision, 21 additional lesions were clarified by MRI intervention, and two ultrasound-detected lesions were not biopsied because of negative MRI. Histologically malignant additional or extended biopsies (n = 34) and two cases of spared biopsies resulted in 36 (30.3%) women who benefited from preoperative BMRI. Twelve patients (10.1%) had additional biopsies of MRI-detected benign lesions, and therefore, had an unfavourable outcome due to BMRI. The change in clinical management and patient benefit were independent of BD and TT (p > 0.05). Conclusion: Preoperative BMRI was beneficial for 30.3% of 119 patients with PBC. The percentage of additional biopsies of benign lesions (10.1%) seems acceptable.

  4. Shear wave speed imaging of breast lesions: Speed within the lesion, fat-to-lesion speed ratio, or gland-to-lesion speed ratio?

    Science.gov (United States)

    Li, Xiao-Long; Ren, Wei-Wei; Fu, Hui-Jun; He, Ya-Ping; Wang, Qiao; Sun, Li-Ping; Guo, Le-Hang; Liu, Bo-Ji; Fang, Lin; Xu, Hui-Xiong

    2017-01-01

    To evaluate the diagnostic performance of shear wave speed (SWS) within the lesion, fat-to-lesion speed ratio (FLR), and gland-to-lesion speed ratio (GLR) for differentiation between benign and malignant breast lesions using a novel SWS imaging technique. From April 2016 to June 2016, 182 breast lesions were prospectively included in the study. For each lesion, SWS-lesion, FLR, and GLR were calculated. Pathological results were used as the reference standard. Receiver operating characteristic curves (ROC) were plotted to assess the diagnostic performance. Of the 182 lesions, 142 (78.0%) were benign and 40 (22.0%) were malignant. Significant differences were found between benign and malignant lesions in SWS-lesion, FLR and GLR (2.12±0.64 m/s vs 3.87±1.45 m/s, 1.63±0.61 vs 2.60±1.04, and 1.33±0.39 vs 2.08±0.78, respectively. All P lesion, FLR, GLR were 2.88 m/s, 2.31 and 1.51, respectively. The diagnostic performance of SWS-lesion in terms of AUC was the highest (i.e. AUC = 0.845), in comparison with FLR and GLR alone or their combination. The associated sensitivity, specificity, and accuracy for SWS-lesion were 75.0%, 89.4%, and 86.3%, respectively. SWS-lesion is a valuable and sufficient method for differentiation between benign and malignant breast lesions.

  5. Primary infiltrating ductal carcinoma of the axillary breast with metastasis to the contralateral chest wall

    Directory of Open Access Journals (Sweden)

    Li-Min Sun

    2013-06-01

    Full Text Available Primary infiltrating ductal carcinoma of the axillary breast is rare and has a high frequency of lymph node (LN involvement. We report a woman with primary infiltrating ductal carcinoma arising from the right axillary breast with metastasis to the contralateral chest wall. Excisional biopsy of the left chest wall nodule and the right axillary mass was carried out and both showed invasive ductal carcinomas histologically. The lesion of the right axillary mass arose from the breast tissue, rather than the LN. Further surgery proved the right axillary LN metastasis. After further review, a primary infiltrating ductal carcinoma of the right axillary breast with metastasis to axillary LNs and contralateral chest wall was diagnosed. The patient also received chemotherapy and radiation and there was no evidence of tumor recurrence after treatment. The present report demonstrated a rare case with uncommon manifestation. Lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma.

  6. Subclonal diversification of primary breast cancer revealed by multiregion sequencing

    Science.gov (United States)

    Yates, Lucy R; Gerstung, Moritz; Knappskog, Stian; Desmedt, Christine; Gundem, Gunes; Loo, Peter Van; Aas, Turid; Alexandrov, Ludmil B; Larsimont, Denis; Davies, Helen; Li, Yilong; Ju, Young Seok; Ramakrishna, Manasa; Haugland, Hans Kristian; Lilleng, Peer Kaare; Nik-Zainal, Serena; McLaren, Stuart; Butler, Adam; Martin, Sancha; Glodzik, Dominic; Menzies, Andrew; Raine, Keiran; Hinton, Jonathan; Jones, David; Mudie, Laura J; Jiang, Bing; Vincent, Delphine; Greene-Colozzi, April; Adnet, Pierre-Yves; Fatima, Aquila; Maetens, Marion; Ignatiadis, Michail; Stratton, Michael R; Sotiriou, Christos; Richardson, Andrea L; Lønning, Per Eystein; Wedge, David C; Campbell, Peter J

    2015-01-01

    Sequencing cancer genomes may enable tailoring of therapeutics to the underlying biological abnormalities driving a particular patient’s tumor. However, sequencing-based strategies rely heavily on representative sampling of tumors. To understand the subclonal structure of primary breast cancer, we applied whole genome and targeted sequencing to multiple samples from each of 50 patients’ tumors (total 303). The extent of subclonal diversification varied among cases and followed spatial patterns. No strict temporal order was evident, with point mutations and rearrangements affecting the most common breast cancer genes, including PIK3CA, TP53, PTEN, BRCA2 and MYC, occurring early in some tumors and late in others. In 13/50 cancers, potentially targetable mutations were subclonal. Landmarks of disease progression, such as resisting chemotherapy and acquiring invasive or metastatic potential, arose within detectable subclones of antecedent lesions. These findings highlight the importance of including analyses of subclonal structure and tumor evolution in clinical trials of primary breast cancer. PMID:26099045

  7. Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

    Science.gov (United States)

    Field, Scott S

    2016-02-01

    Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. © The Author(s) 2015.

  8. Lesion morphology on breast MRI affects targeted ultrasound correlation rate

    Energy Technology Data Exchange (ETDEWEB)

    Hollowell, Lauren; Price, Elissa; Arasu, Vignesh; Wisner, Dorota; Hylton, Nola; Joe, Bonnie [UCSF, San Francisco, CA (United States)

    2015-05-01

    Suspicious lesions on breast MRI are often initially evaluated using targeted ultrasound. However, workup varies. Data on the rate of correlate detection by morphology [mass, non-mass enhancement (NME), or focus] would be useful for developing practice guidelines. Breast MRI examinations from 1 January 2008 to 31 December 2010 were reviewed. BI-RADS 4 or 5 lesions on MRI evaluated with targeted ultrasound where definitive diagnosis was obtained were included. Statistical analysis was performed on aggregate data and at the lesion level. A total of 204 lesions were included in the study. A statistically significant difference in ultrasound correlate identification by morphology was found; a correlate was found in 49.3 % of masses, 15 % of NME, and 42.3 % of foci (p = 0.0006). Additional analysis within each morphology demonstrated significantly greater rate of malignancy in masses with an ultrasound correlate than masses without a correlate (p = 0.0062), while the rate of malignancy in NME and foci did not differ with ultrasound correlation. Morphology of a suspicious lesion on breast MRI affects the probability of identifying an ultrasound correlate. As sonographic correlates are found in nearly half of masses and foci, targeted ultrasound should be the initial step in their workup. (orig.)

  9. Metastatic Breast Cancer or Multiple Myeloma? Camouflage by Lytic Lesions

    Directory of Open Access Journals (Sweden)

    Bruce Hough

    2010-01-01

    Full Text Available We report a case of a female with stage I infiltrating ductal carcinoma who received adjuvant therapy including trastuzumab. One year later she developed lytic lesions and was retreated with trastuzumab that was held after she developed symptomatic heart failure. Lytic lesions were attributed to relapse of breast cancer, and cardiac failure attributed to prior trastuzumab therapy. After complications necessitated multiple hospitalizations, a further workup revealed that the lytic lesions were not metastatic breast cancer but multiple myeloma. Her advanced multiple myeloma was associated with systemic amyloidosis involving gut and heart, which ultimately led to her demise. This report addresses the pitfalls of overlapping symptoms and the question of which patients with suspected metastatic disease should undergo a biopsy.

  10. Primary Pulmonary Lymphoid Lesions: Radiologic and Pathologic Findings.

    Science.gov (United States)

    Sirajuddin, Arlene; Raparia, Kirtee; Lewis, Vanessa A; Franks, Teri J; Dhand, Sabeen; Galvin, Jeffrey R; White, Charles S

    2016-01-01

    The pulmonary lymphoid system is complex and is composed of two compartments: the pulmonary lymphatics and the bronchus-associated lymphoid tissue (BALT). Additional important cells that function in the pulmonary lymphoid system include dendritic cells, Langherhans cells, macrophages, and plasma cells. An appreciation of the normal lymphoid anatomy of the lung as well as its immunology is helpful in understanding the radiologic and pathologic findings of the primary pulmonary lymphoid lesions. Primary lymphoid lesions of the lung arise from the BALT and are uncommon. However, they are increasingly recognized within the growing number of posttransplant patients as well as other patients who are receiving immunosuppressive therapies. Primary lymphoid lesions encompass a wide range of benign and malignant lesions. Benign lymphoid lesions of the lung include reactive lymphoid hyperplasia, follicular bronchiolitis, lymphoid interstitial pneumonia, and nodular lymphoid hyperplasia. Malignant lymphoid lesions of the lung include low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), other non-Hodgkin lymphomas, and Hodgkin lymphoma. Last, a miscellaneous group of primary lymphoid lesions includes lymphomatoid granulomatosis, posttransplant lymphoproliferative disorders, acquired immunodeficiency syndrome (AIDS)-related lymphoma, and intravascular lymphoma/lymphomatosis. These lesions are best evaluated with multidetector chest computed tomography. The radiologic findings of the primary lymphoid lesions are often nonspecific and are best interpreted in correlation with clinical data and pathologic findings. The purpose of this article is to review pulmonary lymphoid anatomy as well as the most common primary pulmonary lymphoid disorders. ©RSNA, 2016.

  11. Cytomorphology of fibrocystic change, high-risk proliferative breast disease, and premalignant breast lesions.

    Science.gov (United States)

    Masood, Shahla

    2005-12-01

    In a prospective study using mammographically guided fine needle aspirates in 100 nonpalpable breast lesions, the author's group assessed the reliability of a cytological grading system to define the cytological features of proliferative and nonproliferative breast disease and to differentiate between benign, premalignant and malignant breast lesions. We developed a cytological grading system evaluating the aspirates for the cellular arrangement, the degrees of cellular pleomorphism and anisonucleosis, presence of myoepithelial cells and nucleoli and the status of the chromatin pattern. This grading system, now recognized as the Masood Cytology Index, is commonly used as a surrogate end point biomarker in chemoprevention trials.

  12. Synchronous Occurrence of Primary Breast Carcinoma and Primary Colon Adenocarcinoma.

    Science.gov (United States)

    Yetkin, Gurkan; Celayir, Fevzi; Akgun, Ismail Ethem; Ucak, Ramazan

    2017-01-01

    A 65-year-old female patient presented to the emergency clinic with abdominal pain, meteorism, and intermittent rectal bleeding. Colonoscopy was performed, and a hepatic flexure tumor was detected. Histopathological examination of biopsy revealed adenocarcinoma. Thoracoabdominal CT was performed for staging, and a spiculated contour mass was found incidentally on the left breast. Mammography and ultrasonography were performed for the cause of these findings, and suspicious lesions of malignancy were seen in the left breast. Invasive ductal carcinoma was detected in core needle biopsy samples from lesions. In the multidisciplinary council consisting of oncologist, pathologist, radiologist, and general surgery specialist, it was decided to perform breast operation first and then colon operation, followed by adjuvant chemotherapy. In the first operation, left total mastectomy and sentinel lymph node biopsy were performed. One week after her initial operation, the patient underwent right hemicolectomy. After operations, the patient did not develop postoperative complications and was sent to medical oncology department for adjuvant chemotherapy.

  13. Magnetic resonance imaging texture analysis classification of primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Waugh, S.A.; Lerski, R.A. [Ninewells Hospital and Medical School, Department of Medical Physics, Dundee (United Kingdom); Purdie, C.A.; Jordan, L.B. [Ninewells Hospital and Medical School, Department of Pathology, Dundee (United Kingdom); Vinnicombe, S. [University of Dundee, Division of Imaging and Technology, Ninewells Hospital and Medical School, Dundee (United Kingdom); Martin, P. [Ninewells Hospital and Medical School, Department of Clinical Radiology, Dundee (United Kingdom); Thompson, A.M. [University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Houston, TX (United States)

    2016-02-15

    Patient-tailored treatments for breast cancer are based on histological and immunohistochemical (IHC) subtypes. Magnetic Resonance Imaging (MRI) texture analysis (TA) may be useful in non-invasive lesion subtype classification. Women with newly diagnosed primary breast cancer underwent pre-treatment dynamic contrast-enhanced breast MRI. TA was performed using co-occurrence matrix (COM) features, by creating a model on retrospective training data, then prospectively applying to a test set. Analyses were blinded to breast pathology. Subtype classifications were performed using a cross-validated k-nearest-neighbour (k = 3) technique, with accuracy relative to pathology assessed and receiver operator curve (AUROC) calculated. Mann-Whitney U and Kruskal-Wallis tests were used to assess raw entropy feature values. Histological subtype classifications were similar across training (n = 148 cancers) and test sets (n = 73 lesions) using all COM features (training: 75 %, AUROC = 0.816; test: 72.5 %, AUROC = 0.823). Entropy features were significantly different between lobular and ductal cancers (p < 0.001; Mann-Whitney U). IHC classifications using COM features were also similar for training and test data (training: 57.2 %, AUROC = 0.754; test: 57.0 %, AUROC = 0.750). Hormone receptor positive and negative cancers demonstrated significantly different entropy features. Entropy features alone were unable to create a robust classification model. Textural differences on contrast-enhanced MR images may reflect underlying lesion subtypes, which merits testing against treatment response. (orig.)

  14. The efficacy of automated breast volume scanning over conventional ultrasonography among patients with breast lesions.

    Science.gov (United States)

    Xiao, Yuan-ming; Chen, Zhi-heng; Zhou, Qi-chang; Wang, Zhiyuan

    2015-12-01

    To compare the efficacy of automated breast volume scanning (ABVS) with that of conventional ultrasonography in the detection of breast cancer lesions. In a retrospective study, patients aged 18-78 years who had breast cancer, had undergone screening using ABVS and conventional ultrasonography, and provided a biopsy sample at a center in Changsha, China, between July 22, 2011, and September 20, 2014, were identified. Results of ultrasonography and ABVS were compared. A total of 417 lesions were detected among 300 patients. Ultrasonography detected 326 lesions, whereas ABVS detected all 417 (Pmicrocalcifications in only two cases, whereas ABVS reported these in eight cases (Pbreast lesions than conventional ultrasonography does. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Imaging Surveillance After Primary Breast Cancer Treatment

    Science.gov (United States)

    Lam, Diana L.; Houssami, Nehmat; Lee, Janie M.

    2017-01-01

    OBJECTIVE Current clinical guidelines are consistent in supporting annual mammography for women after treatment of primary breast cancer. Surveillance imaging beyond standard digital mammography, including digital breast tomosynthesis (DBT), breast ultrasound, and MRI, may improve outcomes. This article reviews the evidence on the performance and effectiveness of breast imaging modalities available for surveillance after treatment of sporadic unilateral primary breast cancer and identifies additional factors to be considered when selecting an imaging surveillance regimen. CONCLUSION Evidence review supports the use of mammography for surveillance after primary breast cancer treatment. Variability exists in guideline recommendations for surveillance initiation, interval, and cessation. DBT offers the most promise as a potential modality to replace standard digital mammography as a front-line surveillance test; a single published study to date has shown a significant decrease in recall rates compared with standard digital mammography alone. Most guidelines do not support the use of whole-breast ultrasound in breast cancer surveillance, and further studies are needed to define the characteristics of women who may benefit from MRI surveillance. The emerging evidence about surveillance imaging outcomes suggests that additional factors, including patient and imaging characteristics, tumor biology and gene expression profile, and choice of treatment, warrant consideration in selecting personalized posttreatment imaging surveillance regimens. PMID:28075622

  16. Aneurysmal bone cyst: a primary or secondary lesion?

    Science.gov (United States)

    Saheeb, B D O; Ojo, M A; Obuekwe, O N

    2007-09-01

    To emphasize the origin of aneurysmal bone cyst as "primary" or "secondary" to other lesions of the jaws and 2. Report two cases of the cyst that illustrate its controversial origin in the hope that it will add to the literature on the subject in Africa. Two cases of aneurysmal bone cyst occurring in the mandible and maxilla are reported. One of the cysts that occurred in a 13-year-old was a primary lesion while the other in a 5-year-old was associated with a cementifying fibroma. The diagnoses of both lesions were confirmed by biopsy. The lesion that occurred in the 13-year-old was treated by curettage while the other in the 5-year-old was treated by excision under general anaesthesia respectively. While the lesion in the 13-year-old was haemorrhagic with 'welling up' of blood, the second lesion though haemorrhagic was not associated with this phenomenon. Both patients were transfused with 2 pints and 1 pint of blood respectively. There has not been recurrence of the lesions after two years post operatively. Aneurysmal bone cyst can arise as a primary lesion or associated with a fibro-osseous lesion as demonstrated by these two cases. There is a need to serially section biopsy specimens of the cyst to detect coexisting lesions.

  17. PLASMINOGEN AND ANGIOSTATIN LEVELS IN FEMALE BENIGN BREAST LESIONS.

    Science.gov (United States)

    Tykhomyrov, A A; Vovchuk, I L; Grinenko, T V

    2015-01-01

    It is known that benign breast tissue exhibit relatively low angiogenic capacity. Activation of angiogenesis in mammary pre-malignant lesions could be associated with disease progression and high risk of transformation into the breast cancer. However, insight into the underlying molecular mechanisms involved in angiogenesis regulation in non-cancerous breast pathologies is still poorly defined. The purpose of the present study was to determine levels of plasminogen and its proteolytic fragments (angiostatins) in mammary dysplasia (mastopathy and breast cyst) and benign neoplasms (fibroadenomas). Plasminogen and angiostatins were analyzed using immunoblotting and quantified by densitometric scanning. The significant increase in plasminogen levels was found in fibrocystic, cysts, and non-proliferatious fibroadenoma masses (4.7-, 3.7-, and 3.5-fold, respectively) compared to healthy breast tissues (control). In the same benign lesions, 6.7-, 4-, and 3.7-fold increase in plasminogen 50 kDa fragment (angiostatin) levels as compared with control were also observed. Activation of matrix metalloproteinase-9, which was detected using gelatine zymography, could be responsible for plasminogen cleavage and abundance of angiostatin infibrocystic and cyst masses. In contrast, dramatic decrease of both plasminogen and angiostatin levels (3.8- and 5.3-folds, respectively) was shown in tissues of proliferatious form of fibroadenoma in comparison with that of the dormant type of this neoplasm. Based on the obtained results, we concluded that angiostatin, a potent vessel growth inhibitor and anti-inflammatory molecule, can play a crucial role in pathophysiology of non-cancerous breast diseases. Further studies are needed to evaluate potential diagnostic and clinical implications of these proteins for prediction and therapy of benign breast pathologies.

  18. Plasminogen and angiostatin levels in female benign breast lesions

    Directory of Open Access Journals (Sweden)

    A. A. Tykhomyrov

    2015-10-01

    Full Text Available It is known that benign breast tissue exhibit relatively low angiogenic capacity. Activation of angiogenesis in mammary pre-malignant lesions could be associated with disease progression and high risk of transformation into the breast cancer. However, insight into the underlying molecular mechanisms involved in angiogenesis regulation in non-cancerous breast pathologies is still poorly defined. The purpose of the present study was to determine levels of plasminogen and its proteolytic fragments (angiostatins in mammary dysplasia (mastopathy and breast cyst and benign neoplasms (fibroadenomas. Plasminogen and angiostatins were analyzed using immunoblotting and quantified by densitometric scanning. The significant increase in plasminogen levels was found in fibrocystic, cysts, and non-proliferatious fibroadenoma masses (4.7-, 3.7-, and 3.5-fold, respectively compared to healthy breast tissues (control. In the same benign lesions, 6.7-, 4-, and 3.7-fold increase in plasminogen 50 kDa fragment (angiostatin levels as compared with control were also observed. Activation of matrix metalloproteinase-9, which was detected using gelatine zymography, could be responsible for plasminogen cleavage and abundance of angiostatin in fibrocystic and cyst masses. In contrast, dramatic decrease of both plasminogen and angiostatin levels (3.8- and 5.3-folds, respectively was shown in tissues of proliferatious form of fibroadenoma in comparison with that of the dormant type of this neoplasm. Based on the obtained results, we concluded that angiostatin, a potent vessel growth inhibitor and anti-inflammatory molecule, can play a crucial role in pathophysiology of non-cancerous breast diseases. Further studies are needed to evaluate potential diagnostic and clinical implications of these proteins for prediction and therapy of benign breast pathologies.

  19. Loss of primary cilia occurs early in breast cancer development

    Science.gov (United States)

    2014-01-01

    Background Primary cilia are microtubule-based organelles that protrude from the cell surface. Primary cilia play a critical role in development and disease through regulation of signaling pathways including the Hedgehog pathway. Recent mouse models have also linked ciliary dysfunction to cancer. However, little is known about the role of primary cilia in breast cancer development. Primary cilia expression was characterized in cancer cells as well as their surrounding stromal cells from 86 breast cancer patients by counting cilia and measuring cilia length. In addition, we examined cilia expression in normal epithelial and stromal cells from reduction mammoplasties as well as histologically normal adjacent tissue for comparison. Results We observed a statistically significant decrease in the percentage of ciliated cells on both premalignant lesions as well as in invasive cancers. This loss of cilia does not correlate with increased proliferative index (Ki67-positive cells). However, we did detect rare ciliated cancer cells present in patients with invasive breast cancer and found that these express a marker of basaloid cancers that is associated with poor prognosis (Cytokeratin 5). Interestingly, the percentage of ciliated stromal cells associated with both premalignant and invasive cancers decreased when compared to stromal cells associated with normal tissue. To understand how cilia may be lost during cancer development we analyzed the expression of genes required for ciliogenesis and/or ciliary function and compared their expression in normal versus breast cancer samples. We found that expression of ciliary genes were frequently downregulated in human breast cancers. Conclusions These data suggest that primary cilia are lost early in breast cancer development on both the cancer cells and their surrounding stromal cells. PMID:24987519

  20. ANEURYSMAL BONE CYST: A PRIMARY OR SECONDARY LESION?

    African Journals Online (AJOL)

    the literature on the subject in Africa. ~. Report: Two cases of aneurysmal bone cyst occurring in the mandible and maxilla are reported. One of the cysts that occurred in a 13-year-old was a primary lesion while the other in a 5-year-old was associated with a cementifying fibroma. Method: The diagnoses of both lesions were ...

  1. Spatial frequency domain imaging for monitoring palpable breast lesions

    Science.gov (United States)

    Robbins, Constance M.; Antaki, James F.; Kainerstorfer, Jana M.

    2017-02-01

    We describe a novel approach for monitoring breast lesions, utilizing spatial frequency domain imaging, a diffuse optical imaging method to detect hemoglobin contrast, in combination with mechanical compression of the tissue. The project is motivated by the growing rate of unnecessary breast biopsies, caused by uncertainty in X-ray mammographic diagnoses. We believe there is a need for an alternate means of tracking the progression palpable lesions exhibiting probably benign features, that can be performed non-invasively and hence frequently: at home or in the clinic. The proposed approach capitalizes on two distinguishing properties of cancerous lesions, namely the relative stiffness with respect to surrounding tissue and the optical absorption due to the greater vascularization, hence hemoglobin concentration. The current research project is a pilot study to evaluate the principle on soft, breast tissue-mimicking phantoms containing stiffer, more highly absorbing inclusions. Spatial frequency domain imaging was performed by projecting onto the phantom a series of wide-field patterns at multiple spatial frequencies. Image analysis then was performed to map absorption and scattering properties. The results of the study demonstrate that compression significantly increases the optical contrast observed for inclusions located 10 and 15 mm beneath the surface. In the latter case, the inclusion was not detectable without compression.

  2. Genetic Alterations in Presumptive Precursor Lesions of Breast Carcinomas

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    Michaela Aubele

    2002-01-01

    Full Text Available The hypothetical multistep model of breast carcinogenesis suggests a transition from normal epithelium to invasive carcinoma via intraductal hyperplasia (without and with atypia and in situcarcinoma. These presumptive precursor lesions are currently defined by their histological features, and their prognosis is imprecisely estimated from indirect epidemiological evidence. Cytogenetic and molecular‐genetic analysis of these lesions give evidence for an accumulation of various genetic alterations during breast tumorigenesis. Using immuno‐histochemistry overexpression of the c‐erbB‐2 oncogene was found in ductal carcinoma in situ(DCIS, but not in atypical intraductal hyperplasia (AIDH and intraductal hyperplasia (IDH. An expression of mutant p53 tumor suppressor gene as well as expression of cyclin D1 was identified in DCIS. In IDH lesions loss of heterozygosity (LOH at various loci could be identified, and comparative genomic hybridization (CGH and fluorescence in situhybridization (FISH studies delivered evidence for DNA amplification on chromosomal region 20q13 in the early stage of IDH. However, little is currently known about genetic alterations in those premalignant lesions, and the chronology of genetic alterations and histopathological changes during carcinogenesis is mainly undiscovered. Figure 1 can be viewed in colour on http://www.esacp.org/acp/2002/24‐23/aubele.htm

  3. Primary osteogenic sarcoma of the breast

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    Akang Effiong E

    2006-12-01

    Full Text Available Abstract Background Primary extra-osseous osteogenic sarcomas have been reported in many tissues of the body but their occurrence in the breast is extremely rare. It can arise as a result of osseous metaplasia in a pre-existing benign or malignant neoplasm of the breast or as non-phylloides sarcoma from the soft tissue of a previously normal breast. Case presentation A 40 year-old Nigerian woman was clinically diagnosed to have carcinoma of the left breast. The histology report of core-needle biopsy of the mass showed a malignant neoplasm comprising islands of chondroblastic and osteoblastic stromal cells. This report changed the diagnosis from carcinoma to osteogenic sarcoma of the breast. She had a left modified radical mastectomy, however there was significant post surgery skin deficit. A latissimus dorsi musculocutaneous flap was used to cover the anterior chest wall defect. Sections from the mastectomy specimen confirmed the diagnosis of osteogenic sarcoma. She died six months after mastectomy. Conclusion A diagnosis of osteogenic sarcoma of the breast was made based on histology report and after excluding an osteogenic sarcoma arising from underlying ribs and sternum. This is the second documented case of primary osteogenic sarcoma of the breast coming from Nigeria

  4. Targeting Premalignant Lesions - Implications for Early Breast Cancer Detection and Intervention

    Science.gov (United States)

    2017-04-01

    AWARD NUMBER: W81XWH-14-1-0032 TITLE: Targeting Premalignant Lesions - Implications for Early Breast Cancer Detection and Intervention PRINCIPAL...Mar 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Targeting Premalignant Lesions - Implications for Early Breast Cancer Detection and...12. DISTRIBUTION / AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Breast cancer

  5. Synchronous Occurrence of Primary Breast Carcinoma and Primary Colon Adenocarcinoma

    OpenAIRE

    Gurkan Yetkin; Fevzi Celayir; Ismail Ethem Akgun; Ramazan Ucak

    2017-01-01

    A 65-year-old female patient presented to the emergency clinic with abdominal pain, meteorism, and intermittent rectal bleeding. Colonoscopy was performed, and a hepatic flexure tumor was detected. Histopathological examination of biopsy revealed adenocarcinoma. Thoracoabdominal CT was performed for staging, and a spiculated contour mass was found incidentally on the left breast. Mammography and ultrasonography were performed for the cause of these findings, and suspicious lesions of malignan...

  6. Differential diagnosis of breast lesions using ultrasound elastography

    Directory of Open Access Journals (Sweden)

    Ioana Andreea Gheonea

    2011-01-01

    Full Text Available Context: The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR index, improves diagnostic accuracy and decreased number of biopsies. Aims: The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions. Settings and Design: This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova. Materials and Methods: Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score. Statistical Analysis: We performed receiver operator characteristic (ROC analysis for assessment of the role of USG elastography in the diagnosis of breast lesions. Results: We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used. There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911. Conclusions: Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.

  7. Imaging of precursor lesions of the female breast; Bildgebung und Vorgehen bei praeinvasiven Laesionen der Mamma

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, Stefanie [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie; Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammografie; Decker, Thomas [Dietrich-Bonhoeffer-Klinikum Neubrandenburg, Neubrandenburg (Germany). Inst. fuer Pathologie; Heindel, Walter [Universitaetsklinikum Muenster (Germany). Referenzzentrum Mammografie; Muenster Univ. (Germany). Medizinische Fakultaet

    2012-06-15

    Precursor lesions of the breast are biologically and clinically heterogeneous neoplastic lesions with a varying risk for progression to an invasive breast cancer. This review presents definitions, diagnostic criteria and concepts for the clinical management of the following lesions: ductal carcinoma in situ (DCIS), atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), lobular neoplasia (LN). (orig.)

  8. Significant differentiation of focal breast lesions: calculation of strain ratio in breast sonoelastography.

    Science.gov (United States)

    Thomas, Anke; Degenhardt, Friedrich; Farrokh, André; Wojcinski, Sebastian; Slowinski, Torsten; Fischer, Thomas

    2010-05-01

    Initial data suggest that elastography can improve the specificity of ultrasound in differentiating benign and malignant breast lesions. The aim of this study was to compare elastography and B-mode ultrasound to determine whether the calculation of strain ratios (SRs) can further improve the differentiation of focal breast lesions. A total of 227 women with histologically proven focal breast lesions (113 benign, 114 malignant) were included at two German breast centers. The women underwent a standardized ultrasound procedure using a high-end ultrasound system with a 9-MHz broadband linear transducer. B-mode scans and sonoelastograms were analyzed by two experienced readers using the Breast Imaging Reporting and Data System criteria. SRs were calculated from a tumor-adjusted region of interest (mean color pixel density) and a comparable region of interest placed in the lateral fatty tissue. Sensitivity, specificity, and cutoff values were calculated for SRs (receiver-operating characteristic analysis). The women had a mean age of 54 years (range, 19-87 years). The mean lesion diameter was 1.6 +/- 0.9 cm. Sensitivity and specificity were 96% and 56% for B-mode scanning, 81% and 89% for elastography, and 90% and 89% for SRs. An SR cutoff value of 2.45 (area under the curve, 0.949) allowed significant differentiation (P calculation was superior to subjective interpretation of sonoelastograms and B-mode scans, with a positive predictive value of 89% compared to 68% and 84% for the other two methods. Calculation of SRs contributes to the standardization of sonoelastography with high sensitivity and allows significant differentiation of benign and malignant breast lesions with higher specificity compared to B-mode ultrasound but not elastography. Copyright 2010 AUR. Published by Elsevier Inc. All rights reserved.

  9. Contrast-enhanced spectral mammography (CESM) versus breast magnetic resonance imaging (MRI): A retrospective comparison in 66 breast lesions.

    Science.gov (United States)

    Li, L; Roth, R; Germaine, P; Ren, S; Lee, M; Hunter, K; Tinney, E; Liao, L

    2017-02-01

    The purpose of this study was to retrospectively compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with that of breast magnetic resonance imaging (BMRI) in breast cancer detection using parameters, including sensitivity, positive predictive value (PPV), lesion size, morphology, lesion and background enhancement, and examination time. A total of 48 women (mean age, 56years±10.6 [SD]) with breast lesions detected between October 2012 and March 2014 were included. Both CESM and BMRI were performed for each patient within 30 days. The enhancement intensity of lesions and breast background parenchyma was subjectively assessed for both modalities and was quantified for comparison. Statistical significance was analyzed using paired t-test for mean size of index lesions in all malignant breasts (an index lesion defined as the largest lesion in each breast), and a mean score of enhancement intensity for index lesions and breast background. PPV, sensitivity, and accuracy were calculated for both CESM and BMRI. The average duration time of CESM and MRI examinations was also compared. A total of 66 lesions were identified, including 62 malignant and 4 benign lesions. Both CESM and BMRI demonstrated a sensitivity of 100% for detection of breast cancer. There was no statistically significant difference between the mean size of index lesions (P=0.108). The enhancement intensity of breast background was significantly lower for CESM than for BMRI (P0.05). The average examination time for CESM was significantly shorter than that of BMRI (P<0.01). CESM has similar sensitivity than BMRI in breast cancer detection, with higher PPV and less background enhancement. CESM is associate with significantly shorter exam time thus a more accessible alternative to BMRI, and has the potential to play an important tool in breast cancer detection and staging. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights

  10. Histopathologic Patterns of Breast Lesions in Northern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hussain Gadelkarim Ahmed

    2017-10-01

    Full Text Available Objective: The aim of this study was to find out the prevalence rates of common types of breast cancer in Northern Saudi Arabia. Methodology: A retrospective cohort study was carried out over a five-year period in two referral hospitals. In this study 257 files were retrieved from departments of Surgery from different hospitals in Hail region, Kingdom of Saudi Arabia (KSA. Results: Of the 257 samples diagnosed using Fine Needle Aspiration Cytology (FNAC, histopathological diagnosis was confirmed for 158 patients. Of the 158 diagnosed samples, 46/158 (23.2% were ductal carcinoma, 7/158 (4.4% were lobular carcinoma, 3/158 (1.9% were mixed tumours, and 102/158 (64.6 were fibroadenoma. Conclusion: Fibroadenoma and ductal carcinoma are the prevalent breast lesions in Hail Region of Saudi Arabia.

  11. The impact of breast structure on lesion detection in breast tomosynthesis

    Science.gov (United States)

    Kiarashi, Nooshin; Nolte, Loren W.; Lo, Joseph Y.; Segars, William P.; Ghate, Sujata V.; Samei, Ehsan

    2015-03-01

    Virtual clinical trials (VCT) can be carefully designed to inform, orient, or potentially replace clinical trials. The focus of this study was to demonstrate the capability of the sophisticated tools that can be used in the design, implementation, and performance analysis of VCTs, through characterization of the effect of background tissue density and heterogeneity on the detection of irregular masses in digital breast tomosynthesis. Twenty breast phantoms from the extended cardiactorso (XCAT) family, generated based on dedicated breast computed tomography of human subjects, were used to extract a total of 2173 volumes of interest (VOI) from simulated tomosynthesis images. Five different lesions, modeled after human subject tomosynthesis images, were embedded in the breasts, for a total of 6×2173 VOIs with and without lesions. Effects of background tissue density and heterogeneity on the detection of the lesions were studied by implementing a doubly composite hypothesis signal detection theory paradigm with location known exactly, lesion known exactly, and background known statistically. The results indicated that the detection performance as measured by the area under the receiver operating characteristic curve (ROC) deteriorated as density was increased, yielding findings consistent with clinical studies. The detection performance varied substantially across the twenty breasts. Furthermore, the log-likelihood ratio under H0 and H1 seemed to be affected by background tissue density and heterogeneity differently. Considering background tissue variability can change the outcomes of a VCT and is hence of crucial importance. The XCAT breast phantoms can address this concern by offering realistic modeling of background tissue variability based on a wide range of human subjects.

  12. Evaluation of a Hanging-Breast PET System for Primary Tumor Visualization in Patients With Stage I-III Breast Cancer: Comparison With Standard PET/CT.

    Science.gov (United States)

    Teixeira, Suzana C; Rebolleda, José Ferrér; Koolen, Bas B; Wesseling, Jelle; Jurado, Raúl Sánchez; Stokkel, Marcel P M; Del Puig Cózar Santiago, María; van der Noort, Vincent; Rutgers, Emiel J Th; Valdés Olmos, Renato A

    2016-06-01

    The purposes of this study were to evaluate the performance of a mammography with molecular imaging PET (MAMMI-PET) system for breast imaging in the hanging-breast position for the visualization of primary breast cancer lesions and to compare this method with whole-body PET/CT. Between March 2011 and March 2014, a prospective evaluation included women with one or more histologically confirmed primary breast cancer lesions (index lesions). After injection of 180-240 MBq of (18)F-FDG, whole-body PET/CT and MAMMI-PET acquisitions were performed, index lesions were scored 0, 1, or 2 for FDG uptake relative to background. Detection and FDG uptake were compared by breast length, maximal tumor diameter, affected breast quadrants, tumor grade, and histologic and immunologic sub-types. Finally, the two PET modalities were compared for detection of index lesions. For 234 index lesions (diameter, 5-170 mm), the overall sensitivity was 88.9% for MAMMI-PET and 91% for PET/CT (p = 0.61). Twenty-three (9.8%) index lesions located too close to the pectoral muscle were missed with MAMMI-PET, and 20 index lesions were missed with PET/CT. Lesion visibility on MAMMI-PET images was influenced by tumor grade (p = 0.034) but not by cancer subtype (p = 0.65). Although in an overall evaluation MAMMI-PET was not superior to PET/CT, MAMMI-PET does have higher sensitivity for primary breast cancer lesions within the scanning range of the device. Optimization of the positioning device may increase visualization of the most dorsal lesions.

  13. Synchronous Occurrence of Primary Breast Carcinoma and Primary Colon Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Gurkan Yetkin

    2017-01-01

    Full Text Available A 65-year-old female patient presented to the emergency clinic with abdominal pain, meteorism, and intermittent rectal bleeding. Colonoscopy was performed, and a hepatic flexure tumor was detected. Histopathological examination of biopsy revealed adenocarcinoma. Thoracoabdominal CT was performed for staging, and a spiculated contour mass was found incidentally on the left breast. Mammography and ultrasonography were performed for the cause of these findings, and suspicious lesions of malignancy were seen in the left breast. Invasive ductal carcinoma was detected in core needle biopsy samples from lesions. In the multidisciplinary council consisting of oncologist, pathologist, radiologist, and general surgery specialist, it was decided to perform breast operation first and then colon operation, followed by adjuvant chemotherapy. In the first operation, left total mastectomy and sentinel lymph node biopsy were performed. One week after her initial operation, the patient underwent right hemicolectomy. After operations, the patient did not develop postoperative complications and was sent to medical oncology department for adjuvant chemotherapy.

  14. The utility of the "bull's-eye" artifact on breast elasticity imaging in reducing breast lesion biopsy rate.

    Science.gov (United States)

    Barr, Richard G; Lackey, Amanda E

    2011-09-01

    The objectives of the study were to evaluate the accuracy of the "bull's-eye" artifact of elasticity imaging (EI) in determining the benignity of cystic breast lesions and to determine the utility of such artifact in reducing the biopsy rate of the benign lesions. This study was performed under local institutional review board supervision and was in compliance with the Health Insurance Portability and Accountability Act of 1996. A retrospective review of 383 breast lesions from 309 consecutive patients undergoing diagnostic breast ultrasonography with EI (Siemens Antares or Siemens S2000; Siemens Healthcare, Mountain View, Calif) was conducted. The B-mode characteristics of those lesions determined whether biopsy was conducted. Pathological reports of the biopsied lesions were reviewed. Lesions demonstrating the bull's-eye artifact on EI were determined. The accuracy of the artifact in determining the benignity of cystic breast lesions was determined. Of the 383 lesions, 243 lesions were recommended for biopsy based on the B-mode characteristics (biopsy rate, 63.4%). Of those 243 lesions, 62 lesions demonstrated the bull's-eye artifact on EI, and all were confirmed benign cysts on pathological reports. Of the 181 lesions without the artifact, 116 were benign noncystic lesions, and 65 were malignant noncystic lesions. Hence, within the biopsied lesions, the bull's-eye artifact had perfect sensitivity, specificity, and positive predictive value in determining pathologically proven benign cysts. If the artifact can be used as a criterion to exclude lesions from biopsy, then the biopsy rate will be 181 (47.3%) of 383, significantly lower than the 63.4% biopsy rate without using this criteria (P breast cysts and has the potential to significantly reduce the amount of unnecessary breast biopsy.

  15. CYTOLOGICAL EVALUATION OF MALE BREAST LESIONS IN GREATER GWALIOR : A FIVE YEAR RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jagannath

    2015-03-01

    Full Text Available BACKGROUNDS: Fine needle aspiration cytology is an effective modality for diagnosis of breast lesions. Usually male breast lesions are benign and affect the young male. Most common lesion is gynaecomastia. Male breast cancer accounts for a small proportion of breast cancers. Male breast cancer usually presents at an advanced age. OBJECTIVE: The aim of this study was to examine the nature of male breast lesions and to determine the cytomorphologic patterns of these lesions. MET HODS: five year retrospective study was conducted in our institution and in that 112 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified as benign, inf lammatory, malignant and others. RESULTS: In 112 male patients diagnosed with breast lesions, the most common lesion was gynecomastia (103/112, 91.9%, followed by breast cancer (6/112, 5.4%, inflammatory (2/112, 1.8% and apocrine metaplasia (01/112, 0.9 %. Gynecomastia was commonly found in male patients less than 40 years of age, while breast cancer is seen in male patients over 40 years of age

  16. Usefulness of serum CA-15.3 in the management of benign breast lesion.

    Science.gov (United States)

    Mondal, Hari Pada; Roy, Himanshu; Mondal, Palash; Saha, Mita; Basu, Nandita

    2012-04-01

    Benign breast lesion is an important risk factor for breast cancer and elevated CA-15.3 in serum is a well established marker of breast cancer. Core-needle biopsy is now the method of choice to sample non-palpable mammographic abnormality and as well as clinically palpable lesion. To asses relationship of serum CA-15.3 with different histologic entities of benign breast lesion and usefulness of this marker in predicting breast cancer in this high risk group, a study was conducted among 140 patients who had a diagnosis of benign breast lesion and malignancy following fine needle aspiration cytology (FNAC) at department of surgery, Medical College, Kolkata between 2007 and 2009. We prospectively estimated serum CA-15.3 level in all patients. Different histologic entities of benign breast lesion, who showed serum CA-15.3 level >30U/ml underwent tru-cut biopsy to detect malignancy. Of 140 patients studied, 50 were stamped as malignancy and 90 as benign after FNAC of which 20 patients had fibroadenoma, 25 had fibro-adenoma with fibrocystic disease, 20 had fibrocystic disease with epitheliosis and 25 had fibrocystic disease with atypia. All breast cancer patients and 10 each from fibro-adenoma with fibrocystic disease, fibrocystic disease with epitheliosis and fibrocystic disease with atypia had serum CA -15.3 level>30U/ml. Thirty patients with benign breast lesion who had raised CA-15.3 underwent core-needle biopsy. Fifteen patients were detected to have intraductal carcinoma, mostly with fibrocystic disease with atypia. Clinical applicability of serum CA-15.3 to detect breast cancer should be strongly considered in management of patients with benign breast lesion and tru-cut biopsy than FNAC be done before benign breast lesion being stamped as benign. Biopsy results that are not concordant with the targeted lesion require surgical biopsy.

  17. Radioguided Surgery for Localization of Nonpalpable Breast Lesions A Mini-Review

    DEFF Research Database (Denmark)

    Langhans, Linnea; Klausen, Thomas Levin; Tvedskov, Tove Filtenborg

    2016-01-01

    The majority of patients with nonpalpable breast lesions are eligible for breast conserving surgery guided by some kind of lesion localization. The current standard is wire-guided localization (WGL) even though it has several disadvantages, the most important one being the considerable proportion...

  18. iROLL: does 3-D radioguided occult lesion localization improve surgical management in early-stage breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Bluemel, Christina; Kajdi, Georg W.; Schmid, Jan; Buck, Andreas K.; Herrmann, Ken [University Hospital of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Cramer, Andreas; Grossmann, Christoph; Grimminger, Hanns-Joerg [Missionsaerztliches Klinikum Wuerzburg, Department of Obstetrics and Gynecology, Wuerzburg (Germany); Malzahn, Uwe [University of Wuerzburg, Institute of Clinical Epidemiology and Biometry, Wuerzburg (Germany); Lamp, Nora [University of Wuerzburg, Institute of Pathology, Wuerzburg (Germany); Langen, Heinz-Jakob [Missionsaerztliches Klinikum Wuerzburg, Department of Radiology, Wuerzburg (Germany)

    2015-10-15

    To prospectively evaluate the feasibility of 3-D radioguided occult lesion localization (iROLL) and to compare iROLL with wire-guided localization (WGL) in patients with early-stage breast cancer undergoing breast-conserving surgery and sentinel lymph node biopsy (SLNB). WGL (standard procedure) and iROLL in combination with SLNB were performed in 31 women (mean age 65.1 ± 11.2 years) with early-stage breast cancer and clinically negative axillae. Patient comfort in respect of both methods was assessed using a ten point scale. SLNB and iROLL were guided by freehand SPECT (fhSPECT). The results of the novel 3-D image-based method were compared with those of WGL, ultrasound-based lesion localization, and histopathology. iROLL successfully detected the malignant primary and at least one sentinel lymph node in 97 % of patients. In a single patient (3 %), only iROLL, and not WGL, enabled lesion localization. The variability between fhSPECT and ultrasound-based depth localization of breast lesions was low (1.2 ± 1.4 mm). Clear margins were achieved in 81 % of the patients; however, precise prediction of clear histopathological surgical margins was not feasible using iROLL. Patients rated iROLL as less painful than WGL with a pain score 0.8 ± 1.2 points (p < 0.01) lower than the score for iROLL. iROLL is a well-tolerated and feasible technique for localizing early-stage breast cancer in the course of breast-conserving surgery, and is a suitable replacement for WGL. As a single image-based procedure for localization of breast lesions and sentinel nodes, iROLL may improve the entire surgical procedure. However, no advantages of the image-guided procedure were found with regard to prediction of complete tumour resection. (orig.)

  19. Benign breast lesions in Bayelsa State, Niger Delta Nigeria: a 5 year multicentre histopathological audit.

    Science.gov (United States)

    Uwaezuoke, Stanley Chibuzo; Udoye, Ezenwa Patrick

    2014-01-01

    There has been no previous study to classify benign breast lesions in details based on histopathologically confirmed diagnosis in Bayelsa State, Nigeria. This study therefore aims to review all cases of benign breast lesions seen in all the three centres in Bayelsa State with histopathology services over a five year period for a comprehensive baseline data in our community for management, research and education. This is a multicentre retrospective descriptive study based on histopathological diagnosed benign breast lesions from January 2009 to December 2013. Archival results and slides on benign breast lesions were retrieved and analysed using simple statistical methods. A total of 228 benign breast lesions (68.3%) were seen among 334 histopathologically diagnosed breast diseases. The male to female ratio was 19.7:1. Peak age incidence was the third decade (43%) with a mean age of 29.1years. Fibroadenoma was the most common benign breast disease (BBD) accounting for 45.6% of all the cases followed by fibrocystic change (23.1%). The mean ages of fibroadenoma and fibrocystic change were 23.1years and 31.1years respectively. Inflammatory breast lesions constituted 8.3%. We recorded only 2 cases (0.9%) of atypical ductal hyperplasia (ADH) with no case of atypical lobular hyperplasia (ALH) within the study period. Gynaecomastia (4%) was the main male breast lesion in the study. Benign breast diseases are the most common breast lesions in Bayelsa State. Fibroadenoma is the most common lesion followed by fibrocystic change. The incidence of atypical hyperplasia recorded was rather low in the state.

  20. Targeting Premalignant Lesions: Implications for Early Breast Cancer Detection and Intervention

    Science.gov (United States)

    2016-04-01

    1 AWARD NUMBER: W81XWH-14-1-0032 TITLE: Targeting Premalignant Lesions : Implications for Early Breast Cancer Detection and Intervention...2015 – 31 Mar 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-14-1-0032 Targeting Premalignant Lesions : Implications for Early Breast...carcinoma. In this study, we aimed to identify peptides that specifically recognize premalignant lesions in the mammary tissue. To achieve this goal, we

  1. Concomitant primary breast carcinoma and primary choroidal melanoma: a case report

    Directory of Open Access Journals (Sweden)

    Jayaram Hari

    2008-03-01

    Full Text Available Abstract Introduction Choroidal melanoma and choroidal metastasis are distinct pathological entities with very different treatments and prognoses. They may be difficult to distinguish to the untrained observer. Case presentation A case of concomitant choroidal melanoma in a woman with primary breast carcinoma is described. The choroidal lesion was thought initially to be a metastasis, and treated with external beam radiotherapy. The tumour did not regress but remained stable in size for a period of three years. Following referral to an ophthalmologist, the diagnosis was revised after re-evaluation of the clinical, ultrasonographic and angiographic findings. Conclusion Although metastases are the most common ocular tumour, a differential diagnosis of a concurrent primary ocular malignancy should always be considered, even in patients with known malignant disease. Thorough ophthalmic evaluation is important, as multiple primary malignancies may occur concomitantly. The prognostic and therapeutic implications of accurate diagnosis by an ophthalmologist are of profound significance to affected patients and their families.

  2. Efficacy and safety of breast radiothermometry in the differential diagnosis of breast lesions.

    Science.gov (United States)

    Caferova, Sahnaz; Uysal, Fatma; Balcı, Pınar; Saydam, Serdar; Canda, Tülay

    2014-01-01

    The aim of this study is to research the contribution of radiothermometry (RTM) to the characterization of breast masses, the differentiation of malignant-benign masses and diagnosis of early stage breast cancer. This prospective study comprised 182 cases of patients diagnosed with a breast mass and a control group of 55 cases: a total of 237. When histopathology is accepted as the gold standard among diagnostic methods, the sensitivity, specificity, and positive-negative predictive value for RTM were 90.9%, 20.8%, 61.2% and 62.5%, respectively. Consistency was 0.129. When compared with mammography the same values for RTM examination are 87%, 81.4%, 58% and 95.5%. Consistency was 0.582. Evaluating with respect to size of the mass accepting mammography as the gold standard, RTM examination had sensitivity, specificity, positive and negative predictive values for masses 2 cm and above of 88.9%, 83.3%, 88.9% and 83.3%. Consistency was 0.722. The consistency of RTM for lesion diagnosis in BI-RADS II breast structure is higher than the consistency of mammography. Identification of lesions in the breast and presence of microcalcification by RTM shows that it is more trustworthy compared to mammography. When compared with mammography the validity results for RTM show there is a good level of conformity between the two methods. When evaluated based on the area below the ROC cure and compared to mammography, RTM is sufficiently successful at evaluating positive and negative cases.

  3. Radio-guided localization of clinically occult breast lesions: current modalities and future directions.

    Science.gov (United States)

    Aydogan, Fatih; Velidedeoglu, Mehmet; Kilic, Fahrettin; Yilmaz, Halit

    2014-01-01

    The extensive availability of breast cancer screening programs and improvement in diagnostic imaging have led to more frequent detection of suspicious and clinically occult breast lesions. Early detection of tumor is important for breast-conserving treatment. Incomplete excision is a major risk factor for local recurrence. Following precise localization and removing the entire lesion while achieving adequate clear margins is the key factor for successful management of non-palpable breast lesions. For this purpose, several techniques such as wire-guided localization, intra-operative ultrasound guided resection, radio-guided occult lesion localization and radioactive seed localization have been described and applied. In this article, we overview the two commonly used localization techniques, radio-guided occult lesion localization and wire-guided localization, particularly describing their advantages and drawbacks.

  4. Breast ultrasound elastography-Results of 193 breast lesions in a prospective study with histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, F.K.W., E-mail: fschaefer@email.uni-kiel.de [Breast Centre, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 3/Haus 24, 24105 Kiel (Germany); Heer, I.; Schaefer, P.J.; Mundhenke, C.; Osterholz, S.; Order, B.M.; Hofheinz, N.; Hedderich, J.; Heller, M.; Jonat, W.; Schreer, I. [Breast Centre, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller-Str. 3/Haus 24, 24105 Kiel (Germany)

    2011-03-15

    Purpose: To evaluate the diagnostic performance of ultrasound elastography in breast masses. Material and methods: 193 lesions (129 benign, 64 malignant) were analyzed with the EUB 8500 Logos-ultrasonic-unit (Hitachi Medical, Japan) and a linear-array-transducer of 7.5-13-MHz. Standard of reference was cytology (FNAfine needle aspiration) or histology (core biopsy). The elastic-score was classified according to a 6-point colour-scale (Ueno classification; 1-3 = benign, 4-5 = malignant). Conventional B-mode ultrasound (US) findings were classified according to the BI-RADS classification. Statistical analysis included sensitivity, specificity, ROC-analysis and kappa-values for intra-/interobserver reliability. Results: The mean score for elasticity was 4.1 {+-} 0.9 for malignant lesions, and 2.1 {+-} 1.0 for benign lesions (p < 0.001). With a best cut-off point between elasticity scores 3 and 4, sensitivity was 96.9%, and specificity 76%. Setting a best cut-off point for conventional US between BI-RADS 4 and 5, sensitivity was 57.8%, and specificity 96.1%. Elastography provided higher sensitivity and lower specificity than conventional US, but two lesions with elasticity score 1 were false negative, whereas no lesion scored BI-RADS 1-3 were false negative. ROC-curve was 0.884 for elastography, and 0.820 for conventional US (p < 0.001). Weighted kappa-values for intra-/interobserver reliability were 0.784/0.634 for BI-RADS classification, and 0.720/0.561 for elasticity scores. Conclusion: In our study setting, elastography does not have the potential to replace conventional B-mode US for the detection of breast cancer, but may complement conventional US to improve the diagnostic performance.

  5. Occult Primary Neuroendocrine Tumor Metastasis to the Breast Detected on Screening Mammogram

    Directory of Open Access Journals (Sweden)

    Fabiana Policeni

    2016-01-01

    Full Text Available Metastatic tumors are rare in the breast. Well-differentiated neuroendocrine tumors (WDNETs are slow-growing neoplasms that arise from neuroendocrine cells, particularly in the gastrointestinal tract and bronchial tree. Metastatic WDNET to the breast is a rare entity. We present a case report of ileal WDNET metastatic to the breast which was initially identified as a small mass in the patient′s left breast on screening mammography. Targeted ultrasound identified a suspicious mass, and ultrasound-guided percutaneous core biopsy was performed. Pathology revealed metastatic WDNET. Breast magnetic resonance imaging (MRI was then performed and demonstrated left axillary Level 2 lymphadenopathy, and liver lesions were suspicious for metastasis. The patient underwent abdominal computed tomography (CT to evaluate for distant metastatic disease. A spiculated mass was found near the ileocecal valve, suggestive of primary ileal WDNET. In addition, CT identified multiple liver lesions, most compatible with metastasis. Indium 111 OctreoScan confirmed radiotracer uptake in the ileum consistent with primary neuroendocrine tumor. In this report, we review the imaging characteristics of metastatic WDNET to the breast by different imaging modalities including mammogram, ultrasound, and breast MRI.

  6. Male breast cancer precursor lesions : Analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program

    NARCIS (Netherlands)

    Doebar, Shusma C.; Slaets, Leen; Cardoso, Fatima; Giordano, Sharon H.; Bartlett, John M. S.; Tryfonidis, Konstantinos; Dijkstra, Nizet H.; Schroder, Caroline P.; van Asperen, Christi J.; Linderholm, Barbro; Benstead, Kim; Dinjens, Winan N. M.; van Marion, Ronald; van Diest, Paul J.; Martens, John W. M.; van Deurzen, Carolien H. M.

    In men, data regarding breast cancer carcinogenesis are limited. The aim of our study was to describe the presence of precursor lesions adjacent to invasive male breast cancer, in order to increase our understanding of carcinogenesis in these patients. Central pathology review was performed for 1328

  7. Male breast cancer precursor lesions : Analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program

    NARCIS (Netherlands)

    Doebar, Shusma C.; Slaets, Leen; Cardoso, Fatima; Giordano, Sharon H.; Bartlett, John M.S.; Tryfonidis, Konstantinos; Dijkstra, Nizet H.; Schröder, Caroline P.; van Asperen, Christi J.; Linderholm, Barbro; Benstead, Kim; Dinjens, Winan N.M.; van Marion, Ronald; Van Diest, Paul J.; Martens, John W. M.; van Deurzen, Carolien H M

    2017-01-01

    In men, data regarding breast cancer carcinogenesis are limited. The aim of our study was to describe the presence of precursor lesions adjacent to invasive male breast cancer, in order to increase our understanding of carcinogenesis in these patients. Central pathology review was performed for 1328

  8. Fine needle aspiration cytologic diagnosis of axillary accessory breast tissue, including its physiologic changes and pathologic lesions.

    Science.gov (United States)

    Das, D K; Gupta, S K; Mathew, S V; Sheikh, Z A; al-Rabah, N A

    1994-01-01

    Sixty-nine cases of axillary accessory breast tissue, including its physiologic changes and pathologic lesions, were diagnosed by fine needle aspiration cytology. The age of the patients ranged from 13 to 40 years, with a median of 25, and all were female. The cases presented with swellings in the left axilla in 16 cases, right axilla in 30 cases and both axillae in 23 cases. The common clinical diagnoses included accessory breast tissue (23.2%), lipomatous lesion (17.4%), lymphadenopathy (18.8%) and swellings not otherwise specified (30.4%). In 8.8% cases two of the possibilities were considered. The cytodiagnoses included axillary accessory breast tissue (47 cases), axillary breast tissue with pregnancy or lactational changes (15), cystic disease (4) and fibroadenoma (3). One of the cystic disease cases showed granulomatous inflammation. Although no case of carcinoma in axillary breast tissue was diagnosed during the study period, there were two cases of malignancy in axillary swellings (diagnosed as metastatic carcinoma) when no primary was detected in the breasts.

  9. MRI and ultrasound evaluation of invasive lobular carcinoma of the breast after primary systemic therapy.

    Science.gov (United States)

    Mori, Miki; Tsunoda, Hiroko; Takamoto, Yayoi; Murai, Michiko; Kikuchi, Mari; Honda, Satoshi; Suzuki, Koyu; Yamauchi, Hideko

    2015-07-01

    To assess magnetic resonance imaging (MRI) and ultrasound (US) evaluation of invasive lobular carcinoma after primary systemic therapy compared to the primary surgery group. A total of 218 breasts with invasive lobular carcinoma (ILC), which were diagnosed by core needle biopsy and underwent surgery between 2004 and 2010 in St. Luke's International Hospital, were reviewed. Of these, 44 breasts received primary systemic therapy (PST) and the residual 174 breasts underwent surgery first. Before surgery, MRI and second-look US were performed. Patients whose extent of lesion from MRI and US was over 90° were recommended to receive total mastectomy. Diagnostic image evaluation was categorized from the final pathology. A negative margin of breast-conserving surgery (BCS) and mastectomy which has over 90° tumor extent in pathology were regarded as "appropriate". A positive margin of BCS was regarded as "underestimated". "Overestimation" was determined when the pathological extension was small enough for BCS although MRI and US diagnosis was over 90°. Of 44 breasts which received PST, 26 breasts received BCS as initial surgery. Of these, 14 (53.8 %) breasts were "underestimated". Of these 14, 5 breasts received additional total mastectomy. Of 174 breasts that received surgery first, 121 (69.5 %) breasts received BCS as the initial surgery. Of these, 46 (38.0 %) breasts were "underestimated" and 6 breast of these 46 received additional total mastectomy. "Underestimated" rate was similar in the two groups, but the additional total mastectomy rate was significantly higher in the PST group (p = 0.025). There were no "overestimations". The "appropriate" rate was similar between the PST (68.2 %) and surgery-first groups (73.6 %). Although 68.2 % of ILC patients were evaluated "appropriately" even after PST, higher additional total mastectomy rates should be considered when selecting the surgical procedure.

  10. Intraoperative specimen radiography in patients with nonpalpable malignant breast lesions

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    Schmachtenberg, C.; Engelken, F.; Fischer, T.; Bick, U.; Poellinger, A.; Fallenberg, E.M. [Charite, Berlin (Germany). Radiology

    2012-07-15

    Purpose: Specimen mammography of nonpalpable wire-localized breast lesions is the standard in breast-conserving surgery. The aim of this study was to evaluate the reliability of intraoperative 2-view specimen mammography in different cancer types. Materials and Methods: After ethics approval, 3 readers retrospectively evaluated margins on 266 2-view specimen radiographs. They determined the closest margin and the orientation. The results were correlated with the histopathology (intra-class correlation coefficient [ICC] and contingency coefficient [CC]) and compared (Wilcoxon test). Results: Invasive ductal carcinoma (IDC) with ductal carcinoma in situ (DCIS) was present in 115 (43 %), IDC in 75 (28 %), invasive lobular carcinoma (ILC) in 57 (22 %) and rare cancers (CA) in 19 specimens (7 %). The sensitivity/specificity and positive/negative predictive value (P/NPV) of specimen mammography were 0.50/0.86 and 0.86/0.50 for CA, 0.42/0.68 and 0.48/0.63 for IDC, 0.36/0.81 and 0.69/0.51 for ILC, and 0.22/0.78 and 0.68/0.32 for IDC+DCIS. Readers correctly identified the orientation of the closest margin in at least one view in an average of 149 specimens (56 %). CCs were between 0.680 (IDC) and 0.912 (CA), suggesting a moderate correlation between radiographic and histological orientation. The correlations were worse for the radiographic and histological distances, with ICC ranging from 0.238 (ILC) to 0.475 (CA). The Wilcoxon test revealed overestimation of the radiographic margins compared to the histological ones for DCIS. Conclusion: Our results suggest that specimen radiography has relatively good overall specificity and good PPV, while the sensitivity and NPV are low for DCIS. A negative result on specimen radiography does not rule out histologically involved margins. (orig.)

  11. PIK3CA mutations may be discordant between primary and corresponding metastatic disease in Breast Cancer

    DEFF Research Database (Denmark)

    Dupont Jensen, Jeanette; Laenkholm, Anne-Vibeke; Knoop, Ann

    2011-01-01

    PURPOSE: PIK3CA mutations are frequent in breast cancer and activate the PI3K/Akt pathway. Unexpectedly, PIK3CA mutation appears in general to be associated with better outcome. In a cohort of patients where both primary and metastatic lesions were available the objective was to assess changes...... recurrence than wild type cases (p=0.03). CONCLUSIONS: PIK3CA mutations occur at high frequency in primary and metastatic breast cancer; these may not necessarily confer increased aggressiveness as mutants had a longer time to recurrence. Because PIK3CA status quite frequently changes between primary...... metastatic breast tumors. Samples were analysed for PIK3CA mutations (exon 9 and 20) as well as immunohistochemical evaluation for PTEN, pAKT, Ki67, ER and HER2. RESULTS: PIK3CA mutation was detected in 45 % of the primary tumors. Overall there was a net gain in mutation in metastatic disease, to 53...

  12. Performance of Ultrasonic Shear Wave Elastography in Assessing Benign and Malignant Breast Lesions.

    Science.gov (United States)

    Shi, Xian-Quan; Li, Jun-Lai; Li, Qiu-Yang; Huang, Yan; Wan, Wen-Bo; Tang, Jie

    2015-06-01

    To determine the best shear wave elastography (SWE) quantitative parameters including the maximum elasticity (Emax), mean elasticity(Emean), minimum elasticity, standard deviation and ratio of Emean (Eratio) in assessing benign and malignant breast lesions. Totally 302 breast lesions underwent conventional ultrasound and SWE. Each lesion was classified according to ultrasound Breast Imaging Reporting and Data System (BI-RADS). The receiver operating characteristic(ROC) curves were used to determine the cut-off values of SWE quantitative parameters and to suggest breast lesions as benign or malignant. The sensitivity,specificity and the Youden index (sum of sensitivity and specificity minus 1) of SWE quantitative parameters were compared,and then the sensitivity,specificity and the Youden index of the combinations of each SWE parameters in assessing breast lesions were compared. The sensitivity,specificity and the Youden index of the Emax were 0.87,0.97 and 0.84,which were higher than other SWE parameters (all Pbreast lesions. It can be used as an important quantitative indicator for the evaluation of benign and malignant breast lesions.

  13. Parietal wall hydatid cyst presenting as a primary lesion

    Directory of Open Access Journals (Sweden)

    Pankaj Gharde

    2012-01-01

    Full Text Available Hydatid cyst is the disease of liver and lungs and is common in some regions especially sheep rearing countries of the world, but this disease may occur in any part of world and anywhere in the body. This report presents primary hydatid cysts located in intramuscular region of left side of the abdomen. A 54-year-old female patient from central India, farmer by occupation, non vegetarian by diet came with chief complaints of a painless mass in the left iliac fossa, gradually increasing in size over a period of 6 months. Superficial ultrasound revealed a lesion resembling a hydatid cyst. Surgical excision was done without injuring the cyst. Diagnosis was confirmed on histo-pathological examination and was compatible with a hydatidcyst. Ahydatid cyst should be considered in the differential diagnosis of subcutaneouscystic lesions, it should be excised totally, with an intact wall and postoperative albendazole should be given to avoid recurrence.

  14. Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

    Directory of Open Access Journals (Sweden)

    de Boer Erwin

    2007-11-01

    Full Text Available Abstract Background In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. Methods/Design The MONET – study (MR mammography Of Nonpalpable BrEast Tumors is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%. The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. Trial registration Study protocol number NCT00302120

  15. IS IT NECESSARY TO EXCISE ALL BREAST LESIONS? EXPERIENCE FROM A UNIVERSITY-BASED BREAST UNIT

    Directory of Open Access Journals (Sweden)

    YIP CH

    2009-01-01

    Full Text Available Background: Breast cancer is becoming more important in Asia since it affect the younger age group. Question arises whether it is safe for breast lesions to be left in-situ if all the elements in triple assessment are benign. The aim of this study is to audit all the excision biopsies of breast lumps done in the University Malaya Medical Centre (UMMC, to review the association of age with the type of pathological finding and to evaluate the rate of carcinoma in these biopsies. Methods: We conducted a retrospective study of all women who had excision biopsy of a breast lump in the University Malaya Medical Centre from January 2005 to December 2006. All patients with malignant preoperative biopsies were excluded. Results: Of 717 lesions in 664 patients, 459 (64% were fibroadenoma, 114 (15.9% were fibrocystic disease, 20 (2.8% were phylloides tumour, 27 (3.8% were papilloma, 59 (8.2% were malignant and 38 (5.3% were of other pathology. Of the 717 open biopsies, 449 (62.6% had fine-needle aspiration cytology (FNAC, 31 (4.3% had core needle biopsy (CNB, while 14 (2.0% had both FNAC and CNB done prior to excision biopsy. 251 (35% had neither FNAC nor CNB. The incidence of fibroadenoma decreased with increasing age and the incidence of fibrocystic changes and papilloma increased with increasing age. There was no association of age with phylloides tumour. The incidence of unexpected malignancy increased with increasing age. The incidence rates were 0.3%, 4.5%, 19.4%, 29.7% and 29.6% for the age group below 30, 30-39, 40-49, 50-59 and above 60 years of age respectively. Of the 59 malignant lesions, FNAC was performed on 47 (79.7% and CNB on 16 (27.1%. 9 had both FNAC and CNB and 3 had neither FNAC nor CNB. Out of the 56 lesions where FNAC/CNB were done, 23 (41.1% were reported as benign, 20 (35.7% as suspicious, 4 (7.1% as atypical, 5 (8.9% as inadequate, 2 (3.6% as equivocal and 2 (3.6% as lymphoid lesions. Out of the 23 prior biopsies reported as

  16. Stage IV Primary Vaginal Leiomyosarcoma with Lung and Breast Metastases

    Science.gov (United States)

    Gong, Lin; Liu, Hui; Yang, Kai-Xuan; Peng, Zhi-Lan

    2012-01-01

    Background Reproductive tract sarcomas metastasizing to the breast are uncommon. To our knowledge, metastasis of vaginal leiomyosarcoma to the breast has not been previously reported in the literature. Case Report We present the first report of a FIGO stage IV primary vaginal leiomyosarcoma with metastases to the lung and left breast. Treatment included neoadjuvant chemotherapy followed by surgery and postoperative chemotherapy. Lung metastasis disappeared but recurred 14 months later in conjunction with left breast metastasis which was resected. Conclusion Primary vaginal sarcoma with lung and breast metastases is very rare in female genital malignancies. We present this case to alert gynecologists to the need for early diagnosis and aggressive management. PMID:22740804

  17. A hierarchical model for automated breast lesion detection from ultrasound 3D data.

    Science.gov (United States)

    Deng, Yinhui; Liu, Weiping; Jago, James

    2015-01-01

    Ultrasound imaging plays an important role in breast cancer screening for which early and accurate lesion detection is crucial for clinical practice. Many researches were performed on supporting the breast lesion detection based on ultrasound data. In the paper, a novel hierarchical model is proposed to automatically detect breast lesion from ultrasound 3D data. The model simultaneously considers the data information from low-level to high-level for the detection by processing with a joint probability. For each layer of the model, the corresponding algorithm is performed to denote the certain level image information. A dynamic programming approach is applied to efficiently obtain the optimal solution. With a preliminary dataset, the superior performance of the proposed model has been demonstrated for the automated detection of breast lesion with 0.375 false positive per case at 91.7% sensitivity.

  18. POSSIBILITIES OF BREAST FEEDING ORGANIZATION FOR CHILDREN WITH PERINATAL LESIONS OF CENTRAL NERVOUS SYSTEM

    Directory of Open Access Journals (Sweden)

    O. L. Lukoyanova

    2012-01-01

    Full Text Available Acute and/or chronic hypoxia is a leading cause of perinatal lesions of central nervous system. Severe consequences of this condition can be the reason of temporary withdrawal from breast-feeding started soon after birth. Study objectives included: scrutiny of lactation establishment, influence of various factors on lactation duration in mothers of children with perinatal lesions of CNS. Study included 86 pairs mother-child, with duration of 12 months. It has been shown that in cases where breast feeding was impossible, regular expression of breast milk with the help of breast pump in the early lactation period allows not only to organize breast feeding by the time of discharge from the hospital, but also to extend its duration almost to the normal one. Severity of perinatal CNS lesion does not correspond with the duration of lactation period of the mother.

  19. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic.

    Science.gov (United States)

    Reddington, Justin A; Mendez, Gustavo A; Ching, Alex; Kubicky, Charlotte Dai; Klimo, Paul; Ragel, Brian T

    2016-01-01

    Surgeons treating metastatic spine disease can use computed tomography (CT) imaging to determine whether lesions are osteolytic, osteoblastic, or mixed. This enables treatment that considers the structural integrity of the vertebral body (VB), which is impaired with lytic lesions but not blastic lesions. The authors analyzed CT imaging characteristics of spine metastasis from breast, lung, prostate, and renal cell carcinomas (RCCs) to determine the metastasis patterns of each of these common tumors. The authors identified patients with metastatic spine disease treated during a 3-year period. Variables studied included age, sex, and cancer type. Lesions from breast, lung, prostate, and RCC primary lesions were selected for imaging analysis. Sixty-six patients were identified: 17 had breast metastasis, 14 prostate, 18 lung, and 17 RCC. Breast cancer metastasis involved 33% of VBs with 56%, 20%, and 24% osteolytic, osteoblastic, and mixed, respectively. Prostate cancer metastasis involved 35% of VBs with 14%, 62%, and 24% osteolytic, osteoblastic, and mixed, respectively. Lung cancer metastasis involved 13% of VBs with 64%, 33%, and 3% osteolytic, osteoblastic, and mixed, respectively. RCC metastasis involved 11% of VBs with 91%, 7%, and 2% osteolytic, osteoblastic, and mixed lesions, respectively. To improve surgical planning, we advocate the use of CT prior to surgery to evaluate whether spine metastases are osteolytic or osteoblastic. In cases of osteolytic lesions, the concern is of segmental instability requiring reconstruction and the risk for screw pull out should instrumentation be considered. In cases of osteoblastic lesions, surgeons should consider debulking dense bone.

  20. Ultrasonic multi-feature analysis procedure for computer-aided diagnosis of solid breast lesions.

    Science.gov (United States)

    Alam, S Kaisar; Feleppa, Ernest J; Rondeau, Mark; Kalisz, Andrew; Garra, Brian S

    2011-01-01

    We have developed quantitative descriptors to provide an objective means of noninvasive identification of cancerous breast lesions. These descriptors include quantitative acoustic features assessed using spectrum analysis of ultrasonic radiofrequency (rf) echo signals and morphometric properties related to lesion shape. Acoustic features include measures of echogenicity, heterogeneity and shadowing, computed by generating spectral-parameter images of the lesion and surrounding tissue. Spectral-parameter values are derived from rf echo signals at each pixel using a sliding-window Fourier analysis. We derive quantitative acoustic features from spectral-parameter maps of the lesion and adjacent areas. We quantify morphometric features by geometric and fractal analysis of traced lesion boundaries. Initial results on biopsy-proven cases show that although a single parameter cannot reliably discriminate cancerous from noncancerous breast lesions, multi-feature analysis provides excellent discrimination for this data set. We have processed data for 130 biopsy-proven patients, acquired during routine ultrasonic examinations at three clinical sites and produced an area under the receiver-operating-characteristics (ROC) curve of 0.947 +/- 0.045. Among the quantitative descriptors, lesion-margin definition, spiculation and border irregularity are the most useful; some additional morphometric features (such as border irregularity) also are particularly effective in lesion classification. Our findings are consistent with many of the BI-RADS (Breast Imaging Reporting and Data System) breast-lesion-classification criteria in use today.

  1. Use of shear wave elastography to differentiate benign and malignant breast lesions.

    Science.gov (United States)

    Çebi Olgun, Deniz; Korkmazer, Bora; Kılıç, Fahrettin; Dikici, Atilla Süleyman; Velidedeoğlu, Mehmet; Aydoğan, Fatih; Kantarcı, Fatih; Yılmaz, Mehmet Halit

    2014-01-01

    We aimed to determine the correlations between the elasticity values of solid breast masses and histopathological findings to define cutoff elasticity values differentiating malignant from benign lesions. A total of 115 solid breast lesions of 109 consecutive patients were evaluated prospectively using shear wave elastography (SWE). Two orthogonal elastographic images of each lesion were obtained. Minimum, mean, and maximum elasticity values were calculated in regions of interest placed over the stiffest areas on the two images; we also calculated mass/fat elasticity ratios. Correlation of elastographic measurements with histopathological results were studied. Eighty-three benign and thirty-two malignant lesions were histopathologically diagnosed. The minimum, mean, and maximum elasticity values, and the mass/fat elasticity ratios of malignant lesions, were significantly higher than those of benign lesions. The cutoff value was 45.7 kPa for mean elasticity (sensitivity, 96%; specificity, 95%), 54.3 kPa for maximum elasticity (sensitivity, 95%; specificity, 94%), 37.1 kPa for minimum elasticity (sensitivity, 96%; specificity, 95%), and 4.6 for the mass/fat elasticity ratio (sensitivity, 97%; specificity, 95%). SWE yields additional valuable quantitative data to ultrasonographic examination on solid breast lesions. SWE may serve as a complementary tool for diagnosis of breast lesions. Long-term clinical studies are required to accurately select lesions requiring biopsy.

  2. Diagnostic Value of ARFI (Acoustic Radiation Force Impulse) in Differentiating Benign From Malignant Breast Lesions.

    Science.gov (United States)

    Magalhães, Mafalda; Belo-Oliveira, Pedro; Casalta-Lopes, João; Costa, Yessica; Gonçalo, Manuela; Gomes, Paula; Caseiro-Alves, Filipe

    2017-01-01

    The aim of this study was to correlate acoustic radiation force impulse (ARFI) imaging velocities with the pathology results and to evaluate the ability of ARFI in distinguishing benign from malignant breast lesions. B-mode ultrasonography (US) and ARFI were performed in patients with previously diagnosed and selected breast lesions for biopsy. Shear wave velocity (SWV) was measured inside lesions and in the surrounding parenchyma (m/s). SWV measurements as well as lesion-to-parenchyma ratio (LPR) were compared between benign and malignant lesions, and receiver operating characteristic (ROC) curves were plotted. Two blinded readers independently classified the lesions as benign or malignant in two separate reading sessions, one using B-mode US alone and the other using a combined set of B-mode US and ARFI. Eighty-one patients with a total of 92 breast lesions were included (57 benign and 35 malignant nodules). SWV inside lesions were significantly higher for malignant neoplasms compared to benign (medians of 9.1 m/s vs 3.5 m/s; P elasticity measurements, adding valuable complementary information to B-mode ultrasound, that can potentially help in breast lesion characterization and assisting the decision for biopsy recommendations. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  3. Management of breast lesions detectable only on MRI; Abklaerung ausschliesslich MRT-detektierbarer Mammalaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Siegmann-Luz, K.C.; Bahrs, S.D.; Preibsch, H.; Hattermann, V.; Claussen, C.D. [Universitaetsklinikum Tuebingen (Germany). Abt. Diagnostische und Interventionelle Radiologie

    2014-01-15

    Breast MR imaging has become established as the most sensitive imaging method for diagnosing breast cancer. As a result of the increasing examination volume and improved image quality, the number of breast lesions detected only on MRI and requiring further clarification has risen in recent years. According to the S3-guideline 'Diagnosis, Therapy, and Follow-Up of Breast Cancer' as revised in July 2012, institutions performing breast MRI should provide the option of an MRI-guided intervention for clarification. This review describes the indications, methods and results of MRI-guided interventions for the clarification of breast lesions only visible on MRI. Recent guidelines and study results are also addressed and alternative methods and pitfalls are presented. (orig.)

  4. Anisotropy of Solid Breast Lesions in 2D Shear Wave Elastography is an Indicator of Malignancy.

    Science.gov (United States)

    Skerl, Katrin; Vinnicombe, Sarah; Thomson, Kim; McLean, Denis; Giannotti, Elisabetta; Evans, Andrew

    2016-01-01

    To investigate if anisotropy at two-dimensional shear wave elastography (SWE) suggests malignancy and whether it correlates with prognostic and predictive factors in breast cancer. Study group A of 244 solid breast lesions was imaged with SWE between April 2013 and May 2014. Each lesion was imaged in radial and in antiradial planes, and the maximum elasticity, mean elasticity, and standard deviation were recorded and correlated with benign/malignant status, and if malignant, correlated with conventional predictive and prognostic factors. The results were compared to a study group B of 968 solid breast lesions, which were imaged in sagittal and in axial planes between 2010 and 2013. Neither benign nor malignant lesion anisotropy is plane dependent. However, malignant lesions are more anisotropic than benign lesions (P ≤ 0.001). Anisotropy correlates with increasing elasticity parameters, breast imaging-reporting and data system categories, core biopsy result, and tumor grade. Large cancers are significantly more anisotropic than small cancers (P ≤ 0.001). The optimal anisotropy cutoff threshold for benign/malignant differentiation of 150 kPa(2) achieves the best sensitivity (74%) with a reasonable specificity (63%). Anisotropy may be useful during benign/malignant differentiation of solid breast masses using SWE. Anisotropy also correlates with some prognostic factors in breast cancer. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  5. {sup 99m}Tc sestamibi scintimammography. Screening mammographic non-palpable suspicious breast lesions: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, R.; Derebek, E.; Degirmenci, B.; Durak, H. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Nuclear Medicine; Balci, P. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Radiology; Kocdor, M.A. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Surgery; Canda, T. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Pathology

    2004-02-01

    Aim: Investigation of the diagnostic role of technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc estamibi) scintimammography in non-palpable, suspicious breast lesions described as microcalcification, mass and increased density using mammography. Patients, method: 35 women with non-palpable breast lesions were enrolled in the study. Anterior, left and right lateral, ipsilateral posterior oblique images were obtained 15 min after the injection of 740 MBq of {sup 99m}Tc sestamibi. All scintigraphic images were evaluated visually and focal increased {sup 99m}Tc sestamibi uptake was accepted as malignant lesion. Breast lesions were classified as microcalcification (13 women), mammographic mass (16 women) and increased density (6 women). Excisional biopsy was performed in all of them irrespective of the scintigraphic results: Results: The focally increased {sup 99m}Tc sestamibi uptake was seen in 11 breast lesions with malignant lesions and in 4 breast lesions with benign lesions. The diffuse uptake of {sup 99m}Tc sestamibi was seen in 18 breast lesions with benign lesions and 2 breast lesions with malignant lesions. There was no false positive result of {sup 99m}Tc sestamibi in microcalcification group and three was no false negative result of the mammographic mass and increased density groups. Conclusion: Scintimammography might be a complementary method in decision making for the non-palpable, suspicious breast lesions that were evaluated as microcalcification, mass and increased density mammograpically. (orig.)

  6. Primary Neuroendocrine Carcinoma of Breast: A Rare Case Report

    African Journals Online (AJOL)

    Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore, India. Abstract. Primary neuroendocrine carcinoma (PNEC) of breast was an unknown pathologic entity till recently due ... whole body computed tomography and magnetic resonance imaging revealed no extra mammary primary tumor.

  7. The value of systematic pattern analysis in FNAC of breast lesions: 225 cases with cytohistological correlation

    Directory of Open Access Journals (Sweden)

    Prakash H Muddegowda

    2011-01-01

    Full Text Available Background : Fine needle aspiration cytology (FNAC has a high rating in the assessment of breast lesions. Various methods have been used to diagnose cytology of breast lesions. Aims : Present study was undertaken to evaluate the feasibility of application of systematic pattern analysis based on morphology in diagnosing breast aspirates. Materials and Methods : This is a retrospective study of FNAC of the breast done over a period of 4 years in a tertiary care centre. A total of 225 cases of breast lesions for which FNAC was done with histological follow-up were included in the study. Breast aspirates were provisionally diagnosed based on systematic pattern analysis. Aspirates were grouped into six categories based on predominant cellular pattern, and correlation between cytological and histological diagnosis was assessed. Results : Application of pattern analysis on FNAC of breast lesions in our study had a sensitivity of 94.5%, specificity of 98%, diagnostic accuracy of 97%, positive predictive value of 95.8%, and negative predictive value of 97.4%. Conclusions : Systematic pattern analysis based on morphology of FNAC smears was found to be highly reliable and could be easily reproducible in the assessment of breast masses.

  8. Excision biopsy of breast lesions changes the pattern of lymphatic drainage

    NARCIS (Netherlands)

    Estourgie, S. H.; Valdés Olmos, R. A.; Nieweg, O. E.; Hoefnagel, C. A.; Rutgers, E. J. T.; Kroon, B. B. R.

    2007-01-01

    BACKGROUND: The aim was to validate the sentinel node biopsy procedure in women who had previous breast excision biopsy by means of determining the reproducibility of lymphoscintigraphy after surgery. METHODS: Twenty-five women scheduled for excision biopsy of a breast lesion were investigated. The

  9. Mucocele-like lesions of the breast: a clinical outcome and histologic analysis of 102 cases.

    Science.gov (United States)

    Meares, Annie L; Frank, Ryan D; Degnim, Amy C; Vierkant, Robert A; Frost, Marlene H; Hartmann, Lynn C; Winham, Stacey J; Visscher, Daniel W

    2016-03-01

    Mucocele-like lesions (MLLs) of the breast are characterized by cystic architecture with stromal mucin and frequent atypia, but it is unknown whether they convey long-term breast cancer risk. We evaluated 102 MLLs that were derived from a single-institution benign breast disease cohort of 13412 women who underwent biopsy from 1967 to 2001. MLLs were histologically characterized by type of lining epithelium, architecture of the lesion, associated atypical hyperplasia (AH), and incidence of breast cancer (14.8-year median follow-up). A relatively large proportion of MLLs (42%) were diagnosed in women older than 55 years. AH was significantly more frequent in MLL patient compared to the cohort overall (27% versus 5%; P Breast cancer has developed in 13 patients with MLL. This frequency is only slightly higher than population expected rates overall (standardized incidence ratio, 2.28; 95% confidence interval, 1.21-3.91) and not significantly different from women in the cohort with (nonatypical) proliferative breast lesions. Younger women (breast lesion that is often associated with coexisting AH. However, in women older than 45 years, MLLs do not convey additional risk of breast cancer beyond that associated with the presence of proliferative disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Contrast enhanced digital mammography: Is it useful in detecting lesions in edematous breast?

    Directory of Open Access Journals (Sweden)

    Noha Abd ElShafy ElSaid

    2015-09-01

    Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in identification of lesions in mammographically dense edematous breasts and proved to be a useful tool in the follow-up of cases presenting by edema after conservative breast surgery and chemotherapy.

  11. Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation

    Directory of Open Access Journals (Sweden)

    Sur Monalisa

    2009-04-01

    Full Text Available Abstract Background Primary non-Hodgkin lymphoma (NHL of the breast represents 0.04–0.5% of malignant lesions of the breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL is a rare T-cell lymphoma typically seen in children and young adults with the breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the breast described in the literature. Eight of these cases occurred in proximity to breast implants, four in relation to silicone breast implant and three in relation to saline filled breast implant with three out of the eight implant related cases having previous history of breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML, the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude

  12. Primary Osteosarcoma of the Breast Arising in an Intraductal Papilloma

    OpenAIRE

    Khalefa Ali Alghofaily; Musab Hamoud Almushayqih; Muhannad Faleh Alanazi; Abdullah Abdulrahman Bin Salamah; Halldor Benediktsson

    2017-01-01

    Introduction. Primary osteosarcoma of the breast is extremely rare, and an osteosarcoma arising from an intraductal papilloma is exceptional. Case Presentation. A 72-year-old Saudi Arabian woman presented with a solid, bone-containing breast mass that was diagnosed as primary osteosarcoma of the breast on biopsy. She had a history of untreated intraductal papilloma. Treatment was completed with a modified mastectomy after excluding extramammary metastases. However, she subsequently developed ...

  13. Oncotype Dx Results in Multiple Primary Breast Cancers

    OpenAIRE

    Michael J. Toole; Kidwell, Kelley M.; Catherine Van Poznak

    2014-01-01

    PURPOSE To determine whether multiple primary breast cancers have similar genetic profiles, specifically Oncotype Dx Recurrence Scores, and whether obtaining Oncotype Dx on each primary breast cancer affects chemotherapy recommendations. METHODS A database of patients with hormone receptor-positive, lymph node-negative, breast cancer was created for those tumors that were sent for Oncotype Dx testing from the University of Michigan Health System from 1/24/2005 to 2/25/2013. Retrospective char...

  14. Shear wave elastography contribution in ultrasound diagnosis management of breast lesions.

    Science.gov (United States)

    Klotz, T; Boussion, V; Kwiatkowski, F; Dieu-de Fraissinette, V; Bailly-Glatre, A; Lemery, S; Boyer, L

    2014-09-01

    To determine the diagnosis performance of shear wave elastography in the differentiation of benign and malignant breast lesions and the factors influencing the elasticity values. To suggest an appropriate management of breast lesions using the ultrasound-elastography combination. Monocentric retrospective study of 167 breast lesions classified by conventional ultrasound as BI-RADS category 3 or higher that underwent an elastography study and histological analysis. The analysis of qualitative parameters, according to the classification established in this study, allows us to obtain a sensitivity of 91.1% and a specificity of 92.3%. These values are very close to or better than the quantitative parameters Emax and Emean. Different Emax thresholds values were established based on the long axis of the lesion and its palpable character, which appeared to be significant factors influencing elasticity. The management of breast lesions by combining ultrasound and elastography, as proposed here, allows us to keep the sensitivity of an ultrasound (96%), while doubling its specificity (86.2% versus 43.1%). With the complementary nature of their performance, the combination of conventional ultrasound and shear wave elastography can improve the management of breast lesions. The qualitative classification proposed appears to be relevant assistance in lesion characterization. Copyright © 2014 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  15. Positive predictive value of additional synchronous breast lesions in whole-breast ultrasonography at the diagnosis of breast cancer: clinical and imaging factors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Hyun; Kim, Min Jung; Kim, Eun Kyung; Moon, Hee Jung [Dept. of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Park, Hee Jung [Dept. of Surgery, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    To evaluate the positive predictive value (PPV) of bilateral whole-breast ultrasonography (BWBU) for detection of synchronous breast lesions on initial diagnosis of breast cancer and evaluate factors affecting the PPV of BWBU according to varying clinicoimaging factors. A total of 75 patients who had synchronous lesions with pathologic confirmation at the initial diagnosis of breast cancer during January 2007 and December 2007 were included. The clinical factors of the patients were evaluated. One observer retrospectively reviewed the imaging studies of the index breast cancer lesion and the synchronous lesion. The PPV for additional biopsy was calculated for BWBU and various clinical and imaging factors affecting the PPV for BWBU were evaluated. The overall PPV for additional biopsy was 25.7% (18 of 70). The PPV for synchronous lesions detected both on mammography and BWBU, and detected only on BWBU, was 76.9% (10 of 13) and 14.3% (7 of 49), respectively. There was no clinical factor affecting the PPV for BWBU. Among the imaging factors, ipsilateral location of the synchronous lesion to the index lesion (P=0.06) showed a marginal statistically significant correlation with malignancy in the synchronous breast lesion. A mass with calcification on mammography presentation (P<0.01), presence of calcification among the ultrasonography findings (P<0.01), and high Breast Imaging Reporting and Data System final assessment (P<0.01) were imaging factors that were associated with malignancy in the additional synchronous lesion. BWBU can detect additional synchronous malignancy at the diagnosis of breast cancer with a relatively high PPV, especially when mammography findings are correlated with ultrasonographic findings.

  16. The negative predictive value of breast Magnetic Resonance Imaging in noncalcified BIRADS 3 lesions

    NARCIS (Netherlands)

    Dorrius, M. D.; Pijnappel, R. M.; Sijens, P. E.; van der Weide, M. C. Jansen; Oudkerk, M.

    Purpose: The purpose of this study is to determine whether breast MRI can provide a sufficient NPV to safely rule out malignancy in mammographic BIRADS 3 lesions. Materials and methods: In a 3-year consecutive mammographic examination study 176 out of 4391 patients had a lesion classified as BIRADS

  17. New Fully Automated Method for Segmentation of Breast Lesions on Ultrasound Based on Texture Analysis.

    Science.gov (United States)

    Gómez-Flores, Wilfrido; Ruiz-Ortega, Bedert Abel

    2016-07-01

    The study described here explored a fully automatic segmentation approach based on texture analysis for breast lesions on ultrasound images. The proposed method involves two main stages: (i) In lesion region detection, the original gray-scale image is transformed into a texture domain based on log-Gabor filters. Local texture patterns are then extracted from overlapping lattices that are further classified by a linear discriminant analysis classifier to distinguish between the "normal tissue" and "breast lesion" classes. Next, an incremental method based on the average radial derivative function reveals the region with the highest probability of being a lesion. (ii) In lesion delineation, using the detected region and the pre-processed ultrasound image, an iterative thresholding procedure based on the average radial derivative function is performed to determine the final lesion contour. The experiments are carried out on a data set of 544 breast ultrasound images (including cysts, benign solid masses and malignant lesions) acquired with three distinct ultrasound machines. In terms of the area under the receiver operating characteristic curve, the one-way analysis of variance test (α=0.05) indicates that the proposed approach significantly outperforms two published fully automatic methods (pbreast lesions. In addition, the proposed approach can potentially be used for automated computer diagnosis purposes to assist physicians in detection and classification of breast masses. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. Pre-surgical Multiparametric Assessment of Breast Lesions Using 3-Tesla Magnetic Resonance.

    Science.gov (United States)

    Mirka, Hynek; Tupy, Radek; Narsanska, Andrea; Hes, Ondrej; Ferda, Jiri

    2017-12-01

    The aim of this study was to evaluate experience with multiparametric breast imaging on 3-Tesla magnetic resonance (3T-MRI) scanner using a dedicated 18-channel coil compared to histological findings in women after surgery. The study included 100 women with 105 Breast Imaging Reporting and Data System (BI-RADS) 4 to 6 lesions by mammography who were examined using 3T-MRI and subsequently underwent surgery. MRI included non-contrast T1, T2 and T2 short tau inversion recovery (STIR) sequences, diffusion-weighted imaging with apparent diffusion coeficient maps, postcontrast dynamic study and single-voxel MRI spectroscopy. The results were compared to those of histopathological examination. A sensitivity of 98.68% was found for the whole population, with a specificity of 86.20%. The most valuable findings were diffusion restriction with sensitivity of 90.79% and specificity of 89.66%, and increased choline in the spectrum with sensitivity of 68.42% and specificity of 93.10%. Evaluation of the enhancement curve had sensitivity of 45.05% and specificity of 72.41%. In examination of lymph nodes, 3T-MRI had sensitivity of 92.59% and specificity of 93.87%. Multiparametric 3T-MRI breast imaging shows excellent results in evaluation of breast cancer compared to histological findings, both for primary tumor and nodal metastases. The greatest contribution to improving diagnostic performance is the evaluation of diffusion. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  19. Risk of primary non-breast cancer after female breast cancer by age at diagnosis

    DEFF Research Database (Denmark)

    Mellemkjær, Lene; Christensen, Jane; Frederiksen, Kirsten Skovsgaard

    2011-01-01

    Women diagnosed with breast cancer at young age have been shown to be at higher risk of developing a new primary cancer than women diagnosed at older ages, but little is known about whether adjustment for calendar year of breast cancer diagnosis, length of follow-up, and/or breast cancer treatment...

  20. Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients

    DEFF Research Database (Denmark)

    Jensen, Siri Beier; Mouridsen, Henning T.; Bergmann, Olav Jonas

    2008-01-01

    OBJECTIVE: The aim of the study was to examine oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy (CT) in breast cancer patients during and 1 year after treatment. STUDY DESIGN: Forty-five consecutive breast cancer patients, eligible for adjuvant CT...... with cyclophosphamide, epirubicin or methotrexate, and 5-fluorouracil were followed before, during, 6 months and 1 year after CT and were compared to a control group of 31 breast cancer patients not receiving adjuvant CT. RESULTS: During CT, oral mucosal lesions developed including erythema (n = 10, 22%) and ulceration...... in the CT group. CONCLUSION: In breast cancer patients, moderate-intensive adjuvant CT caused oral mucosal lesions, oral candidosis, taste disturbances and a more acidophilic oral microflora. These adverse effects were temporary and the majority of the patients were mildly affected....

  1. 99mTc-3PRGD2 Scintimammography in Palpable and Nonpalpable Breast Lesions

    Directory of Open Access Journals (Sweden)

    Lin Liu

    2014-07-01

    Full Text Available The aim of this study was to explore the diagnostic performance of 99mTc-3(poly-(ethylene glycol,PEG4-RGD2 (99mTc-3PRGD2 scintimammography (SMM in patients with either palpable or nonpalpable breast lesions and compare SMM to mammography to assess the possible incremental value of SMM in breast cancer detection. We also investigated the αvβ3 expression in malignant and benign breast lesions. Ninety-four patients with 110 lesions were included in this study. Mammograms were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS by a specialized imaging radiologist. Prone SMM was performed 1 hour after injection of 99mTc-3PRGD2. Scintigraphic images were interpreted independently by two experienced nuclear medicine physicians using a three-point system, and the kappa value was calculated to determine the interreader agreement. The McNemar test was used to compare SMM and mammography with respect to sensitivity, specificity, and accuracy. Diagnostic values for breast cancer detection were evaluated for each lesion. Immunohistochemistry was performed to evaluate integrin αvβ3 expression. Histopathology revealed 46 malignant lesions and 64 benign lesions. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SMM were 83%, 73%, 77%, 69%, and 85%, respectively. The kappa value between the two reviewers was 0.63. The diagnostic values of SMM were higher than those of mammography in evaluating overall breast lesions. A sensitivity of 91% was achieved when SMM and mammography results were combined with 60% of all false-negative mammography findings classified as true-positive results by SMM. Integrin αvβ3 expression was positively identified using SMM imaging. SMM is a promising tool to avoid unnecessary biopsies when used in addition to mammography and can be used to image αvβ3 expression in breast cancer with good image quality.

  2. A Radial Sclerosing Lesion Mimicking Breast Cancer on Mammography in a Young Woman

    Directory of Open Access Journals (Sweden)

    Masashi Furukawa

    2012-02-01

    Full Text Available A spiculated mass on a mammogram is highly suggestive of malignancy. We report the case of a 32-year-old woman with a radial sclerosing lesion that mimicked breast cancer on mammography. She visited her physician after palpating a lump in her left breast. Mammography showed architectural distortion in the upper inner quadrant of the left breast. Ultrasonography showed a low echoic area with an ambiguous boundary. Core needle biopsy was performed because of the suspicion of malignancy. Histological examination did not reveal any malignant cells. After 6 months, the breast lump became larger and the patient was referred to our hospital. Mammography performed in our hospital showed a spiculated mass, and therefore mammotome biopsy was performed. Histological examination revealed dense fibroelastic stroma with a wide variety of mastopathic changes, leading to a diagnosis of a radial sclerosing lesion. One year after the biopsy, the lump on her left breast had disappeared and mammography showed no spiculated mass.

  3. Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation.

    Directory of Open Access Journals (Sweden)

    Mahdi Bayat

    Full Text Available Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography (CUSE performance in differentiating breast masses.With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients (19-85 years, mean 59.93±14.96 years with 227 suspicious breast masses identifiable by ultrasound (mean size 1.83±2.45cm were analyzed. CUSE was performed on all patients. Three regions of interest (ROI, 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young's modulus. In correlation to pathology results, statistical analyses were performed.Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions (BI-RADS 2 and 3 were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity (91 of 108, 89.92% specificity (107 of 119, 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve (P 0.21.CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their stiffness.

  4. Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation.

    Science.gov (United States)

    Bayat, Mahdi; Denis, Max; Gregory, Adriana; Mehrmohammadi, Mohammad; Kumar, Viksit; Meixner, Duane; Fazzio, Robert T; Fatemi, Mostafa; Alizad, Azra

    2017-01-01

    Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography (CUSE) performance in differentiating breast masses. With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients (19-85 years, mean 59.93±14.96 years) with 227 suspicious breast masses identifiable by ultrasound (mean size 1.83±2.45cm) were analyzed. CUSE was performed on all patients. Three regions of interest (ROI), 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young's modulus. In correlation to pathology results, statistical analyses were performed. Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions (BI-RADS 2 and 3) were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity (91 of 108), 89.92% specificity (107 of 119), 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve (P 0.21). CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their stiffness.

  5. Spectrum of giant cells and its significance on FNAC in breast lesions

    OpenAIRE

    S Dayal; M Mathur; V Gupta

    2017-01-01

    Fine needle aspiration of breast is being performed from last several years. It is not uncommon to find giant cell on FNAC of breast smears .Giant cells arises from monocyte / macrophage lineage which are capable of fusion to form multinucleated giant cell. The common giant cell seen in breast on fna smears are foreign body , Langhan’s type , stromal giant cells , tumor giant cells and osteoclastic giant cell . It arises in benign as well as malignant lesions of the breast. Hence, their recog...

  6. Breast ultrasound lesions classification: a performance evaluation between manual delineation and computer segmentation

    Science.gov (United States)

    Yap, Moi Hoon; Yap, Chuin Hong

    2016-03-01

    Breast cancer is a threat to women worldwide. Manual delineation on breast ultrasound lesions is time-consuming and operator dependent. Computer segmentation of ultrasound breast lesions can be a challenging task due to the ill-defined lesions boundaries and issues related to the speckle noise in ultrasound images. The main contribution of this paper is to compare the performance of the computer classifier on the manual delineation and computer segmentation in malignant and benign lesions classification. This paper we implement computer segmentation using multifractal approach on a database consists of 120 images (50 malignant lesions and 70 benign lesions). The computer segmentation result is compared with the manual delineation using Jaccard Similarity Index (JSI). The result shows that the average JSI of 0.5010 (+/-0.2088) for malignant lesions and the average JSI of 0.6787 (+/-0.1290) for benign lesions. These results indicate lower agreement in malignant lesions due to the irregular shape while the higher agreement in benign lesions with regular shape. Further, we extract the shape descriptors for the lesions. By using logistic regression with 10 fold cross validation, the classification rates of manual delineation and computer segmentation are computed. The computer segmentation produced results with sensitivity 0.780 and specificity 0.871. However, the manual delineation produced sensitivity of 0.520 and specificity of 0.800. The results show that there are no clear differences between the delineation in MD and CS in benign lesions but the computer segmentation on malignant lesions shows better accuracy for computer classifier.

  7. FDG-PET/CT detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening.

    Science.gov (United States)

    Peng, Nan-Jing; Chou, Chen-Pin; Pan, Huay-Ben; Chang, Tsung-Hsien; Hu, Chin; Chiu, Yu-Li; Fu, Ting-Ying; Chang, Hong-Tai

    2015-08-01

    To assess the efficacy of positron emission tomography/computed tomography with the glucose analogue 2-[(18) F]fluoro-2-deoxy-D-glucose (FDG-PET/CT) in Taiwanese women with early breast cancer detected by mammography screening. Dual-time-point imaging of whole-body supine and breast prone scans using FDG-PET/CT were performed sequentially in the pre-operative stage. A total of 11,849 patients underwent screening mammography, of whom 1,209 (10.2%) displayed positive results. After further investigation, 54 patients underwent FDG-PET/CT. Post-operative pathology examinations revealed malignancies in 26 lesions, including invasive breast cancer in 11 cases and non-invasive breast cancer in 15 cases, as well as benign disease in 30 lesions. The FDG-PET/CT findings from the whole-body scans were positive for 9 of 11 invasive breast cancers (81.8%) and 3 of 15 non-invasive cancers (20%), and they were negative for all benign lesions. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG-PET/CT with whole-body supine imaging were 46.2%, 100%, 100% and 68.2%, respectively. Breast prone imaging revealed another patient with ductal carcinoma in situ, increasing the sensitivity to 50%. Importantly, positive PET findings were significantly correlated with tumour histology (P = 0.006), tumour size (P = 0.039) and Ki-67 expression (P = 0.011). FDG-PET/CT with whole-body scanning demonstrated high sensitivity to invasive breast cancer, limited sensitivity to non-invasive breast cancer, and high specificity for breast cancer. FDG-PET/CT might be useful for differentiating tumour invasiveness. However, the good PPV but poor NPV do not allow the physician to discard the biopsy. © 2015 The Royal Australian and New Zealand College of Radiologists.

  8. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1997-11-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.

  9. Pattern of Histopathological Diagnosis of Breast lesions in Gombe ...

    African Journals Online (AJOL)

    Background: Diseases of the breast are common and include problems, related to pregnancy and lactation, abscesses and other inflammatory conditions, nonneoplastic proliferative ... Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease. Keywords: ...

  10. Management for BI-RADS category 3 lesions detected in preoperative breast MR imaging of breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Gweon, Hye Mi [Seoul National University College of Medicine, Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Cho, Nariya; Kim, Soo-Yeon [Seoul National University College of Medicine, Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Koo, Hye Ryoung [Hanyang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seo, Mirinae [Kyung Hee University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Chu, Ajung [Seoul National University College of Medicine, Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Son, Eun Ju [Gangnam Severance Hospital, Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2017-08-15

    To retrospectively evaluate characteristics of and determine appropriate follow-up recommendations for BI-RADS category 3 lesions detected in preoperative MRI of breast cancer patients. BI-RADS category 3 assessments were identified from the breast MRI database for 5,110 consecutive breast cancer patients who had undergone preoperative MRI and surgery. Patient and lesion characteristics, malignancy rate, and interval between lesion detection and cancer diagnosis were analysed. Histopathological results or imaging at or after 2-year follow-up were used as reference standards. Of the 626 lesions, morphological features included a single focus in 26.5% (n = 166), multiple foci in 47.1% (n = 295), mass in 21.7% (n = 136) and non-mass enhancement in 4.6% (n = 29). Cancer was found in 0.8% (5/626) at a median interval of 50 months (range, 29-66 months). Malignancy rate according to morphological feature was: 1.8% (3/166) in a single focus, 0.7% (1/136) in mass and 3.4% (1/29) in non-mass enhancement. All detected cancers were stage 0 or IA. Annual follow-up might be adequate for BI-RADS category 3 lesions detected at preoperative MRI because of the 0.8% (5/626) malignancy rate, long interval between lesion detection and cancer diagnosis, and early stage of diagnosed cancers. (orig.)

  11. Primary Rectal Adenocarcinoma Metastasizing to Bilateral Breast - a Rare Case Demonstrated by {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Soundararajan, Ramya; Arora, Saurabh; Das, Chandan Jyoti; Roy, Maitrayee; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, New Delhi (India)

    2016-06-15

    A 22-year-old female presented with multiple painless bilateral breast masses for the past 2 months. On Further questioning she had hematochezia and constipation for three months. On digital rectal examination, thickening of rectal mucosa at 5 cm from the anal verge was found. On physical examination, multiple firm, non-tender, nodular lesions were found in bilateral breasts. Metastatic breast disease from extra mammary primaries is uncommon and it constitutes 0.5 - 6% of all breast malignancies. melanomas, lymphomas, leukemias, ands sarcomas are the most common malignancies causing breast metastases. Infrequently, carcinomas of the lung, stomach, ovary, liver, tonsil, pleura, pancreas, cervix, perineum, endometrium, bladder, carcinoid tumors and renal cell carcinomas can cause metastatic breast disease. Metastatic breast disease from colorectal cancer is characterised by disseminated metastatic disease and a poor prognosis. In this case, It was essential to distinguish between metastatic breast disease primary breast carcinoma to plan appropriate management. Because of its rare incidence and high index of clinical suspicion, appropriate radiological investigations and histopathology is essential for accurate diagnosis. {sup 18}F-FDG PET/CT, being a whole-body metabolic functional imaging modality, helped us determine the extent of the primary and metastatic disease. In view of disseminated metastases, the bilateral breast disease was also considered as metastatic involvement, Which was proven by histopathology.

  12. Evaluation of breast lesions using sonographic elasticity imaging: a multicenter trial.

    Science.gov (United States)

    Barr, Richard G; Destounis, Stamatia; Lackey, Logan B; Svensson, William E; Balleyguier, Corinne; Smith, Carmel

    2012-02-01

    The purpose of this study was to determine the sensitivity and specificity of real-time compression elasticity imaging in characterizing breast lesions as benign or malignant. A cohort of 578 women scheduled for sonographically guided biopsy of breast lesions were recruited from 6 sites under an Institutional Review Board-approved protocol. All participants received an elastogram, which displayed both the B-mode and elasticity images in real time. The longest dimensions of the lesion on the B-mode and elasticity imaging were measured. An elasticity imaging/B-mode ratio of at least 1.0 was considered positive for malignant lesions. The reference standard was based on biopsy. A total of 635 lesions were imaged and biopsied. There were 222 (35%) malignant or borderline lesions and 413 (65%) benign lesions. The benign lesions were either cystic (145 [35%]) or solid (268 [65%]). Of the 222 malignant lesions, 219 had an elasticity imaging/B-mode ratio of at least 1.0. Of the 413 benign lesions, 361 had an elasticity imaging/B-mode ratio less than 1.0. These results corresponded to overall sensitivity of 98.6% and overall specificity of 87.4%. Individual site sensitivities ranged from 96.7% to 100% whereas specificities ranged from 66.7% to 95.4%. Elasticity imaging has high sensitivity in characterizing malignant lesions of the breast. Variability in specificity between sites and sonographers is possibly due to individual technique differences in performing elastography and measuring lesions. Further work in standardizing the technique is required.

  13. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy

    Science.gov (United States)

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled based on the breast tissue components and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma (FA) and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity and specificity of 100%, 95.6%, 62.5% and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, FA or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study demonstrates the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing non-diagnostic and false negative biopsies. PMID:23729641

  14. Fear of missing a lesion: use of simulated breast models to decrease student anxiety when learning clinical breast examinations.

    Science.gov (United States)

    Pugh, Carla M; Salud, Lawrence H

    2007-06-01

    Medical students experience a considerable amount of discomfort during their training. The purpose of the current study was to identify sources of student anxiety when learning clinical breast examinations (CBEs) and to evaluate the effects of simulated breast models on student comfort. Simulated breast models were introduced into the curriculum for 175 second-year medical students. Using surveys, students identified sources of anxiety and rated their comfort levels when learning CBE skills. "Fear of missing a lesion" and the "Intimate/personal nature of the exam" accounted for 73.8% of student anxiety when learning CBEs. In addition, there were significant improvements (P student comfort levels when using simulated breast models to learn CBE skills. We have identified 2 of the top causes of anxiety for second-year medical students learning CBE. In addition, we found simulated breast models to be effective in increasing student comfort levels when learning CBEs.

  15. Radioguided breast surgery for occult lesion localization – correlation between two methods

    Directory of Open Access Journals (Sweden)

    Gutfilen Bianca

    2008-08-01

    Full Text Available Abstract Background The detection of sub-clinical breast lesions has increased with screening mammography. Biopsy techniques can offer precision and agility in its execution, as well as patient comfort. This trial compares radioguided occult lesion localization (ROLL and wire-guided localization (WL of breast lesions. We investigate if a procedure at the ambulatorial level (ROLL could lead to a better aesthetic result and less postoperative pain. In addition, we intend to demonstrate the efficacy of radioguided localization and removal of occult breast lesions using radiopharmaceuticals injected directly into the lesions and correlate radiological and histopathological findings. Methods One hundred and twenty patients were randomized into two groups (59 WL and 61 ROLL. The patients were requested to score the cosmetic appearance of their breast after surgery, and a numerical rating scale was used to measure pain on the first postoperative day. Clearance margins were considered at ≥ 10 mm for invasive cancer, ≥ 5 mm for ductal carcinoma in situ, and ≥ 1 mm for benign disease. Patients were subsequently treated according to the definitive histological result. When appropriate, different statistical tests were used in order to test the significance between the two groups, considering a P value Results WL and ROLL located all the occult breast lesions successfully. In the ROLL group, the specimen volume was smaller and there were more cases with clear margins (P Conclusion ROLL is an effective method for the excision of non-palpable breast lesions. It enables more careful planning of the cutaneous incision, leading to better aesthetic results, less postoperative symptoms, and smaller volumes of excised tissue.

  16. Expression of c-kit in common benign and malignant breast lesions.

    Science.gov (United States)

    Kondi-Pafiti, Agatha; Arkadopoulos, Nikolaos; Gennatas, Constantinos; Michalaki, Vassiliki; Frangou-Plegmenou, Matrona; Chatzipantelis, Paschalis

    2010-01-01

    c-kit (CD117) is a transmembrane tyrosine kinase that acts as a type III receptor for mast cell growth factor. In recent years, the role of c-kit in the development of preinvasive and invasive breast carcinomas has been investigated. The aim of our study was to detect c-kit expression in the entire spectrum of common benign and malignant breast lesions in correlation with a well-studied myoepithelial or stem-cell like marker (p63). We evaluated 270 cases of benign and malignant breast lesions including fibrocystic disease, fibroadenoma, sclerosing adenosis, atypical ductal hyperplasia, ductal/lobular carcinoma in situ, and ductal/lobular/mixed type carcinoma. C-kit staining was evaluated in the cytoplasm/cell membrane in epithelial and myoepithelial cells and p63 in the nuclei of myoepithelial cells. c-kit was highly expressed (85.3%) in benign lesions (fibrocystic disease, sclerosing adenosis, fibroadenoma), and p63 expression was 95.5% in the aforementioned lesions. c-kit distribution in preinvasive and invasive lesions was as follows: ductal/lobular carcinoma in-situ, 43%/35%; ductal/lobular carcinoma, 36%/39%; and mixed type carcinoma, 20%. c-kit was highly expressed in myofibroblast/fibroblast cells only in grade III ductal/lobular carcinomas. c-kit was totally absent in stromal cells in benign lesions and in situ carcinomas whereas expression was weak in grade I and II carcinomas. Combined overexpression of c-kit and p63 is indicative of benign breast lesions. In contrast, there is reduced expression of c-kit in in situ and invasive breast carcinomas, with simultaneous overexpression in the stromal cells. This suggests that c-kit may play a role in breast cancer progression.

  17. Breast Lesions Evaluated by Color-Coded Acoustic Radiation Force Impulse (ARFI) Imaging.

    Science.gov (United States)

    Zhou, JianQiao; Yang, ZhiFang; Zhan, WeiWei; Zhang, JingWen; Hu, Na; Dong, YiJie; Wang, YingYing

    2016-07-01

    The goal of our study was to investigate the value of color-coded Virtual Touch tissue imaging (VTI) using acoustic radiation force impulse (ARFI) technology in the characterization of breast lesions and to compare it with conventional ultrasound (US). Conventional US and color-coded VTI were performed in 196 solid breast lesions in 196 consecutive women (age range 17-91 y; mean 48.17 ± 14.46 y). A four-point scale VTI score was assigned for each lesion according to the color pattern both in the lesion and in the surrounding breast tissue. The mean VTI score was significantly higher for malignant lesions (3.80 ± 0.66, range 1-4) than for benign ones (2.02 ± 1.20, range 1-4) (p breast lesions. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  18. Assessing algorithms for defining vascular architecture in subharmonic images of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Eisenbrey, John R; Joshi, Neha; Dave, Jaydev K; Forsberg, Flemming, E-mail: Flemming.Forsberg@jefferson.edu [Department of Radiology, Thomas Jefferson University, 137 South 10th St, Philadelphia, PA 19107 (United States)

    2011-02-21

    The ability to accurately and non-invasively characterize breast lesions and their vasculature would greatly limit the number of unneeded biopsies performed annually. Subharmonic ultrasound imaging (SHI) allows exclusive imaging of vasculature in real time, while completely suppressing tissue signals. Previously, cumulative maximum intensity (CMI) projections of SHI data were shown to be useful for characterization, but lacked means of quantification. In this study we investigate three potential thinning algorithms for defining breast lesion architecture. Sequential thinning, parallel thinning, and distance transformation algorithms were compared using 40 in vitro test images. Sequential thinning was selected due to superior connectivity, minimal rotational variance, and sufficient data reduction. This algorithm was then applied to 16 CMI SHI images of breast lesions, out of which 13 were successfully skeletonized. Average bifurcations were 9.8 {+-} 8.18 and 6.9 {+-} 6.50 in malignant and benign lesions, respectively (p > 0.60). Average vessel-chain length was 88.9 {+-} 79.10 pixels versus 63.2 {+-} 45.65 pixels in malignant versus benign lesions (p > 0.40). While the sequential thinning algorithm was promising for quantifying breast vasculature, its ability to significantly differentiate between malignant and benign lesions in this study was limited by a high degree of variability and limited sample size.

  19. Assessing algorithms for defining vascular architecture in subharmonic images of breast lesions.

    Science.gov (United States)

    Eisenbrey, John R; Joshi, Neha; Dave, Jaydev K; Forsberg, Flemming

    2011-02-21

    The ability to accurately and non-invasively characterize breast lesions and their vasculature would greatly limit the number of unneeded biopsies performed annually. Subharmonic ultrasound imaging (SHI) allows exclusive imaging of vasculature in real time, while completely suppressing tissue signals. Previously, cumulative maximum intensity (CMI) projections of SHI data were shown to be useful for characterization, but lacked means of quantification. In this study we investigate three potential thinning algorithms for defining breast lesion architecture. Sequential thinning, parallel thinning, and distance transformation algorithms were compared using 40 in vitro test images. Sequential thinning was selected due to superior connectivity, minimal rotational variance, and sufficient data reduction. This algorithm was then applied to 16 CMI SHI images of breast lesions, out of which 13 were successfully skeletonized. Average bifurcations were 9.8 ± 8.18 and 6.9 ± 6.50 in malignant and benign lesions, respectively (p > 0.60). Average vessel-chain length was 88.9 ± 79.10 pixels versus 63.2 ± 45.65 pixels in malignant versus benign lesions (p > 0.40). While the sequential thinning algorithm was promising for quantifying breast vasculature, its ability to significantly differentiate between malignant and benign lesions in this study was limited by a high degree of variability and limited sample size.

  20. PRIMARY BREAST SARCOMA: CASE REPORT S. HASSAN and G ...

    African Journals Online (AJOL)

    hi-tech

    East African Medical Journal Vol. 81 No. 7 July 2004. PRIMARY BREAST SARCOMA: CASE REPORT. S. Hassan, BSc., MBChB, MMed, (Surg) FCS, Consultant Surgeon, Nairobi Womens Hospital Breast Center and Senior Lecturer, Department of Human Anatomy,. College of Health Sciences, University of Nairobi, P.O. ...

  1. Primary Bilateral Breast Burkitt\\'s Lymphoma, Presenting for ...

    African Journals Online (AJOL)

    INTRODUCTION: Primary breast lymphoma is a rare disease. The treatment of lymphomas is chemotherapy and radiotherapy. SUBJECT: We present a 22-year old lady who was referred to the plastic surgery unit for a reduction mammoplasty following a painless bilateral breast enlargement. The initial investigations ...

  2. Correlation between enhancement characteristics of MR mammography and capillary density of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Poellinger, Alexander, E-mail: alexander.poellinger@charite.de [Charité, Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany); El-Ghannam, Sahra; Diekmann, Susanne; Fischer, Thomas [Charité, Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany); Kristiansen, Glen [Universitätsklinikum Bonn, Department of Pathology, Sigmund-Freud-Str. 25, D-53127 Bonn (Germany); Fritzsche, Florian [Institut für Histologie und Zytologie, Bahnhofplatz 11, Postfach, 9101 Herisau (Switzerland); Fallenberg, Eva [Charité, Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany); Morawietz, Lars [Diagnostik Ernst von Bergmann GmbH, Charlottenstr. 72, 14467 Potsdam (Germany); Diekmann, Felix [Charité, Universitätsmedizin Berlin, Department of Radiology, Augustenburger Platz 1, 13353 Berlin (Germany)

    2014-12-15

    Highlights: • We correlate capillary density of breast lesions with MRM. • Capillary density correlates with tumor enhancement for all lesions. • However no such correlation exists for the malignant or benign groups separately. • Mean vessel number of lymphatic vessels do not correlate with tumor enhancement.These results might be of help in the workup of MR-guided breast biopsies. • These results might be of help in the workup of MR-guided breast biopsies. - Abstract: Objective: To correlate capillary density of breast lesions using the markers D2-40, CD31, and CD34 with early and late enhancement of magnetic resonance mammography (MRM). Materials and methods: The local ethics committee approved this study, and informed consent was available from all patients. The study included 64 women with 66 histologically proven breast lesions (41 malignant, 25 benign). MR-enhancement 1 min after contrast medium administration was determined in the tumor (I{sub t1}/I{sub t0} ratio) and in comparison to the surrounding tissue (I{sub t1}/I{sub t1-fat} ratio). Capillary density was quantified based on immunohistological staining with D2-40, CD31, and CD34 in breast tumors and surrounding breast tissue. Mean capillary densities were correlated with contrast enhancement in the tumor and surrounding breast tissue. The Kruskal–Wallis test was used to test whether lesions with different MR enhancement patterns differed in terms of capillary density. Results: For CD34, there was statistically significant correlation between capillary density and tumor enhancement (r = 0.329, p = 0.012), however not for the malignant or benign groups separately. Mean vessel number identified by staining with D2-40 and CD31 did not correlate significantly with tumor enhancement (D2-40: r = −0.188, p = 0.130; CD31: r = 0.095, p = 0.448). There were no statistically significant differences in capillary density between breast lesions with delayed enhancement or a plateau and lesions showing

  3. Visualization of suspicious lesions in breast MRI based on intelligent neural systems

    Science.gov (United States)

    Twellmann, Thorsten; Lange, Oliver; Nattkemper, Tim Wilhelm; Meyer-Bäse, Anke

    2006-05-01

    Intelligent medical systems based on supervised and unsupervised artificial neural networks are applied to the automatic visualization and classification of suspicious lesions in breast MRI. These systems represent an important component of future sophisticated computer-aided diagnosis systems and enable the extraction of spatial and temporal features of dynamic MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogenity of the cancerous tissue, these techniques reveal the malignant, benign and normal kinetic signals and and provide a regional subclassification of pathological breast tissue. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging.

  4. Preparation and administration of I-125 labeled seeds for localization of nonpalpable breast lesions

    DEFF Research Database (Denmark)

    Langhans, Linnea; Klausen, Thomas Levin; Tvedskov, Tove Holst Filtenborg

    2016-01-01

    Radioactive seed localization (RSL) is a new technique for surgical identification of nonpalpable breast lesions. We describe the preparation of the needle with I-125 seeds for ultrasound-guided deposition in breast lesions. In a feasibility study we investigated the minimum activity amount needed...... identified. The surgeon removed the seeds together with the breast lesions, and they were identified by the pathologist. There were no unexpected adverse drug reactions. Water bath studies suggest that 1-3 MBq I-125 was sufficient for precise identification, regardless of the presence of conventional Tc-99m...... for this promising new radioguided surgical technique. The radiation exposure to staff involved is considerably below the permissible limits and almost negligible....

  5. Time to enhancement derived from ultrafast breast MRI as a novel parameter to discriminate benign from malignant breast lesions

    NARCIS (Netherlands)

    Mus, R.D.M.; Borelli, C.; Bult, P.; Weiland, E.; Karssemeijer, N.; Barentsz, J.O.; Gubern-Merida, A.; Platel, B.; Mann, R.M.

    2017-01-01

    OBJECTIVES: To investigate time to enhancement (TTE) as novel dynamic parameter for lesion classification in breast magnetic resonance imaging (MRI). METHODS: In this retrospective study, 157 women with 195 enhancing abnormalities (99 malignant and 96 benign) were included. All patients underwent a

  6. Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound

    NARCIS (Netherlands)

    Liu, H.; Tan, T.; Zelst, J. van; Mann, R.; Karssemeijer, N.; Platel, B.

    2014-01-01

    We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing

  7. YKL-40 expression in benign and malignant lesions of the breast: a methodologic study

    DEFF Research Database (Denmark)

    Roslind, Anne; Johansen, Julia S; Junker, Nanna

    2007-01-01

    Elevated serum levels of the protein YKL-40 are associated with a poor prognosis in patients with solid and hematologic malignancies including breast cancer. The aim of this study was to develop a valid reproducible immunohistochemical method to visualize YKL-40 expression in normal breast tissue...... diffuse cytoplasmic YKL-40 immunoreactivity. No nuclear and membrane staining was found. A subpopulation of cells of macrophage morphology in normal breast tissue and in malignant lesions showed strong YKL-40 immunoreactivity.......Elevated serum levels of the protein YKL-40 are associated with a poor prognosis in patients with solid and hematologic malignancies including breast cancer. The aim of this study was to develop a valid reproducible immunohistochemical method to visualize YKL-40 expression in normal breast tissue...... as well as in benign and malignant breast lesions. The presence of YKL-40 in breast tissue was verified by in situ hybridization and protein extraction procedures. An immunohistochemical method was developed and 4 different antibodies directed against YKL-40 were tested. Ten patients with normal breast...

  8. 89Zr-bevacizumab PET imaging in primary breast cancer

    NARCIS (Netherlands)

    Gaykema, Sietske B M; Brouwers, Adrienne H; Lub-de Hooge, Marjolijn N; Pleijhuis, Rick G; Timmer-Bosscha, Hetty; Pot, Linda; van Dam, Gooitzen M; van der Meulen, Sibylle B; de Jong, Johan R; Bart, Joost; de Vries, Jakob; Jansen, Liesbeth; de Vries, Elisabeth G. E.; Schröder, Carolien P; de Vries, J

    UNLABELLED: Vascular endothelial growth factor (VEGF)-A is overexpressed in most malignant and premalignant breast lesions. VEGF-A can be visualized noninvasively with PET imaging and using the tracer (89)Zr-labeled bevacizumab. In this clinical feasibility study, we assessed whether VEGF-A in

  9. Targeting breast cancer outcomes-what about the primary relatives?

    LENUS (Irish Health Repository)

    Johnston, Alison

    2017-07-01

    Up to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately.

  10. Eccrine hidradenoma of the breast: distinct pathological lesion mimicking a carcinoma

    Directory of Open Access Journals (Sweden)

    Olfa El Amine El Hadj

    2016-10-01

    Full Text Available Eccrine hidradenoma (EH is a rare benign cutaneous neoplasm, believed to arise from the distal excretory duct of the eccrine sweat glands. We report an exceptional lesion of eccrine hidradenoma localized to the breast and clinically mimicking a carcinoma of the breast. Aim: We aim to describe the pathological characteristics of this lesion. We report the case of a 59 year old woman. She presented with a right-sided breast nodule. Physical examination, found a mobile firm nodule retracting the skin. By ultrasound examination, the tumor was heterogeneous and measured 11 mm in great diameter. A local surgical excision of the nodule was performed. By histological exam, the diagnosis of EH was retained. The complement of immunohistochemistry was not requested. This tumor is usually confined to the dermis or subcutaneous layer without. EH of the breast is an uncommon site. Histopathological confirmation is necessary and wide excision of these tumors is the treatment of choice.

  11. Advances in Optical Spectroscopy and Imaging of Breast Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S; Vogel, A J; Gandjbakhche, A H

    2006-01-03

    A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and monitoring of treatment.

  12. Second-look US examination of MR-detected breast lesions.

    Science.gov (United States)

    Candelaria, Rosalind; Fornage, Bruno D

    2011-01-01

    To review our institutional experience in using second-look ultrasound (SLUS) to identify breast lesions initially detected on MR imaging that were indeterminate or suspicious for malignancy. This Health Insurance Portability and Accountability Act compliant retrospective review included 83 women with 131 lesions initially identified as indeterminate or suspicious for malignancy on MR imaging from February 1, 2008 through July 31, 2009. An SLUS correlate was confirmed on the basis of concordant location, size, and morphologic features. The detection rate of SLUS was determined. Patients' demographics, lesion size, and MR imaging morphologic features (focus, mass, non-masslike) were reviewed to identify which factors led to successful detection on SLUS. Likelihood ratio χ(2) tests were used for statistical analysis. SLUS correlates were found for 88 of 131 (67%) lesions initially detected on MR imaging; 27 of 88 (31%) were malignant. SLUS detected foci (67%) and masses (73%) more frequently than it did non-masslike lesions (54%). The detection rate of SLUS was independent of lesion size on MR imaging. Malignant lesions were not more likely than benign lesions to be detected on SLUS (61% versus 70%). SLUS provides value in the clinical workup of breast lesions that are indeterminate or suspicious for malignancy. It identified two thirds of the MR-detected lesions evaluated and permitted performance of US-guided needle biopsy on 70 of 88lesions. The likelihood of finding MR-detected lesions on SLUS was significantly higher for foci and masses than for non-masslike lesions (P < 0.05). Copyright © 2010 Wiley Periodicals, Inc.

  13. Breast lesion classification based on supersonic shear-wave elastography and automated lesion segmentation from B-mode ultrasound images.

    Science.gov (United States)

    Yu, Yanyan; Xiao, Yang; Cheng, Jieyu; Chiu, Bernard

    2018-02-01

    Supersonic shear-wave elastography (SWE) has emerged as a useful imaging modality for breast lesion assessment. Regions of interest (ROIs) were required to be specified for extracting features that characterize malignancy of lesions. Although analyses have been performed in small rectangular ROIs identified manually by expert observers, the results were subject to observer variability and the analysis of small ROIs would potentially miss out important features available in other parts of the lesion. Recent investigations extracted features from the entire lesion segmented by B-mode ultrasound images either manually or semi-automatically, but lesion delineation using existing techniques is time-consuming and prone to variability as intensive user interactions are required. In addition, rich diagnostic features were available along the rim surrounding the lesion. The width of the rim analyzed was subjectively and empirically determined by expert observers in previous studies after intensive visual study on the images, which is time-consuming and susceptible to observer variability. This paper describes an analysis pipeline to segment and classify lesions efficiently. The lesion boundary was first initialized and then deformed based on energy fields generated by the dyadic wavelet transform. Features of the SWE images were extracted from inside and outside of a lesion for different widths of the surrounding rim. Then, feature selection was performed followed by the Support Vector Machine (SVM) classification. This strategy obviates the empirical and time-consuming selection of the surrounding rim width before the analysis. The pipeline was evaluated on 137 lesions. Feature selection was performed 20 times using different sets of 14 lesions (7 malignant, 7 benign). Leave-one-out SVM classification was performed in each of the 20 experiments with a mean sensitivity, specificity and accuracy of 95.1%, 94.6% and 94.8% respectively. The pipeline took an average of 20

  14. Magnetic Resonance Spectroscopy of the Breast at 3T: Pre- and Post-Contrast Evaluation for Breast Lesion Characterization

    Directory of Open Access Journals (Sweden)

    E. Kousi

    2012-01-01

    Full Text Available Purpose. To determine whether in vivo proton magnetic resonance spectroscopy at 3T can provide accurate breast lesion characterization, and to determine the effect of gadolinium on the resonance of tCho. Methods. Twenty-four positive-mammogram patients were examined on a 3T MR scanner. 1H-MRS was performed before and after gadolinium administration. tCho peak was qualitatively evaluated before and after contrast injection. Results. Fourteen out of 27 lesions proved to be malignant after histopathological diagnosis. Using 1H-MRS, before contrast injection, 6/14 confirmed malignancies and 11/13 benign lesions were correctly classified; while, after contrast injection, 11/14 confirmed malignancies and 12/13 benign processes were correctly classified. Post gadolinium 1H-MRS proved useful in picking up tCho signal, improving the overall accuracy, sensitivity, and specificity by 35%, 83%, and 9%, respectively. Conclusion. 1H-MRS overall accuracy, sensitivity, and specificity in detecting breast lesion’s malignancy were increased after gadolinium administration. It is prudent to perform 1H-MRS before contrast injection in large breast lesions to avoid choline underestimation. In cases of small or non-mass lesions, it is recommended to perform 1H-MRS after contrast injection for better voxel prescription to enable a reliable preoperative diagnosis.

  15. Dickkopf-1 negatively regulates the expression of osteoprotegerin, a key osteoclastogenesis inhibitor, by sequestering Lrp6 in primary and metastatic lytic bone lesions

    Science.gov (United States)

    Wang, Jian-Hang; Zhang, Yuanjin; Li, Hong-Yan; Liu, Yun-Yan; Sun, Tao

    2016-01-01

    Abstract Recently, an inverse role for Wnt signaling in the development of osteoclasts in the bone was demonstrated. In the present study, we examined whether there is a commonality in the mechanism of bone resorption and lysis that occur in a diverse set of bone metastatic lesions, as well as in primary bone lesions. Compared with control bone tissue and bone biopsies from patients with nonmetastatic primary tumors (i.e., breast carcinoma, lung adenocarcinoma, and prostate carcinoma), patients with bone metastatic lesions from the three aforementioned primary tumors, as well as osteolytic lesions obtained from the bone biopsies of patients with multiple myeloma, demonstrated an upregulated expression of the glycoprotein Dickkopf-1 at both the mRNA and protein levels. Additionally, by coimmunoprecipitation, Dickkopf-1 pulled-down low-density lipoprotein receptor-related protein 6 (Lrp6), which is a key downstream effector of the Wnt signaling pathway. The expression of Lrp6 was unaltered in the osteometastatic lesions. This negative regulation was associated with a lowered expression of osteoprotegerin in the osteometastatic lesions, an observation that was previously reported to promote osteoclastogenesis. These findings provide a common mechanism for the inverse relationship between the Wnt signaling pathway and the development of primary or metastatic bone lesions. Pharmacological modulation of the Wnt signaling pathway might benefit the clinical management of primary and metastatic bone lesions. PMID:27310953

  16. AXIAL-SHEAR STRAIN ELASTOGRAPHY FOR BREAST LESION CLASSIFICATION: FURTHER RESULTS FROM IN VIVO DATA

    OpenAIRE

    Thittai, Arun K.; Yamal, Jose-Miguel; Mobbs, Louise M; Kraemer-Chant, Christina M.; Chekuri, Srinivasa; Garra, Brian S.; Ophir, Jonathan

    2011-01-01

    The purpose of this work was to investigate the potential of the normalized axial-shear strain area (NASSA) feature, derived from axial-shear strain elastograms (ASSE), for breast lesion classification of fibroadenoma and cancer. This study consisted of previously-acquired in vivo digital RF-data of breast lesions. A total of 33 biopsy-proven malignant tumors and 30 fibroadenoma cases were included in the study that involved 3 observers blinded to the original BIRADS®-ultrasound scores. The o...

  17. Indeterminate breast lesions: Can contrast enhanced digital mammography change our decisions?

    OpenAIRE

    Samira Saraya; Lamia Adel; Asmaa Mahmoud

    2017-01-01

    Objective: To assess the efficiency of dual energy contrast enhanced mammography in the assessment of the indeterminate breast lesions (BIRADS 3 and BIRADS 4). Materials and methods: 34 female having 39 indeterminate breast lesions (BIRADS 3 and BIRADS 4) by digital mammography were further examined by dual energy contrast enhanced mammography. Two images were acquired at low and high energy in MLO view after 2 min and in CC view at 4 min post iodinated contrast injection (1.5 ml/kg with f...

  18. Unenhanced breast MRI (STIR, T2-weighted TSE, DWIBS): An accurate and alternative strategy for detecting and differentiating breast lesions.

    Science.gov (United States)

    Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe; Moschetta, Marco

    2015-10-01

    To assess the role of STIR, T2-weighted TSE and DWIBS sequences for detecting and characterizing breast lesions and to compare unenhanced (UE)-MRI results with contrast-enhanced (CE)-MRI and histological findings, having the latter as the reference standard. Two hundred eighty consecutive patients (age range, 27-73 years; mean age±standard deviation (SD), 48.8±9.8years) underwent MR examination with a diagnostic protocol including STIR, T2-weighted TSE, THRIVE and DWIBS sequences. Two radiologists blinded to both dynamic sequences and histological findings evaluated in consensus STIR, T2-weighted TSE and DWIBS sequences and after two weeks CE-MRI images searching for breast lesions. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for UE-MRI and CE-MRI were calculated. UE-MRI results were also compared with CE- MRI. UE-MRI sequences obtained sensitivity, specificity, diagnostic accuracy, PPV and NPV values of 94%, 79%, 86%, 79% and 94%, respectively. CE-MRI sequences obtained sensitivity, specificity, diagnostic accuracy, PPV and NPV values of 98%, 83%, 90%, 84% and 98%, respectively. No statistically significant difference between UE-MRI and CE-MRI was found. Breast UE-MRI could represent an accurate diagnostic tool and a valid alternative to CE-MRI for evaluating breast lesions. STIR and DWIBS sequences allow to detect breast lesions while T2-weighted TSE sequences and ADC values could be useful for lesion characterization. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. [Comparison of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis].

    Science.gov (United States)

    Liu, Y Y; Wu, S F; Liang, Z Y; Zeng, X

    2016-06-08

    To investigate the discordant rate of HER2 gene status between primary breast cancer and synchronous axillary lymph node metastasis. One hundred and fifty cases of primary breast cancer with corresponding synchronous lymph node metastases were collected, including 50 cases of HER2 FISH positive, 50 cases of HER2 FISH negative and 50 cases of HER2 FISH equivocal primary tumors, at Peking Union Medical College Hospital between May 2012 and June 2015. The HER2 gene status in lymph node metastatic tumors was analyzed by FISH, and the discordance of HER2 gene status was identified between primary and metastatic tumors. The incidence of discordant HER2 gene status between primary breast cancer and synchronous lymph node metastasis was 20.67%(31/150). Forty-four FISH positive, 3 FISH equivocal and 3 FISH negative cases were found in the first group of 50 patients with HER2 positive results in primary tumor. Forty seven FISH negative, 3 FISH equivocal cases were discovered in the second group of 50 patients with HER2 negative results in primary tumor. Four FISH positive, 18 FISH negative and 28 equivocal cases were observed in the third group of 50 patients with HER2 equivocal results in primary tumor. The discordance of HER2 gene status between primary tumor and lymph node metastasis in the third group of patients was significantly higher than the other two groups (Pgene status between the primary and lymph node metastatic tumors exists. Patients with lymph node metastasis, simultaneous testing of HER2 status may be performed in both primary breast tumor and its lymph node metastasis. HER2 status of nodal metastatic lesion may be more relevant for guiding anti-HER2 target therapy.

  20. Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience.

    Science.gov (United States)

    Thind, C R; Desmond, S; Harris, O; Nadeem, R; Chagla, L S; Audisio, R A

    2005-06-01

    Wire-guided localization (WGL) of clinically occult breast lesions is a well established technique. The aim of this study was to evaluate radio-guided localization (ROLL) within the breast screening service of a district general hospital. The study group comprised 70 women who underwent ROLL under US and stereotaxis. This required an injection of Technetium-labelled colloidal albumen into the impalpable breast lesion. The women then proceeded to theatre, where localization was achieved with the use of a gamma probe. The lesion was identified by the presence of a high signal, caused by the injected isotope. The results of 70 consecutive cases in which a breast lesion was localized using ROLL were compared with the results of the latest 70 WGLs. All 140 lesions were successfully localized. However, the change in technique from WGL to ROLL offered significant benefits to patients. Our study demonstrated that ROLL is a practical and reliable localization technique. It can be implemented in hospital units without using valuable gamma camera time. The cost compares well with WGL. There is an improved cosmetic outcome for patients, and the very small quantity of radioactivity used is safe for both patients and staff.

  1. Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience

    Energy Technology Data Exchange (ETDEWEB)

    Thind, C.R. [St Helens and Knowsley Hospitals, Prescot (United Kingdom)]. E-mail: thindr@aol.com; Desmond, S. [St Helens and Knowsley Hospitals, Prescot (United Kingdom); Harris, O. [St Helens and Knowsley Hospitals, Prescot (United Kingdom); Nadeem, R. [St Helens and Knowsley Hospitals, Prescot (United Kingdom); Chagla, L.S. [St Helens and Knowsley Hospitals, Prescot (United Kingdom); Audisio, R.A. [St Helens and Knowsley Hospitals, Prescot (United Kingdom)

    2005-06-01

    AIM: Wire-guided localization (WGL) of clinically occult breast lesions is a well established technique. The aim of this study was to evaluate radio-guided localization (ROLL) within the breast screening service of a district general hospital. METHOD: The study group comprised 70 women who underwent ROLL under US and stereotaxis. This required an injection of Technetium-labelled colloidal albumen into the impalpable breast lesion. The women then proceeded to theatre, where localization was achieved with the use of a gamma probe. The lesion was identified by the presence of a high signal, caused by the injected isotope. The results of 70 consecutive cases in which a breast lesion was localized using ROLL were compared with the results of the latest 70 WGLs. RESULTS: All 140 lesions were successfully localized. However, the change in technique from WGL to ROLL offered significant benefits to patients. CONCLUSION: Our study demonstrated that ROLL is a practical and reliable localization technique. It can be implemented in hospital units without using valuable gamma camera time. The cost compares well with WGL. There is an improved cosmetic outcome for patients, and the very small quantity of radioactivity used is safe for both patients and staff.

  2. Agreement between a computer-assisted tool and radiologists to classify lesions in breast elastography images

    Science.gov (United States)

    Marcomini, Karem D.; Fleury, Eduardo F. C.; Oliveira, Vilmar M.; Carneiro, Antonio A. O.; Schiabel, Homero; Nishikawa, Robert M.

    2017-03-01

    Breast elastography is a new sonographic technique that provides additional information to evaluate tissue stiffness. However, interpreting breast elastography images can vary depending on the radiologist. In order to provide quantitative and less subjective data regarding the stiffness of a lesion, we developed a tool to measure the amount of hard area in a lesion from the 2D image. The database consisted of 78 patients with 83 breast lesions (31 malignant and 52 benign). Two radiologists and one resident manually drew the contour of the lesions in B-mode ultrasound images and the contour was mapped in the elastography image. By using the system proposed, the radiologists obtained a very good diagnostic agreement among themselves (kappa = 0.86), achieving the same sensitivity and specificity (80.7 and 88.5, respectively), and an AUC of 0.883 for Radiologist 1 and 0.892 for Radiologist 2. The Resident had less interobserver agreement, as well as lower specificity and AUC, which may be related to less experience. Furthermore, the radiologists had an agreement with the tool used in the automatic method higher than 90%. Thus, the method developed was useful in aiding the diagnosis of breast lesions in strain elastography, minimizing its subjectivity.

  3. Stereotaxic Fine-Needle Aspiration Cytologic Evaluation of Non-palpable Breast Lesions

    Directory of Open Access Journals (Sweden)

    M Haghighi

    2005-07-01

    Full Text Available Background: Although long-term mammography is the standard means of evaluation for the probably benign lesions of breast, some times we feel obliged to know about the benignity and the extent of lesions earlier. Therefore we evaluated the diagnostic value of stereotaxic fine-needle aspiration (SFNA in low suspicion breast lesions as an alternative to the routine modality. Methods: The study included 150 low-suspicion or probably benign breast lesions detected on mammography. All cases underwent SFNA and followed by exciosional biopsy or follow-up mammography based on SFNA findings. Results: Fibroadenoma and normal tissue lesions were diagnosed in 57% of patients, in whom no evidence of malignancy was found in the follow-up period. In 48 patients with cytologic findings suggestive of proliferative fibrocystic disease, three cases of malignancy were detected by excisional biopsy. Conclusion: A SFNA result suggesting benignity allows safe clinical follow-up, whereas a suspicious or equivocal diagnosis needs more invasive modalities for further investigations. Key words: Breast, Mammography, Stereotaxic, Fine-Needle Aspiration (FNA

  4. Primary Leiomyosarcoma of the Breast: A Case Report

    Science.gov (United States)

    Akkaya, Hampar; Moray, Gökhan

    2012-01-01

    Primary leiomyosarcoma of the breast is an extremely rare tumor, accounting for less than 1% of all breast tumors and only 24 cases have been reported in the English medical journals. It is quite difficult to diagnose leiomyosarcoma preoperatively. Establishing an accurate diagnosis is very important in planning treatment. When preoperative diagnosis can be achieved before or during the operation, wide resection should be performed. There is no need for axillary lymph node dissection. In this case report, we present a case involving primary leiomysarcoma of the breast in a 48-year-old woman and we discuss optimal treatment options. PMID:22493639

  5. Primary leiomyosarcoma of the breast: a case report.

    Science.gov (United States)

    Karabulut, Zülfikar; Akkaya, Hampar; Moray, Gökhan

    2012-03-01

    Primary leiomyosarcoma of the breast is an extremely rare tumor, accounting for less than 1% of all breast tumors and only 24 cases have been reported in the English medical journals. It is quite difficult to diagnose leiomyosarcoma preoperatively. Establishing an accurate diagnosis is very important in planning treatment. When preoperative diagnosis can be achieved before or during the operation, wide resection should be performed. There is no need for axillary lymph node dissection. In this case report, we present a case involving primary leiomysarcoma of the breast in a 48-year-old woman and we discuss optimal treatment options.

  6. Parametric imaging using subharmonic signals from ultrasound contrast agents in patients with breast lesions.

    Science.gov (United States)

    Eisenbrey, John R; Dave, Jaydev K; Merton, Daniel A; Palazzo, Juan P; Hall, Anne L; Forsberg, Flemming

    2011-01-01

    Parametric maps showing perfusion of contrast media can be useful tools for characterizing lesions in breast tissue. In this study we show the feasibility of parametric subharmonic imaging (SHI), which allows imaging of a vascular marker (the ultrasound contrast agent) while providing near complete tissue suppression. Digital SHI clips of 16 breast lesions from 14 women were acquired. Patients were scanned using a modified LOGIQ 9 scanner (GE Healthcare, Waukesha, WI) transmitting/receiving at 4.4/2.2 MHz. Using motion-compensated cumulative maximum intensity (CMI) sequences, parametric maps were generated for each lesion showing the time to peak (TTP), estimated perfusion (EP), and area under the time-intensity curve (AUC). Findings were grouped and compared according to biopsy results as benign lesions (n = 12, including 5 fibroadenomas and 3 cysts) and carcinomas (n = 4). For each lesion CMI, TTP, EP, and AUC parametric images were generated. No significant variations were detected with CMI (P = .80), TTP (P = .35), or AUC (P = .65). A statistically significant variation was detected for the average pixel EP (P = .002). Especially, differences were seen between carcinoma and benign lesions (mean ± SD, 0.10 ± 0.03 versus 0.05 ± 0.02 intensity units [IU]/s; P = .0014) and between carcinoma and fibroadenoma (0.10 ± 0.03 versus 0.04 ± 0.01 IU/s; P = .0044), whereas differences between carcinomas and cysts were found to be nonsignificant. In conclusion, a parametric imaging method for characterization of breast lesions using the high contrast to tissue signal provided by SHI has been developed. While the preliminary sample size was limited, results show potential for breast lesion characterization based on perfusion flow parameters.

  7. Impact of fibroglandular tissue and background parenchymal enhancement on diffusion weighted imaging of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Iacconi, Chiara, E-mail: chiara.iacconi@tin.it [Breast Unit, USL1 Massa-Carrara, Piazza Monzoni 2, Carrara 54033 (Italy); Thakur, Sunitha B., E-mail: thakurs@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, NY 1275 York Avenue, New York, NY 10065 (United States); Dershaw, David D., E-mail: dershawd@mskcc.org [Department of Radiology – Breast Imaging Center, Memorial Sloan-Kettering Cancer Center, NY 1275 York Avenue, New York, NY 10065 (United States); Brooks, Jennifer, E-mail: brooksj@mskcc.org [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, New York, NY 10065 (United States); Fry, Charles W., E-mail: charles_fry@nymc.edu [Memorial Sloan-Kettering Cancer Center, NY 1275 York Avenue, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: morrise@mskcc.org [Department of Radiology – Breast Imaging Center, Memorial Sloan-Kettering Cancer Center, NY 1275 York Avenue, New York, NY 10065 (United States)

    2014-12-15

    Highlights: • Aim of the paper is to evaluate if the amount of fibroglandular breast tissue (FGT) and the background enhancement(BPE) influence the detection of lesions and their quantitative analysis in diffusion weighted imaging(DWI) • The structure of the breast, including both FGT and BPE, as well as the menopausal status of the patient are not a relevant factor for lesion identification in DWI. • Quantitative analysis of normal breast is not uniform and is influenced by the amount of fibroglandular tissue,while there is no influence of background parenchymal enhancement. - Abstract: Purpose: To evaluate the influence of the amount of fibroglandular breast tissue (FGT) and background-parenchymal enhancement (BPE) on lesion detection, quantitative analysis of normal breast tissue and of breast lesions on DWI. Materials and methods: IRB approved this retrospective study on focal findings at contrast-enhanced (CE) breast MR and DWI performed during July–December 2011. Patients with cysts, previous irradiation, silicone implants and current chemotherapy were excluded. DWI with fat suppression was acquired before dynamic acquisition (b factors: 0.1000 s/mm{sup 2}) using 1.5 and 3 T scanners. Using correlation with dynamic and T2 images, ROIs were drawn free-hand within the borders of any visible lesion and in contralateral normal breast. Fisher's exact test to evaluate visibility and Wilcoxon-rank-sum test for comparison of ADC values were used. The amount of FGT and BPE was visually assessed by concurrent MRI. Analysis was stratified by menopausal status. Results: 25/127 (20%) lesions were excluded for technical reasons. 65/102 (64%) lesions were visible on DWI (median diameter: 1.85 cm). Mass lesions (M) were more visible (43/60 = 72%) than non-mass enhancement (NME) (22/42 = 52%) and malignant lesions were more visible (55/72 = 76%) than benign (10/30 = 33%). BPE and FGT did not influence visibility of M (p = 0.35 and p = 0.57 respectively) as well

  8. Improving the Accuracy of Computer-aided Diagnosis for Breast MR Imaging by Differentiating between Mass and Nonmass Lesions.

    Science.gov (United States)

    Gallego-Ortiz, Cristina; Martel, Anne L

    2016-03-01

    To determine suitable features and optimal classifier design for a computer-aided diagnosis (CAD) system to differentiate among mass and nonmass enhancements during dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast. Two hundred eighty histologically proved mass lesions and 129 histologically proved nonmass lesions from MR imaging studies were retrospectively collected. The institutional research ethics board approved this study and waived informed consent. Breast Imaging Reporting and Data System classification of mass and nonmass enhancement was obtained from radiologic reports. Image data from dynamic contrast-enhanced MR imaging were extracted and analyzed by using feature selection techniques and binary, multiclass, and cascade classifiers. Performance was assessed by measuring the area under the receiver operating characteristics curve (AUC), sensitivity, and specificity. Bootstrap cross validation was used to predict the best classifier for the classification task of mass and nonmass benign and malignant breast lesions. A total of 176 features were extracted. Feature relevance ranking indicated unequal importance of kinetic, texture, and morphologic features for mass and nonmass lesions. The best classifier performance was a two-stage cascade classifier (mass vs nonmass followed by malignant vs benign classification) (AUC, 0.91; 95% confidence interval (CI): 0.88, 0.94) compared with one-shot classifier (ie, all benign vs malignant classification) (AUC, 0.89; 95% CI: 0.85, 0.92). The AUC was 2% higher for cascade (median percent difference obtained by using paired bootstrapped samples) and was significant (P = .0027). Our proposed two-stage cascade classifier decreases the overall misclassification rate by 12%, with 72 of 409 missed diagnoses with cascade versus 82 of 409 missed diagnoses with one-shot classifier. Separately optimizing feature selection and training classifiers for mass and nonmass lesions improves the accuracy

  9. MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Velloso, Maria J.; Ribelles, Maria J.; Rodriguez, Macarena; Sancho, Lidia; Prieto, Elena [Clinica Universidad de Navarra, Department of Nuclear Medicine, Pamplona (Spain); Fernandez-Montero, Alejandro [Clinica Universidad de Navarra, Department of Occupational Medicine, Pamplona (Spain); Santisteban, Marta [Clinica Universidad de Navarra, Department of Oncology, Pamplona (Spain); Rodriguez-Spiteri, Natalia; Martinez-Regueira, Fernando [Clinica Universidad de Navarra, Department of Surgery, Pamplona (Spain); Idoate, Miguel A. [Clinica Universidad de Navarra, Department of Pathology, Pamplona (Spain); Elizalde, Arlette; Pina, Luis J. [Clinica Universidad de Navarra, Department of Radiology, Pamplona (Spain)

    2017-08-15

    Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions). The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p < 0.01). MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI. (orig.)

  10. Imaging findings of primary breast sarcoma: Results of a first multicenter study.

    Science.gov (United States)

    Wienbeck, Susanne; Meyer, Hans Jonas; Herzog, Aimee; Nemat, Sogand; Teifke, Andrea; Heindel, Walter; Schäfer, Fritz; Kinner, Sonja; Müller-Schimpfle, Markus; Surov, Alexey

    2017-03-01

    To investigate imaging findings in patients with primary breast sarcoma (PBS). A retrospective search in the databases of 10 radiological departments in Germany from 2000 to 2011 was performed. Only histologically proven cases of PBS were included into the study. Mammography was available in 31 patients (33 lesions), ultrasound images in 24 patients (24 lesions), and for 10 patients (14 lesions) magnetic resonance imaging (MRI) of the breast was performed. The breast findings were classified according to the American College of Radiology Breast Imaging Reporting and Data Systems (BI-RADS) 5th edition categories. Collected data were evaluated by means of descriptive statistics. Forty-two female patients (mean age 62.0 years, range, 30-86 years) were included in the study. Clinically, all women had painless lumps. Irregular (53.3% [16/30]) or oval (30.0% [9/30]) mass with indistinct (73.3% [22/30]) or microlobulated (10% [3/30]) margins were common findings on mammograms. Ultrasound revealed typically an irregular (79.2% [19/24]), hypoechoic (62.5% [15/24]) mass, with indistinct margins (79.2% [19/24]), and posterior acoustic shadowing (79.2% [19/24]). MRI showed irregular masses (81.8% [9/11]) with irregular or spiculated margins, and a rapid initial signal increase with a delayed washout in kinetic analysis. Overall, PBS has no pathognomonic imaging features and can mimic those of invasive mammary carcinoma. Breast sarcoma should be taken into the differential diagnosis of breast findings described above. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. In vivo proton magnetic resonance spectroscopy of breast lesions: an update.

    Science.gov (United States)

    Tse, Gary M; Yeung, David K Y; King, Ann D; Cheung, Humairah S; Yang, Wei-Tse

    2007-09-01

    In vivo proton magnetic resonance spectroscopy ((1)H-MRS) has been demonstrated to be successful in the differentiation of benign and malignant breast lesions in a non-invasive manner by detecting increased levels of composite choline (Cho) compounds. Currently there is molecular evidence of increased Cho metabolism in breast cancer cells. In breast malignancies, (1)H-MRS achieved a high-overall sensitivity (82%). Most test cases were infiltrating duct carcinoma, but infiltrating lobular, medullary, mucinous and adenoid cystic carcinomas were also positive by (1)H-MRS. Large lesional size is a pre-requisite for (1)H-MRS testing, and technical problems account for some of the false negative results. Another potential of (1)H-MRS is to assess patients' response to neoadjuvant chemotherapy. In ductal carcinoma in situ, the results of (1)H-MRS on the limited number of cases were negative. Most of the assessed benign breast lesions including fibroadenoma, fibrocystic changes, cysts and galactoceles, papilloma, tubular adenoma and phyllodes tumours and were mostly negative by (1)H-MRS, with an overall false positive rate was about 8%. Normal breast tissue was almost always negative by (1)H-MRS, whereas, lactating breast tissue showed positivity with a slightly different spectrum on further analysis. With the clinical use of stronger field MR scanners and better coils, the sensitivity of (1)H-MRS may be further improved. With these improvements, (1)H-MRS may potentially be useful in detection of smaller malignant lesions, characterization of malignant lesions into non-invasive or invasive, and as an invaluable tool in disease progression monitoring.

  12. Expression Patterns of Biomarkers in Primary Tumors and Corresponding Metastases in Breast Cancer

    DEFF Research Database (Denmark)

    Kümler, Iben; Balslev, Eva; Knop, Ann S

    2016-01-01

    Tumor heterogeneity has been shown for several cancers including breast cancer (BC). Despite the fact that expression of tumor markers may change throughout the metastatic process, rebiopsies at the time of recurrence are still not performed routinely at all institutions. The aims of the study were......, and Ki-67 in 110 paired samples of primary BC and corresponding asynchronous metastases. We found discordant expressions in primary tumor and metastasis for all biomarkers, although only significant for Ki-67. Changes in the expression profile of the metastatic lesions would have altered treatment...

  13. Effect of Precompression on the Power Doppler Assessment of Breast Lesion Vascularity.

    Science.gov (United States)

    DeVita, Robert; Barr, Richard G

    2017-02-01

    To evaluate the effect of precompression on power Doppler visualization of blood flow in breast masses. This Institutional Review Board-approved and Health Insurance Portability and Accountability Act-compliant study evaluated 30 patients with breast masses (16 benign and 14 malignant) undergoing ultrasound-guided breast biopsy. A computational mathematics program was used to calculate the number of color pixels in a region of interest at various degrees of compression of the breast by the transducer. The amount of precompression was calculated as previously described. The percentage of color pixels compared to minimal compression was plotted against the percentage of precompression. The amount of precompression needed to decrease the number of color pixels by 50% and 100% was calculated. The differences between benign and malignant lesions were compared. The mean percentages of precompression ± SD needed to decrease the number of color voxels by 50% in were 15.9% ± 6.43% (range, 8%-30%) for benign lesions and 14.0% ± 4.17% (range, 8%-20%) for malignant lesions (P = .35). The percentages of precompression needed to decrease the number of color pixels by 100% in were 34.7% ± 12.33% (range, 23%-62%) for benign lesions and for malignant lesions 26.7% ± 3.89% (range, 18%-31%), which were statistically significant (P = .027). The amount of precompression normally used when obtaining B-mode images can substantially decrease the number of color voxels on power Doppler sonography. When performing quantitative work on Doppler evaluation of breast lesions, precompression needs to be controlled. © 2016 by the American Institute of Ultrasound in Medicine.

  14. Quantitative evaluation of peripheral tissue elasticity for ultrasound-detected breast lesions.

    Science.gov (United States)

    Xiao, Y; Yu, Y; Niu, L; Qian, M; Deng, Z; Qiu, W; Zheng, H

    2016-09-01

    To evaluate the diagnostic performance of the quantitative measurement of peripheral tissue elasticity using shear-wave elastography (SWE) in differentiating between benign and malignant breast lesions detected by ultrasonography (US). This study was approved by institutional review board; informed consent was signed from all patients. From June 2012 to April 2014, conventional B-mode US and SWE were performed in 205 breast lesions (78 malignant, 127 benign) of 205 consecutive women (mean age, 41.9±12.3 years; age range, 18-76 years). For each lesion, a rim around its contour was constructed by using a computer-aided tool, including adequate adjacent peripheral tissue. Quantitative elastographic features of the rim (elasticity mean, maximum, standard deviation, and elasticity ratio) as well as Breast Imaging Reporting and Data System (BI-RADS) categories were assessed according to the final histopathological results. Sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curve analysis were performed to evaluate the diagnostic performances for the three data sets (conventional B-mode US alone, SWE features alone, and combined B-mode US and SWE features). SWE features of the peripheral tissue differed significantly between benign and malignant breast lesions (mean±standard deviation [SD]: elasticity mean, 16.1±6.6 versus 43.6±17.8; maximum, 55.4±31.4 versus 150.3±44.6; SD, 8.1±4.1 versus 30±13.8 and elasticity ratio, 1.1±0.2 versus 2±0.7, respectively, all pelastic properties of the peripheral tissue exhibited good discriminatory ability in differentiating US-detected breast lesions and could be used to further stratify low-suspicion lesions within BI-RADS category 3 and 4a to avoid unnecessary biopsy. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. Small breast lesion classification performance using the normalized axial-shear strain area feature.

    Science.gov (United States)

    Thittai, Arun K; Yamal, Jose-Miguel; Ophir, Jonathan

    2013-03-01

    Breast cancers that are found and confirmed because they are causing symptoms tend to be larger and are more likely to have already spread to the lymph nodes and beyond. Thus, early detection and confirmation are of paramount importance. The normalized axial-shear strain area (NASSA) feature from the axial-shear strain elastogram (ASSE) has been shown to be a feature that can identify the boundary-bonding conditions that are indicative of the presence of cancer. Recently, we investigated and reported on the potential of the NASSA feature for breast lesion classification into fibroadenomas and cancers. In this article, we investigate the size distribution of the lesions that were part of the previous study and analyze classification performance specifically on small lesions (NASSA feature from ASSE was computed semi-automatically. Receiver operating characteristic curves were then generated for the subset of cases involving small lesions. Box plots were produced for the two different lesion size groups, small and large, from a logistic regression classifier that was built previously. The results of our study show that approximately 38% and 22% of the fibroadenomas and cancers, respectively, were small. Furthermore, it was found that the NASSA feature resulted in a perfect classification of the small lesions, both in the training data and in the cross-validation. For lesions 10 mm had a difference of 0.52 ± 0.24 (p 10 mm). These results suggest that the ASSE feature can work equally well, even on small lesions, to improve the standard ultrasound BIRADS-based breast lesion classification of fibroadenoma and malignant tumors. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  16. Contrast-enhanced spectral mammography: Impact of the qualitative morphology descriptors on the diagnosis of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed Kamal, Rasha [Radiology Department (Women' s Imaging unit), Kasr ElAiny Hospital, Cairo University (Egypt); Hussien Helal, Maha [Radiology Department (Breast Imaging unit), National Cancer Institute, Cairo University (Egypt); Wessam, Rasha [Radiology Department (Women' s Imaging unit), Kasr ElAiny Hospital, Cairo University (Egypt); Mahmoud Mansour, Sahar, E-mail: sahar_mnsr@yahoo.com [Radiology Department (Breast Imaging unit), National Cancer Institute, Cairo University (Egypt); Godda, Iman [Pathology Department, National Cancer Institute, Cairo University (Egypt); Alieldin, Nelly [Statistics Department, National Cancer Institute, Cairo University (Egypt)

    2015-06-15

    Highlights: • We studied interpretation criteria for enhancing lesions on CESM. • We evaluated the enhancement patterns of 211 breast lesions. • Our results proved that CESM minimized positive and negative falsies in DM. • The proposed CESM lexicon helped in characterization and categorization. - Abstract: Objective: To analyze the morphology and enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) and to assess their impact on the differentiation between benign and malignant lesions. Materials and method: This ethics committee approved study included 168 consecutive patients with 211 breast lesions over 18 months. Lesions classified as non-enhancing and enhancing and then the latter group was subdivided into mass and non-mass. Mass lesions descriptors included: shape, margins, pattern and degree of internal enhancement. Non-mass lesions descriptors included: distribution, pattern and degree of internal enhancement. The impact of each descriptor on diagnosis individually assessed using Chi test and the validity compared in both benign and malignant lesions. The overall performance of CESM were also calculated. Results: The study included 102 benign (48.3%) and 109 malignant (51.7%) lesions. Enhancement was encountered in 145/211 (68.7%) lesions. They further classified into enhancing mass (99/145, 68.3%) and non-mass lesions (46/145, 31.7%). Contrast uptake was significantly more frequent in malignant breast lesions (p value ≤0.001). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p value ≤0.001). CESM showed an overall sensitivity of 88.99% and specificity of 83.33%. The positive and negative likelihood ratios were 5.34 and 0.13 respectively. Conclusion: The assessment of the morphology and enhancement characteristics of breast lesions on CESM enhances the performance of digital mammography in the differentiation between benign and malignant

  17. The added diagnostic value of dynamic contrast-enhanced MRI at 3.0 T in nonpalpable breast lesions

    NARCIS (Netherlands)

    Merckel, L.G.; Verkooijen, H.M.; Peters, N.H.G.M.; Mann, R.M.; Veldhuis, W.B.; Storm, R.K.; Weits, T.; Duvivier, K.M.; Dalen, T. van; Mali, W.P.Th.; Peeters, P.H.M.; Bosch, Martijn van den

    2014-01-01

    To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading.We evaluated MRI scans of patients with nonpalpable BI-RADS 3-5 lesions who underwent

  18. Ubiquitin-conjugating enzyme UBE2C is highly expressed in breast microcalcification lesions.

    Directory of Open Access Journals (Sweden)

    Chen-Pin Chou

    Full Text Available Ubiquitin-conjugating enzyme 2C (UBE2C contributes to ubiquitin-mediated proteasome degradation of cell cycle progression in breast cancer. Microcalcification (MC is the most common mammographic feature of early breast cancer. In this study, we evaluated whether UBE2C could be a tumor marker of early breast cancer with MC found on screening mammography. UBE2C protein and mRNA expression were measured in breast core biopsy pairs of MC and adjacent non-MC breast tissue from each subject. Immunohistochemistry revealed UBE2C positivity in 69.4% of MC samples and 77.6% negativity in non-MC samples (p<0.0001. On RT-qPCR, 56.1% of malignant MC lesion samples showed high mRNA level of UBE2C and 80% of benign MC lesion samples showed a low level of UBE2C (p = 0.1766. We investigated the carcinogenic role of UBE2C in MCF-7 breast cancer cells with UBE2C knockdown; UBE2C knockdown downregulated cell proliferation and activated the cellular apoptosis pathway to inhibit cell colony formation. Furthermore, UBE2C expression was associated with that of carcinogenic genes human epidermal growth factor receptor type 2 (HER2, cellular c-Ki-ras2 proto-oncogene (KRAS, vascular endothelial growth factor (VEGF, CXC chemokine receptor 4 (CXCR4, C-C motif chemokine 5 (CCL5, neural precursor cell expressed, developmentally downregulated 9 (NEDD9 and Ras homolog family member C (RhoC. UBE2C may be a marker for diagnosis of nonpalpable breast lesions but not benign or malignant tumors in mammography core biopsies. Suppression of UBE2C may be a potential therapy target in breast cancer.

  19. Mammographic quantitative image analysis and biologic image composition for breast lesion characterization and classification

    Energy Technology Data Exchange (ETDEWEB)

    Drukker, Karen, E-mail: kdrukker@uchicago.edu; Giger, Maryellen L.; Li, Hui [Department of Radiology, University of Chicago, Chicago, Illinois 60637 (United States); Duewer, Fred; Malkov, Serghei; Joe, Bonnie; Kerlikowske, Karla; Shepherd, John A. [Radiology Department, University of California, San Francisco, California 94143 (United States); Flowers, Chris I. [Department of Radiology, University of South Florida, Tampa, Florida 33612 (United States); Drukteinis, Jennifer S. [Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612 (United States)

    2014-03-15

    Purpose: To investigate whether biologic image composition of mammographic lesions can improve upon existing mammographic quantitative image analysis (QIA) in estimating the probability of malignancy. Methods: The study population consisted of 45 breast lesions imaged with dual-energy mammography prior to breast biopsy with final diagnosis resulting in 10 invasive ductal carcinomas, 5 ductal carcinomain situ, 11 fibroadenomas, and 19 other benign diagnoses. Analysis was threefold: (1) The raw low-energy mammographic images were analyzed with an established in-house QIA method, “QIA alone,” (2) the three-compartment breast (3CB) composition measure—derived from the dual-energy mammography—of water, lipid, and protein thickness were assessed, “3CB alone”, and (3) information from QIA and 3CB was combined, “QIA + 3CB.” Analysis was initiated from radiologist-indicated lesion centers and was otherwise fully automated. Steps of the QIA and 3CB methods were lesion segmentation, characterization, and subsequent classification for malignancy in leave-one-case-out cross-validation. Performance assessment included box plots, Bland–Altman plots, and Receiver Operating Characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) for distinguishing between benign and malignant lesions (invasive and DCIS) was 0.81 (standard error 0.07) for the “QIA alone” method, 0.72 (0.07) for “3CB alone” method, and 0.86 (0.04) for “QIA+3CB” combined. The difference in AUC was 0.043 between “QIA + 3CB” and “QIA alone” but failed to reach statistical significance (95% confidence interval [–0.17 to + 0.26]). Conclusions: In this pilot study analyzing the new 3CB imaging modality, knowledge of the composition of breast lesions and their periphery appeared additive in combination with existing mammographic QIA methods for the distinction between different benign and malignant lesion types.

  20. Metastatic Breast Lesion to the Falx Detected with PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, Chester; Schuster, David M. [Emory Univ., Atlanta (United States)

    2012-06-15

    Intracranial dural metastasis is increasingly encountered in imaging. Autopsies conducted on patients with advanced metastatic disease demonstrate dural involvement in 9% of cases, with breast and prostate cancer the most common primaries. Awareness of this entity and imaging appearances is especially important in evaluating malignancies prone to dural metastasis. A 57-year-old woman with a strong family history of breast cancer initially presented after self-detection of a right breast lump. Subsequent mammogram and biopsies yielded a diagnosis of right infiltrating ductal carcinoma with a positive lymph node as well as left invasive lobular carcinoma. Initial staging PET-CT (not shown) at the time of diagnosis demonstrated no abnormal FDG uptake remote from the breast. Neoadjuvant chemotherapy was instituted, and a PET-CT was obtained to evaluate disease response, demonstrating an approximately 1.8 cm hypermetabolic intra-cranial mass, localized to the region of the anterior corpus callosum on axian PET (Fig. 1a), axial fused PET-CT (Fig. 1b), and sagittal fused PET-CT (Fig. 1c) with a maximum SUV of 15.9. There was associated bifrontal vasogenic edema (Fig. 1d) on the CT demonstrated on brain windows. Marked progression of disease was noted elsewhere, including hypermetabolic adenopathy and skeletal disease. A contrast-enhanced MRI of the brain was obtained demonstrating extensive T1 hypointensity, T2, and FLAIR (Fig. 2a) hyperintensity in the bilateral paramedian frontallobes representing vasogenic edema. Post-contrast imaging demonstrated three solidly enhancing masses in the areas of described vasogenic edema, one large extra-axial and two sub-centimeter parenchymal lesions. The large extra-axial and two sub-centimeter parenchymal lesions. The large extra-axial mass demonstrated homogeneous solid enhancement, in the midline anteriorly centered on the falx, just superior to the anterior corpus callosum. This measured 1.7cm transverse x 3.1cm AP x 2.4cm

  1. Primary neuroendocrine carcinoma of breast with liver and bone metastasis detected with fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography.

    Science.gov (United States)

    Kamaleshwaran, Koramadai Karuppusamy; Mohanan, Vyshak; Shibu, Deepu; Radhakrishnan, Edathuruthy Kalarikal; Shinto, Ajit Sugunan

    2014-01-01

    Cases of primary neuroendocrine carcinoma (NEC) of the breast have been reported, though rare. We report the case of a 45-year-old woman presented with jaundice and evaluated to have liver metastasis from neuroendocrine origin. She underwent whole body positron emission tomography/computed tomography, which showed left breast lesion and bone metastasis. Fine-needle aspiration (FNA) of breast revealed a NEC. A diagnosis of a primary NEC of the breast was rendered with hepatic and bone metastasis. She was treated with peptide receptor radionuclide therapy and is on follow-up.

  2. Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique: initial observations.

    Science.gov (United States)

    Liu, He; Jiang, Yu-Xin; Liu, Ji-Bin; Zhu, Qing-Li; Sun, Qiang

    2008-10-01

    The objective of this study was to evaluate the usefulness of contrast-enhanced ultrasound using the microvascular imaging technique in the diagnosis of breast lesions. In 104 patients with 104 breast lesions scheduled for surgery, conventional and contrast-enhanced ultrasound using the microvascular imaging technique were performed after administration of SonoVue. The enhancement patterns of breast lesions were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, or heterogeneous enhancement based on the morphologic features of enhancement. The diagnostic value of contrast-enhanced ultrasound using the microvascular imaging technique was analyzed with the observers blinded to the clinical data and pathology (which served as the gold standard). None of the enhancement patterns was suggestive of benignity, with a sensitivity of 18.3%, specificity of 97.7%, positive predictive value (PPV) of 91.7%, negative predictive value (NPV) of 46.2%, and accuracy of 51.5%. The peripheral enhancement pattern was suggestive of malignancy, with a sensitivity of 39.5%, specificity of 98.3%, PPV of 94.4%, NPV of 69.4%, and accuracy of 73.8%. Homogeneous, regional, and heterogeneous enhancement patterns did not show meaningful diagnostic information. Contrast-enhanced ultrasound using the microvascular imaging technique provides diagnostic information on breast lesions.

  3. Audit of performance of needle core biopsy diagnoses of screen detected breast lesions.

    Science.gov (United States)

    El-Sayed, Maysa E; Rakha, Emad A; Reed, Jacquie; Lee, Andrew Hs; Evans, Andrew J; Ellis, Ian O

    2008-11-01

    Breast needle core biopsy (NCB) is now a standard diagnostic procedure in the triple assessment of screen detected breast lesions. Therefore, it is important to provide robust and up-to-date data on the performance of NCB in the screening setting. However, previous studies of NCB have suffered from either limitation in the number of assessed cases or included a mix of symptomatic and screen detected breast lesions. In this study, we have evaluated the performance of a large series of uniformly assessed NCBs of screen detected lesions (20001 cases) over a period of 10 years (1997-2007). Our results showed a gradual increase in the number of NCBs and an improvement of their performance over the period of the study; absolute sensitivity increased from 84.9% to 96.4% and complete sensitivity increased from 90.9% to 99.7%. There was also a gradual reduction in the number of surgical interventions after benign (B2) and negative (B1) NCB diagnoses. Our study provides data showing variance from the suggested thresholds for the measures of performance of NCB in the United Kingdom which could be used to provide updated evidence-based thresholds for assessment of performance of NCB diagnosis use in the assessment of breast cancer screen detected lesions in the UK and elsewhere.

  4. Clinical experiences with photoacoustic breast imaging: the appearance of suspicious lesions

    NARCIS (Netherlands)

    Heijblom, M.

    2014-01-01

    This thesis describes photoacoustic (PA) imaging of suspicious breast lesions. In PA imaging, the tissue of interest is illuminated by short pulses of laser light, usually in the near infrared (NIR) regime. Upon absorption by primarily the tumor vasculature, the light causes a small temperature

  5. The Influence of Primary Microenvironment on Prostate Cancer Osteoblastic Bone Lesion Development

    Science.gov (United States)

    2015-09-01

    AWARD NUMBER: W81XWH-12-1-0271 TITLE: The Influence of Primary Microenvironment on Prostate Cancer Osteoblastic Bone Lesion Development PRINCIPAL...31Aug 2015 4. TITLE AND SUBTITLE The Influence of Primary Microenvironment on Prostate Cancer Osteoblastic Bone Lesion Development 5a. CONTRACT NUMBER...initiate prostate cancer (PCa), promote PCa progression, and facilitate the development of mixed osteoblastic/osteolytic bone lesions . However, the

  6. Assessing breast cancer risk in a primary care setting.

    Science.gov (United States)

    Kiely, Deirdre; Schwartz, Shira

    2014-10-15

    Individuals who are given a preventive exam by a primary care provider are more likely to agree to cancer screening. The provider recommendation has been identified as the strongest factor associated with screening utilization. This article provides a framework for breast cancer risk assessment for an advanced practice registered nurse working in primary care practice.

  7. Prevalence comparison of accompanying lesions between primary and recurrent anterior dislocation in the shoulder.

    Science.gov (United States)

    Kim, Doo-Sup; Yoon, Yeo-Seung; Yi, Chang Ho

    2010-10-01

    Many authors have reported the presence of intra-articular lesions after primary dislocation of the shoulder joint. However, few studies have focused on their prevalence or the differences in accompanying lesions between primary and recurrent dislocations of the shoulder joint. This study was undertaken to investigate and analyze accompanying lesions, including types of anteroinferior labrum injuries, using diagnostic arthroscopy and magnetic resonance arthrography (MRA) in 144 patients with traumatic anterior dislocation of the shoulder joint. Cohort study; Level of evidence, 3. There were 33 patients with 33 dislocations in the primary dislocation group and 111 patients with 111 dislocations in the recurrent dislocation group. Preoperative magnetic resonance arthrography and diagnostic arthroscopy were performed on all patients. In the primary dislocation group, 8 Bankart lesions, 9 free anterior labrum periosteal sleeve avulsion (ALPSA) lesions, 4 bony Bankart lesions, and 1 adhesive ALPSA lesion were observed. In the recurrent dislocation group, 68 Bankart lesions, 11 free ALPSA lesions, 13 bony Bankart lesions, 16 adhesive ALPSA lesions, and 1 glenoid articular rim disruption lesion were found. There were 22 (66.6%) and 109 (98.1%) patients with lesions in the anteroinferior labrum in the primary and recurrent groups, respectively. There was a statistically significant difference between the 2 groups (P = .002). Also, there was a significant difference between the 2 groups in the prevalence of the Hill-Sachs lesion and inverted pear-shaped glenoid lesion (P = .008/P = .047). Inverted pear-shaped glenoids were observed in 15 patients in the recurrent group. In 139 of 144 patients, surgical findings of accompanying lesions coincided with magnetic resonance arthrography findings (96.5%). Various forms of anteroinferior labral lesions were seen in patients with traumatic anterior dislocation of shoulder. The recurrent dislocation group showed a significantly

  8. Lobular neoplasia found on breast biopsy: marker of increased risk of malignancy or direct pre-cancerous lesion?

    Directory of Open Access Journals (Sweden)

    Jan Kornafel

    2011-10-01

    Full Text Available The aim of this study was to compare the imaging symptoms and microscopic findings in females with lobular neoplasia (LN found on biopsy. 1,478 women who underwent primary open biopsy or surgical excision after percutaneous biopsy were reviewed. In 24 of them (1.6%, LN was found. In four patients, excisional biopsy with hook-wire localization was done primarily due to the radial scar. In 20 females, surgical excision of BIRADS 4 lesion was performed because of the presence of LN in specimens from the vacuum-assisted or core-needle percutaneous biopsy. Postoperative pathologic findings were compared to the radiological symptoms. In 13 women, LN did not produce any radiological symptoms and was an additional histologic finding existing near the other lesion: fibroadenoma and radial scar. In none of these lesions was an invasive cancer noticed. In one single patient, ductal carcinoma in situ was observed in the other segment of the breast. Invasive ductal cancer developed in the contralateral breast in one patient. In 11 patients, LN was diagnosed due to radiological symptoms produced by itself. In this group, the invasive lobular cancer was found in seven lesions (64%. Our finding suggests that LN producing suspicious radiological symptoms can be a different biologic type of this lesion when compared asymptomatic LN diagnosed which is usually found on biopsy as additional microscopic pathology. Symptomatic LN is probably associated with a higher potential of malignant transformation. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 417–424

  9. Genetic Heterogeneity in Therapy-Naïve Synchronous Primary Breast Cancers and Their Metastases.

    Science.gov (United States)

    Ng, Charlotte K Y; Bidard, Francois-Clement; Piscuoglio, Salvatore; Geyer, Felipe C; Lim, Raymond S; de Bruijn, Ino; Shen, Ronglai; Pareja, Fresia; Berman, Samuel H; Wang, Lu; Pierga, Jean-Yves; Vincent-Salomon, Anne; Viale, Agnes; Norton, Larry; Sigal, Brigitte; Weigelt, Britta; Cottu, Paul; Reis-Filho, Jorge S

    2017-08-01

    Purpose: Paired primary breast cancers and metachronous metastases after adjuvant treatment are reported to differ in their clonal composition and genetic alterations, but it is unclear whether these differences stem from the selective pressures of the metastatic process, the systemic therapies, or both. We sought to define the repertoire of genetic alterations in breast cancer patients with de novo metastatic disease who had not received local or systemic therapy.Experimental Design: Up to two anatomically distinct core biopsies of primary breast cancers and synchronous distant metastases from nine patients who presented with metastatic disease were subjected to high-depth whole-exome sequencing. Mutations, copy number alterations and their cancer cell fractions, and mutation signatures were defined using state-of-the-art bioinformatics methods. All mutations identified were validated with orthogonal methods.Results: Genomic differences were observed between primary and metastatic deposits, with a median of 60% (range 6%-95%) of shared somatic mutations. Although mutations in known driver genes including TP53, PIK3CA, and GATA3 were preferentially clonal in both sites, primary breast cancers and their synchronous metastases displayed spatial intratumor heterogeneity. Likely pathogenic mutations affecting epithelial-to-mesenchymal transition-related genes, including SMAD4, TCF7L2, and TCF4 (ITF2), were found to be restricted to or enriched in the metastatic lesions. Mutational signatures of trunk mutations differed from those of mutations enriched in the primary tumor or the metastasis in six cases.Conclusions: Synchronous primary breast cancers and metastases differ in their repertoire of somatic genetic alterations even in the absence of systemic therapy. Mutational signature shifts might contribute to spatial intratumor genetic heterogeneity. Clin Cancer Res; 23(15); 4402-15. ©2017 AACR. ©2017 American Association for Cancer Research.

  10. SPECTRUM OF BENIGN BREAST LESIONS : A CYTOLOGIC STUDY

    OpenAIRE

    Nirmala; Shulbha V.; Dayananda

    2015-01-01

    INTRODUCTION: Open biopsy is widely considered to be the procedure of choice for diagnostic tissue sampling of bone tumors. However, associated disadvantages include in - patient procedure requiring hospitalization, risk of infection, hematoma formation and pathological fractures. As an alternative FNA cytology is increasingly used as a diagnostic modality. It is a challenging technique due to difficulties in approaching bone lesions and obtaining adequate materi...

  11. Primary non-Hodgkin's lymphoma of breast – A rare cause of breast lump

    Directory of Open Access Journals (Sweden)

    Veena Gupta

    2017-03-01

    Full Text Available We, here, report a case of primary breast lymphoma in a 59 years old female. The diagnosis was suspected on fine needle aspiration cytology and confirmed on excision biopsy of the tumor. Histology and immunophenotyping were in accordance with non-Hodgkin's diffuse large B-cell lymphoma. The patient has been planned for adjuvant chemoradiation. The management and outcome of primary breast lymphoma and carcinoma are totally different. Early and prompt diagnosis of primary breast lymphoma is of utmost importance to avoid unnecessary mastectomies. Fine needle aspiration cytology supplemented by immuno-cytochemistry can be applied as a reliable and cost-effective tool in the early diagnosis of primary breast lymphomas, while histopathology and immunohistochemistry are conclusive.

  12. Development of a computational three-dimensional breast lesion phantom model

    Science.gov (United States)

    de Sisternes, Luis; Zysk, Adam M.; Brankov, Jovan G.; Wernick, Miles N.

    2010-04-01

    We have developed a realistic three-dimensional breast lesion phantom that can be computationally embedded in physically-acquired background images of normal breast tissue. In order to develop new imaging techniques aimed at the detection and diagnosis of breast lesions, a large number of lesions with varying physical characteristics must be tested, especially if physical characteristics must be correlated with observed image features. The new tool presented here, which incorporates three-dimensional tumor features, is potentially useful for testing imaging techniques such as CT, tomosynthesis, and phase-sensitive X-ray imaging, as these require three-dimensional tissue models. The simulated lesions improve significantly upon current methods, which lack the complexity and physical attributes of real tumors, by incorporating a stochastic Gaussian random sphere model to simulate the central tumor mass and calcifications, and an iterative fractal branching algorithm to model the complex spicula present in many tumors. Results show that userdefined lesions with realistic features can be computationally embedded in mammographic background images and that a wide range of physical properties can be modeled.

  13. Automatic ultrasound image enhancement for 2D semi-automatic breast-lesion segmentation

    Science.gov (United States)

    Lu, Kongkuo; Hall, Christopher S.

    2014-03-01

    Breast cancer is the fastest growing cancer, accounting for 29%, of new cases in 2012, and second leading cause of cancer death among women in the United States and worldwide. Ultrasound (US) has been used as an indispensable tool for breast cancer detection/diagnosis and treatment. In computer-aided assistance, lesion segmentation is a preliminary but vital step, but the task is quite challenging in US images, due to imaging artifacts that complicate detection and measurement of the suspect lesions. The lesions usually present with poor boundary features and vary significantly in size, shape, and intensity distribution between cases. Automatic methods are highly application dependent while manual tracing methods are extremely time consuming and have a great deal of intra- and inter- observer variability. Semi-automatic approaches are designed to counterbalance the advantage and drawbacks of the automatic and manual methods. However, considerable user interaction might be necessary to ensure reasonable segmentation for a wide range of lesions. This work proposes an automatic enhancement approach to improve the boundary searching ability of the live wire method to reduce necessary user interaction while keeping the segmentation performance. Based on the results of segmentation of 50 2D breast lesions in US images, less user interaction is required to achieve desired accuracy, i.e. < 80%, when auto-enhancement is applied for live-wire segmentation.

  14. Primary and metastatic lobular carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Harake, Marie D.J.; Maxwell, Anthony J.; Sukumar, Sathi A

    2001-08-01

    Invasive lobular carcinoma of the breast is the second most common type of primary breast cancer, accounting for 8-14% of cases, but is often difficult to diagnose early. It typically shows a diffuse pattern of infiltration within the breast, resulting in a variety of often subtle radiological appearances. A similar infiltrative pattern is seen in its metastatic form, with involvement of the gastrointestinal tract, peritoneum, retroperitoneum, bone marrow, meninges and uterus occurring more frequently than with the more common infiltrating ductal carcinoma of the breast. This pictorial essay illustrates the spectrum of radiological appearances which may be encountered with both primary and secondary lobular carcinoma. Harake, M.D.J., Maxwell, A.J. and Sukumar, S.A. (2001). Clinical Radiology 56, 621-630.

  15. Interactive lesion segmentation on dynamic contrast enhanced breast MRI using a Markov model

    Science.gov (United States)

    Wu, Qiu; Salganicoff, Marcos; Krishnan, Arun; Fussell, Donald S.; Markey, Mia K.

    2006-03-01

    The purpose of this study is to develop a method for segmenting lesions on Dynamic Contrast-Enhanced (DCE) breast MRI. DCE breast MRI, in which the breast is imaged before, during, and after the administration of a contrast agent, enables a truly 3D examination of breast tissues. This functional angiogenic imaging technique provides noninvasive assessment of microcirculatory characteristics of tissues in addition to traditional anatomical structure information. Since morphological features and kinetic curves from segmented lesions are to be used for diagnosis and treatment decisions, lesion segmentation is a key pre-processing step for classification. In our study, the ROI is defined by a bounding box containing the enhancement region in the subtraction image, which is generated by subtracting the pre-contrast image from 1st post-contrast image. A maximum a posteriori (MAP) estimate of the class membership (lesion vs. non-lesion) for each voxel is obtained using the Iterative Conditional Mode (ICM) method. The prior distribution of the class membership is modeled as a multi-level logistic model, a Markov Random Field model in which the class membership of each voxel is assumed to depend upon its nearest neighbors only. The likelihood distribution is assumed to be Gaussian. The parameters of each Gaussian distribution are estimated from a dozen voxels manually selected as representative of the class. The experimental segmentation results demonstrate anatomically plausible breast tissue segmentation and the predicted class membership of voxels from the interactive segmentation algorithm agrees with the manual classifications made by inspection of the kinetic enhancement curves. The proposed method is advantageous in that it is efficient, flexible, and robust.

  16. Role of shear-wave elastography (SWE) in complex cystic and solid breast lesions in comparison with conventional ultrasound.

    Science.gov (United States)

    Lee, Bo Eun; Chung, Jin; Cha, Eun-Suk; Lee, Jee Eun; Kim, Jeoung Hyun

    2015-07-01

    To evaluate the additional role of shear-wave elastography (SWE) in differential diagnosis of complex cystic and solid breast lesions. From January 2013 to November 2013, 140 complex cystic and solid breast lesions from 139 consecutive patients were performed ultrasound and SWE prior to biopsy. BI-RADS ultrasound final assessment and SWE parameters were recorded for each lesion. Histopathologic diagnosis was used as the reference standard. Among the 140 lesions, 30 lesions (21.4%) were malignant. The mean maximum elasticity (Emax) of malignant lesions (184.3 kPa) was significantly higher than that of benign lesions (45.5 kPa) (Pelasticity and color pattern were significantly different from malignancy and benign lesions (Pbreast lesions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Relationship Between Primary Patency and Lesion Length Following Bare Nitinol Stent Placement for Femoropopliteal Disease.

    Science.gov (United States)

    Soga, Yoshimitsu; Takahara, Mitsuyoshi; Iida, Osamu; Suzuki, Kenji; Hirano, Keisuke; Kawasaki, Daizo; Shintani, Yoshiaki; Yamaoka, Terutoshi; Ando, Kenji

    2015-12-01

    To evaluate the relationship between 1-year primary patency and lesion length in patients with femoropopliteal disease treated with bare nitinol stents. The study was a retrospective analysis of a prospectively maintained multicenter database. Between January 2004 and December 2011, 1047 consecutive patients (mean age 72 years; 765 men) underwent femoropopliteal stenting with nitinol stents in 1373 limbs. The mean vessel diameter was 5.3±0.7 mm and the mean lesion length was 142±75 mm. One-year follow-up data were collected and analyzed to ascertain which lesion length would be expected to demonstrate a 1-year primary patency above the established 66% objective performance goal (OPG). The lower limit of the 95% confidence interval (CI) for the unadjusted 1-year primary patency was >66% when the lesion length was ≤243 mm. After adjustment of the covariates to match those of the OPG-derived population, the 1-year primary patency decreased linearly with longer lesion length. The 1-year primary patency was 83.2% (95% CI 79.8% to 86.1%) for a 100-mm lesion length, 76.4% (95% CI 71.7% to 80.5%) for a 200-mm lesion length, and 70.7% (95% CI 62.4% to 77.7%) for a 300-mm lesion length. The maximum lesion length providing a 1-year primary patency significantly greater than 66% was calculated to be 263 mm. The 1-year primary patency of femoropopliteal lesions treated with bare nitinol stents decreased linearly with longer lesion length. The maximum lesion length providing a higher patency rate than the OPG of 66% was ~25 cm. © The Author(s) 2015.

  18. Time-lapse Imaging of Primary Preneoplastic Mammary Epithelial Cells Derived from Genetically Engineered Mouse Models of Breast Cancer

    OpenAIRE

    Nakles, Rebecca E.; Millman, Sarah L.; Cabrera, M. Carla; Johnson, Peter; Mueller, Susette; Hoppe, Philipp S.; Schroeder, Timm; Furth, Priscilla A.

    2013-01-01

    Time-lapse imaging can be used to compare behavior of cultured primary preneoplastic mammary epithelial cells derived from different genetically engineered mouse models of breast cancer. For example, time between cell divisions (cell lifetimes), apoptotic cell numbers, evolution of morphological changes, and mechanism of colony formation can be quantified and compared in cells carrying specific genetic lesions. Primary mammary epithelial cell cultures are generated from mammary glands without...

  19. Primary Leiomyosarcoma of the Breast: A Case Report

    OpenAIRE

    Karabulut, Zülfikar; Akkaya, Hampar; Moray, Gökhan

    2012-01-01

    Primary leiomyosarcoma of the breast is an extremely rare tumor, accounting for less than 1% of all breast tumors and only 24 cases have been reported in the English medical journals. It is quite difficult to diagnose leiomyosarcoma preoperatively. Establishing an accurate diagnosis is very important in planning treatment. When preoperative diagnosis can be achieved before or during the operation, wide resection should be performed. There is no need for axillary lymph node dissection. In this...

  20. Double breast contour in primary aesthetic breast augmentation: incidence, prevention and treatment.

    Science.gov (United States)

    Médard de Chardon, Victor; Balaguer, Thierry; Chignon-Sicard, Bérengère; Lebreton, Elisabeth

    2010-04-01

    The goal of this study was to define the incidence of double breast contour in primary aesthetic breast augmentation and to analyze its risk factors. An independent plastic surgeon analyzed the data of 200 patients who had a primary aesthetic breast augmentation with silicone gel implant and with a minimum 12-month follow-up. All patients had pre and postoperative standardized photography. Mastopexy-augmentations, breast reconstructions, breast malformations (tuberous breasts and Poland syndrome), and patients with incomplete data were excluded from the study. Assessment was achieved using an original standardized evaluation form (preoperative breast morphology, surgical options, postoperative aesthetic results). Patients were also asked to complete an exhaustive satisfaction form. A double breast contour was assessed clinically using Massiha's classification. The mean follow-up was 36 months. The double breast contour incidence was 7%. All of them were type I (the so called waterfall deformity). There was no type II (double inframammary crease). They were minor for 6.5% and major for 0.5%. They were related to a preoperative breast ptosis, subpectoral placement, and implant upper malposition. The rate of the type I was 10.5% of submuscular augmentation and 15% of preoperative breast ptosis. A double breast contour was primitive for 6% and secondary for 1% (pregnancy and breast-feeding postaugmentation). It was bilateral for 4.5% (3 cases of upper malposition, 1 case of medial malposition, 2 cases of pregnancy with breast-feeding postaugmentation and 1 patient refused a mastopexy-augmentation). It was unilateral for 2.5% related to a preoperative breast asymmetry with ptosis asymmetry and skin quality asymmetry. The satisfaction rate in the group "double contour" (14 patients) was 85.7% (vs. 91.9%). One patient had revision surgery (upper malposition). These types of deformities are fundamentally different with consideration on their clinical aspects

  1. Conspicuity of breast lesions at different b values on diffusion-weighted imaging

    Directory of Open Access Journals (Sweden)

    Chen Xin

    2012-08-01

    Full Text Available Abstract Background Diffusion-weighted (DW imaging has shown potential to differentiate between malignant and benign breast lesions. However, different b values have been used with varied sensitivity and specificity. This study aims to prospectively evaluate the influence of b value on the detection and assessment of breast lesions. Methods Institutional review board approval and informed patient consent were obtained. Between February 2010 and September 2010, sixty women suspected of having breast cancer by clinical examination and mammography underwent bilateral breast MRI and DW imaging (with maximum b values of 600, 800, and 1000 s/mm2. Conspicuity grades of lesions at different b values on DW images were performed. Signal intensity and apparent diffusion coefficient (ADC values were recorded and compared among different b values by the signal-to-noise ratio (SNR, contrast-to-noise ratio (CNR and receiver operating characteristic (ROC curve. Results Fifty-seven lesions from 52 recruited patients including 39/57 (68% malignant and 18/57 (32% benign were confirmed with pathology. DCE MRI accurately detected 53 lesions with the sensitivity of 93.0% and specificity of 66.7%, and DW imaging accurately detected 51 lesions with the sensitivity of 89.5% and specificity of 100%. There were no significant differences in conspicuity grades compared among the three b values (P = 0.072, although the SNR and CNR of breast lesions decreased significantly with higher b values. Mean ADCs of malignant lesions (b = 600 s/mm2, 1.07 ± 0.26 × 10-3 mm2/s; b = 800 s/mm2, 0.96 ± 0.22 × 10-3 mm2/s; b = 1000 s/mm2, 0.92 ± 0.26 × 10-3 mm2/s were significantly lower than those of benign lesions (b = 600 s/mm2, 1.55 ± 0.40 × 10-3 mm2/s; b = 800 s/mm2, 1.43 ± 0.38 × 10-3 mm2/s; b = 1000 s/mm2, 1.49 ± 0.38 × 10-3 mm2/s with all P values P = 0.303 and 0

  2. Role of shear-wave elastography (SWE) in complex cystic and solid breast lesions in comparison with conventional ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo Eun; Chung, Jin, E-mail: aqua0724@ewha.ac.kr; Cha, Eun-Suk; Lee, Jee Eun; Kim, Jeoung Hyun

    2015-07-15

    Highlights: • Complex cystic lesions have a broad spectrum of malignancy rate. • SWE is useful to evaluate cystic breast lesions. • Cutoff value of Emax was 108.5 kPa, for predicting malignancy. • Using this cutoff value, sensitivity of 86.7% and specificity of 97.3%. • SWE could reduce unnecessary biopsies in complex cystic and solid breast lesions. - Abstract: Objective: To evaluate the additional role of shear-wave elastography (SWE) in differential diagnosis of complex cystic and solid breast lesions. Materials and methods: From January 2013 to November 2013, 140 complex cystic and solid breast lesions from 139 consecutive patients were performed ultrasound and SWE prior to biopsy. BI-RADS ultrasound final assessment and SWE parameters were recorded for each lesion. Histopathologic diagnosis was used as the reference standard. Results: Among the 140 lesions, 30 lesions (21.4%) were malignant. The mean maximum elasticity (Emax) of malignant lesions (184.3 kPa) was significantly higher than that of benign lesions (45.5 kPa) (P < 0.001). Homogeneity of elasticity and color pattern were significantly different from malignancy and benign lesions (P < 0.05). Emax with cutoff value at 108.5 kPa showed Az value of 0.968 (95% CI, 0.932–0.985) with sensitivity of 86.7% and specificity of 97.3%. Using this cutoff value, false-positive rate was 2.7% and false-negative rate was 13.3%. By applying an Emax value of 108.5 kPa or less as a criterion for downgrading BI-RADS category 4a lesions to category 3 lesions, 103/123 (83.7%) lesions could be downgraded to category 3 lesions. Conclusion: Additional use of SWE could reduce unnecessary benign biopsies in complex cystic and solid breast lesions.

  3. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ianculescu, Victor; Ciolovan, Laura Maria [Radiology Department, Gustave Roussy, Villejuif (France); Dunant, Ariane [Department of Statistics, Gustave Roussy, Villejuif (France); Vielh, Philippe [Department of Biopathology, Gustave Roussy, Villejuif (France); Mazouni, Chafika [Department of Surgery, Gustave Roussy, Villejuif (France); Delaloge, Suzette [Department of Oncology, Gustave Roussy, Villejuif (France); Dromain, Clarisse [Radiology Department, Gustave Roussy, Villejuif (France); Blidaru, Alexandru [Department of Surgery, Bucharest Institute of Oncology, Bucharest (Romania); Balleyguier, Corinne, E-mail: corinne.balleyguier@gustaveroussy.fr [Radiology Department, Gustave Roussy, Villejuif (France); UMR 8081, IR4M, Paris-Sud University, 91405 Orsay (France)

    2014-05-15

    Purpose: To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Materials and methods: Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. Results: BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. Conclusion: VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies.

  4. Contrast-enhanced MR mammography for evaluation of the contralateral breast in patients with diagnosed unilateral breast cancer or high-risk lesions.

    Science.gov (United States)

    Pediconi, Federica; Catalano, Carlo; Roselli, Antonella; Padula, Simona; Altomari, Fiorella; Moriconi, Enrica; Pronio, Anna Maria; Kirchin, Miles A; Passariello, Roberto

    2007-06-01

    To prospectively evaluate accuracy of gadobenate dimeglumine-enhanced magnetic resonance (MR) mammography for depiction of synchronous contralateral breast cancer in patients with newly diagnosed unilateral breast cancer or high-risk lesions, with histologic analysis or follow-up as reference. The study had ethics committee approval; all patients provided written informed consent. One hundred eighteen consecutive women (mean age, 52 years) with unilateral breast cancer or high-risk lesions and negative findings in the contralateral breast at physical examination, ultrasonography, and conventional mammography underwent gadobenate dimeglumine-enhanced 1.5-T MR mammography. Transverse three-dimensional T1-weighted gradient-echo images were acquired before and at 0, 2, 4, 6, and 8 minutes after gadobenate dimeglumine administration (0.1 mmol per kilogram body weight). Breast Imaging Reporting and Data System (BI-RADS) was used to categorize breast density and the level of suspicion for malignant contralateral breast lesions. Results were compared with histologic findings. Sensitivity, specificity, accuracy, and positive and negative predictive values for contrast-enhanced MR mammography were evaluated. Contrast-enhanced MR mammography revealed contralateral lesions in 28 (24%) of 118 patients. Twenty-four lesions were detected in patients with dense breasts (BI-RADS breast density category III or IV). Lesions in eight (29%) of 28 patients were BI-RADS category 4; patients underwent biopsy. Lesions in 20 (71%) patients were BI-RADS category 5; patients underwent surgery. At histologic analysis, 22 lesions were confirmed as malignant; six lesions were fibroadenomas. No false-negative lesions were detected; none of the fibroadenomas were BI-RADS category 5. The sensitivity, specificity, accuracy, and positive and negative predictive values of contrast-enhanced MR mammography for depiction of malignant or high-risk contralateral lesions were 100%, 94%, 95%, 79%, and 100

  5. Other primary malignancies in breast cancer patients treated with breast conserving surgery and radiation therapy.

    Science.gov (United States)

    Yi, Min; Cormier, Janice N; Xing, Yan; Giordano, Sharon Hermes; Chai, Christy; Meric-Bernstam, Funda; Vlastos, Georges; Kuerer, Henry M; Mirza, Nadeem Q; Buchholz, Thomas A; Hunt, Kelly K

    2013-05-01

    Our purpose was to examine the incidence and impact on survival of other primary malignancies (OPM) outside of the breast in breast cancer patients and to identify risk factors associated with OPM. Patients with stage 0-III breast cancer treated with breast conserving therapy at our center from 1979 to 2007 were included. Risk factors were compared between patients with/without OPM. Logistic regression was used to identify factors that were associated with OPM. Standardized incidence ratios (SIRs) were calculated. Among 4,198 patients in this study, 276 (6.6 %) developed an OPM after breast cancer treatment. Patients with OPM were older and had a higher proportion of stage 0/I disease and contralateral breast cancer compared with those without OPM. In a multivariate analysis, older patients, those with contralateral breast cancer, and those who did not receive chemotherapy or hormone therapy were more likely to develop OPM after breast cancer. Patients without OPM had better overall survival. The SIR for all OPM sites combined after a first primary breast cancer was 2.91 (95 % confidence interval: 2.57-3.24). Significantly elevated risks were seen for numerous cancer sites, with SIRs ranging from 1.84 for lung cancer to 5.69 for ovarian cancer. Our study shows that breast cancer patients have an increased risk of developing OPM over the general population. The use of systemic therapy was not associated with increased risk of OPM. In addition to screening for a contralateral breast cancer and recurrences, breast cancer survivors should undergo screening for other malignancies.

  6. A deep learning framework for supporting the classification of breast lesions in ultrasound images

    Science.gov (United States)

    Han, Seokmin; Kang, Ho-Kyung; Jeong, Ja-Yeon; Park, Moon-Ho; Kim, Wonsik; Bang, Won-Chul; Seong, Yeong-Kyeong

    2017-10-01

    In this research, we exploited the deep learning framework to differentiate the distinctive types of lesions and nodules in breast acquired with ultrasound imaging. A biopsy-proven benchmarking dataset was built from 5151 patients cases containing a total of 7408 ultrasound breast images, representative of semi-automatically segmented lesions associated with masses. The dataset comprised 4254 benign and 3154 malignant lesions. The developed method includes histogram equalization, image cropping and margin augmentation. The GoogLeNet convolutionary neural network was trained to the database to differentiate benign and malignant tumors. The networks were trained on the data with augmentation and the data without augmentation. Both of them showed an area under the curve of over 0.9. The networks showed an accuracy of about 0.9 (90%), a sensitivity of 0.86 and a specificity of 0.96. Although target regions of interest (ROIs) were selected by radiologists, meaning that radiologists still have to point out the location of the ROI, the classification of malignant lesions showed promising results. If this method is used by radiologists in clinical situations it can classify malignant lesions in a short time and support the diagnosis of radiologists in discriminating malignant lesions. Therefore, the proposed method can work in tandem with human radiologists to improve performance, which is a fundamental purpose of computer-aided diagnosis.

  7. The Value of Ultrasound-Guided Tattooing Localization of Nonpalpable Breast Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kyung-Ran [National Cancer Center, Goyang (Korea, Republic of); Han, Boo-Kyung; Jang, Kyung-Mi; Choe, Yeon-Hyeon; Shin, Jung-Hee [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Yang, Jung-Hyun; Nam, Suk-Jin [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2007-08-15

    To investigate the value of ultrasound-guided tattooing localization (US-tattoo) using a charcoal suspension for breast lesions. One hundred sixty-four nonpalpable breast lesions in 134 patients (mean age 47 years; range 30 74 years) were marked with a charcoal suspension under US guidance. The medical records associated with the US-tattoo, the pathology results and the follow-up US results were reviewed. The average size of the localized lesions was 1.0 cm. The procedure time was < 5 minutes (range, 2 10 minutes) per lesion. The US-tattoo was well tolerated in all cases. The only technical difficulty encountered was a needle tip blockage caused by a large charcoal particle (4.9%). The surgeon easily identified the tattoo with the exception one case. In addition, surgery could be safely delayed from one to 57 days after the making US-tattoo. The pathology result was benign in 108 cases, borderline in five, and malignant in 51. The excised specimen was < 4 cm in 76.6% (82/107) of the benign cases (mean; 2.7 cm). The pathologist could identify the mass around the tattoo and was able to make a specific diagnosis in 81.3% (87/107) of benign lesions. The only complication encountered was residual charcoal marking along the incision scar (3.6%). All follow- up US documented the removal of the lesions. An US-tattoo for nonpalpable breast lesions is a very simple and accurate method that can help surgeons design and schedule an open biopsy.

  8. Tissue Doppler and strain imaging for evaluating tissue elasticity of breast lesions.

    Science.gov (United States)

    Thomas, Anke; Warm, Mathias; Hoopmann, Markus; Diekmann, Felix; Fischer, Thomas

    2007-05-01

    Sonoelastography depicts the intrinsic elastic properties of a tissue which are characterized by the strain applied to achieve tissue deformation and the velocity at which tissue deformation occurs. The present study served to investigate whether the specificity of B-mode ultrasound (US) can be improved by combining B-mode imaging with tissue Doppler imaging (TDI) and offline analysis of tissue strain imaging (TSI). Fifty women, 25 with malignant and 25 with benign focal breast lesions, were examined by US with a linear transducer (9 MHz, Aplio, Toshiba, Otawara, Japan). B-mode US views of the lesions were overlaid with color-coded TDI information and area quotients (AQ = area B-mode view/area TDI) were calculated. TSI views were reconstructed offline from the source data. This was done by placing a region of interest (ROI) in the target lesion and color-encoded display of the information. In addition, tissue elasticity was evaluated using a scale of 1-5 corresponding to the BI-RADS categories. Maximum strain (strain factor, SF) was determined in the ROI. All patients also underwent mammography. Sensitivities and specificities were calculated and statistical analysis was performed using Wilcoxon's test. Sensitivity/specificity was 96%/68% for B-mode US, 100%/40% for combined B-mode US and mammography, and 96%/80% for TSI. The AQ of benign and malignant lesions was significantly different (p = .00008) as was the difference in SF (p = .0004). The readers considered TSI a feasible technique. Evaluation of elasticity based on the quantification of strain factors improves characterization of focal breast lesions, especially the differentiation of BI-RADS 3 and 4 lesions. Surprisingly, significant results in characterizing breast lesions were obtained with the simple technique of TDI, showing a lower tissue displacement in malignant cases.

  9. Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Lincoln J.; Samei, Ehsan; Lo, Joseph Y.; Baker, Jay A.; Ghate, Sujata V.; Kim, Connie; Soo, Mary Scott; Walsh, Ruth [Medical Physics Graduate Program, Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Medical Physics Graduate Program, and Department of Biomedical Engineering, Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Carl E. Ravin Advanced Imaging Laboratories, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710 (United States)

    2011-04-15

    Purpose: Mammography is known to be one of the most difficult radiographic exams to interpret. Mammography has important limitations, including the superposition of normal tissue that can obscure a mass, chance alignment of normal tissue to mimic a true lesion and the inability to derive volumetric information. It has been shown that stereomammography can overcome these deficiencies by showing that layers of normal tissue lay at different depths. If standard stereomammography (i.e., a single stereoscopic pair consisting of two projection images) can significantly improve lesion detection, how will multiview stereoscopy (MVS), where many projection images are used, compare to mammography? The aim of this study was to assess the relative performance of MVS compared to mammography for breast mass detection. Methods: The MVS image sets consisted of the 25 raw projection images acquired over an arc of approximately 45 deg. using a Siemens prototype breast tomosynthesis system. The mammograms were acquired using a commercial Siemens FFDM system. The raw data were taken from both of these systems for 27 cases and realistic simulated mass lesions were added to duplicates of the 27 images at the same local contrast. The images with lesions (27 mammography and 27 MVS) and the images without lesions (27 mammography and 27 MVS) were then postprocessed to provide comparable and representative image appearance across the two modalities. All 108 image sets were shown to five full-time breast imaging radiologists in random order on a state-of-the-art stereoscopic display. The observers were asked to give a confidence rating for each image (0 for lesion definitely not present, 100 for lesion definitely present). The ratings were then compiled and processed using ROC and variance analysis. Results: The mean AUC for the five observers was 0.614{+-}0.055 for mammography and 0.778{+-}0.052 for multiview stereoscopy. The difference of 0.164{+-}0.065 was statistically significant with a

  10. Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection.

    Science.gov (United States)

    Webb, Lincoln J; Samei, Ehsan; Lo, Joseph Y; Baker, Jay A; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Walsh, Ruth

    2011-04-01

    Mammography is known to be one of the most difficult radiographic exams to interpret. Mammography has important limitations, including the superposition of normal tissue that can obscure a mass, chance alignment of normal tissue to mimic a true lesion and the inability to derive volumetric information. It has been shown that stereomammography can overcome these deficiencies by showing that layers of normal tissue lay at different depths. If standard stereomammography (i.e., a single stereoscopic pair consisting of two projection images) can significantly improve lesion detection, how will multiview stereoscopy (MVS), where many projection images are used, compare to mammography? The aim of this study was to assess the relative performance of MVS compared to mammography for breast mass detection. The MVS image sets consisted of the 25 raw projection images acquired over an arc of approximately 45 degrees using a Siemens prototype breast tomosynthesis system. The mammograms were acquired using a commercial Siemens FFDM system. The raw data were taken from both of these systems for 27 cases and realistic simulated mass lesions were added to duplicates of the 27 images at the same local contrast. The images with lesions (27 mammography and 27 MVS) and the images without lesions (27 mammography and 27 MVS) were then postprocessed to provide comparable and representative image appearance across the two modalities. All 108 image sets were shown to five full-time breast imaging radiologists in random order on a state-of-the-art stereoscopic display. The observers were asked to give a confidence rating for each image (0 for lesion definitely not present, 100 for lesion definitely present). The ratings were then compiled and processed using ROC and variance analysis. The mean AUC for the five observers was 0.614 +/- 0.055 for mammography and 0.778 +/- 0.052 for multiview stereoscopy. The difference of 0.164 +/- 0.065 was statistically significant with a p-value of 0

  11. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    Directory of Open Access Journals (Sweden)

    Dobrosavljević Aleksandar

    2016-01-01

    Full Text Available Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%, fibroadenoma (26.7%, fibrocystic dysplasia with/without atypia (10%, lipoma (3.3% and intramammary lymph node (3.3%. Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05. All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05. Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C and BI-RADS 5 lesions should be worked-up with biopsy.

  12. Automatic segmentation of lesion from breast DCE-MR image using artificial fish swarm optimization algorithm

    Science.gov (United States)

    Janaki, Sathya D.; Geetha, K.

    2017-06-01

    Interpreting Dynamic Contrast-Enhanced (DCE) MR images for signs of breast cancer is time consuming and complex, since the amount of data that needs to be examined by a radiologist in breast DCE-MRI to locate suspicious lesions is huge. Misclassifications can arise from either overlooking a suspicious region or from incorrectly interpreting a suspicious region. The segmentation of breast DCE-MRI for suspicious lesions in detection is thus attractive, because it drastically decreases the amount of data that needs to be examined. The new segmentation method for detection of suspicious lesions in DCE-MRI of the breast tissues is based on artificial fishes swarm clustering algorithm is presented in this paper. Artificial fish swarm optimization algorithm is a swarm intelligence algorithm, which performs a search based on population and neighborhood search combined with random search. The major criteria for segmentation are based on the image voxel values and the parameters of an empirical parametric model of segmentation algorithms. The experimental results show considerable impact on the performance of the segmentation algorithm, which can assist the physician with the task of locating suspicious regions at minimal time.

  13. Extraction of a Foreign Body from the Breast Using Radio-guided Occult Lesion Localization (ROLL): Metallic Foreign Body in the Breast

    Science.gov (United States)

    Dal, Fatih; Ökmen, Hasan; Yılmaz, Meltem Küçük; Sarı, Serkan; Nazlı, Mehmet Ali; Arslan, Esra

    2017-01-01

    The most common clinical causes of metallic foreign body in the breast are surgical clips, pieces of guide-wire and gunshot wounds. Metallic foreign bodies can lead to local breast pain, abscesses, pneumothorax after granulomas or migration, and cardiac tamponade. Mammotome biopsy, fluoroscopy, guide-wire biopsy and radio-guided occult lesion localization (ROLL) are the standard techniques applied for surgical excision of non-palpable breast lesions. This article presents the second case in the literature undergoing the ROLL technique for the removal of a metallic foreign body from the breast. PMID:28894857

  14. Ubiquitin-conjugating enzyme UBE2C is highly expressed in breast microcalcification lesions.

    Science.gov (United States)

    Chou, Chen-Pin; Huang, Nan-Chieh; Jhuang, Shu-Jhen; Pan, Huay-Ben; Peng, Nan-Jing; Cheng, Jiin-Tsuey; Chen, Chian-Feng; Chen, Jih-Jung; Chang, Tsung-Hsien

    2014-01-01

    Ubiquitin-conjugating enzyme 2C (UBE2C) contributes to ubiquitin-mediated proteasome degradation of cell cycle progression in breast cancer. Microcalcification (MC) is the most common mammographic feature of early breast cancer. In this study, we evaluated whether UBE2C could be a tumor marker of early breast cancer with MC found on screening mammography. UBE2C protein and mRNA expression were measured in breast core biopsy pairs of MC and adjacent non-MC breast tissue from each subject. Immunohistochemistry revealed UBE2C positivity in 69.4% of MC samples and 77.6% negativity in non-MC samples (pbreast cancer cells with UBE2C knockdown; UBE2C knockdown downregulated cell proliferation and activated the cellular apoptosis pathway to inhibit cell colony formation. Furthermore, UBE2C expression was associated with that of carcinogenic genes human epidermal growth factor receptor type 2 (HER2), cellular c-Ki-ras2 proto-oncogene (KRAS), vascular endothelial growth factor (VEGF), CXC chemokine receptor 4 (CXCR4), C-C motif chemokine 5 (CCL5), neural precursor cell expressed, developmentally downregulated 9 (NEDD9) and Ras homolog family member C (RhoC). UBE2C may be a marker for diagnosis of nonpalpable breast lesions but not benign or malignant tumors in mammography core biopsies. Suppression of UBE2C may be a potential therapy target in breast cancer.

  15. Alterations in Vitamin D signalling and metabolic pathways in breast cancer progression: a study of VDR, CYP27B1 and CYP24A1 expression in benign and malignant breast lesions Vitamin D pathways unbalanced in breast lesions

    Directory of Open Access Journals (Sweden)

    Lopes Nair

    2010-09-01

    Full Text Available Abstract Background Breast cancer is a heterogeneous disease associated with different patient prognosis and responses to therapy. Vitamin D has been emerging as a potential treatment for cancer, as it has been demonstrated that it modulates proliferation, apoptosis, invasion and metastasis, among others. It acts mostly through the Vitamin D receptor (VDR and the synthesis and degradation of this hormone are regulated by the enzymes CYP27B1 and CYP24A1, respectively. We aimed to study the expression of these three proteins by immunohistochemistry in a series of breast lesions. Methods We have used a cohort comprising normal breast, benign mammary lesions, carcinomas in situ and invasive carcinomas and assessed the expression of the VDR, CYP27B1 and CYP24A1 by immunohistochemistry. Results The results that we have obtained show that all proteins are expressed in the various breast tissues, although at different amounts. The VDR was frequently expressed in benign lesions (93.5% and its levels of expression were diminished in invasive tumours (56.2%. Additionally, the VDR was strongly associated with the oestrogen receptor positivity in breast carcinomas. CYP27B1 expression is slightly lower in invasive carcinomas (44.6% than in benign lesions (55.8%. In contrast, CYP24A1 expression was augmented in carcinomas (56.0% in in situ and 53.7% in invasive carcinomas when compared with that in benign lesions (19.0%. Conclusions From this study, we conclude that there is a deregulation of the Vitamin D signalling and metabolic pathways in breast cancer, favouring tumour progression. Thus, during mammary malignant transformation, tumour cells lose their ability to synthesize the active form of Vitamin D and respond to VDR-mediated Vitamin D effects, while increasing their ability to degrade this hormone.

  16. Primary osteosarcoma of the breast presenting as a large breast abscess

    Directory of Open Access Journals (Sweden)

    Nadeesha J Nawarathna

    2016-01-01

    Full Text Available Primary extra osseous osteogenic sarcoma is one of the rarest forms of malignant tumor of the breast. It can arise as a result of osseous metaplasia of a preexisting neoplasm or from a none-phylloides sarcoma of a previously normal breast. Due to its rarity, the natural history and optimal treatment methods remain unclear. Sixty-year-old patient presented to the surgical casualty with a large breast abscess. Abscess wall histology revealed an osteosarcoma of the breast. Left total mastectomy with axillary clearance was performed. Histology and subsequent imunohistochemical studies confirmed the diagnosis of osteogenic sarcoma without lymph nodal metastasis. Patient was referred to the oncologist for further management. Rare types of breast tumors can be presented as breast abscess. Incision and drainage together with wall biopsy aid to exclude associated sinister pathologies. Diagnosis of primary osteosarcoma of the breast was made using histological and immunohistochemical findings once the possible primary from the bones of sternum and ribs was excluded. Treatment is as for sarcomas affecting other locations and should comprise a multidisciplinary approach.

  17. Primary and Secondary T-cell Lymphomas of the Breast: Clinico-pathologic Features of 11 Cases

    Science.gov (United States)

    Gualco, Gabriela; Chioato, Lucimara; Harrington, William J.; Weiss, Lawrence M.; Bacchi, Carlos E.

    2009-01-01

    Breast involvement by non-Hodgkin lymphomas is rare, and exceptional for T-cell lymphomas; we studied the morphologic, immunophenotypic, and clinical features of 11 patients with T-cell non-Hodgkin lymphomas involving the breast. Four cases fulfilled the definition criteria for primary breast lymphomas, 3 females and 1 male, with a median age of 51 years. One primary breast lymphomas was T-cell lymphoma unspecified, other was subcutaneous panniculitis-like T-cell lymphoma, and 2 cases were anaplastic large cell lymphomas. One of the anaplastic large cell lymphoma cases was found surrounding a silicone breast implant and presented as clinically as mastitis; whereas the other case occurred in a man. T-cell lymphoma secondarily involved the breast in 7 patients, all women and 1 bilateral, with a median age of 29 years. These secondary breast lymphomas occurred as part of widespread nodal or leukemic disease. Three patients had adult T-cell leukemia/lymphoma, including the patient with bilateral lesions, 3 others had precursor T-lymphoblastic lymphoma/leukemia, and the other presented with a peripheral-T-cell lymphoma nonotherwise specified type. Breast T-cell lymphomas are very infrequent and are morphologically and clinically heterogeneous. PMID:19318917

  18. Non-mass-like breast lesions at ultrasonography: Feature analysis and BI-RADS assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kai-Hsiung [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Yu, Jyh-Cherng [Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Peng, Yi-Jen [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC (China); Chu, Chi-Ming [Section of Health Informatics, Institute of Public Health, National Defense Medical Center and University, Taipei, Taiwan, ROC (China); Chang, Tsun-Hou; Chang, Wei-Chou; Wu, Yu-Cheng; Lin, Yu-Pang; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China)

    2015-01-15

    Highlights: • The positive predictive value of an NML lesion on ultrasound ranges from 10 to 79%. • A sizable number of NML malignant lesions are pure DCIS or ILC. • Biopsy is indicated for histopathological diagnosis when an ultrasound NML lesion is recognized. - Abstract: Objective: To analyze the features of non-mass-like (NML) breast lesions on ultrasound (US) and determine their corresponding malignancy rate and to stratify these lesion patterns according to US BI-RADS categories. Materials and methods: One hundred sixty-four consecutive lesions were retrospectively classified into four types according to the US features, the corresponding positive predictive values (PPVs) were obtained. Clinical, imaging, and histopathological findings were reviewed. Results: Among the 164 lesions, 39 (24%) were classified as type Ia, 14 (8%) as type Ib, 39 (24%) as type IIa, 19 (12%) as type IIb, 19 (12%) as type III, and 34 (21%) as type IV. The PPVs for malignancy were 21% for type Ia, 79% for type Ib, 10% for type IIa, 58% for type IIb, 16% for type III, and 21% for type IV. All NML lesions were classified as BI-RADS category 4a (type IIa), 4b (type Ia, III and IV) and 4c (type Ib and IIb) according to their PPVs. There was a significantly higher frequency of malignancy among lesions of type Ib and type IIb compared with the other types (P < 0.01 for each). Lesions with associated calcifications, presence of abnormal axillary nodes, or a mammographic finding of suspected malignancy had a higher probability of malignancy (P < 0.05 for each). Conclusion: US is useful in clarifying the indication for biopsy of NML lesions. The types of US classifications used in our study establish reliable references for the NML patterns when stratified according to the BI-RADS categories.

  19. Parietal Wall Hydatid Cyst Presenting as a Primary Lesion | Gharde ...

    African Journals Online (AJOL)

    A 54.year.old female patient from central India, farmer by occupation, non vegetarian by diet came with chief complaints of a painless mass in the left iliac fossa, gradually increasing in size over a period of 6 months. Superficial ultrasound revealed a lesion resembling a hydatid cyst. Surgical excision was done without ...

  20. Aneurysmal bone cyst: a primary or secondary lesion? | Saheeb ...

    African Journals Online (AJOL)

    secondary” to other lesions of the jaws and 2. Report two cases of the cyst that illustrate its controversial origin in the hope that it will add to the literature on the subject in Africa.. Report: Two cases of aneurysmal bone cyst occurring in the mandible ...

  1. Contrast-enhanced spectral mammography: Impact of the qualitative morphology descriptors on the diagnosis of breast lesions.

    Science.gov (United States)

    Mohamed Kamal, Rasha; Hussien Helal, Maha; Wessam, Rasha; Mahmoud Mansour, Sahar; Godda, Iman; Alieldin, Nelly

    2015-06-01

    To analyze the morphology and enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) and to assess their impact on the differentiation between benign and malignant lesions. This ethics committee approved study included 168 consecutive patients with 211 breast lesions over 18 months. Lesions classified as non-enhancing and enhancing and then the latter group was subdivided into mass and non-mass. Mass lesions descriptors included: shape, margins, pattern and degree of internal enhancement. Non-mass lesions descriptors included: distribution, pattern and degree of internal enhancement. The impact of each descriptor on diagnosis individually assessed using Chi test and the validity compared in both benign and malignant lesions. The overall performance of CESM were also calculated. The study included 102 benign (48.3%) and 109 malignant (51.7%) lesions. Enhancement was encountered in 145/211 (68.7%) lesions. They further classified into enhancing mass (99/145, 68.3%) and non-mass lesions (46/145, 31.7%). Contrast uptake was significantly more frequent in malignant breast lesions (p value ≤ 0.001). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p value ≤ 0.001). CESM showed an overall sensitivity of 88.99% and specificity of 83.33%. The positive and negative likelihood ratios were 5.34 and 0.13 respectively. The assessment of the morphology and enhancement characteristics of breast lesions on CESM enhances the performance of digital mammography in the differentiation between benign and malignant breast lesions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Classification of breast MRI lesions using small-size training sets: comparison of deep learning approaches

    Science.gov (United States)

    Amit, Guy; Ben-Ari, Rami; Hadad, Omer; Monovich, Einat; Granot, Noa; Hashoul, Sharbell

    2017-03-01

    Diagnostic interpretation of breast MRI studies requires meticulous work and a high level of expertise. Computerized algorithms can assist radiologists by automatically characterizing the detected lesions. Deep learning approaches have shown promising results in natural image classification, but their applicability to medical imaging is limited by the shortage of large annotated training sets. In this work, we address automatic classification of breast MRI lesions using two different deep learning approaches. We propose a novel image representation for dynamic contrast enhanced (DCE) breast MRI lesions, which combines the morphological and kinetics information in a single multi-channel image. We compare two classification approaches for discriminating between benign and malignant lesions: training a designated convolutional neural network and using a pre-trained deep network to extract features for a shallow classifier. The domain-specific trained network provided higher classification accuracy, compared to the pre-trained model, with an area under the ROC curve of 0.91 versus 0.81, and an accuracy of 0.83 versus 0.71. Similar accuracy was achieved in classifying benign lesions, malignant lesions, and normal tissue images. The trained network was able to improve accuracy by using the multi-channel image representation, and was more robust to reductions in the size of the training set. A small-size convolutional neural network can learn to accurately classify findings in medical images using only a few hundred images from a few dozen patients. With sufficient data augmentation, such a network can be trained to outperform a pre-trained out-of-domain classifier. Developing domain-specific deep-learning models for medical imaging can facilitate technological advancements in computer-aided diagnosis.

  3. Primary Cystic Lesions of the Retrorectal Space: MRI Evaluation and Clinical Assessment.

    Science.gov (United States)

    Dwarkasing, Roy S; Verschuuren, Sylvia I; van Leenders, Geert J L H; Braun, Loes M M; Krestin, Gabriel P; Schouten, W Rudolph

    2017-10-01

    The purpose of this study was to assess the a priori chance that primary cystic lesions of the retrorectal space are malignant and to investigate MRI characteristics that indicate malignancy. Patients referred to a center for colorectal surgery were recruited from 2000 to 2014. Lesions were proven by clinical assessment and histopathology. MRI was performed at 1.5 T with examinations evaluated by two radiologists. Interobserver agreement was assessed (Cohen kappa) and differences between malignant and benign lesions calculated (Fisher exact test). Twenty-eight patients (22 women, six men; age range, 18-70 years) with 31 lesions were included. Lesions were categorized as tailgut cysts (n = 16, 52%), teratomas (n = 9, 29%), lesions of colorectal origin (n = 4, 13%), or neurogenic lesions (n = 2, 6%). Five patients (18%) had malignant lesions. Colorectal lesions had the highest percentage of malignancy (3/4, 75%). A solid tissue component was found in all five (100%) malignant lesions and two (8%) of the benign lesions, which were both teratomas (p debris, septa, and wall thickening, differences were not significant. Interobserver agreement was excellent (κ = 1) for all characteristics except debris (κ = 0.795). The majority of retrorectal cystic lesions are benign. The presence of a solid tissue component should raise suspicion for malignancy.

  4. The radiological excision of high risk and malignant lesions using the INTACT breast lesion excision system. A case series with an imaging follow up of at least 5 years.

    Science.gov (United States)

    Allen, S D; Osin, P; Nerurkar, A

    2014-07-01

    To evaluate the efficacy of a BLES procedure as a primary excisional biopsy rather than a surgical wide local excision for treatment of a high risk or a malignant lesion. 41 patients underwent a BLES procedure in order to attempt to remove a small breast lesion using a 15 mm or 20 mm wand from August 2007 to January 2009. The lesions were either proven on prior core biopsy to show high risk or malignant pathology or were considered to be indeterminate or suspicious on ultrasound or mammography. The pathology was reviewed to include the final status of lesion excision. If margin involvement was demonstrated then a formal surgical excision was subsequently recommended. Follow up mammography or ultrasound was performed annually in patients following the final pathological diagnosis. 9 patients had a primary diagnosis of atypia (columnar cell change with atypia or atypical ductal hyperplasia (ADH)), 23 patients had ductal carcinoma in situ (DCIS) and 9 had an invasive carcinoma (IC) at the original BLES pathology. Clear BLES margins of >1 mm were obtained in 3/9 atypia lesions, 15/23 DCIS and 0/9 IC. 12/13 low grade DCIS were completely excised. Subsequent surgical margin excisions were undertaken in 20 patients. After at least 5 years of follow up (mean 66 months), 1 lesion had recurred on imaging. A BLES excision has potential as an alternative technique to traditional surgical wide local excision in the management of certain small breast lesions with high risk and low grade malignant potential. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Heterogeneous Chromosomal Aberrations in Intraductal Breast Lesions Adjacent to Invasive Carcinoma

    Directory of Open Access Journals (Sweden)

    Michaela Aubele

    2000-01-01

    Full Text Available There is evidence that breast cancer is a heterogeneous disease phenotypically as well as molecular biologically. So far, heterogeneity on the molecular biological level has not been investigated in potential precursor lesions, such as ductal hyperplasia (DH and ductal carcinoma in situ (DCIS. In this study we applied comparative genomic hybridization (CGH to formalin‐fixed, paraffin‐embedded breast tissue with DH and DCIS, adjacent to invasive ductal carcinoma (IDC, to screen these potential precursor lesions for whole genomic chromosomal imbalances. Laser‐microdissection was used to select pure cell populations from the sections. Isolated DNA was amplified by degenerate oligonucleotide primed PCR (DOP‐PCR and further processed for CGH analysis.

  6. Time-resolved optical mammography between 637 and 985 nm: clinical study on the detection and identification of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Taroni, Paola [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Torricelli, Alessandro [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Spinelli, Lorenzo [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Pifferi, Antonio [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Arpaia, Francesco [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Danesini, Gianmaria [Dipartimento di Radiologia, Casa di Cura S.Pio X, via Francesco Nava 31, I-20159 Milan (Italy); Cubeddu, Rinaldo [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy)

    2005-06-07

    The first time-resolved optical mammograph operating beyond 900 nm was tested in a retrospective clinical study involving 194 patients with malignant and benign lesions, to investigate the diagnostic potential for the detection and characterization of breast lesions. For the first part of the study (101 patients with 114 lesions), the system was operated at 683, 785, 913 and 975 nm. Subsequently, to improve the spectral content of optical images, the number of wavelengths was increased (up to 7) and the spectral range was extended (637-985 nm). Late gated intensity and scattering images provide sensitivity to tissue composition (oxy- and deoxyhaemoglobin, water and lipids) and physiology (total haemoglobin content and oxygen saturation), as well as to structural changes. Tumours are typically identified because of the strong blood absorption at short wavelengths (637-685 nm), while cysts are characterized by low scattering, leading to a detection rate of approximately 80% for both lesion types, when detection is required in both cranio-caudal and oblique views. The detection rate for other benign lesions, such as fibroadenomas, is presently much lower (<40%). The effectiveness of the technique in localizing and identifying different lesion types was analysed as a function of various parameters (lesion size, compressed breast thickness, age, body mass index, breast parenchymal pattern). The possibility that physiologic changes due to the development of a malignant lesion could affect the entire breast was investigated. The capacity to assess the density of breast based on the average scattering properties was also tested.

  7. Viscoelastic shear properties of in vivo breast lesions measured by MR elastography.

    Science.gov (United States)

    Sinkus, Ralph; Tanter, Mickael; Xydeas, Tanja; Catheline, Stefan; Bercoff, Jeremy; Fink, Mathias

    2005-02-01

    Elastography is a technique to assess the viscoelastic properties of tissue by measuring an acoustic wave propagating though the object. Here, the technique is applied in the course of standard MR mammography to 15 patients with different pathologies (six breast cancer cases, six fibroadenoma cases and three mastopathy cases). Low-frequency mechanical waves are coupled longitudinally into the tissue in order to obtain sufficient wave amplitude throughout the entire breast. This leads to the presence of a substantial fraction of compressional waves, which contribute to the total displacement field. It is shown theoretically that the correct evaluation of these contributions from the compressional wave is rather difficult due to the almost incompressible nature of tissue. To overcome this problem, it is proposed to apply the curl-operator to the measured displacement field in order to completely remove contributions from the compressional wave. Results from simulations and a breast phantom demonstrate the feasibility of the technique. The in vivo results show a good separation between breast cancer and benign fibroadenoma utilizing the shear modulus. Breast cancer appears on average 2.2 (Pbreast cancer cases showed a good delineation to the surrounding breast tissue with an average elevation of a factor of 3.3 (P< 1.4 x 10(-6)). The results as obtained for the shear viscosity do not indicate to be useful for separating benign from malignant lesions.

  8. Value of whole breast magnetic resonance elastography added to MRI for lesion characterization.

    Science.gov (United States)

    Balleyguier, Corinne; Lakhdar, Aicha Ben; Dunant, Ariane; Mathieu, Marie-Christine; Delaloge, Suzette; Sinkus, Ralph

    2017-10-26

    The purpose of this work was to assess the diagnostic value of magnetic resonance elastography (MRE) in addition to MRI to differentiate malignant from benign breast tumors, and the feasibility of performing MRE on the whole breast. MRE quantified biomechanical properties within the entire breast (50 slices) using an 11 min acquisition protocol at an isotropic image acquisition resolution of 2 × 2 × 2 mm(3) . Fifty patients were included. Finally, 43 patients (median age 52) with a suspect breast lesion detected by mammography and/or ultrasound were examined by MRI and MRE at 1.5 T. The viscoelastic parameters, i.e. elasticity (Gd ), viscosity (Gl ), the magnitude of the complex shear modulus Gd2+Gl2, and the phase angle y=2πatanGlGd, were measured via MRE and correlated with MRI Breast Imaging-Reporting and Data System (BI-RADS) score, histological type, and histological grade. Stroma component and angiogenesis were also correlated with viscoelastic properties. In the 43 lesions, Gd decreased and y increased with the MRI BI-RADS score (pGd  = 0.02, py  = 0.002), whereas (Gl ) and y were increased in malignant lesions (pGl  = 0.045, py  = 0.0004). The area under the curve increased from 0.84 for MRI BI-RADS alone to 0.92 with the MRI BI-RADS and y (AUC increase +0.08; 95% CI (-0.003; 0.16)). Lesion characterization using the y parameter increased the diagnostic accuracy. The phase angle y was found to have a significant role (p = 0.01) in predicting malignancy independently of the MRI BI-RADS. Interestingly, histological analysis showed no correlation between viscoelastic parameters and percentage and type of stroma, CD34 quantification of vessels, or histological grade. The combination of MRE and MRI improves the diagnostic accuracy for breast lesions in the studied cohort. In particular, the phase angle y was found to have a significant role in predicting malignancy in addition to BI-RADS. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Primary breast lymphoma in an immunocompromised male patient: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Bong Guk; Park, Jeong Seon; Koo, Hye Ryoung; Kim, Soo Yeon; Jang, Ki Seok [Hanyang University Medical Center, Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Jin Young; Choi, Yun Young [Dept. of Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri (Korea, Republic of)

    2015-10-15

    Primary breast lymphoma in a male patient is extremely rare. We report a case of primary breast lymphoma in an immunocompromised male patient, after renal transplantation. The sonographic and histological features are described in depth.

  10. Breast lesion co-localisation between X-ray and MR images using finite element modelling.

    Science.gov (United States)

    Lee, Angela W C; Rajagopal, Vijayaraghavan; Babarenda Gamage, Thiranja P; Doyle, Anthony J; Nielsen, Poul M F; Nash, Martyn P

    2013-12-01

    This paper presents a novel X-ray and MR image registration technique based on individual-specific biomechanical finite element (FE) models of the breasts. Information from 3D magnetic resonance (MR) images was registered to X-ray mammographic images using non-linear FE models subject to contact mechanics constraints to simulate the large compressive deformations between the two imaging modalities. A physics-based perspective ray-casting algorithm was used to generate 2D pseudo-X-ray projections of the FE-warped 3D MR images. Unknown input parameters to the FE models, such as the location and orientation of the compression plates, were optimised to provide the best match between the pseudo and clinical X-ray images. The methods were validated using images taken before and during compression of a breast-shaped phantom, for which 12 inclusions were tracked between imaging modalities. These methods were then applied to X-ray and MR images from six breast cancer patients. Error measures (such as centroid and surface distances) of segmented tumours in simulated and actual X-ray mammograms were used to assess the accuracy of the methods. Sensitivity analysis of the lesion co-localisation accuracy to rotation about the anterior-posterior axis was then performed. For 10 of the 12 X-ray mammograms, lesion localisation accuracies of 14 mm and less were achieved. This analysis on the rotation about the anterior-posterior axis indicated that, in cases where the lesion lies in the plane parallel to the mammographic compression plates, that cuts through the nipple, such rotations have relatively minor effects.This has important implications for clinical applicability of this multi-modality lesion registration technique, which will aid in the diagnosis and treatment of breast cancer. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Spontaneous infarction of benign breast lesion during pregnancy: Ultrasonographic and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Young; Kim, Kyu Soon; Kim, Ju Hun [Eulji University Hospital, Daejeon (Korea, Republic of); Lee, Yun Hak [Dept. of Radiology, Health Care Center, Pohang (Korea, Republic of)

    2015-10-15

    The spontaneous infarction of benign breast lesions is a rare entity and hence is not usually considered in the differential diagnosis during radiologic or clinical examination. There have been a few published cases of infarction during pregnancy and lactation. In this study we report the ultrasonographic and pathologic features of a spontaneous infarction of a lactating adenoma with acute mastitis and abscess and a spontaneously infarcted fibroadenoma.

  12. Breast lesion detection and characterization at contrast-enhanced MR mammography: gadobenate dimeglumine versus gadopentetate dimeglumine.

    Science.gov (United States)

    Pediconi, Federica; Catalano, Carlo; Occhiato, Rossella; Venditti, Fiammetta; Fraioli, Francesco; Napoli, Alessandro; Kirchin, Miles A; Passariello, Roberto

    2005-10-01

    To prospectively and intraindividually compare equivalent (0.1 mmol per kilogram of body weight) doses of gadobenate dimeglumine and gadopentetate dimeglumine for accuracy of detection and characterization of breast lesions at contrast material-enhanced magnetic resonance (MR) mammography. Ethics committee approval and informed consent were obtained. Twenty-six consecutive women (mean age, 47.8 years) suspected of having a breast tumor at mammography and sonography underwent two identical MR examinations at 1.5 T; examinations were separated by more than 48 hours but less than 72 hours. A T1-weighted three-dimensional gradient-echo sequence was used, and images were acquired before and at 0, 2, 4, 6, and 8 minutes after randomized injection of gadopentetate dimeglumine or gadobenate dimeglumine at an identical flow rate of 2 mL/sec. Separate and combined assessment of unenhanced, contrast-enhanced, and subtracted images was performed blindly by two readers in consensus. Accuracy for lesion detection was determined against a final diagnosis based on findings at conventional mammography, sonography, and surgery. Sensitivity, specificity, positive and negative predictive values, and overall accuracy for malignant lesion identification were determined against histologic results. Data were analyzed with the McNemar test, proportional odds models, and analysis of variance. MR mammography with gadobenate dimeglumine depicted significantly (P = .003) more lesions (45 of 46) than did that with gadopentetate dimeglumine (36 of 46), and detected lesions were significantly (P dimeglumine. Confidence for characterization was significantly (P = .031) greater with gadobenate dimeglumine. Comparison of the contrast agents for their ability to help identify malignant lesions revealed significant (P = .02) superiority for gadobenate dimeglumine: Sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy for malignant lesion identification

  13. Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound.

    Science.gov (United States)

    Liu, Haixia; Tan, Tao; van Zelst, Jan; Mann, Ritse; Karssemeijer, Nico; Platel, Bram

    2014-07-01

    We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing different lesion properties; however, it does not include texture features. In this work, we expand the system by including texture features based on local binary patterns, gray level co-occurrence matrices, and Gabor filters computed from each lesion to be diagnosed. To deal with the resulting large number of features, we proposed a combination of feature-oriented classifiers combining each group of texture features into a single likelihood, resulting in three additional features used for the final classification. The classification was performed using support vector machine classifiers, and the evaluation was done with 10-fold cross validation on a dataset containing 424 lesions (239 benign and 185 malignant lesions). We compared the classification performance of the CAD system with and without texture features. The area under the receiver operating characteristic curve increased from 0.90 to 0.91 after adding texture features ([Formula: see text]).

  14. Whole breast lesion detection using naive bayes classifier for portable ultrasound.

    Science.gov (United States)

    Yang, Min-Chun; Huang, Chiun-Sheng; Chen, Jeon-Hor; Chang, Ruey-Feng

    2012-11-01

    In recent years, portable PC-based ultrasound (US) imaging systems developed by some companies can provide an integrated computer environment for computer-aided diagnosis and detection applications. In this article, an automatic whole breast lesion detection system based on the naive Bayes classifier using the PC-based US system Terason t3000 (Terason Ultrasound, Burlington, MA, USA) with a hand-held probe is proposed. To easily retrieve the US images for any regions of the breast, a clock-based storing system is proposed to record the scanned US images. A computer-aided detection (CAD) system is also developed to save the physicians' time for a huge volume of scanned US images. The pixel classification of the US is based on the naive Bayes classifier for the proposed lesion detection system. The pixels of the US are classified into two types: lesions or normal tissues. The connected component labeling is applied to find the suspected lesions in the image. Consequently, the labeled two-dimensional suspected regions are separated into two clusters and further checked by two-phase lesion selection criteria for the determination of the real lesion, while reducing the false-positive rate. The free-response operative characteristics (FROC) curve is used to evaluate the detection performance of the proposed system. According to the experimental results of 31 cases with 33 lesions, the proposed system yields a 93.4% (31/33) sensitivity at 4.22 false positives (FPs) per hundred slices. Moreover, the speed for the proposed detection scheme achieves 12.3 frames per second (fps) with an Intel Dual-Core Quad 3 GHz processor and can be also effectively and efficiently used for other screening systems. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  15. Revaluation of breast cytology with pathologist on-site of lesions with suspicious sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Capalbo, Emanuela, E-mail: emanuelacapalbo@tiscalinet.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Sajadidehkordi, Farideh, E-mail: faridehit@yahoo.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Colombi, Claudio; Ticha, Vladimira; Moretti, Angela, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy); Peli, Michela, E-mail: peli.michela@gmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Cosentino, Maria, E-mail: maria-cosentino@tiscali.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Lovisatti, Maria, E-mail: marialovisatti@hotmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Berti, Elisabetta, E-mail: eliberti@hotmail.it [Dipartimento di Scienze Diagnostiche, UOC di Anatomia Patologica, A.O San Carlo Borromeo. Via Pio II, 3, Milano 20153 (Italy); Cariati, Maurizio, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy)

    2013-09-15

    Objective: Evaluating correlation estimation between diagnostic ultrasound (U.S.) of breast lesions and fine needle aspiration cytology (FNAC), and the correlation between cytology and histology (I) of these lesions undergo surgery. Materials and methods: In 2010 we performed 1589 ultrasound breast. We identified 210 suspicious lesions to be subjected to FNAC, which was performed with pathologist on site, and extemporaneous analysis of the sample to assess their appropriateness. We classified the lesions in 5 ultrasound (U) classes according to the criteria defined by Echographic BIRADS Lexicon. The results of cytology were classified in 5 classes (C) according to the guidelines of F.O.N.Ca.M. Then we evaluated the diagnostic correlation between U.S. and FNAC, and between FNAC and Histology. Results: The distribution of lesions in U classes was: 57U2, 55U3, 36U4 and 62U5. The diagnostic concordance between U and FNAC was 96.7%, with a sensitivity of 98%, specificity 93%, negative and positive predictive value respectively of 94.9% and 97.3%, and diagnostic accuracy of 96.6%. The 98 patients with C4-C5 lesions were subjected to surgery and the histology confirmed high-grade malignancy of lesions with a concordance of 99.7%. Conclusions: Having achieved high diagnostic concordance between U and FNAC, and then between FNAC and histology, we may say that the FNAC, less invasive and traumatic for the patient than needle biopsy (CB), may be still a valid method when performed with pathologist on-site to assess the adequacy of the sample taken.

  16. An unusual breast lesion: the ultrasonographic, mammographic, MRI and nuclear medicine findings of mammary hibernoma

    Science.gov (United States)

    Martini, N; Londero, V; Machin, P; Travaini, L L; Zuiani, C; Bazzocchi, M; Paganelli, G

    2010-01-01

    We report the case of a 42-year-old woman being treated for an ovarian cancer who was diagnosed at the age of 40. A CT–positron emission tomography (PET) scan performed as follow-up documented abnormal uptake in the right breast. Mammograms were negative for malignancy, while a focal hyperechoic lesion was observed on ultrasonography in the same breast. Thus, she was referred to our institution for breast MRI, which showed a focal area of enhancement with atypical features. Percutaneous biopsy was performed, and a mammary hibernoma was diagnosed. Radiological and pathological correlation was provided. To our knowledge, this is the only report that describes the features of this rare tumour on four different imaging modalities (mammography, ultrasonography, MRI and CT–PET). PMID:20139247

  17. Liquid biopsy in the diagnosis of HPV DNA in breast lesions.

    Science.gov (United States)

    De Carolis, Sabrina; Pellegrini, Alice; Santini, Donatella; Ceccarelli, Claudio; De Leo, Antonio; Alessandrini, Federica; Arienti, Chiara; Pignatta, Sara; Tesei, Anna; Mantovani, Vilma; Zamagni, Claudio; Taffurelli, Mario; Sansone, Pasquale; Bonafé, Massimiliano; Cricca, Monica

    2017-10-04

    HPV DNA has never been investigated in nipple discharges (ND) and serum-derived extracellular vesicles, although its presence has been reported in ductal lavage fluids and blood specimens. We analyzed 50 ND, 22 serum-derived extracellular vesicles as well as 51 pathologic breast tissues for the presence of 16 HPV DNA types. We show that the presence of HPV DNA in the ND is predictive of HPV DNA-positive breast lesions and that HPV DNA is more represented in intraductal papillomas. We also show the presence of HPV DNA in the serum-derived extracellular vesicles. Our data supports the use of liquid biopsy to detect HPV DNA in breast pathology.

  18. Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

    OpenAIRE

    Jomhori P; Daneshpajooh M; Akhiani M

    2001-01-01

    Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting...

  19. Research on the lesion segmentation of breast tumor MR images based on FCM-DS theory

    Science.gov (United States)

    Zhang, Liangbin; Ma, Wenjun; Shen, Xing; Li, Yuehua; Zhu, Yuemin; Chen, Li; Zhang, Su

    2017-03-01

    Magnetic resonance imaging (MRI) plays an important role in the treatment of breast tumor by high intensity focused ultrasound (HIFU). The doctors evaluate the scale, distribution and the statement of benign or malignancy of breast tumor by analyzing variety modalities of MRI, such as the T2, DWI and DCE images for making accurate preoperative treatment plan and evaluating the effect of the operation. This paper presents a method of lesion segmentation of breast tumor based on FCM-DS theory. Fuzzy c-means clustering (FCM) algorithm combined with Dempster-Shafer (DS) theory is used to process the uncertainty of information, segmenting the lesion areas on DWI and DCE modalities of MRI and reducing the scale of the uncertain parts. Experiment results show that FCM-DS can fuse the DWI and DCE images to achieve accurate segmentation and display the statement of benign or malignancy of lesion area by Time-Intensity Curve (TIC), which could be beneficial in making preoperative treatment plan and evaluating the effect of the therapy.

  20. The assessment of angiogenesis and fibroblastic stromagenesis in hyperplastic and pre-invasive breast lesions

    Directory of Open Access Journals (Sweden)

    Louvrou Niki

    2008-04-01

    Full Text Available Abstract Background To investigate the changes of the neoplastic microenvironment during the different morphological alterations of hyperplastic and pre-invasive breast lesions. Methods 78 in situ ductal carcinomas of all degrees of differentiation, 22 atypical ductal hyperplasias, 25 in situ lobular carcinomas, 18 atypical lobular hyperplasias, 32 ductal epithelial hyperplasias of usual type and 8 flat atypias were immunohistochemically investigated for the expression of vascular endothelial growth factor (VEGF, smooth muscle actin (SMA and CD34, while microvessel density (MVD was counted using the anti-CD31 antibody. Results VEGF expression was strongly correlated with MVD in all hyperplastic and pre-invasive breast lesions (p Conclusion Angiogenesis is observed before any significant fibroblastic stromagenesis in pre-invasive breast lesions. A composite phenotype characterized by VEGF positive epithelial cells and SMA positive/CD34 negative stromal cells, is identified mostly in intermediate and high grade DCIS. These findings might imply for new therapeutic strategies using both anti-angiogenic factors and factors selectively targeting tumor stroma in order to prevent the progression of DCIS to invasive carcinoma.

  1. Role of shear wave sonoelastography in differentiation between focal breast lesions.

    Science.gov (United States)

    Dobruch-Sobczak, Katarzyna; Nowicki, Andrzej

    2015-02-01

    Our goal in this study was to evaluate the relevance of shear wave sonoelastography (SWE) in the differential diagnosis of masses in the breast with respect to ultrasound (US). US and SWE were performed (Aixplorer System, SuperSonic Imagine, Aix en Provence, France) in 76 women (aged 24 to 85) with 84 lesions (43 malignant, 41 benign). The study included BI-RADS-US (Breast Imaging Reporting and Data System for Ultrsound) category 3-5 lesions. In elastograms, the following values were calculated: mean elasticity in lesions (E(av.l)) and in fat tissue (E(av.f.)) and maximal (E(max.adj.)) and mean (E(av.adj.)) elasticity in lesions and adjacent tissues. The sensitivity and specificity of the BI-RADS category 4a/4b cutoff value were 97.7% and 90.2%. For an E(av.adj.) of 68.5 kPa, the cutoff sensitivity was 86.1% and the specificity was 87.8%, and for an E(max.adj.) of 124.1 kPa, 74.4% and 92.7%, respectively. For BI-RADS-US category 3 lesions, E(av.l), E(max.adj.) and E(av.adj.) were below cutoff levels. On the basis of our findings, E(av.adj.) had lower sensitivity and specificity compared with US. Emax.adj. improved the specificity of breast US with loss of sensitivity. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  2. Computer-assisted assessment of ultrasound real-time elastography: Initial experience in 145 breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xue; Xiao, Yang [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China); Zeng, Jie [Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (China); Qiu, Weibao; Qian, Ming; Wang, Congzhi [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China); Zheng, Rongqin, E-mail: zhengronggin@hotmail.com [Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (China); Zheng, Hairong, E-mail: hr.zheng@siat.ac.cn [Shenzhen Key Lab for Molecular Imaging, Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen (China)

    2014-01-15

    Purpose: To develop and evaluate a computer-assisted method of quantifying five-point elasticity scoring system based on ultrasound real-time elastography (RTE), for classifying benign and malignant breast lesions, with pathologic results as the reference standard. Materials and methods: Conventional ultrasonography (US) and RTE images of 145 breast lesions (67 malignant, 78 benign) were performed in this study. Each lesion was automatically contoured on the B-mode image by the level set method and mapped on the RTE image. The relative elasticity value of each pixel was reconstructed and classified into hard or soft by the fuzzy c-means clustering method. According to the hardness degree inside lesion and its surrounding tissue, the elasticity score of the RTE image was computed in an automatic way. Visual assessments of the radiologists were used for comparing the diagnostic performance. Histopathologic examination was used as the reference standard. The Student's t test and receiver operating characteristic (ROC) curve analysis were performed for statistical analysis. Results: Considering score 4 or higher as test positive for malignancy, the diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8% (136/145), 92.5% (62/67), 94.9% (74/78), 93.9% (62/66), and 93.7% (74/79) for the computer-assisted scheme, and 89.7% (130/145), 85.1% (57/67), 93.6% (73/78), 92.0% (57/62), and 88.0% (73/83) for manual assessment. Area under ROC curve (A{sub z} value) for the proposed method was higher than the A{sub z} value for visual assessment (0.96 vs. 0.93). Conclusion: Computer-assisted quantification of classical five-point scoring system can significantly eliminate the interobserver variability and thereby improve the diagnostic confidence of classifying the breast lesions to avoid unnecessary biopsy.

  3. Diagnosing benign and malignant lesions in breast tissue sections by using IR-microspectroscopy.

    Science.gov (United States)

    Fabian, Heinz; Thi, Ngoc Anh Ngo; Eiden, Michael; Lasch, Peter; Schmitt, Jürgen; Naumann, Dieter

    2006-07-01

    The collection of IR spectra through microscope optics and the visualization of the IR data by IR imaging represent a visualization approach, which uses infrared spectral features as a native intrinsic contrast mechanism. To illustrate the potential of this spectroscopic methodology in breast cancer research, we have acquired IR-microspectroscopic data from benign and malignant lesions in breast tissue sections by point microscopy with spot sizes of 30-40 microm. Four classes of distinct breast tissue spectra were defined and stored in the data base: fibroadenoma (a total of 1175 spectra from 14 patients), ductal carcinoma in situ (a total of 1349 spectra from 8 patients), connective tissue (a total of 464 spectra), and adipose tissue (a total of 146 spectra). Artifical neural network analysis, a supervised pattern recognition method, was used to develop an automated classifier to separate the four classes. After training the artifical neural network classifier, infrared spectra of independent external validation data sets ("unknown spectra") were analyzed. In this way, all spectra (a total of 386) taken from micro areas inside the epithelium of fibroadenomas from 4 patients were correctly classified. Out of the 421 spectra taken from micro areas of the in situ component of invasive ductal carcinomas of 3 patients, 93% were correctly identified. Based on these results, the potential of the IR-microspectroscopic approach for diagnosing breast tissue lesions is discussed.

  4. Improving three-dimensional mechanical imaging of breast lesions with principal component analysis.

    Science.gov (United States)

    Tyagi, Mohit; Wang, Yuqi; Hall, Timothy J; Barbone, Paul E; Oberai, Assad A

    2017-08-01

    Elastography has emerged as a new tool for detecting and diagnosing many types of diseases including breast cancer. To date, most clinical applications of elastography have utilized two-dimensional strain images. The goal of this paper is to present a new quasi-static elastography technique that yields shear modulus images in three dimensions. An automated breast volume scanner was used to acquire ultrasound images of the breast as it was gently compressed. Cross-correlation between successive images was used to determine the displacement within the tissue. The resulting displacement field was filtered of all but compressive motion through principal component analysis. This displacement field was used to infer spatial distribution of shear modulus by solving a 3D elastic inverse problem. Three dimensional shear modulus images of benign breast lesions for two subjects were generated using the techniques described above. It was found that the lesions were visualized more clearly in images generated using the displacement data de-noised through the use of principal components. We have presented experimental and algorithmic techniques that lead to three-dimensional imaging of shear modulus using quasi-static elastography. This work demonstrates feasibility of this approach, and lays the foundation for images of other, more informative, mechanical parameters. © 2017 American Association of Physicists in Medicine.

  5. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)

    2015-09-15

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  6. Presumed prevalence analysis on suspected and highly suspected breast cancer lesions in São Paulo using BIRADS® criteria

    Directory of Open Access Journals (Sweden)

    Vivian Milani

    Full Text Available CONTEXT AND OBJECTIVE: Breast cancer screening programs are critical for early detection of breast cancer. Early detection is essential for diagnosing, treating and possibly curing breast cancer. Since there are no data on the incidence of breast cancer, nationally or regionally in Brazil, our aim was to assess women by means of mammography, to determine the prevalence of this disease. DESIGN AND SETTING: The study protocol was designed in collaboration between the Department of Diagnostic Imaging (DDI, Institute of Diagnostic Imaging (IDI and São Paulo Municipal Health Program. METHODS: A total of 139,945 Brazilian women were assessed by means of mammography between April 2002 and September 2004. Using the American College of Radiology (ACR criteria (Breast Imaging Reporting and Data System, BIRADS®, the prevalence of suspected and highly suspected breast lesions were determined. RESULTS: The prevalence of suspected (BIRADS® 4 and highly suspected (BIRADS® 5 lesions increased with age, especially after the fourth decade. Accordingly, BIRADS® 4 and BIRADS® 5 lesions were more prevalent in the fourth, fifth, sixth and seventh decades. CONCLUSION: The presumed prevalence of suspected and highly suspected breast cancer lesions in the population of São Paulo was 0.6% and it is similar to the prevalence of breast cancer observed in other populations.

  7. Automatic ultrasonic breast lesions detection using support vector machine based algorithm

    Science.gov (United States)

    Yeh, Chih-Kuang; Miao, Shan-Jung; Fan, Wei-Che; Chen, Yung-Sheng

    2007-03-01

    It is difficult to automatically detect tumors and extract lesion boundaries in ultrasound images due to the variance in shape, the interference from speckle noise, and the low contrast between objects and background. The enhancement of ultrasonic image becomes a significant task before performing lesion classification, which was usually done with manual delineation of the tumor boundaries in the previous works. In this study, a linear support vector machine (SVM) based algorithm is proposed for ultrasound breast image training and classification. Then a disk expansion algorithm is applied for automatically detecting lesions boundary. A set of sub-images including smooth and irregular boundaries in tumor objects and those in speckle-noised background are trained by the SVM algorithm to produce an optimal classification function. Based on this classification model, each pixel within an ultrasound image is classified into either object or background oriented pixel. This enhanced binary image can highlight the object and suppress the speckle noise; and it can be regarded as degraded paint character (DPC) image containing closure noise, which is well known in perceptual organization of psychology. An effective scheme of removing closure noise using iterative disk expansion method has been successfully demonstrated in our previous works. The boundary detection of ultrasonic breast lesions can be further equivalent to the removal of speckle noise. By applying the disk expansion method to the binary image, we can obtain a significant radius-based image where the radius for each pixel represents the corresponding disk covering the specific object information. Finally, a signal transmission process is used for searching the complete breast lesion region and thus the desired lesion boundary can be effectively and automatically determined. Our algorithm can be performed iteratively until all desired objects are detected. Simulations and clinical images were introduced to

  8. Impact of lesion segmentation metrics on computer-aided diagnosis/detection in breast computed tomography.

    Science.gov (United States)

    Kuo, Hsien-Chi; Giger, Maryellen L; Reiser, Ingrid; Drukker, Karen; Boone, John M; Lindfors, Karen K; Yang, Kai; Edwards, Alexandra

    2014-10-01

    Evaluation of segmentation algorithms usually involves comparisons of segmentations to gold-standard delineations without regard to the ultimate medical decision-making task. We compare two segmentation evaluations methods-a Dice similarity coefficient (DSC) evaluation and a diagnostic classification task-based evaluation method using lesions from breast computed tomography. In our investigation, we use results from two previously developed lesion-segmentation algorithms [a global active contour model (GAC) and a global with local aspects active contour model]. Although similar DSC values were obtained (0.80 versus 0.77), we show that the global + local active contour (GLAC) model, as compared with the GAC model, is able to yield significantly improved classification performance in terms of area under the receivers operating characteristic (ROC) curve in the task of distinguishing malignant from benign lesions. [Area under the [Formula: see text] compared to 0.63, [Formula: see text

  9. US-guided diffuse optical tomography for breast lesions: the reliability of clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung; Kim, Ji Youn; Youn, Jung Hyun; Kim, Myung Hyun; Koo, Hye Ryoung; Kim, Soo Jin; Sohn, Yu-Mee; Moon, Hee Jung; Kim, Eun-Kyung [Yonsei University College of Medicine, Institute of Radiological Science, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2011-07-15

    To prospectively assess the reliability of US-guided diffuse optical tomography (US-DOT) using interobserver agreement for the diagnosis of breast lesions with individual real-time imaging and to assess the interobserver agreement of conventional sonography (US) combined with US-DOT for differentiation between benignity and malignancy breast lesions. An Institutional Review Board approved this study, and all subjects provided written informed consent. 122 breast lesions in 111 patients evaluated with US-guided core biopsy were included. Assessments with US and US-DOT for cases subjected to biopsy were obtained by two radiologists using individual real-time imaging prior to biopsy and were prospectively recorded by each performer. With DOT, the total haemoglobin concentration (THC) for each breast lesion was measured. Histopathological results from US-guided biopsies were used as a reference standard. To assess measurement interobserver agreement, the intraclass correlation coefficient (ICC) and the Bland-Altman plot were used for THC in US-DOT and the kappa values and ROC analysis were used to evaluate the diagnostic performances of the US BI-RADS final assessment in US and combined US and US-DOT. Of 122 US-guided core biopsied lesions, 83 (68.0%) were diagnosed as benign, and 39 (32.0%) as malignant. Excellent correlation was seen in the THC in US-DOT (ICC score 0.796; 95% confidence interval, 0.708-0.857). The interobserver agreement in BI-RADS final assessment with US and US-DOT (almost perfect; {kappa} = 0.8618) was improved compared with that of US (substantial agreement, {kappa} = 0.6574). However, the overall areas under the ROC curve did not show significant differences between US and combined US and US-DOT, 0.8894 and 0.8975, respectively (P = 0.981). The reliability of THC in US-DOT showed excellent correlation in overall real-time performance. Although the inter-observer agreement for BI-RADS final assessment of US was improved by using US-DOT, the

  10. Design, Implementation, and Characterization of a Dedicated Breast Computed MammoTomography System for Enhanced Lesion Imaging

    Science.gov (United States)

    2008-03-01

    4 Introduction In the USA, breast cancer in women is one of the leading causes of malignancy and the second leading cause of death due to cancer ...lead to a commercial system capable of in vivo tissue differentiation resulting in an improvement in the detection and diagnosis of breast cancer ...completeness. Task 3(a). This subtask was to evaluate different breast sizes, compositions, lesion sizes, microcalcifications to determine upper and

  11. Concordance between preoperative and postoperative assessments of primary caries lesion depth: results from the Dental PBRN

    DEFF Research Database (Denmark)

    Nascimento, Marcelle M; Bader, James D; Qvist, Vibeke

    2010-01-01

    This study investigated the concordance between pre- and postoperative assessments of primary caries lesion depths by dentists from The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org). A total of 229 DPBRN dentists collected data on 8,351 consecutive restorations inserted due...... depths were recorded as being in the outer half (E1) or inner half (E2) of enamel, or in the outer third (D1), middle third (D2) or inner third (D3) of dentin. Most restorations were placed to treat lesions that were preoperatively assessed as extending to the D1 (53%) and D2 (25%) depths....... Of the restored caries lesions, 10% were preoperatively assessed as being limited to E2 depth and 3% to E1 depth. The majority of the restored enamel lesions were located on occlusal surfaces. Preoperative estimates of caries lesion depth were more concordant with postoperative depths when the lesion...

  12. Shear-Wave Elastography: Could it be Helpful for the Diagnosis of Non-Mass-Like Breast Lesions?

    Science.gov (United States)

    Wang, Zhi Li; Li, Ye; Wan, Wen Bo; Li, Nan; Tang, Jie

    2017-01-01

    The goal of this study was to analyze the diagnostic performance of shear wave elastography (SWE) in differentiation of benign and malignant non-mass-like (NML) breast lesions. Three hundred sixteen consecutive breast lesions in 305 patients who have been scheduled for ultrasound (US)-guided core needle biopsy or vacuum-assisted biopsy or surgical excision between January 2013 and August 2013 were initially included in this study. Finally, 63 patients with 67 lesions classified as NML lesions comprised our study population. The features of SWE and its diagnostic performance in NML lesions were analyzed. Among the 67 NML lesions, 33 were malignant and 34 were benign. The maximum elastic modulus, mean elastic modulus, minimum elastic modulus, elastic modulus ratio and stiff rim sign of the malignant lesions were all significantly higher than those of benign lesions (p modulus and stiff rim sign got significantly higher diagnostic specificity and positive predictive value (PPV) than conventional US (p breast lesions. The combination of conventional US and SWE could reduce unnecessary benign biopsies of NML lesions. Copyright © 2016. Published by Elsevier Inc.

  13. Digital epiluminescence dermoscopy for pigmented cutaneous lesions, primary care physicians, and telediagnosis: a useful tool?

    Science.gov (United States)

    Grimaldi, Luca; Silvestri, Alessandro; Brandi, Cesare; Nisi, Giuseppe; Brafa, Anna; Calabrò, Massimiliano; Campa, Alessandra; D'Aniello, Carlo

    2009-08-01

    Digital epiluminescence dermoscopy is a relatively recent tool, based on the acquisition of high-definition digital images, for the diagnosis of pigmented cutaneous lesions. To verify the usefulness of digital dermoscopy in detecting pigmented lesions with features which may lead to suspicion of malignancy, when the examination is carried out by primary care physicians (PCP), not expert in that kind of diagnosis. Another target was an appraisal of the effectiveness and safety of telediagnosis based on epiluminescence digital dermoscopy on pigmented lesions. Digital images from some peripheral centres (235 lesions) have been forwarded in real time to the reference centre (Unit of Plastic Surgery, University of Siena, Italy), with a double judgement by each primary care physician ('benign' or 'suspicious of malignancy') on the basis of anamnesis and clinical examination at first step, and dermoscopy as second step. The image analysis carried out from the reference centre identified every lesion examined as 'to be controlled' (219 lesions) or 'to be removed' (16 lesions). Regarding the patients with dermoscopic examination (197 subjects, 235 lesions), the investigation reduced the number of lesions suspected of malignancy from 68 to 29 after the first dermoscopy, and from 29 to 16 after the re-examination of the image by the central unit researchers. Fourteen lesions suspected of malignancy when examined in the peripheral centres were then evaluated as benign by the central unit researchers, while one lesion, judged as benign at first (always labelled as 'benign' by the PCP), was then revealed as a dysplastic naevus. Digital dermoscopy can be enhanced by telediagnosis, which provides a better control of cutaneous pigmented lesions in the peripheral areas, thus reducing the number of consultations in specialised centres.

  14. Breast lesions of uncertain malignant nature and limited metastatic potential: Proposals to improve their recognition and clinical management

    Science.gov (United States)

    Rakha, Emad A.; Badve, Sunil; Eusebi, Vincenzo; Reis-Filho, Jorge S.; Fox, Stephen B.; Dabbs, David J.; Decker, Thomas; Hodi, Zsolt; Ichihara, Shu; Lee, Andrew HS.; Palacios, José; Richardson, Andrea L.; Vincent-Salomon, Anne; Schmitt, Fernando C.; Tan, Puay-Hoon; Tse, Gary M.; Ellis, Ian O.

    2016-01-01

    Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are traditionally classified into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey-zone between benign and malignant as their behaviour cannot be predicted reliably. Defined pathological categorisation of such lesions is challenging and for some entities is recognised to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over-treatment or under-treatment. The rarity of these lesions makes acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification, behaviour and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions remain of uncertain malignant nature such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of 1) breast lesions of uncertain malignant nature and 2) breast lesions of limited metastatic potential, are proposed with details of which histological entities could be included in each category, and their management implications are discussed. PMID:26348644

  15. Effects of increased compression with an ultrasound transducer on the conspicuity of breast lesions in a phantom

    Science.gov (United States)

    Szczepura, Katy; Faqir, Tahreem; Manning, David

    2017-03-01

    Ultrasound imaging of the breast is highly operator dependent. The amount of pressure applied with the transducer has a direct impact on the lesion visibility in breast ultrasound. The conspicuity index is a quantitative measure of lesion visibility, taking into account more parameters than standard measures that impact on lesion detection. This study assessed the conspicuity of lesions within a breast phantom using increased transducer compression in breast ultrasound. Methods A phantom was constructed of gelatine to represent adipose tissue, steel wool for glandular/blood vessels and silicone spheres to represent lesions, this meant that the lesions were also compressible, but less than the surrounding tissue. The phantom was imaged under increasing transducer compression. The conspicuity index was measured using the Conspicuity Index Software. The distance between the transducer surface and lesion surface was measured as an indication of increased compression. Results When moderate compression (17mm) was applied, the conspicuity index increased resulting in better visualisation of the silicone lesions. However, with increased compression the conspicuity index decreased. New work to be presented The conspicuity index has never been demonstrated in ultrasound imaging before. This is preliminary phantom work to demonstrate the impact of increased transducer compression on quantitative lesion visibility assessment. Conclusion The compression applied should be considered for optimum visualisation, as excessive pressure decreases conspicuity. However, further work needs to be conducted in order to consider other factors, such as density of the breast and lesion location, for a better understanding of the effect of compression on the visualisation of the lesion. A human study is planned.

  16. Axial-shear strain elastography for breast lesion classification: further results from in vivo data.

    Science.gov (United States)

    Thittai, Arun K; Yamal, Jose-Miguel; Mobbs, Louise M; Kraemer-Chant, Christina M; Chekuri, Srinivasa; Garra, Brian S; Ophir, Jonathan

    2011-02-01

    The purpose of this work was to investigate the potential of the normalized axial-shear strain area (NASSA) feature, derived from axial-shear strain elastograms (ASSE), for breast lesion classification of fibroadenoma and cancer. This study consisted of previously acquired in vivo digital radiofrequency data of breast lesions. A total of 33 biopsy-proven malignant tumors and 30 fibroadenoma cases were included in the study, which involved three observers blinded to the original BIRADS-ultrasound scores. The observers outlined the lesions on the sonograms. The ASSEs were segmented and color-overlaid on the sonograms, and the NASSA feature from the ASSE was computed semi-automatically. Receiver operating characteristic (ROC) curves were then generated and the area under the curve (AUC) was calculated for each observer performance. A logistic regression classifier was built to compare the improvement in the AUC when using BIRADS scores plus NASSA values as opposed to BIRADS scores alone. BIRADS score ROC had an AUC of 0.89 (95% CI = 0.81 to 0.97). In comparison, the average of the AUC for all the three observers using ASSE feature alone was 0.84. However, the AUC increased to 0.94 (average of 3 observers) when BIRADS score and ASSE feature were combined. The results demonstrate that the NASSA feature derived from ASSE has the potential to improve BIRADS breast lesion classification of fibroadenoma and malignant tumors. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. The Added Value of Color Parameters in Analyzing Elastographic Images of Ultrasound Detected Breast Focal Lesions.

    Science.gov (United States)

    Duma, Maria Magdalena; Chiorean, Angelica Rita; Feier, Diana Sorina; Florea, Madalina; Chiorean, Marco; Rusu, Georgeta Mihaela; Dudea, Sorin Marian; Sfrangeu, Silviu Andrei

    2015-01-01

    The purpose of the study was to determine if the color quantitative analysis obtained on elastographic images of breast lesions could improve the benign-malignant differentiation, and also to identify some of the circumstances which would benefit most from such an analysis. The study design was a longitudinal prospective one, all data being acquired between May 2007 and September 2008. The US device used: Hitachi 8500 EUB machine with elastography option. For suspicious breast lesions histopathology was obtained by means of percutaneous biopsy or post-surgery. Studied color parameters (numeric values): average color (red, green, blue), color dispersion, average intensity, average hue, hue dispersion. Calculus modality: Image Processing Version 1.3, a program developed in collaboration with the Technical University of Cluj Napoca. Seventy-one (71) women were selected for the study. A hundred and six circumscribed breast lesions were detected by means of ultrasound in the studied group. Five color parameters were independently associated with the histological diagnosis (AvgBlue, AvgGreen and AvgRed; DispRed and DispIntensity) with AvgBlue parameter making the most important contribution (p<0.0001); the greater the values of AvgBlue (more than 92), the higher the chances of malignancy and the greater the values of AvgGreen (more than 88), the higher the chances for a benign lesion. High numeric values for Avg Blue (more than 92) would increase the probability of malignancy and thus recommend a more aggressive diagnostic management (biopsy), while high numeric values for AvgGreen (more than 88) would reassure the examiner to proceed conservatively with short interval or routine follow-ups.

  18. Radioguided occult lesion localisation in breast cancer using an intraoperative portable gamma camera: first results.

    Science.gov (United States)

    Paredes, P; Vidal-Sicart, S; Zanón, G; Roé, N; Rubí, S; Lafuente, S; Pavía, J; Pons, F

    2008-02-01

    The role of the radioguided occult lesion localisation (ROLL) technique in breast cancer has been increasing in recent years. One of the important drawbacks of such a technique is radiotracer spillage within the mammary gland that makes the precise lesion resection difficult, and this requires the use of a hook-wire collocation to reach the lesion. The possibility of obtaining an intraoperative image of the specimen could help to confirm whether the lesion is correctly removed. Some types of portable gamma cameras have been designed, but up to now, intraoperative use has been confined to surgery of parathyroid adenomas and sentinel lymph node location. The aim of the study was to value the usefulness of an intraoperative gamma camera to assess the resection of non-palpable breast lesions. The study involved 42 women diagnosed with non-palpable early breast cancer. Lymphoscintigraphy was performed on the day before surgery by injection of (99m)Tc-labelled nanocolloid. During surgery a gamma probe was used to guide the surgeon, and afterwards images of the surgical bed and the tumoral specimen were acquired by means of a portable gamma camera, fitted with a pinhole collimator. A (99m)Tc pointer was used to draw an outline image around the specimen. On lymphoscintigraphy, radiotracer was concentrated in 31 cases. During surgery, all lesions were removed. In the images acquired by the portable gamma camera, the lesion was centred inside the surgical specimen in 23 of 42 cases, non-centred in 15 and in contact in 4 cases. Congruence of 60% was found between the intraoperative images and the histopathological results. The posterior margin was the most frequently involved. The whole acquisition time for the tumoral specimen with its margins was 5 min at most. The use of portable gamma cameras in theatre is in an early phase. The short period of time required during the surgical procedure will allow the surgical team to improve this technique until it can replace hand

  19. Radioguided occult lesion localisation in breast cancer using an intraoperative portable gamma camera: first results

    Energy Technology Data Exchange (ETDEWEB)

    Paredes, P. [Hospital Sant Pau, Nuclear Medicine Department, Barcelona (Spain); Vidal-Sicart, S.; Pavia, J.; Pons, F. [University of Barcelona, Nuclear Medicine Department, Hospital Clinic, Barcelona (Spain); Institut d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); Zanon, G. [University of Barcelona, Obstetrics and Gynaecology Department, Hospital Clinic, Barcelona (Spain); Roe, N.; Rubi, S. [University of Barcelona, Nuclear Medicine Department, Hospital Clinic, Barcelona (Spain); Lafuente, S. [Hospital Joan XXIII, Nuclear Medicine Department, Tarragona (Spain)

    2008-02-15

    The role of the radioguided occult lesion localisation (ROLL) technique in breast cancer has been increasing in recent years. One of the important drawbacks of such a technique is radiotracer spillage within the mammary gland that makes the precise lesion resection difficult, and this requires the use of a hook-wire collocation to reach the lesion. The possibility of obtaining an intraoperative image of the specimen could help to confirm whether the lesion is correctly removed. Some types of portable gamma cameras have been designed, but up to now, intraoperative use has been confined to surgery of parathyroid adenomas and sentinel lymph node location. The aim of the study was to value the usefulness of an intraoperative gamma camera to assess the resection of non-palpable breast lesions. The study involved 42 women diagnosed with non-palpable early breast cancer. Lymphoscintigraphy was performed on the day before surgery by injection of {sup 99m}Tc-labelled nanocolloid. During surgery a gamma probe was used to guide the surgeon, and afterwards images of the surgical bed and the tumoral specimen were acquired by means of a portable gamma camera, fitted with a pinhole collimator. A {sup 99m}Tc pointer was used to draw an outline image around the specimen. On lymphoscintigraphy, radiotracer was concentrated in 31 cases. During surgery, all lesions were removed. In the images acquired by the portable gamma camera, the lesion was centred inside the surgical specimen in 23 of 42 cases, non-centred in 15 and in contact in 4 cases. Congruence of 60% was found between the intraoperative images and the histopathological results. The posterior margin was the most frequently involved. The whole acquisition time for the tumoral specimen with its margins was 5 min at most. The use of portable gamma cameras in theatre is in an early phase. The short period of time required during the surgical procedure will allow the surgical team to improve this technique until it can replace

  20. Ultrasonographic features and clinical implications of benign palpable breast lesions in young women

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Richard; Kim, Hyon Ah; Mango, Victoria; Wynn, Ralph [Dept. of Radiology, Columbia University Medical Center, New York (United States); Comstock, Christopher [Dept. of Radiology, Memorial Sloan Kettering Cancer Center, New York (United States)

    2015-01-15

    The purpose of this study was to describe the breast ultrasonography (US) features and to investigate whether performing a core biopsy is warranted in young women having palpable solid breast masses. A total of 76 solid palpable masses in 68 consecutive women (≤25 years old) underwent tissue diagnosis by percutaneous core biopsy. Two radiologists, who were blinded to the clinical history and histopathology, independently evaluated the US features according to Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The frequency of benign and malignant descriptor terms that were used to characterize the lesions were compared to the final pathology. All 76 palpable solid masses yielded benign pathology. On the US, the shape of the mass was described by radiologists 1 and 2 as oval or round (63.2% and 71.1%), margin as circumscribed (68.4% and 77.6%) and orientation as parallel (85.5% and 90.8%); the frequency of using all three benign descriptors was 61.8% and 68.5%, respectively. Suspicious descriptors were used less frequently by radiologists 1 and 2 including irregular shape (9.2% and 13.1%), non-circumscribed margin (31.6% and 22.4%) and non-parallel orientation (14.5% and 9.2%); the frequency of using all three suspicious descriptors was 9.2% and 11.8%, respectively. Despite the variable US features, breast malignancy seems extremely low in 25 years or younger women for palpable breast lesions. Using the BI-RADS lexicon, US accurately predicted benignity in about two thirds of our patients, supporting US surveillance as a safe alternative to invasive tissue sampling in this setting.

  1. Ultrasonographic features and clinical implications of benign palpable breast lesions in young women

    Directory of Open Access Journals (Sweden)

    Richard Ha

    2015-01-01

    Full Text Available Purpose: The purpose of this study was to describe the breast ultrasonography (US features and to investigate whether performing a core biopsy is warranted in young women having palpable solid breast masses. Methods: A total of 76 solid palpable masses in 68 consecutive women (≤25 years old underwent tissue diagnosis by percutaneous core biopsy. Two radiologists, who were blinded to the clinical history and histopathology, independently evaluated the US features according to Breast Imaging-Reporting and Data System (BI-RADS lexicon. The frequency of benign and malignant descriptor terms that were used to characterize the lesions were compared to the final pathology. Results: All 76 palpable solid masses yielded benign pathology. On the US, the shape of the mass was described by radiologists 1 and 2 as oval or round (63.2% and 71.1%, margin as circumscribed (68.4% and 77.6% and orientation as parallel (85.5% and 90.8%; the frequency of using all three benign descriptors was 61.8% and 68.5%, respectively. Suspicious descriptors were used less frequently by radiologists 1 and 2 including irregular shape (9.2% and 13.1%, non-circumscribed margin (31.6% and 22.4% and non-parallel orientation (14.5% and 9.2%; the frequency of using all three suspicious descriptors was 9.2% and 11.8%, respectively. Conclusion: Despite the variable US features, breast malignancy seems extremely low in 25 years or younger women for palpable breast lesions. Using the BI-RADS lexicon, US accurately predicted benignity in about two thirds of our patients, supporting US surveillance as a safe alternative to invasive tissue sampling in this setting.

  2. In Vivo Quantification of the Nonlinear Shear Modulus in Breast Lesions: Feasibility Study.

    Science.gov (United States)

    Bernal, Miguel; Chamming's, Foucauld; Couade, Mathieu; Bercoff, Jeremy; Tanter, Mickaël; Gennisson, Jean-Luc

    2016-01-01

    Breast cancer detection in the early stages is of great importance since the prognosis, and the treatment depends more on this. Multiple techniques relying on the mechanical properties of soft tissues have been developed to help in early detection. In this study, we implemented a technique that measures the nonlinear shear modulus (NLSM) (μ(NL)) in vivo and showed its utility to detect breast lesions from healthy tissue. The technique relies on the acoustoelasticity theory in quasi-incompressible media. In order to recover μ(NL), static elastography and supersonic shear imaging are combined to subsequently register strain maps and shear modulus maps while the medium is compressed. Then, μ(NL) can be recovered from the relationship between the stress, deduced from strain maps, and the shear modulus. For this study, a series of five nonlinear phantoms were built using biological tissue (pork liver) inclusions immersed in an agar-gelatin gel. Furthermore, 11 in vivo acquisitions were performed to characterize the NLSM of breast tissue. The phantom results showed a very good differentiation of the liver inclusions when measuring μ(NL) with a mean value of -114.1 kPa compared to -34.7 kPa for the gelatin. Meanwhile, values for the shear modulus for the liver and the gelatin were very similar, 3.7 and 3.4 kPa, respectively. In vivo NLSM mean value for the healthy breast tissue was of -95 kPa, while mean values of the benign and the malignant lesions were -619 and -806 kPa with a strong v ariability, respectively. This study shows the potential of the acoustoelasticity theory in quasi-incompressible medium to bring a new parameter for breast cancer diagnosis.

  3. Identificación de lesiones mamarias malignas en México Identification of malignant breast lesions in Mexico

    Directory of Open Access Journals (Sweden)

    Lizbeth López-Carrillo

    2001-06-01

    Full Text Available Objetivo. Evaluar la forma en que se detectan las lesiones mamarias malignas en la ciudad de México y estimar el número de pacientes que son diagnosticadas en etapas avanzadas de dicho tumor. Material y métodos. Estudio transversal realizado en 256 mujeres entre 1994 y 1996, a quienes se les hizo un diagnóstico histopatológico de cáncer mamario en tres hospitales públicos de tercer nivel en la ciudad de México. Se les entrevistó personalmente y se obtuvo información acerca de sus características reproductivas, clínicas y la forma en la que fue detectado el cáncer mamario. Se calcularon porcentajes y razones de momios, con un intervalo de confianza de 95%. Resultados. El 90% de las mujeres identificaron por sí mismas la presencia de un abultamiento en el seno. Del total de las pacientes, sólo 10% fueron diagnosticadas con tumores en estadio I y 27 casos fueron identificados por el médico; estos últimos resultaron con tumores de estadios II B en adelante. Conclusiones. La situación actual sugiere que la mortalidad por cáncer mamario en la ciudad de México mantendrá su tendencia al incremento, a menos de que se logre aumentar la proporción de mujeres diagnosticadas en la etapa de los tumores in situ, para lo cual se requieren cambios en el funcionamiento de los servicios y un vasto esfuerzo educativo entre la población susceptible de desarrollar la enfermedad. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To evaluate the modes of detection of breast malignancies in Mexico City and to estimate the number of patients diagnosed in advanced stages. Material and methods. This cross-sectional study was conducted between 1994 and 1996, among 256 women with a histological diagnosis of breast cancer, at three tertiary level public hospitals in Mexico City. Personal interviews were conducted to collect data on reproductive characteristics, clinical history, and breast

  4. Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

    Directory of Open Access Journals (Sweden)

    Laura Regina Antunes PONTES

    2017-11-01

    Full Text Available Abstract We aimed to investigate the performance of fluorescence-based methods (FBMs, compared to visual inspection after histological validation, in detecting and assessing the activity status of occlusal carious lesions in primary teeth. One examiner evaluated 50 primary molars close to exfoliation in 24 children. Teeth were assessed using quantitative light-induced fluorescence (QLF and pen-type laser fluorescence (LFpen. After exfoliation, histological validation was performed. Teeth were cut and sections were evaluated for lesion depth and activity status (after utilization of a pH indicator under a stereomicroscope. Parameters related to the performance of the methods in detecting caries lesions at two thresholds (initial and dentin lesions were calculated. Regarding the activity status, lesions were classified into sound+inactive or active, and the area under the ROC curve and the diagnostic odds ratio values of the methods were calculated and compared. Evaluation of red fluorescence using QLF presented higher sensitivity but lower specificity than visual inspection in detecting dentin caries lesions. However, QLF considering different parameters and LFpen had similar performance to that obtained with visual inspection. Regarding activity assessment, all FBMs and visual inspection also presented similar performance. In conclusion, FBMs did not prove advantageous for the detection and activity assessment of occlusal caries lesions in primary molars when compared to visual inspection.

  5. The added diagnostic value of dynamic contrast-enhanced MRI at 3.0 T in nonpalpable breast lesions.

    Directory of Open Access Journals (Sweden)

    Laura G Merckel

    Full Text Available OBJECTIVE: To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading. MATERIALS AND METHODS: We evaluated MRI scans of patients with nonpalpable BI-RADS 3-5 lesions who underwent dynamic contrast-enhanced 3.0 Tesla breast MRI. Initially, MRI scans were read by radiologists in a routine clinical setting. All histologically confirmed index lesions were re-evaluated by two dedicated breast radiologists. Sensitivity and specificity for the three MRI readings were determined, and the diagnostic value of breast MRI in addition to conventional imaging was assessed. Interobserver reliability between the three readings was evaluated. RESULTS: MRI examinations of 207 patients were analyzed. Seventy-eight of 207 (37.7% patients had a malignant lesion, of which 33 (42.3% patients had pure DCIS and 45 (57.7% invasive breast cancer. Sensitivity of breast MRI was 66.7% during routine, and 89.3% and 94.7% during expert reading. Specificity was 77.5% in the routine setting, and 61.0% and 33.3% during expert reading. In the routine setting, MRI provided additional diagnostic information over clinical information and conventional imaging, as the Area Under the ROC Curve increased from 0.76 to 0.81. Expert MRI reading was associated with a stronger improvement of the AUC to 0.87. Interobserver reliability between the three MRI readings was fair and moderate. CONCLUSIONS: 3.0 T breast MRI of nonpalpable breast lesions is of added diagnostic value for the diagnosis of in situ and invasive breast cancer.

  6. The added diagnostic value of dynamic contrast-enhanced MRI at 3.0 T in nonpalpable breast lesions.

    Science.gov (United States)

    Merckel, Laura G; Verkooijen, Helena M; Peters, Nicky H G M; Mann, Ritse M; Veldhuis, Wouter B; Storm, Remmert K; Weits, Teun; Duvivier, Katya M; van Dalen, Thijs; Mali, Willem P Th M; Peeters, Petra H M; van den Bosch, Maurice A A J

    2014-01-01

    To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading. We evaluated MRI scans of patients with nonpalpable BI-RADS 3-5 lesions who underwent dynamic contrast-enhanced 3.0 Tesla breast MRI. Initially, MRI scans were read by radiologists in a routine clinical setting. All histologically confirmed index lesions were re-evaluated by two dedicated breast radiologists. Sensitivity and specificity for the three MRI readings were determined, and the diagnostic value of breast MRI in addition to conventional imaging was assessed. Interobserver reliability between the three readings was evaluated. MRI examinations of 207 patients were analyzed. Seventy-eight of 207 (37.7%) patients had a malignant lesion, of which 33 (42.3%) patients had pure DCIS and 45 (57.7%) invasive breast cancer. Sensitivity of breast MRI was 66.7% during routine, and 89.3% and 94.7% during expert reading. Specificity was 77.5% in the routine setting, and 61.0% and 33.3% during expert reading. In the routine setting, MRI provided additional diagnostic information over clinical information and conventional imaging, as the Area Under the ROC Curve increased from 0.76 to 0.81. Expert MRI reading was associated with a stronger improvement of the AUC to 0.87. Interobserver reliability between the three MRI readings was fair and moderate. 3.0 T breast MRI of nonpalpable breast lesions is of added diagnostic value for the diagnosis of in situ and invasive breast cancer.

  7. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study

    DEFF Research Database (Denmark)

    Stovall, M.; Smith, S.A.; Langholz, B.M.

    2008-01-01

    PURPOSE: To quantify the risk of second primary breast cancer in the contralateral breast (CB) after radiotherapy (RT) for first breast cancer. METHODS AND MATERIALS: The study population included participants in the Women's Environmental, Cancer, and Radiation Epidemiology study: 708 cases (wome...

  8. A new background distribution-based active contour model for three-dimensional lesion segmentation in breast DCE-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hui; Liu, Yiping; Qiu, Tianshuang [Department of Biomedical Engineering, Dalian University of Technology, Dalian 116024 (China); Zhao, Zuowei, E-mail: liuhui@dlut.edu.cn [Second Affiliated Hospital, Dalian Medical University, Dalian 116027 (China); Zhang, Lina [Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian 116027 (China)

    2014-08-15

    Purpose: To develop and evaluate a computerized semiautomatic segmentation method for accurate extraction of three-dimensional lesions from dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) of the breast. Methods: The authors propose a new background distribution-based active contour model using level set (BDACMLS) to segment lesions in breast DCE-MRIs. The method starts with manual selection of a region of interest (ROI) that contains the entire lesion in a single slice where the lesion is enhanced. Then the lesion volume from the volume data of interest, which is captured automatically, is separated. The core idea of BDACMLS is a new signed pressure function which is based solely on the intensity distribution combined with pathophysiological basis. To compare the algorithm results, two experienced radiologists delineated all lesions jointly to obtain the ground truth. In addition, results generated by other different methods based on level set (LS) are also compared with the authors’ method. Finally, the performance of the proposed method is evaluated by several region-based metrics such as the overlap ratio. Results: Forty-two studies with 46 lesions that contain 29 benign and 17 malignant lesions are evaluated. The dataset includes various typical pathologies of the breast such as invasive ductal carcinoma, ductal carcinomain situ, scar carcinoma, phyllodes tumor, breast cysts, fibroadenoma, etc. The overlap ratio for BDACMLS with respect to manual segmentation is 79.55% ± 12.60% (mean ± s.d.). Conclusions: A new active contour model method has been developed and shown to successfully segment breast DCE-MRI three-dimensional lesions. The results from this model correspond more closely to manual segmentation, solve the weak-edge-passed problem, and improve the robustness in segmenting different lesions.

  9. Quantitative evaluation of automatic methods for lesions detection in breast ultrasound images

    Science.gov (United States)

    Marcomini, Karem D.; Schiabel, Homero; Carneiro, Antonio Adilton O.

    2013-02-01

    Ultrasound (US) is a useful diagnostic tool to distinguish benign from malignant breast masses, providing more detailed evaluation in dense breasts. Due to the subjectivity in the images interpretation, computer-aid diagnosis (CAD) schemes have been developed, increasing the mammography analysis process to include ultrasound images as complementary exams. As one of most important task in the evaluation of this kind of images is the mass detection and its contours interpretation, automated segmentation techniques have been investigated in order to determine a quite suitable procedure to perform such an analysis. Thus, the main goal in this work is investigating the effect of some processing techniques used to provide information on the determination of suspicious breast lesions as well as their accurate boundaries in ultrasound images. In tests, 80 phantom and 50 clinical ultrasound images were preprocessed, and 5 segmentation techniques were tested. By using quantitative evaluation metrics the results were compared to a reference image delineated by an experienced radiologist. A self-organizing map artificial neural network has provided the most relevant results, demonstrating high accuracy and low error rate in the lesions representation, corresponding hence to the segmentation process for US images in our CAD scheme under tests.

  10. Correlative analysis of breast lesions on full-field digital mammography and magnetic resonance imaging

    Science.gov (United States)

    Yuan, Yading

    Multi-modality imaging techniques are increasingly being applied in clinical practice to improve the accuracy with which breast cancer can be diagnosed. However, interpreting images from different modalities is not trivial as different images of the same lesion may exhibit different physical lesion attributes, and currently the various image modality acquisitions are performed under different breast positioning protocols. The general objective of this research is to investigate computerized correlative feature analysis (CFA) methods for integrating information from full-field digital mammographic (FFDM) images and dynamic contrast-enhanced magnetic resonance (DCE-MR) images by taking advantage of the information from different imaging modalities, and thus improving the diagnostic ability of computer-aided diagnosis (CADx) in breast cancer workup. The main hypothesis to be tested is that by incorporating correlative feature analysis in CADx, one can achieve an accurate and efficient discrimination between corresponding and non-corresponding lesion pairs, and subsequently improve performance in the estimation of computer-estimated probabilities of malignancy. The main contributions of this research work are summarized as follows. (1) A novel active-contour model based algorithm was developed for lesion segmentation on mammograms. This new algorithm yielded a statistically improved segmentation performance as compared to previously developed methods: a region-growing method and a radial gradient index (RGI) based method. (2) A computerized feature-based, supervised-learning driven CFA method was investigated to identify corresponding lesions in different mammographic views. The performance obtained by combining multiple features was found to be statistically better than the use of a distance feature alone, and robust across different mammographic view combinations. (3) A multi-modality CADx method that automatically selects and combines discriminative information from

  11. Determining whether excision of all fibroepithelial lesions of the breast is needed to exclude phyllodes tumor: upgrade rate of fibroepithelial lesions of the breast to phyllodes tumor.

    Science.gov (United States)

    Van Osdol, Andrew D; Landercasper, Jeffrey; Andersen, Jeremiah J; Ellis, Richard L; Gensch, Erin M; Johnson, Jeanne M; De Maiffe, Brooke; Marcou, Kristen A; Al-Hamadani, Mohammed; Vang, Choua A

    2014-10-01

    Fibroepithelial lesions (FELs) are a common histologic finding on core needle biopsy (CNB) of the breast. Fibroepithelial lesions include fibroadenoma and phyllodes tumor, which can be difficult to distinguish with an initial CNB. An institutional experience was reviewed from February 12, 2001, to January 4, 2007, to determine the safety of selective rather than routine excision of FELs and to determine the factors associated with upgrading diagnosis of FELs to phyllodes tumors without definitive phyllodes tumor diagnosis by CNB. Of 313 patients, 261 (83%) with FELs diagnosed by CNB received observation with long-term follow-up (mean, 8 years). Of the observed patients, 3 (1%) were diagnosed with phyllodes tumor on follow-up. Eighteen of 52 patients (35%) who received excision had an upgrade of diagnosis to phyllodes tumor. Sensitivity and specificity of the pathologist's comment of concern for phyllodes tumor on a CNB demonstrating FELs without definitive phyllodes tumor diagnosis were 82% and 93%, respectively. Our policy of selective excision of FELs without definitive phyllodes tumor diagnosis resulted in safe avoidance of many surgical procedures.

  12. Injectable iodine-125 labeled tissue marker for radioactive localization of non-palpable breast lesions

    DEFF Research Database (Denmark)

    Schaarup-Jensen, Henrik; Jensen, Andreas Ingemann; Hansen, Anders Elias

    2018-01-01

    through thin hypodermic needles (≥27G), the marker holds great promise for clinical application, since patient discomfort is reduced significantly compared to current methods. Statement of Significance. A new type of tissue marker for local administration to non-palpable breast tumors has been developed......We have developed a 125I-radiolabeled injectable fiducial tissue marker with the potential to replace current methods used for surgical guidance of non-palpable breast tumors. Methods in routine clinical use today such as radioactive seed localization, radio-guided occult lesion localization...... and wire-guided localization suffers from limitations that this injectable fiducial tissue marker offers solutions to. The developed 125I-radiolabeled injectable fiducial tissue marker is based on highly viscous sucrose acetate isobutyrate. The marker was readily inserted in NMRI mice and proved...

  13. New metallic marker used after mammotome biopsy for the localization of breast lesions: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Mi; Park, Jeong Mi; Song, Ho Young [Asan Medical Center, Ulsan University College of Medicine, Ulsan (Korea, Republic of)] (and others)

    2003-12-15

    To determine the usefulness and complications of a newly made metallic tissue marker inserted after mammotome biopsy of breast lesions. We manufactured a new gold tissue marker and introducer for the insertion after ultrasound-guided mammotome biopsy for breast lesions. The new tissue marker was inserted to 7 dogs and 22 patients. Histopathologic findings were evaluated in all dogs and patients with malignant diseases who underwent surgery. Follow-up mammography and ultrasonography were performed in patients with benign diseases 6 months after the biopsy for the evaluation of complications including migration. In dogs, there was no foreign body reaction in 3 dogs, mild foreign body reactions in 3 dogs, and moderate foreign body reactions in one dog. Meanwhile, the marker was successfully inserted in 17 (77.3%) of 22 patients under ultrasonography-guidance. There were mild foreign body reactions in 4 patients with malignant diseases. On one month follow-up mammography and ultrasonography in 12 of 13 patients with benign diseases with the successful marker insertion showed hematoma with the size ranging from 8 to 23 mm in 8 patients (66.7%). Rotation of the marker without any change of location was seen in 4 patients while rotation with the changed location, about 1 cm in distance, was seen in 1 patient. On six month follow-up ultrasonography performed in 9 patients showed the disappearance of all hematomas. There was no change of the marker's location on mammography compared to the one-month follow-up mammography. Pain or inflammatory reaction was not noted in any patient. This new gold post-mammotome tissue marker showed mild foreign body reaction and no significant complication including migration. It will be very useful in routine practice of mammotome for breast lesions.

  14. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    Directory of Open Access Journals (Sweden)

    Masatoshi Yamada

    2016-01-01

    Full Text Available Background: Intraductal proliferative lesions (IDPLs of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH and low-grade ductal carcinoma in situ (LG-DCIS. In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH, ADH, LG-DCIS, intermediate-grade (IM-DCIS, and high-grade (HG-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA and a support vector machine. Results: High diagnostic accuracy (81.8–99.3% was achieved between pathologists' diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer.

  15. Expression of glucocorticoid receptor is associated with aggressive primary endometrial cancer and increases from primary to metastatic lesions.

    Science.gov (United States)

    Tangen, Ingvild L; Veneris, Jennifer Taylor; Halle, Mari K; Werner, Henrica M; Trovik, Jone; Akslen, Lars A; Salvesen, Helga B; Conzen, Suzanne D; Fleming, Gini F; Krakstad, Camilla

    2017-12-01

    Glucocorticoid receptor (GR) has emerged as an important steroid nuclear receptor in hormone dependent cancers, however few data are available regarding a potential role of GR in endometrial cancer. The aim of this study was to investigate expression of GR in primary and metastatic endometrial cancer lesions, and to assess the relationship between GR expression and clinical and histopathological variables and survival. Expression of GR was investigated by IHC in 724 primary tumors and 289 metastatic lesions (from 135 patients), and correlations with clinical and histopathological data and survival were explored. Expression of GR was significantly increased in non-endometrioid tumors compared to endometrioid tumors, and was associated with markers of aggressive disease and poor survival both in univariate and multivariate analysis after correcting for age, FIGO stage and histologic grade. Within the subgroups of hormone receptor negative tumors (loss of androgen receptor, estrogen receptor or progesterone receptor) expression of GR was highly significantly associated with poor disease specific survival. There was an overall increase in GR expression from primary to metastatic lesions, and the majority of metastases expressed GR. GR expression in primary endometrial cancer is associated with aggressive disease and poor survival. The majority of metastatic endometrial cancer lesions express GR; therefore GR may represent a therapeutic target in the adjuvant therapy of poor prognosis early-stage as well as metastatic endometrial cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Primary systemic chemotherapy of breast cancer: indication and predictive factors.

    Science.gov (United States)

    Jinno, Hiromitsu; Sakata, Michio; Hayashida, Tetsu; Takahashi, Maiko; Sato, Tomomi; Seki, Hirohito; Kitagawa, Yuko

    2011-04-01

    Primary systemic chemotherapy has become a standard of care for operable breast cancer patients who are candidates for adjuvant chemotherapy. Induction of pathological complete response (pCR) is one of the main goals of primary systemic chemotherapy because patients with pCR have shown a better prognosis. The definition of pCR has varied across clinical trials. It would be ideal for all researchers to use the same terminology in describing pathologic response. Identification of accurate predictive factors of pCR to primary systemic chemotherapy is urgent, because patients with a low chance of pCR and clinical response should be spared unnecessary toxicity. Early response to primary systemic chemotherapy might be correlated with a high probability of a pCR. Therefore, evaluation of early response is useful to avoid unnecessary toxicity without potential benefit from chemotherapy.

  17. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Bezzon, Elisabetta; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo [Veneto Institute of Oncology (IRCCS), Padua (Italy); Hendrick, R.E. [University of Colorado-Denver, Department of Radiology, School of Medicine, Aurora, CO (United States); Toledano, Alicia [Biostatistics Consulting, LLC, Kensington, MD (United States); Paquelet, Jean R. [Advanced Medical Imaging Consultants, Fort Collins, CO (United States); Breast Imaging, McKee Medical Center, Loveland, CO (United States); Chersevani, Roberta [Private Medical Practice, Gorizia (Italy); Di Maggio, Cosimo [Private Medical Practice, Padua (Italy); La Grassa, Manuela [Department of Radiology, Oncological Reference Center (IRCCS), Aviano (Italy)

    2013-08-15

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT{sub (MLO)}+MX{sub (CC)}, was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT{sub (MLO)}+MX{sub (CC)} was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. (orig.)

  18. The impact of motion correction on lesion characterization in DCE breast MR images

    Science.gov (United States)

    Bergtholdt, Martin; Kabus, Sven; Wiemker, Rafael; Buelow, Thomas

    2011-03-01

    In the context of dynamic contrast enhanced breast MR imaging we analyzed the effect of motion compensating registration on the characterization of lesions. Two registration techniques were applied: 1) rigid registration and 2) elastic registration based on the Navier-Laḿe equation. Interpreting voxels that exhibit a decline in image intensity after contrast injection (compared to the non-contrasted native image) as motion outliers, it can be shown that the rate of motion outliers can be largely reduced by both rigid and elastic registration. The performance of lesion features, including maximal signal enhancement ratio and variance of the signal enhancement ratio, was measured by area under the ROC curve as well as Cohen's κ and showed significant improvement for elastic registration, whereas features derived from rigidly registered images did not in general exhibit a significant improvement over the level of unregistered data.

  19. Proximal caries lesion detection in primary teeth: does this justify the association of diagnostic methods?

    Science.gov (United States)

    Bussaneli, D G; Restrepo, M; Boldieri, T; Albertoni, T H; Santos-Pinto, L; Cordeiro, R C L

    2015-12-01

    The aim of this clinical study was to evaluate and compare the performance of visual exam with use of the Nyvad criteria (visual examination - (VE)), interproximal radiography (BW), laser fluorescence device (DIAGNOdent Pen-DDPen), and their association in the diagnosis of proximal lesions in primary teeth. For this purpose, 45 children (n = 59 surfaces) of both sexes, aged between 5 and 9 years were selected, who presented healthy primary molars or primary molars with signs suggestive of the presence of caries lesions. The surfaces were clinically evaluated and coded according to the Nyvad criteria and immediately afterwards with the DDPen. Radiographic exam was performed only on the surfaces coded with Nyvad scores 2, 3, 5, or 6. Active caries lesions and/or those with discontinuous surfaces were restored, considering the depth of lesion as reference standard. Sensitivity, specificity, accuracy, and area under ROC curve were calculated for each technique and its associations. Visual exam with Nyvad criteria presented the highest specificity, accuracy, and area under ROC curve values. The DDPen presented the highest sensitivity values. Association with one or more methods resulted in an increase in specificity. The performance of visual, radiographic, and DDpen exams and their associations were good; however, the clinical examination with the Nyvad criteria was sufficient for the diagnosis of interproximal lesions in primary teeth.

  20. Diagnosis of solid breast lesions by elastography 5-point score and strain ratio method

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Qiao Ling, E-mail: imagingzhaoql@126.com [Department of Ultrasound, the First Affiliated Hospital, Medical College of Xi' an Jiaotong University, Xi' an Yanta West Road No. 277, Shaanxi 710061 (China); Ruan, Li Tao, E-mail: ruanlitao@163.com [Department of Ultrasound, the First Affiliated Hospital, Medical College of Xi' an Jiaotong University, Xi' an Yanta West Road No. 277, Shaanxi 710061 (China); Zhang, Hua, E-mail: Zhanghua54322@163.com [Department of Ultrasound, the First Affiliated Hospital, Medical College of Xi' an Jiaotong University, Xi' an Yanta West Road No. 277, Shaanxi 710061 (China); Yin, Yi Min, E-mail: yymxbh@yahoo.cn [Department of Ultrasound, the First Affiliated Hospital, Medical College of Xi' an Jiaotong University, Xi' an Yanta West Road No. 277, Shaanxi 710061 (China); Duan, Shao Xue, E-mail: doujiaoyueer@163.com [Department of Ultrasound, the First Affiliated Hospital, Medical College of Xi' an Jiaotong University, Xi' an Yanta West Road No. 277, Shaanxi 710061 (China)

    2012-11-15

    Purpose: To compare the diagnostic performance of 5-point scoring system and strain ratio by sonoelastography in the assessment of solid breast lesions. Material and methods: One hundred and eighty-seven solid masses in 155 patients were scanned by two-dimensional ultrasonography and sonoelastography. Elasticity scores were determined with a 5-point scoring method, and the strain ratio was based on the comparison of the average strain measured in the lesion with the adjacent breast tissue in the same depth. Pathological results were taken as gold standards to compare the diagnostic efficacy of two methods with clinical diagnostic test and receiver operating characteristic (ROC) curves. Results: Among 187 lesions, 130 were benign and 57 were malignant. The mean scores (1.62 {+-} 0.69 vs 4.07 {+-} 0.26, P < 0.05) and strain ratios (2.06 {+-} 1.27 vs 6.66 {+-} 4.62, P < 0.05) were significantly higher of malignant than benign lesions. The area under the curve for the 5-point scoring system and for strain ratio-based elastographic analysis was 0.892 and 0.909, respectively (P > 0.05). For 5-point scoring, sonoelastography had 84.2% sensitivity, 84.6% specificity, 84.5% accuracy, 70.6% positive predictive value and 92.4% negative predictive value. When a cutoff point of 3.06 was used, sensitivity, specificity, accuracy, positive and negative predictive values were 87.7%, 88.5%, 88.2%, 76.9% and 94.3%, respectively for the strain ratio (P > 0.05). Conclusions: The 5-point scoring system and strain ratio has similar diagnostic performance, and the strain ratio could be more objective to differentiate the masses when those masses were difficult to be judged by using 5-point scoring system in sonoelastographic images.

  1. Combination of one-view digital breast tomosynthesis with one-view digital mammography versus standard two-view digital mammography: per lesion analysis.

    Science.gov (United States)

    Gennaro, Gisella; Hendrick, R Edward; Toledano, Alicia; Paquelet, Jean R; Bezzon, Elisabetta; Chersevani, Roberta; di Maggio, Cosimo; La Grassa, Manuela; Pescarini, Luigi; Polico, Ilaria; Proietti, Alessandro; Baldan, Enrica; Pomerri, Fabio; Muzzio, Pier Carlo

    2013-08-01

    To evaluate the clinical value of combining one-view mammography (cranio-caudal, CC) with the complementary view tomosynthesis (mediolateral-oblique, MLO) in comparison to standard two-view mammography (MX) in terms of both lesion detection and characterization. A free-response receiver operating characteristic (FROC) experiment was conducted independently by six breast radiologists, obtaining data from 463 breasts of 250 patients. Differences in mean lesion detection fraction (LDF) and mean lesion characterization fraction (LCF) were analysed by analysis of variance (ANOVA) to compare clinical performance of the combination of techniques to standard two-view digital mammography. The 463 cases (breasts) reviewed included 258 with one to three lesions each, and 205 with no lesions. The 258 cases with lesions included 77 cancers in 68 breasts and 271 benign lesions to give a total of 348 proven lesions. The combination, DBT(MLO)+MX(CC), was superior to MX (CC+MLO) in both lesion detection (LDF) and lesion characterization (LCF) overall and for benign lesions. DBT(MLO)+MX(CC) was non-inferior to two-view MX for malignant lesions. This study shows that readers' capabilities in detecting and characterizing breast lesions are improved by combining single-view digital breast tomosynthesis and single-view mammography compared to two-view digital mammography. • Digital breast tomosynthesis is becoming adopted as an adjunct to mammography (MX) • DBT (MLO) +MX (CC) is superior to MX (CC+MLO) in lesion detection (overall and benign lesions) • DBT (MLO) +MX (CC) is non-inferior to MX (CC+MLO) in cancer detection • DBT (MLO) +MX (CC) is superior to MX (CC+MLO) in lesion characterization (overall and benign lesions) • DBT (MLO) +MX (CC) is non-inferior to MX (CC+MLO) in characterization of malignant lesions.

  2. Preoperative Tomosynthesis-guided Needle Localization of Mammographically and Sonographically Occult Breast Lesions.

    Science.gov (United States)

    Freer, Phoebe E; Niell, Bethany; Rafferty, Elizabeth A

    2015-05-01

    To assess the feasibility and accuracy of digital breast tomosynthesis (DBT)-guided needle localization for DBT-detected suspicious abnormalities not visualized with other modalities and to analyze the imaging and pathologic characteristics of abnormalities detected only with DBT to determine the positive predictive value for malignancy. This HIPAA-compliant study was approved by the institutional review board, and the requirement to obtain informed consent was waived. A retrospective query of the imaging database identified 34 consecutive women (average age, 55 years; age range, 28-84 years) with 36 lesions who underwent DBT-guided needle localization between April 2011 and January 2013 with use of commercially available equipment. Imaging findings and medical records were reviewed. Findings that were attributable to previous surgical changes were classified as benign or probably benign and excluded from analysis because the lesions did not proceed to localization. Architectural distortion was the imaging finding identified in all 36 abnormalities (100%). Findings from pathologic examination after the first attempt at localization were concordant with those from imaging in 35 of the 36 lesions (97%), which is suggestive of appropriate sampling. Histologic findings were malignant in 17 of the 36 lesions (47%; 95% confidence interval: 30.4%, 64.5%). Thirteen of the 17 lesions (76%; 95% confidence interval: 50.1%, 93.1%) were invasive malignancies. Twenty-two of the 36 abnormalities (61%) were either malignant or high-risk lesions (atypical ductal hyperplasia, lobular carcinoma in situ, atypical lobular hyperplasia). DBT-guided needle localization is an accurate and feasible method with which to biopsy DBT-detected suspicious architectural distortions not visualized at mammography or sonography. The high risk of malignancy in abnormalities detected only with DBT (47%) confirms that routine biopsy is required for histologic analysis. (©) RSNA,

  3. EFFECT OF FLUORIDE VARNISHES CONTAINING DIFFERENT CALCIUM PHOSPHATE SOURCES ON MINERALIZATION OF INITIAL PRIMARY ENAMEL LESIONS.

    Science.gov (United States)

    Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Pornmahala, Tuenjai

    2014-11-01

    This study was conducted to evaluate the effect of fluoride varnishes containing different calcium phosphate sources on demineralization of initial primary enamel lesions. Forty-eight sound primary incisors were completely coated with nail varnish except for two 1 x 1 mm windows before being placed in demineralizing solution for 4 days. After demineralization, one of the windows in each tooth was coated with nail varnish. The teeth were randomly divided into four groups (A to D; n = 12), and then the other (exposed) window was treated with: Group A: deionized water, Group B: Duraphat® fluoride varnish, Group C: Clinpro™ White varnish and Group D: Enamel Pro® varnish. The pH-cycling regimen was carried out consisting of demineralization (6 hours) and remineralization (18 hours) for 7 days. Polarized light microscopy was used to evaluate the lesion depth initially and then after a seven-day pH cycle. Lesion depth was measured using a computerized method with the Image-Pro® Plus Program. The pair t-test was used to compare lesion depths before and after treatment. Differences in mean lesion depths among the groups were compared with the one-way ANOVA and Tukey's multiple comparison tests with 95% confidence intervals. The lesion depths had a significant difference between before and after treatment of the all groups. There was a significant increase in lesion depth in Group A compared to the other groups. No significant differences were seen among Groups B, C and D, containing fluoride and the different calcium phosphate sources in inhibiting progression of initial primary enamel lesions.

  4. The texture quantitative analysis of the normal mammary parenchyma and in breast lesions: acoustic radiation force impulse (ARFI) technology.

    Science.gov (United States)

    Li, Y; Liu, C; Geng, J; Zheng, X; Chen, B; Lu, Z; Wang, X

    2014-01-01

    The purpose of this work is to investigate the feasibility of acoustic radiation force impulse (ARFI) technology in the normal mammary parenchyma and in breast lesions. The virtual touch tissue quantification (VTQ) value was measured on a total of 150 cases in the normal mammary parenchyma and a total of 69 cases in breast lesions (19 cases of nodules, 28 cases of fibroadenoma, and 22 cases of cancer). Then the statistic analysis was carried out on the VTQ value combined with mammographic density, ages, menstrual stages, and pathological result. The VTQ value of mammary parenchyma rose with the increase of the mammographic density, and the value of VTQ had statistical differences in the comparison of group C with group B and in the comparison of group D with group C. The comparison of the VTQ value of the mammary parenchyma in patients with breast cancer and the nodule had statistical difference. The comparison of the VTQ value of the mammary parenchyma in patients with breast cancer, and the fibroadenoma had statistical difference. The value ofVTQ in masses gradually increased in the groups of nodule, fibroadenoma, and breast cancer. There was significant difference in the comparison of VTQ value of the nodule group and the fibroadenoma group with breast cancer group respectively. ARFI-VTQ technology has some reference value in assessing mammographic density. ARFI-VTQ can be used as the quantitative indicater for differentially diagnosing the breast lesions.

  5. MRI-guided breast vacuum biopsy: Localization of the lesion without contrast-agent application using diffusion-weighted imaging.

    Science.gov (United States)

    Berger, Nicole; Varga, Zsuzsanna; Frauenfelder, Thomas; Boss, Andreas

    2017-05-01

    In magnetic resonance-guided breast vacuum biopsies, the contrast agent for targeting suspicious lesions can typically be applied only once during an intervention, due to the slow elimination of the gadolinium chelate from the extracellular fluid space. This study evaluated the feasibility of diffusion-weighted imaging (DWI) for lesion targeting in vacuum assisted magnetic resonance imaging (MRI) biopsies. DWI may be used as an alternative to dynamic contrast-enhanced MRI with the advantage of reproducibility. However, the targeted lesion requires the characteristics of a mass-like lesion, substantial diffusion restriction, and a minimum size of approximately 1cm. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Ulcerated primary fibrosarcoma of breast: case report and review of literature.

    Science.gov (United States)

    Yadav, S K; Yadav, Jitin; Abhinav, Anand; Satish, K; Om, Prakash; Manish, K; Anjana, G

    2015-01-01

    Breast carcinoma is a common condition worldwide but stromal sarcomas of breast are rarity in day to day surgical practice. Out of primary breast sarcomas, fibrosarcoma constitutes only 16% of cases. We report a primary fibrosarcoma of breast in a young female patient which presented as ulcerated growth and fixity to chest wall and multiple ipsilateral axillary lympadenopathy (Stage IIIb). After biopsy confirmation palliation mastectomy was done and patient was sent for chemoradiotherapy.

  7. Striking life events associated with primary breast cancer susceptibility in women: a meta-analysis study

    OpenAIRE

    Lin, Yan; Wang, Changjun; Zhong, Ying; Huang, Xin; Peng, Li; Shan, Guangliang; Wang, Ke; Sun, Qiang

    2013-01-01

    Purpose The association between striking life events, an important stress and acute anxiety disorder, and the occurrence of primary breast cancer is unclear. The current meta-analysis was designed to assess the relationship between striking life events and primary breast cancer incidence in women. Methods Systematic computerized searching of the PubMed, ScienceDirect, Embase, and BMJ databases with the combinations of controlled descriptors from Mesh, including breast cancer, breast tumor, ca...

  8. [Diagnostic value of quantitative pharmacokinetic parameters and relative quantitative pharmacokinetic parameters in breast lesions with dynamic contrast-enhanced MRI].

    Science.gov (United States)

    Sun, T T; Liu, W H; Zhang, Y Q; Li, L H; Wang, R; Ye, Y Y

    2017-08-01

    Objective: To explore the differential between the value of dynamic contrast-enhanced MRI quantitative pharmacokinetic parameters and relative pharmacokinetic quantitative parameters in breast lesions. Methods: Retrospective analysis of 255 patients(262 breast lesions) who was obtained by clinical palpation , ultrasound or full-field digital mammography , and then all lessions were pathologically confirmed in Zhongda Hospital, Southeast University from May 2012 to May 2016. A 3.0 T MRI scanner was used to obtain the quantitative MR pharmacokinetic parameters: volume transfer constant (K(trans)), exchange rate constant (k(ep))and extravascular extracellular volume fraction (V(e)). And measured the quantitative pharmacokinetic parameters of normal glands tissues which on the same side of the same level of the lesions; and then calculated the value of relative pharmacokinetic parameters: rK(rans)、rk(ep) and rV(e).To explore the diagnostic value of two pharmacokinetic parameters in differential diagnosis of benign and malignant breast lesions using receiver operating curves and model of logistic regression. Results: (1)There were significant differences between benign lesions and malignant lesions in K(trans) and k(ep) ( t =15.489, 15.022, respectively, P 0.05). The areas under the ROC curve(AUC)of K(trans), k(ep) and V(e) between malignant and benign lesions were 0.933, 0.948 and 0.387, the sensitivity of K(trans), k(ep) and V(e) were 77.1%, 85.0%, 51.0% , and the specificity of K(trans), k(ep) and V(e) were 96.3%, 93.6%, 60.8% for the differential diagnosis of breast lesions if taken the maximum Youden's index as cut-off. (2)There were significant differences between benign lesions and malignant lesions in rK(trans), rk(ep) and rV(e) ( t =14.177, 11.726, 2.477, respectively, P quantitative pharmacokinetic parameters and the prediction probability of relative quantitative pharmacokinetic parameters( Z =0.867, P =0.195). Conclusion: There was no significant

  9. Fine needle aspiration cytology in symptomatic breast lesions: still an important diagnostic modality?

    LENUS (Irish Health Repository)

    Smith, Myles J

    2012-01-01

    The objective of this study was to make an assessment of the utility of fine needle aspiration cytology (FNAC), in a "one-stop" symptomatic breast triple assessment clinic. Controversy surrounds the optimal tissue biopsy methodology in the diagnosis of symptomatic breast cancer and the identification of benign disease. FNAC in the context of a Rapid Assessment Breast Clinic (RABC) allows the same day diagnosis and early treatment of breast cancer, with the immediate reassurance and discharge of those with benign disease. We analyzed prospective data accrued at a RABC, over a 4-year period from 2004 to 2007. All patients were triple assessed, with FNACs performed on site by two consultant cytopathologists. Investigations were reported immediately, and clinical data were captured via a database using compulsory data field entry. There were 4487 attendances at our RABC, with 1572 FNACs were performed. The positive predictive value of FNAC with a C5 cancer diagnosis was 100%, 95.6% for a C4 report, with a complete sensitivity of 94%. The full specificity of correctly identified benign lesions was 77.4%, with a false negative rate of 3.85%. This enabled 66% of patients attending the RABC to receive a same day diagnosis of benign disease and discharge. FNAC is highly accurate in the diagnosis of symptomatic breast cancer in an RABC. FNAC allows accurate diagnosis of benign disease and immediate discharge of the majority of patients. In this era, when a large majority of patients have benign disease, we believe that FNAC provides an equivalent, if not better, method of evaluation of patients in a triple assessment RABC.

  10. [Update of breast cancer in primary care (IV/V)].

    Science.gov (United States)

    Álvarez-Hernández, C; Brusint, B; Vich, P; Díaz-García, N; Cuadrado-Rouco, C; Hernández-García, M

    2015-01-01

    Breast cancer is a prevalent disease affecting all areas of patients' lives. Therefore, family physicians must thoroughly understand this pathology in order to optimize the health care services and make the best use of available resources, for these patients. A series of 5 articles on breast cancer is presented below. It is based on a review of the scientific literature over the last 10 years. This fourth article deals with the treatment of the disease, the role of the primary care physician, and management of major complications. This summary report aims to provide a current and practical review about this problem, providing answers to family doctors and helping them to support their patients and care for them throughout their illness. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. Sealing distal proximal caries lesions in first primary molars: efficacy after 2.5 years.

    Science.gov (United States)

    Martignon, S; Tellez, M; Santamaría, R M; Gomez, J; Ekstrand, K R

    2010-01-01

    The prevalence of proximal caries in primary molar teeth is high in many countries. (1) To study by means of a split-mouth design the 1- and 2.5-year efficacy of sealing proximal lesions vs. flossing instructions (control) on primary molar teeth. (2) To assess children's behaviour and pain perception during the procedure. Ninety-one 4- to 6-year-old children from Bogotá, Colombia participated. Participants had to have at least two proximal lesions scored according to the following radiographic classification system: radiolucency (1) in enamel outer half, (2) restricted to enamel-dentine junction, or (3) restricted to dentine outer third. Baseline, 1- and 2.5-year follow-up bitewing radiographs were taken. Test and control lesions were randomly selected. After temporary separation test lesions were sealed (adhesive). Parents/caregivers received a flossing leaflet for their children. Progression of the lesions was assessed by means of independent reading of conventional bitewing radiographs. One-year (n = 73) test vs. control lesion progression was 27.4 vs. 50.7%, respectively (p caries baseline data. More than 88% of the participants presented positive to definitively positive behaviour and very low or low pain intensity at both first and second appointments. The sealing technique was superior to flossing instructions both after 1 and 2.5 years of follow-up and the majority of the participants had no anxiety or pain during the treatment. Copyright © 2010 S. Karger AG, Basel.

  12. Metastatic Malignant Melanoma of the Inguinal Lymph Node with Unknown Primary Lesion

    Directory of Open Access Journals (Sweden)

    Sherif Ali Eltawansy

    2015-01-01

    Full Text Available Background. Malignant melanoma could present with metastasis with unknown primary (MUP and this happens in 2-3% according to the studies. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. Case Report. We report a 58-year-old Caucasian male who presented with a right sided swelling in the inguinal region. Surgery was performed and biopsy showed metastatic malignant melanoma. No cutaneous lesions were identified by history or physical examination. Work up could not detect the primary lesion and patient was started on radiotherapy and immunotherapy. Conclusion. We present a case of malignant melanoma of unknown primary presenting in an unusual place which is the inguinal lymph node. Theories try to explain the pathway of development of such tumors and one of the theories mentions that it could be a spontaneous regression of the primary cutaneous lesion. Another theory is that it could be from transformation of aberrant melanocyte within the lymph node. Prognosis is postulated to be better in this case than in melanoma with a known primary.

  13. Quantitative analysis of vascular heterogeneity in breast lesions using contrast-enhanced 3-D harmonic and subharmonic ultrasound imaging.

    Science.gov (United States)

    Sridharan, Anush; Eisenbrey, John R; Machado, Priscilla; Ojeda-Fournier, Haydee; Wilkes, Annina; Sevrukov, Alexander; Mattrey, Robert F; Wallace, Kirk; Chalek, Carl L; Thomenius, Kai E; Forsberg, Flemming

    2015-03-01

    Ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D harmonic (HI) and subharmonic (SHI) ultrasound imaging was investigated in a clinical population. Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3-D HI, and 3-D SHI on a modified Logiq 9 scanner (GE Healthcare). A region of interest corresponding to ultrasound contrast agent flow was identified in 4D View (GE Medical Systems) and mapped to raw slice data to generate a map of time-intensity curves for the lesion volume. Time points corresponding to baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 84 lesions (63 benign and 21 malignant). The 3-D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3-D SHI visualized flow in 68 lesions (49 benign and 19 malignant). Analysis of vascular heterogeneity in the 3-D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79 dB, p < 0.001, respectively), whereas malignant lesions showed no difference (1.66 ± 1.39 vs. 1.24 ± 1.14 dB, p = 0.24), indicative of more vascular coverage. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3-D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions.

  14. Implementation of Elastography Score and Strain Ratio in Combination with B-Mode Ultrasound Avoids Unnecessary Biopsies of Breast Lesions.

    Science.gov (United States)

    Bojanic, Kristina; Katavic, Natasa; Smolic, Martina; Peric, Marija; Kralik, Kristina; Sikora, Miroslav; Vidačić, Kristina; Pacovski, Mirta; Stimac, Damir; Ivanac, Gordana

    2017-04-01

    The aim of this study was to evaluate whether the combination of B-mode ultrasound, elastography score (ES) and strain ratio (SR) improves diagnostic performance with respect to breast lesions. One hundred thirty lesions were prospectively evaluated by B-mode ultrasound and strain elastography, followed by fine-needle aspiration cytology/biopsy in 117 woman who were scheduled for regular breast BUS. The median ES (4.5 vs. 2.9, p ultrasound improved the specificity, accuracy and positive predictive value. Receiver operating characteristic curves yielded a higher value for the combined technique for diagnosis of breast lesions. Routine use of such a diagnostic algorithm could reduce the number of unnecessary biopsies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. The role of second-look ultrasound of BIRADS-3 mammary lesions detected by breast MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fiaschetti, V., E-mail: fiaschettivaleria@tin.it [Department of Imaging Diagnostic, Molecular Imaging, Interventional Radiology and Radiation Therapy University Hospital ' Tor Vergata' , 81 Oxford street, 00133 Rome (Italy); Salimbeni, C.; Gaspari, E.; Dembele, G. Kabunda; Bolacchi, F.; Cossu, E.; Pistolese, C.A.; Perretta, T.; Simonetti, G. [Department of Imaging Diagnostic, Molecular Imaging, Interventional Radiology and Radiation Therapy University Hospital ' Tor Vergata' , 81 Oxford street, 00133 Rome (Italy)

    2012-11-15

    Objective: To asses the value of second-look ultrasound (US) for identifying BIRADS 3 (Breast Imaging Reporting Data System) mammary lesions detected by breast Magnetic Resonance imaging (MRI). Materials and methods: From April 2008 to May 2009 330 breast MRI were performed of which 60 patients are classified as BIRADS 3. 84 lesions underwent second-look US and percutaneous vacuum biopsy Vacora system US-guided. Statistical analysis: lesions were stratified into two groups: visible on US (Group 1) and not visible on US (Group 2). The clinical impact of second-look US was studied in terms of negative predictive value (NPV). Results: The positive predictive value (PPV) of category 3 BIRADS MRI was found to be 89%. Second look-US results detected lesions in 51% of the MRI enhancing lesions. The second look-US showed a NPV of 97%. The NPV of second look-US was significantly greater than the NPV of MRI BIRADS 3 (97% vs 89%, p < 0.05). The logistic regression analysis showed a higher number of malignant lesions in group 1 than in group 2 (7vs 2, OR 3.7, p < 0.05). Conclusions: The second-look US permitted the correct management of subcentimetric MRI BIRADS 3 lesions not visible with conventional imaging tecniques.

  16. Manufacture and characterization of breast tissue phantoms for emulating benign lesions

    Science.gov (United States)

    Villamarín, J. A.; Rojas, M. A.; Potosi, O. M.; Narváez-Semanate, J. L.; Gaviria, C.

    2017-11-01

    Phantoms elaboration has turned a very important field of study during the last decades due to its applications in medicine. These objects are capable of emulating or mimicking acoustically biological tissues in which parameters like speed of sound (SOS) and attenuation are successfully attained. However, these materials are expensive depending on their characteristics (USD 460.00 - 6000.00) and is difficult to have precise measurements because of their composition. This paper presents the elaboration and characterization of low cost ( USD $25.00) breast phantoms which emulate histological normality and pathological conditions in order to support algorithm calibration procedures in imaging diagnosis. Quantitative ultrasound (QUS) was applied to estimate SOS and attenuation values for breast tissue (background) and benign lesions (fibroadenoma and cysts). Results showed values of the SOS and attenuation for the background between 1410 - 1450 m/s and 0.40 - 0.55 dB/cm at 1 MHz sampling frequency, respectively. On the other hand, the SOS obtained for the lesions ranges from 1350 to 1700 m/s and attenuation values between 0.50 - 1.80 dB/cm at 1 MHz. Finally, the fabricated phantoms allowed for obtaining ultrasonograms comparable with real ones whose acoustic parameters are in agree with those reported in the literature.

  17. Is it Ethical to Withhold Restorative Dental Care From a Child with Occlusoproximal Caries Lesions Into Dentin of Primary Molars?

    Science.gov (United States)

    Nainar, S M Hashim

    2015-01-01

    Non-restorative caries treatment (NRCT) has been mentioned as a treatment option for occluso-proximal caries lesions into dentin of primary molars. The NRCT approach for occluso-proximal caries lesions in primary molars was considered from an ethical perspective. In summary, it is not ethical to withhold restorative dental care from a child with occluso-proximal caries lesions into dentin of primary molars.

  18. Lesion type and reader experience affect the diagnostic accuracy of breast MRI: A multiple reader ROC study

    Energy Technology Data Exchange (ETDEWEB)

    Baltzer, Pascal A.T., E-mail: patbaltzer@gmail.com [Department of Biomedical Imaging and Imge-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna (Austria); Kaiser, Werner Alois [Department of Diagnostic and Interventional Radiology, University Hospital Jena, Erlanger Allee 101, 07740 Jena (Germany); Dietzel, Matthias, E-mail: dietzelmatthias2@hotmail.com [Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen (Germany)

    2015-01-15

    Highlights: • The main findings of our study are, that reader experience and lesion type (i.e., mass versus non-mass enhancement) are independent predictors of the diagnostic accuracy of breast MRI. • Specifically, benign and malignant non-mass lesions cannot be differentiated with sufficient accuracy, especially if readers are not experienced. • We conclude that future research in breast MRI should focus on non-mass lesions, as these are the problem makers in modern breast MRI. - Abstract: Purpose: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. Materials and methods: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n = 103). Six blinded readers (experience level, high (HE, n = 2); intermediate (IE, n = 2); and low (LE, n = 2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. Results: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P < 0.0001) and

  19. Radiation therapy for metastatic lesions from breast cancer. Breast cancer metastasis to bone

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Shinya; Hoshi, Hiroaki [Gifu Univ. (Japan). School of Medicine

    2000-10-01

    This paper summarizes radiation therapy in the treatment of bone metastases from breast cancer. Bone metastasis occurs in approximately 70% of breast cancer patients, and the goals of radiation therapy for bone metastasis are: palliation of pain, prevention and treatment of neuropathic symptoms, and prevention of pathologic fractures. The prognosis of bone metastasis from breast cancer is known to be better than that of bone metastasis from other solid tumors. Local-field radiation, hemibody (or wide-field) radiation, and systemic radionuclide treatment are the major methods of radiation therapy for pain palliation. Although many studies have shown that breast cancer is more responsive to radiation therapy for pain palliation than other solid tumors, some studies found no significant difference. Local-field radiation therapy, which includes multi-fraction irradiation and single-fraction irradiation, is currently the most generally used method of radiotherapy for pain palliation. Pain palliation has been reported to be achieved in approximately 80% to 90% of patients treated with local-field external beam irradiation. Three types of multi-fraction irradiation therapy are administered depending on the prognosis: high-dose fraction irradiation (36-50 Gy/12-25 Fr/2.4-5 wk), short-course irradiation (20-30 Gy/10-15 Fr/2-3 wk), and ultra-short-course irradiation (15-25 Gy/2-5 Fr/1 wk). The most common irradiation schedule is 30 Gy/10 Fr/2 wk. Although many reports indicate no significant difference in pain palliation according to the dose, the percentage of patients who show a complete cure is significantly higher in those treated with doses of 30 Gy or more, and thus the total irradiation dose should be at least 30 Gy. High-dose fraction irradiation is indicated for patients with an expected survival time of 6 months or more while short-course or single-fraction irradiation is indicated for those with an expected survival time of 3 months or more. Single

  20. Magnetic resonance imaging of breast cancer: does the time interval between biopsy and MRI influence MRI-pathology discordance in lesion sizing?

    Science.gov (United States)

    Mennella, Simone; Paparo, Francesco; Revelli, Matteo; Baccini, Paola; Secondini, Lucia; Barbagallo, Stella; Friedman, Daniele; Garlaschi, Alessandro

    2017-07-01

    Background Breast magnetic resonance imaging (MRI) is more accurate than ultrasound and mammography in estimating local extension of both invasive breast cancer and ductal carcinoma in situ (DCIS) and it is part of a breast cancer patient's preoperative management. Purpose To verify if time interval between breast biopsy and preoperative MRI, lesion margins, and biopsy technique can influence tumor sizing on MRI. Material and Methods By a database search, we retrospectively identified all women with a newly diagnosed, biopsy-proven, primary breast cancer who underwent MRI before surgery. The time interval between biopsy and MRI, the type of biopsy procedure, and various pathological features of tumors were collected. We defined the concordance between MRI and pathology measurements as a difference of biopsy and MRI showed only a weak correlation with the absolute MRI-pathology difference (r = 0.236). Stratifying the whole cohort of patients using a cutoff value of 30 days, we found that the MRI-pathology discordance was significantly higher in patients with a biopsy-MRI time interval >30 days ( P biopsy procedure and the time interval between biopsy and preoperative MRI are not independently associated to MRI-pathology discordance.

  1. Characterization of breast lesions with CE-MR multimodal morphological and kinetic analysis: Comparison with conventional mammography and high-resolution ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Vassiou, Katherine [Department of Anatomy, Medical School, University of Thessaly, Mezourlo 41110, Larissa (Greece)], E-mail: avassiou@med.uth.gr; Kanavou, Theodorab; Vlychou, Mariann [Department of Radiology, Medical School, University of Thessaly (Greece); Poultsidi, Antigoni; Athanasiou, Evagelos [Department of Surgery, Medical School, University of Thessaly (Greece); Arvanitis, Dimitrios L. [Department of Anatomy, Medical School, University of Thessaly, Mezourlo 41110, Larissa (Greece); Fezoulidis, Ioannis V. [Department of Radiology, Medical School, University of Thessaly (Greece)

    2009-04-15

    Objective: Evaluation of the diagnostic value of magnetic resonance mammography and comparison with conventional mammography and ultrasonography in cases of women with suspicious breast lesions. Subjects and methods: Sixty-nine women (age range 39-68 years) with 78 focal breast lesions were examined with mammography, ultrasonography and dynamic magnetic resonance mammography. The lesions were classified according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology for each diagnostic method. Histological reports were available after biopsy or surgical excision of the lesions. Results: Pathological examination confirmed that 53 lesions were malignant and 25 benign. Conventional mammography estimated a total of 59/78 lesions as malignant with 44 true positive lesions, ultrasonography estimated a total of 50/78 lesions as malignant with 44 true positive lesions and magnetic resonance mammography estimated a total of 66/78 lesions as malignant with 52 true positive lesions. Sensitivity and specificity of magnetic resonance mammography in the diagnosis of malignancy was 98.1% and 44%, of conventional mammography 83% and 40% and of ultrasonography 83% and 76%. Negative predictive value for magnetic resonance mammography was 91.7%, for ultrasonography 67.9% and for mammography 52.6% for malignancies. Conclusion: Magnetic resonance mammography has the highest negative predictive value compared with mammography and ultrasound in cases of suspicious breast lesions. The combination of morphologic and enhancement criteria can improve the diagnostic capability of magnetic resonance mammography (MRM) in breast lesion characterization.

  2. Examination history and abnormal thyroid and breast lesions according to residential distance from nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Khi [Dept. of Radiological Science, Gachon University, Incheon (Korea, Republic of)

    2016-12-15

    Ascertainment bias are common in epidemiologic studies to assess the association between thyroid cancer risk and living near nuclear power plants because many thyroid cancers are diagnosed by chance through health examination. We surveyed the ultra sonography (USG) examination history and conducted thyroid and breast USG in residents living near nuclear power plants. The study population comprised 2,421 residents living near nuclear power plants in Korea. Information on demographic characteristics, including diagnostic examination history, was collected by interview using questionnaires. USG examination was conducted to evaluate the presence of thyroid nodules and breast lesion. Study participants were divided into 3 groups according to the distance of their respective villages from a nuclear power plant. The proportions of USG examination history and prevalence of thyroid nodules and breast lesions were compared between groups. Examination histories of thyroid USG were 23.1%, 13.7%, and 10.5% in men and 31.3%, 26.7%, 18.3% in women in the short, intermediate, and long distance groups, respectively. There were significant inverse associations between thyroid USG history and the distance from nuclear power plants (P for trend=0.001 for men and 0.017 for women). However, there was no association between the distance of villages from nuclear power plants and prevalence of thyroid nodules. Our results suggest that there may be an ascertainment bias in population-based studies examining the harmful effects of NPPs examination and researchers should pay attention to ascertainment bias resulted from differential health examination. Correction for ascertainment bias, active follow-up and examination for all study population to remove differential health examination is needed.

  3. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2011-01-01

    OBJECTIVE: To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. BASIC RESEARCH DESIGN: Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from

  4. Sutura primaria en las lesiones traumáticas del colon Primary suture applied in the colonic traumatic lesions

    Directory of Open Access Journals (Sweden)

    Maribel Vicente Medina

    2009-06-01

    Full Text Available INTRODUCCIÓN. Las suturas digestivas siempre han sido una preocupación para los cirujanos por la gravedad de las complicaciones que pueden presentarse. Fue objetivo de esta presentación demostrar la factibilidad de la sutura primaria en el colon. MÉTODOS. Presentamos los resultados de un período de 14 meses en los cuales se realizaron 32 suturas primarias en el colon a causa de lesiones traumáticas. Los pacientes fueron atendidos en dos hospitales, uno provincial y otro nacional en la República de Yemen. Se tomaron como datos fundamentales el tipo de trauma, la parte afectada del colon, las lesiones asociadas, el tipo de operación en el colon, las demás operaciones asociadas o complementarias, así como el uso de antibióticos. RESULTADOS. Se estudiaron 32 pacientes con lesiones traumáticas de colon, 29 de ellos (90,62 % por arma de fuego. Otras causas fueron las heridas por arma blanca y los accidentes de tránsito. Un porcentaje elevado de los casos necesitó la intervención en órganos abdominales o la resección de estos. El índice de complicaciones fue bajo (6 pacientes con una sola dehiscencia y 2 fístulas. No hubo que lamentar fallecidos. CONCLUSIONES. Es factible obtener buenos resultados con este procedimiento, que a la vez evita la tan objetada y molesta para los pacientes colostomía, con mínimo riesgo para ellos.INTRODUCTION: Digestive sutures always have been a concern for surgeons due to severity of possible complications. Aim of present presentation was to show feasibility of colon primary suture. METHODS: Results achieved during 14 months are presented, in which we performed 12 primary sutures in colon due to traumatic lesions. Patients were seen in two hospitals, one al provincial level and the other at national level in Yemen Republic. We took as essential data the type of trauma, the involved portion of colon, associated lesions, type of surgery in colon, the other associated or complementary surgeries, as well

  5. The outcome of papillary lesions of the breast diagnosed by standard core needle biopsy within a BreastScreen Australia service.

    Science.gov (United States)

    Armes, Jane E; Galbraith, Christine; Gray, Janet; Taylor, Kathleen

    2017-04-01

    Papillary lesions of the breast are most commonly diagnosed via mammographic screening. The standard practice has been to excise these lesions, since a subset of papillary lesions are neoplastic. However, this approach leads to a high proportion of negative excisions. In order to identify papillary lesions which could be managed by surveillance alone, we assessed the outcome of 103 papillary lesions diagnosed on core needle biopsy in a public screening program. Subsequent excision biopsy led to an upgrade to malignancy in 30% of cases. Segregation via presence or absence of atypia stratified the outcome into 72% upgrade, compared with 7% upgrade, respectively. Further, in the latter group (i.e., no atypia on core needle biopsy with 7% upgrade to malignancy), the neoplasia found in the targeted excision area was low to intermediate grade ductal carcinoma in situ only, with no invasive neoplasia (4 cases). Of the lesions identified due to microcalcification, the microcalcification was present within an adjacent benign lesion in 35% of cases and hence the papillary lesion was detected incidentally. Overall therefore, we have identified a cohort of papillary lesions in which conservative management, rather than excision, could be considered, i.e., those without atypia, including those without atypia in which the papillary lesion was found incidental to microcalcification in an adjacent benign lesion. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  6. Evaluation of significance of AgNOR counts in differentiating benign from malignant lesions in the breast.

    Science.gov (United States)

    Dube, M K; Govil, A

    1995-01-01

    Nucleolar organizer regions (NORs) have been identified by means of an argyrophilic technique (AgNOR) in routinely processed formalin-fixed paraffin sections of breast lesions. 85 cases of different breast lesions were examined. The AgNOR counts were, normal breast 1.2 (1.0-1.5) Fibroadenoma 1.74 (1.6-2.7), purely cystic disease 1.6 (1.5-1.82) adenosis 2.1 (1.7-2.8), Epitheliosis 2.4 (1.9-3.2) gynaecomastia 3.7 (3.6-4.7), Noninvasive caccinoma 2.8 (2.6-4.4) invasive carcimomas 3.89 (2.7-9.9) i.e. mean AgNOR counts between benign and malignant lesions. Also gynaecomastia, a benign condition had a high mean AgNOR count. There was no significant difference in the mean AgNOR count of various types of invasive breast caninoma. Higher the histological grade, higher was the AgNOR count. To conclude, AgNOR technique does not enable a clear distinction between benign & malignant lesions. But, it could be used with other prognostic indices to predict the behaviour of breast malignancy.

  7. Kinetic analysis of lesions without mass effect on breast MRI using manual and computer-assisted methods.

    Science.gov (United States)

    Vag, Tibor; Baltzer, Pascal A T; Dietzel, Matthias; Zoubi, Ramy; Gajda, Mieczyslaw; Camara, Oumar; Kaiser, Werner A

    2011-05-01

    To analyse the kinetic characteristics of lesions without mass effect in dynamic breast MRI using manual and computer assisted methods. The enhancement pattern of 82 histopathologically verified lesions without mass effect (36 malignant, 46 benign) was evaluated on breast MRI using manual placement of a region of interest. Commercially available computer analysis software automatically assessed volume enhancement characteristics of a lesion voxelwise. Kinetic features evaluated included classification of the signal-intensity time curve as washout, plateau or persistent enhancement. Unlike manual ROI placement, computer-aided analysis demonstrated a significant difference in enhancement pattern between benign (washout: 32.6%, plateau: 32.6%, persistent: 34.8%) and malignant lesions without mass effect (77.1%, 8.6%, 14.3% respectively, P effect.

  8. Breast cancer in situ. From pre-malignant lesion of uncertain significance to well-defined non-invasive malignant lesion

    DEFF Research Database (Denmark)

    Laenkholm, Anne-Vibeke; Jensen, Maj-Britt; Kroman, Niels

    2008-01-01

    In addition to nationwide standardized pathology forms for operable primary invasive breast cancer, the Danish Breast Cancer cooperative Group (DBCG) in 1982 introduced pathology forms for breast cancer in situ (CIS). The histological reporting form was used primarily for ductal cancer in situ...... receptor (ER) and Progesteron receptor (PR) status. Also mastectomy specimens were included. In 2004 the previous malignancy grading was replaced by the Van Nuys classification, and information on microcalcifications was introduced. The axillary status now included the sentinel node technique only. In 2006...

  9. Metastatic breast cancer presenting as a primary hindgut neuroendocrine tumour.

    Science.gov (United States)

    Okines, Alicia F C; Hawkes, Eliza A; Rao, Sheela; VAN As, Nicholas; Marsh, Henry; Riddell, Angela; Wilson, Philip O G; Osin, Peter; Wotherspoon, Andrew C; Wetherspoon, Andrew C

    2010-07-01

    The examination of limited, potentially non-representative fragments of tumour tissue from a core biopsy can be misleading and misdirect subsequent treatment, especially in cases where a primary tumour has not been identified. This case report is of a 65-year-old woman presenting with a destructive sacral mass, diagnosed on radiological imaging and core biopsy as a hindgut neuroendocrine tumour, which on histopathological review of the subsequently resected tumour was found instead to represent a metastasis from an occult hormone-positive breast cancer with neuroendocrine features.

  10. A Rare Case of Primary Breast Mucosa- Associated Lymphoid Tissue Lymphoma

    Directory of Open Access Journals (Sweden)

    Marić Daliborka

    2016-12-01

    Full Text Available Breast involvement by lymphoma is uncommon and poses challenges in diagnosis. Breast involvement by malignant lymphoma, whether primary or secondary, is a rare event. Primary breast lymphomas account for 0.38% - 0.7% of all non-Hodgkin lymphomas, 1.7%-2.2% of all extranodal non-Hodgkin lymphomas, and only 0.04% - 0.5% of all breast cancer cases. Most frequent primary breast lymphomas are diffuse large B cell lymphomas (53%. Breast mucosa-associated lymphoid tissue (MALT lymphomas account for a small fraction of all the MALT lymphomas (1% - 2%. Herein we report a case of a patient with primary breast MALT lymphoma and its presentation on different imaging modalities. Two years after the presentation and treatment with eight cycles of chemotherapy, the patient is alive and well, without evidence of residual disease or recurrence.

  11. Usefulness and Complications of Ultrasonography- Guided Vacuum Assisted Biopsy for the Removal of Benign Breast Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Keum Won; Cho, Young Jun; Hwang, Cheol Mog; Kim, Dae Ho; Oh, Kyoung Jin; Yoon, Dae Sung [Konyang University College of Medicine, Daejeon (Korea, Republic of); Kim, Kyu Soon [Eulji University College of Medicine, Daejeon (Korea, Republic of)

    2010-09-15

    To evaluate the usefulness and complications of ultrasonography (US)- guided vacuum assisted biopsy (VAB) for the removal of benign breast lesions, and the short- and long-term changes after VAB as shown on follow-up US. From January 2007 to May 2008, 110 sonographically benign lesions in 62 patients were sampled via US-guided VAB. We prospectively evaluated the sonographic findings 1 week and 6 months after VAB in all patients to determine the presence of residual tumors, hematomas and scarring. We evaluated the prevalence of hematoma, pain, skin dimpling, fibrotic scarring and residual tumors after US-guided VAB, and determined if correlation existed between complications, size of the lesions and lesion pathology. The age of the patients was 15-65 years, with a mean age of 36.5 years. The pathologic diagnoses were fibroadenomas (41.8%, n = 46), fibrocystic changes (30.9%, n = 34), fibroadenomatoid hyperplasias (13.6%, n = 15), fibroadenomatoid mastopathies (6.3%, n = 7), adenoses (3.6%, n = 4), hamartomas (1.8%, n = 2) and phyllodes tumors (1.8%, n = 2). Complications 1 week after the US-guided VAB included hematomas (n = 39, 35.4%), pain (n = 23, 20.9%), fibrotic scars (n = 26, 23.68%), residual tumors (n = 4, 3.6%) and skin dimplings (n = 4, 3.6%). Complications 6 months after the US-guided VAB included hematomas (n = 12, 10.9%), pain (n = 3 2.7%), fibrotic scars (n = 14, 12.7%), and residual tumors (n = 17, 15.4%). Residual tumor after US-guided VAB existed in association with 15.2% of fibroadenomas (7/46), 14.7% of fibrocystic changes (5/34), 13.3% of fibroadenomatoid hyperplasias (2/15), 25% of adenoses (1/4), and 100% of phyllodes tumors (2/2). US-guided VAB is an effective procedure for removal of benign breast lesion. Periodic follow up studies at 1 week and 6 months after the VAB are useful to assess Post-VAB complications

  12. Characterization of female breast lesions from multi-wavelength time-resolved optical mammography

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, Lorenzo [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Torricelli, Alessandro [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Pifferi, Antonio [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Taroni, Paola [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy); Danesini, Gianmaria [Dipartimento di Radiologia, Casa di Cura S. Pio X, via Francesco Nava 31, I-20159 Milan (Italy); Cubeddu, Rinaldo [INFM-Dipartimento di Fisica and IFN-CNR, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milan (Italy)

    2005-06-07

    Characterization of both malignant and benign lesions in the female breast is presented as the result of a clinical study that involved more than 190 subjects in the framework of the OPTIMAMM European project. All the subjects underwent optical mammography, by means of a multi-wavelength time-resolved mammograph, in the range 637-985 nm. Optical images were processed by applying a perturbation model, relying on a nonlinear approximation of time-resolved transmittance curves in the presence of an inclusion, with the aim of estimating the major tissue constituents (i.e. oxy- and deoxy-haemoglobin, lipid and water) and structural parameters (linked to dimension and density of the scatterer centres) for both the lesion area and the surrounding tissue. The critical factors for the application of the perturbation model on in vivo data are also discussed. Forty-six malignant and 68 benign lesions were analysed. A subset of 32 cancers, 40 cysts and 14 fibroadenomas were found reliable for the perturbation analysis. For cancers, we show a higher blood content with respect to the surrounding tissue, while cysts are characterized by a lower concentration of scattering centres with respect to the surrounding tissue. For fibroadenomas, the low number of cases does not allow any definite conclusions.

  13. Telomerase Activity and Genetic Alterations in Primary Breast Carcinomas

    Directory of Open Access Journals (Sweden)

    Anna Papadopoulou

    2003-03-01

    Full Text Available It has been proposed that the structural and numerical chromosome abnormalities recorded in breast cancer could be the result of telomere dysfunction and that telomerase is activated de novo to provide a survival mechanism curtailing further chromosomal aberrations. However, recent in vivo and in vitro data show that the ectopic expression of telomerase promotes tumorigenesis via a telomere length-independent mechanism. In this study, the relation between telomerase expression and the extent of chromosomal aberrations was investigated in 62 primary breast carcinomas. Telomerase activity was measured using a polymerase chain reaction-based telomeric repeat amplification protocol assay and 92% of the tumors were found to express telomerase with a relative activity ranging from 0 to 3839.6. Genetic alterations were determined by G-banding and comparative genomic hybridization analysis and 97% of the tumors exhibited chromosomal aberrations ranging from 0 to 44 (average: 10.98. In the overall series, the relationship between telomerase activity levels and genetic changes could be best described by a quadratic model, whereas in tumors with below-average genetic alteration numbers, a significant positive association was recorded between the two variables (coefficient=0.374, P= .017. The relationship between telomerase activity levels and the extent of genetic alteration may reflect the complex effect of telomerase activation upon tumor progression in breast carcinomas.

  14. High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

    Energy Technology Data Exchange (ETDEWEB)

    Crystal, Pavel [Mount Sinai Hospital, University Health Network, Division of Breast Imaging, Toronto, ON (Canada); Mount Sinai Hospital, Toronto, ON (Canada); Sadaf, Arifa; Bukhanov, Karina; Helbich, Thomas H. [Mount Sinai Hospital, University Health Network, Division of Breast Imaging, Toronto, ON (Canada); McCready, David [Princess Margaret Hospital, Department of Surgical Oncology, Toronto, ON (Canada); O' Malley, Frances [Mount Sinai Hospital, Department of Pathology, Laboratory Medicine, Toronto, ON (Canada)

    2011-03-15

    To evaluate the frequency of diagnosis of high-risk lesions at MRI-guided vacuum-assisted breast biopsy (MRgVABB) and to determine whether underestimation may be predicted. Retrospective review of the medical records of 161 patients who underwent MRgVABB was performed. The underestimation rate was defined as an upgrade of a high-risk lesion at MRgVABB to malignancy at surgery. Clinical data, MRI features of the biopsied lesions, and histological diagnosis of cases with and those without underestimation were compared. Of 161 MRgVABB, histology revealed 31 (19%) high-risk lesions. Of 26 excised high-risk lesions, 13 (50%) were upgraded to malignancy. The underestimation rates of lobular neoplasia, atypical apocrine metaplasia, atypical ductal hyperplasia, and flat epithelial atypia were 50% (4/8), 100% (5/5), 50% (3/6) and 50% (1/2) respectively. There was no underestimation in the cases of benign papilloma without atypia (0/3), and radial scar (0/2). No statistically significant differences (p > 0.1) between the cases with and those without underestimation were seen in patient age, indications for breast MRI, size of lesion on MRI, morphological and kinetic features of biopsied lesions. Imaging and clinical features cannot be used reliably to predict underestimation at MRgVABB. All high-risk lesions diagnosed at MRgVABB require surgical excision. (orig.)

  15. Evaluation of a known breast cancer using an abbreviated breast MRI protocol: Correlation of imaging characteristics and pathology with lesion detection and conspicuity.

    Science.gov (United States)

    Heacock, Laura; Melsaether, Amy N; Heller, Samantha L; Gao, Yiming; Pysarenko, Kristine M; Babb, James S; Kim, Sungheon G; Moy, Linda

    2016-04-01

    This study evaluates use of an abbreviated magnetic resonance imaging protocol with T2-weighted imaging in detecting biopsy-proven unifocal breast cancer. This is an institutional review board approved retrospective study of patients with biopsy-proven unifocal breast cancer (88% invasive; 12% in situ) undergoing magnetic resonance imaging. In three separate sessions, three breast imagers evaluated (1) T1-weighted non-contrast, post-contrast and post-contrast subtracted images, (2) T1-weighted images with clinical history and prior imaging, and (3) T1-weighted images and T2-weighted images with clinical history and prior imaging. Protocols were compared for cancer detection, reading time and lesion conspicuity. An independent breast radiologist retrospectively analyzed initial enhancement ratio of cancers and retrospectively reviewed lesion morphology and final pathology. All 107 cancers were identified at first protocol by at least one reader; five cancers were missed by either one or two readers. One cancer was missed by one reader at protocols two and three. Mean percentage detection for protocol one was 97.8%; protocol two, 99.4%, protocol three, 99.4%. T2-weighted images did not alter cancer detection but increased lesion conspicuity for 2/3 readers. 3/5 missed lesions were low grade cancers. Initial enhancement ratio was positively associated with increasing tumor grade (p=0.031) and pathology (p=0.002). Reader interpretation time decreased and lesion conspicuity increased as initial enhancement ratio increased. Abbreviated magnetic resonance imaging has high rate of detection for known breast cancer and short interpretation time. T2 weighted imaging increased lesion conspicuity without altering detection rate. Initial enhancement ratio correlated with invasive disease and tumor grade. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Correlation between {sup 99m}Tc-MIBI uptake and angiogenesis in MIBI-positive breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, Recep [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey)]. E-mail: recep.bekis@deu.edu.tr; Degirmenci, Berna [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Aydin, Aysel [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Ozdogan, Ozhan [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Canda, Tulay [Department of Pathology, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey); Durak, Hatice [Department of Nuclear Medicine, Dokuz Eyluel University School of Medicine, Inciralti-Izmir 35340 (Turkey)

    2005-07-01

    This study was undertaken to assess the correlation between the degree of accumulation and the washout of 99m technetium methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) and angiogenesis in MIBI-positive breast lesions. Twenty-eight patients (mean age, 51{+-}11 years) with 31 breast lesions who underwent scintimammography were studied. Anterior, left and right prone lateral images were obtained 20 min and 3 h after the injection of 740 MBq {sup 99m}Tc-MIBI. All breast lesions showed increased {sup 99m}Tc-MIBI uptake. Early and delayed tumor to background activity ratios (T/BG) and washout index (early tumor uptake-delayed tumor uptake divided by early tumor uptake) were calculated. Vascular endothelium was immunohistochemically labeled using a biotinylated monoclonal antibody directed against the factor-VIII-associated antigen using standard biotin-avidin technique. Angiogenesis was evaluated by assessing the vascular surface density (VSD) and the microvessel number (NVES) within 10 randomly chosen areas. All pathological data were compared with early and delayed T/BG activity ratios and washout index of {sup 99m}Tc-MIBI. Statistical analysis was performed using Spearman correlation test. There was no statistically significant correlation between the degree of angiogenesis and early T/BG (r=.287, P>.05 with VSD, r=.351, P>.05 with NVES), delayed T/BG (r=.277, P>.05 with VSD, r=.315, P>.05 with NVES) and the washout index (r=.268, P>.05 with VSD, r=.285, P>.05 with NVES) of {sup 99m}Tc-MIBI in all breast lesions. There was no statistically significant correlation between the degree of angiogenesis and early T/BG (r=.235, P>.05 with VSD, r=.356, P>.05 with NVES), delayed T/BG (r=.181, P>.05 with VSD, r=.285, P>.05 with NVES) and the washout index (r=.158, P>.05 with VSD, r=.187, P>.05 with NVES) of {sup 99m}Tc-MIBI in 24 invasive breast lesions. No statistically significant correlation was found between the degree of angiogenesis and early T/BG (r=-.036, P>.05 with VSD

  17. Using three-class BANN classifier in the automated analysis of breast cancer lesions in DCE-MRI

    Science.gov (United States)

    Bhooshan, Neha; Giger, Maryellen; Edwards, Darrin; Drukker, Karen; Jansen, Sanaz; Li, Hui; Lan, Li; Newstead, Gillian

    2009-02-01

    The purpose of this study is to investigate three-class Bayesian artificial neural networks (BANN) in dynamic contrastenhanced MRI (DCE-MRI) CAD in distinguishing different types of breast lesions including ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), and benign. The database contains 72 DCIS lesions, 124 IDC lesions, and 131 benign breast lesions (no cysts). Breast MR images were obtained with a clinical DCE-MRI scanning protocol. In 3D, we automatically segmented each lesion and calculated its characteristic kinetic curve using the fuzzy c-means method. Morphological and kinetic features were automatically extracted, and stepwise linear discriminant analysis was utilized for feature selection in four subcategories: DCIS vs. IDC, DCIS vs. benign, IDC vs. benign, and malignant (DCIS + IDC) vs. benign. Classification was automatically performed with the selected features for each subcategory using round-robin-by-lesion two-class BANN and three-class BANN. The performances of the classifiers were assessed with two-class ROC analysis. We failed to show any statistically significant differences between the two-class BANN and three-class BANN for all four classification tasks, demonstrating that the three-class BANN performed similarly to the two-class BANN. A three-class BANN is expected to be more desirable in the clinical arena for both diagnosis and patient management.

  18. Development and comparative assessment of Raman spectroscopic classification algorithms for lesion discrimination in stereotactic breast biopsies with microcalcifications

    Science.gov (United States)

    Dingari, Narahara Chari; Barman, Ishan; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2014-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. Here, we develop and compare different approaches for developing Raman classification algorithms to diagnose invasive and in situ breast cancer, fibrocystic change and fibroadenoma that can be associated with microcalcifications. In this study, Raman spectra were acquired from tissue cores obtained from fresh breast biopsies and analyzed using a constituent-based breast model. Diagnostic algorithms based on the breast model fit coefficients were devised using logistic regression, C4.5 decision tree classification, k-nearest neighbor (k-NN) and support vector machine (SVM) analysis, and subjected to leave-one-out cross validation. The best performing algorithm was based on SVM analysis (with radial basis function), which yielded a positive predictive value of 100% and negative predictive value of 96% for cancer diagnosis. Importantly, these results demonstrate that Raman spectroscopy provides adequate diagnostic information for lesion discrimination even in the presence of microcalcifications, which to the best of our knowledge has not been previously reported. Raman spectroscopy and multivariate classification provide accurate discrimination among lesions in stereotactic breast biopsies, irrespective of microcalcification status. PMID:22815240

  19. Breast metastases of gastric signet ring cell carcinoma: A differential diagnosis with primary breast signet ring cell carcinoma

    Directory of Open Access Journals (Sweden)

    Qureshi S

    2005-01-01

    Full Text Available Metastatic deposits within the breast may be difficult to distinguish from primary breast carcinoma. Radiological features and immunohistochemistry especially for steroid hormone receptors and expression of gross cystic disease fluid protein may be helpful in differentiating these two conditions. In this report, we present a case of signet ring cell stomach cancer with metastasis to the breast and discuss the differential diagnostic options.

  20. Breast sarcoidosis appearing as a primary manifestation of sarcoidosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hye Jeong; Kim, Eun Kyung; Kim, Min Jung; Oh, Ki Keun; Kim, Se Hoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-06-15

    Breast sarcoidosis is a rare disease entity and may have similar imaging findings as a breast malignancy. We report here a case of primary breast sarcoidosis that was diagnosed as nonspecific inflammation by sonography-guided 14-G automated needle biopsy. A directional vacuum assisted biopsy was helpful for a correct diagnosis.

  1. Two-dimensional shear wave elastography of breast lesions: Comparison of two different systems.

    Science.gov (United States)

    Ren, Wei-Wei; Li, Xiao-Long; He, Ya-Ping; Li, Dan-Dan; Wang, Dan; Zhao, Chong-Ke; Bo, Xiao-Wan; Liu, Bo-Ji; Yue, Wen-Wen; Xu, Hui-Xiong

    2017-01-01

    To evaluate the diagnostic performance of two different shear wave elastography (SWE) techniques in distinguishing malignant breast lesions from benign ones. From March 2016 to May 2016, a total of 153 breast lesions (mean diameter, 16.8 mm±10.5; range 4.1-90.0 mm) in 153 patients (mean age, 46.4 years±15.1; age range 20-86 years) were separately performed by two different SWE techniques (i.e. T-SWE, Aplio500, Toshiba Medical System, Tochigi, Japan; and S-SWE, the Aixplorer US system, SuperSonic Imagine, Provence, France). The maximum (Emax), mean (Emean) and standard deviation (ESD) of elasticity modulus values in T-SWE and S-SWE were analyzed. All the lesions were confirmed by ultrasound (US)-guided core needle biopsy (n = 26), surgery (n = 122), or both (n = 5), with pathological results as the gold standard. The areas under the receiver operating characteristic curves (AUROCs) were calculated. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) were calculated to assess the diagnostic performance between T-SWE and S-SWE. Operator consistency was also evaluated. Among the 153 lesions, 41 (26.8%) were malignant and 112 (73.2%) were benign. Emax (T-SWE: 40.10±37.14 kPa vs. 118.78±34.41 kPa; S-SWE: 41.22±22.54 kPa vs. 134.77±60.51 kPa), Emean (T-SWE: 19.75±16.31 kPa vs. 52.93±25.75 kPa; S-SWE: 20.95±10.98 kPa vs. 55.95±22.42 kPa) and ESD (T-SWE: 9.00±8.55 kPa vs. 38.44±12.30 kPa; S-SWE: 8.17±6.14 kPa vs. 29.34±13.88 kPa) showed statistical differences in distinguishing malignant lesions from benign ones both in T-SWE and S-SWE (all p  0.05 in comparison with Emax) and Emean (AUROC = 0.930, p = 0.034 in comparison with Emax). AUROC-max (T-SWE: 0.909 vs. 0.967), AUROC-mean (T-SWE: 0.892 vs. 0.930) and AUROC-SD (T-SWE: 0.958 vs. 0.962) showed no significant difference between T-SWE and S-SWE (all p > 0.05). The intra-class correlation coefficients

  2. US-Guided Vacuum-Assisted Biopsy of Microcalcifications in Breast Lesions and Long-Term Follow-Up Results

    Science.gov (United States)

    Kim, Hua Sun; Kim, Eun-Kyung; Kwak, Jin Young; Son, Eun Ju; Oh, Ki Keun

    2008-01-01

    Objective To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. Materials and Methods US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. Results There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. Conclusion US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where

  3. ROLE OF SINGLE VOXEL PROTON MAGNETIC RESONANCE SPECTROSCOPY ON A 3 TESLA MR SCANNER IN CHARACTERISING BREAST LESIONS- A TERTIARY CARE CENTRE EXPERIENCE IN EASTERN INDIA

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    Archana Singh

    2016-12-01

    Full Text Available BACKGROUND To evaluate whether the detection of choline-containing compounds in single voxel MR spectroscopy of breast lesions can differentiate between benign and malignant breast lesions. MATERIALS AND METHODS This prospective observational study included 99 breast lesions in 77 patients (between 18 and 86 years age who underwent 3T breast MRI including proton MR spectroscopy before biopsy. Following dynamic contrast-enhanced study, single voxel, water and fat suppressed proton MR spectroscopy was performed. The position and size of the Volume of Interest (VOI was placed so as to include the enhancing part of the lesion and excluding as much as possible the nonenhancing gland parenchyma, adjoining fat or necrotic part of the lesion. Choline peak at 3.2 ppm was qualitatively evaluated. MRI BIRADS scoring was done for each lesion. Sensitivity and specificity of the (1 H-MRS were calculated. Final histopathological diagnosis was taken as the gold standard. RESULTS According to histopathology, 53 lesions were malignant and 46 were benign. The qualitative approach based on presence or absence of choline peak yielded 88.68% [95% CI 76.97% to 95.73%] sensitivity and 76.09% [95% CI 61.23 to 87.41%] specificity for differentiating malignant and benign lesions (p<0.0001. CONCLUSION In vivo proton, MR spectroscopy can be used as an adjunctive tool for characterising breast lesions. However, the detection of choline-containing compounds is not specific for malignancy. Benign breast lesions may also demonstrate choline peak.

  4. Fine-needle aspiration cytology of extra mammary metastatic lesions in the breast: A retrospective study of 36 cases diagnosed during 18 years

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    Sauer Torill

    2010-01-01

    Full Text Available Background: Metastatic tumors in the breast require treatment according to origin and type of tumor. It is important to recognize these lesions in fine-needle aspiration cytology (FNAC in order to avoid unnecessary mastectomy or non-relevant chemotherapy. The aim of this study was to evaluate the cytological features of metastatic tumors and possible criteria that could alert us as to the possibility of a metastasis from an extra mammary malignancy. Methods: The material included 36 confirmed or suspected metastases in the breast registered in the pathology files at Oslo University Hospital, Ulleval, during 1990-2007. There were a total of 6,325 cases of malignant breast FNAC, representing 30 men and 6,295 women. Smears were evaluated for the amount of material, presence or absence of myoepithelial cells, microcalcifications, mitoses and necrotic material. All carcinomas were graded. Results: There were seven men (7/30 = 23.3% and 29 women (29/6,295 = 0.46%. The primary tumor was known in 22 cases (22/36 = 61.1%. No other primary tumor was known and metastatic lesion was not initially suspected in 14 cases (14/36 = 38.9%. The most common origin was lung (15/36 = 41.7%. In five cases (5/36 = 13.9%, the origin remained uncertain. Conclusions: Metastases from extra mammary sites are (relatively common in males (23.3%. In women, metastatic lesions are rare (0.46%. A large proportion of them (88% are high-grade adenocarcinomas and poorly differentiated carcinomas that may resemble grade 3 ductal carcinomas. Unusual clinical and/or radiological presentation in combination with high-grade malignant cells should alert us to consider the possibility of a metastasis.

  5. A retrospective study investigating the rate of HER2 discordance between primary breast carcinoma and locoregional or metastatic disease

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    Chan Arlene

    2012-11-01

    Full Text Available Abstract Background Overall survival of HER2 positive metastatic breast cancer patients has been significantly improved with inclusion of trastuzumab to chemotherapy. Several studies have demonstrated discordant HER2 status in the primary and metastatic tumour. However, rates of discordance vary considerably in published reports. Methods Information collected prospectively was analysed for all patients seen from 1999 to 2009 with primary breast cancer and who had biopsy of a local or distant recurrence. Patients were included if adequate tissue was available from both paired samples. Recurrent samples included fine needle aspirations, core and excisional biopsies. HER2 status in all paired samples was assessed by in-situ hybridisation by a single pathologist in a national reference laboratory. This was compared with HER2 immunohistochemistry results provided in the course of routine diagnosis at regional laboratories. Results In total, 157 patients with recurrent (n = 137; 87.3% or synchronous primary and metastatic (n = 20; 12.7% breast cancer had biopsy of the metastatic site. The study population comprised of 116 patients with adequate tissue in both primary and metastasis. The concordance between HER2 status of the paired samples by local immunohistochemistry testing and central in-situ hybridization were 78% and 99%, respectively. Only one patient demonstrated HER2 discordance – primary lesion was positive whilst a metastatic site was negative. Conclusions This single institution study demonstrated a low rate of HER2 discordance between primary and recurrent breast cancer as assessed by in-situ hybridisation. This contrasts to results reported by others, which may be explained by differences in study methodology, definition of recurrent disease samples and generally small numbers of patients assessed. Despite the current findings, the decision to obtain metastatic tissue for evaluation is influenced by other factors. These include disease

  6. Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression

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    Moretti, J.L. [Medicine Nucleaire, CHU Bobigny, Paris (France); Azaloux, H. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Boisseron, D. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Kouyoumdjian, J.C. [Service de Biochemie, Hopital Henri Mondor, Creteil (France); Vilcoq, J. [Service de Cancerologie-Radiotherapie, Inst. Curie, Paris (France)

    1996-08-01

    The aim of this preliminary study was to evaluate retrospectively sestamibi scintigraphy in relation to the presence of the 170-kDa P-glycoprotein (Pgp), which represents an expression of multidrug resistance in patients with primary breast cancer. Fifteen women (age range 37-76 years) were referred for technetium-99m sestamibi scintigraphy because of suspicious breast lesions detected by mammography and ultrasonography, and subsequently assessed by fine-needle aspiration. Scintigraphy was performed 30 min following the injection of 500 MBq {sup 99m}Tc-sestamibi. Three planar anterior and oblique images were obtained with the patient in the supine position. Excised tumours were assessed for cytosolic CA 15.3, oestrogen (OR) and progesterone (PR) receptors and c-erb B2 neu oncogene. Pathology revealed that only 13 of the 15 patients had malignant tumours. The two benign tumours were sestamibi-negative and Pgp-positive. Sestamibi scintigraphy was positive in 10 of the 13 malignant lesions (including nine of ten infiltrating ductal carcinomas). Two of the three lesions with false-negative scintigraphy were Pgp-negative; in one of these cases histology revealed an invasive lobular carcinoma and in the other, mucinous adenocarcinoma. The third false-negative lesion was a Pgp-positive infiltrating ductal carcinoma which was c-erb B2 neu-negative but CA 15.3-, OR- and PR-positive. This preliminary study confirms that the resistance to chemotherapy which may occur in patients with primary breast cancer can be a cause of negative sestamibi scintigraphy. (orig.)

  7. Qualitative and quantitative diffusion-weighted imaging of the breast at 3T - A useful adjunct to contrast-enhanced MRI in characterization of breast lesions

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    Richa Bansal

    2015-01-01

    Full Text Available Objective: To distinguish between benign and malignant breast lesions on the basis of their signal intensity on diffusion-weighted imaging and their apparent diffusion coefficient (ADC values at 3 T MRI, along with histopathological correlation. Materials and Methods: A retrospective analysis of 500 patients who underwent 3 T MRI between August 2011 and May 2013 was done. Of these, 226 patients with 232 lesions that were proved by histopathology were included in the study. ADC values were calculated at b values of 0, 1000, and 1500 s/mm2 after identification on contrast-enhanced images and appropriate ROI(Region of interest placement. ADC value and histopathology correlation was analyzed. Results: Out of 232 lesions, 168 lesions were histologically malignant and 64 were histologically benign. With an ADC cut-off value of 1.1 ×10−3 mm2/s for malignant lesions, a sensitivity of 92.80% and specificity of 80.23% was obtained. Out of 12/232 false-negative lesions, 6 were mucinous carcinoma in which a high ADC value of 1.8-1.9 ×10−3 mm2/s was obtained. Purely DCIS (Ductal carcinoma in situ lesions presenting as non-mass-like enhancement had a high ADC value of 1.2-1.5 ×10−3 mm2/s, thereby reducing specificity. Conclusion: Diffusion-weighted Imaging and quantitative assessment by ADC values may act as an effective parameter in increasing the diagnostic accuracy and specificity of contrast-enhanced breast MRI in characterization of breast lesions.

  8. Primary adenoid cystic carcinoma of the breast: Case report and review of the literature.

    Science.gov (United States)

    Naseer, M A; Mohammed, S S; Alyusuf, R; Al Marzooq, R; Das Majumdar, S K; Al Hammadi, A

    2013-01-01

    Adenoid cystic carcinoma of the breast is a very rare neoplasm. We report a case of adenoid cystic carcinoma of the right breast presented with painless lump in the upper outer quadrant managed with lumpectomy, axillary lymph node staging and adjuvant local external radiotherapy to the whole breast with simultaneous integrated boost to the site of primary disease using respiratory gated intensity modulated radiotherapy. The available literature is reviewed. Adenoid cystic cancer breast, mastectomy, adjuvant radiotherapy.

  9. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

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    Selami Ilgaz Kayılıoğlu

    2014-01-01

    Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

  10. Screening of breast lesions: a comparative study between mammography, B-mode ultrasonography, sonoelastography and histological results

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    Raquel Constantino Pardal

    2013-07-01

    Full Text Available Objective To compare the capacity of mammography, sonoelastography, B-mode ultrasonography and histological analysis to differentiate benign from malignant breast lesions. Materials and Methods A total of 12 histopathologically confirmed breast lesions were documented. The lesions were assessed by means of mammography, B-mode ultrasonography and sonoelastography, and histopathological analysis was utilized as a gold standard. Sensitivity and specificity were calculated. A receiver operating characteristic (ROC curve was constructed to evaluate the diagnostic performance of the mentioned techniques. Results Sensitivity and specificity in the differentiation between benign and malignant lesions were respectively 100% and 50% for mammography, 100% and 71% for B-mode ultrasonography, and 67% and 83% for sonoelastography. The area under the ROC curve was calculated for the three imaging modalities and corresponded to 0.792 for mammography, 0.847 for B-mode ultrasonography, and 0.806 for sonoelastography. Conclusion Sonoelastography demonstrated higher specificity and lower sensitivity as compared with mammography and B-mode ultrasonography. On the other hand, B-mode ultrasonography had the largest area under the ROC curve. Sonoelastography has demonstrated to be a promising technique to detect and evaluate breast lesions, and could potentially reduce the number of unnecessary biopsies.

  11. Usefulness of combined BI-RADS analysis and Nakagami statistics of ultrasound echoes in the diagnosis of breast lesions.

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    Dobruch-Sobczak, K; Piotrzkowska-Wróblewska, H; Roszkowska-Purska, K; Nowicki, A; Jakubowski, W

    2017-04-01

    To develop a method combining the statistics of the ultrasound backscatter and the Breast Imaging-Reporting and Data System (BI-RADS) classification to enhance the differentiation of breast tumours. The Nakagami shape parameter m was used to characterise the scatter properties of breast tumours. Raw data from the radiofrequency (RF) echo-signal and B-mode images from 107 (32 malignant and 75 benign) lesions and their surrounding tissue were recorded. Three different characteristic values of the shape parameters of m (maximum [mLmax], minimum [mLmin] and average [mLavg]) and differences between m parameters (Δmmax, Δmmin, Δmavg) of the lesions and their surrounding tissues were assessed. A lesion with a BI-RADS score of 3 was considered benign, while a lesion with a score of 4 was considered malignant (a cut-off of BI-RADS 3/4 was set for all patients). The area under the receiver operating characteristic (ROC) curve (AUC) was equal to 0.966 for BI-RADS, with 100% sensitivity and 54.67% specificity. All malignant lesions were diagnosed correctly, whereas 34 benign lesions were biopsied unnecessarily. In assessing the Nakagami statistics, the sum of the sensitivity and specificity was the best for mLavg (62.5% and 93.33%, respectively). Only four of 20 lesions were found over the cut-off value in BI-RADS of 4a. When comparing the differences in m parameters, Δmavg had the highest sensitivity of 90% (only three of 32 lesions were false negative). These three lesions were classified as BI-RADS category 4c. The combined use of B-mode and mLmin parameter improve the AUC up to 0.978 (p=0.088), compared to BI-RADS alone. The combination of the parametric imaging and the BI-RADS assessment does not significantly improve the differentiation of breast lesions, but it has the potential to better identify the group of patients with mainly benign lesions that have a low level of suspicion for malignancy with a BI-RADS score of 4a. Copyright © 2016 The Royal College of

  12. Synthetic matrix metalloproteinase inhibitors inhibit growth of established breast cancer osteolytic lesions and prolong survival in mice

    DEFF Research Database (Denmark)

    Winding, Bent; NicAmhlaoibh, Róisín; Misander, Henriette

    2002-01-01

    (MMPs) play an important role in all of these processes, but the possibility of using synthetic MMP inhibitors to decrease bone metastasis has received little attention. EXPERIMENTAL DESIGN: In the present study, we tested two general MMP inhibitors, BB-94 and GM6001, in a mouse model of breast cancer......-induced bone metastasis. RESULTS: In a simulation of intervention therapy, mice were inoculated with breast cancer cells, and at the time of diagnosis of osteolytic lesions, the mice were treated for 10 or 15 consecutive days with BB-94 or GM6001, respectively. Both inhibitors reduced the growth of osteolytic...... lesions by >55% compared with control mice. Next, we simulated prevention therapy by initiating treatment with GM6001 at time of inoculation with cancer cells or 3 days earlier. Assessment of osteolytic lesions 28 days after inoculation showed that, in both cases, the treatment reduced the size...

  13. Evaluation of a Nonrigid Motion Compensation Technique Based on Spatiotemporal Features for Small Lesion Detection in Breast MRI

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    F. Steinbruecker

    2012-01-01

    the performance of a new nonrigid motion correction algorithm based on the optical flow method. For each of the small lesions, we extracted morphological and dynamical features describing both global and local shape, and kinetics behavior. In this paper, we compare the performance of each extracted feature set under consideration of several 2D or 3D motion compensation parameters for the differential diagnosis of enhancing lesions in breast MRI. Based on several simulation results, we determined the optimal motion compensation parameters. Our results have shown that motion compensation can improve the classification results. The results suggest that the computerized analysis system based on the non-rigid motion compensation technique and spatiotemporal features has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.

  14. A Unique Presentation of Occult Primary Breast Cancer with a Review of the Literature

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    Inaya Ahmed

    2015-01-01

    Full Text Available We are reporting a case of a 34-year-old woman with occult primary breast cancer discovered after initially presenting with neurological symptoms. She was successfully treated with neoadjuvant chemotherapy followed by definitive axillary lymph node dissection and ipsilateral whole breast radiotherapy. The case presented is unique due to the rarity of occult primary breast cancer, especially in light of her initial confounding neurological signs and symptoms, which highlights the importance of careful staging.

  15. Materials used to restore class II lesions in primary molars: a survey of California pediatric dentists.

    Science.gov (United States)

    Pair, Rebecca Lee; Udin, Richard D; Tanbonliong, Thomas

    2004-01-01

    The purpose of this study was to determine which materials were most commonly used by pediatric dentists in California to restore Class II lesions in the primary dentition. A questionnaire consisting of 18 multiple-choice questions was mailed to all 440 active members of the California Society of Pediatric Dentistry (CSPD). The questions related to the practitioners' material of choice for restoring Class II lesions in primary molars. A 66% response rate was received. For 57% of the respondents, amalgam was the material of choice for restoration of Class II lesions in primary molars. Twenty-nine percent selected composite, 5% glass ionomer, 6% compomer, and 1% (1 practitioner) stainless steel crowns. Sixty-eight percent responded that amalgam has historically proven to be a safe, reliable, and affordable material. The main reasons cited for using composite resin were "patient preference" (86%) and "better esthetics" (78%). Most practitioners used either a single-step (fifth-generation) or 2-step (fourth-generation) bonding agent (53% and 35%, respectively). When using a nonamalgam restorative material, 49% of practitioners used a traditional Class II amalgam preparation. The role of dental literature in treatment decision-making was not significantly related to the restorative material used. While amalgam was the most common material used for Class II restorations, nonamalgam materials were significantly popular among California pediatric dentists.

  16. Reoperations after primary breast conserving surgery in women with invasive breast cancer in Catalonia, Spain: a retrospective study.

    Science.gov (United States)

    Escribà, J M; Esteban, L; Gálvez, J; Pla, M J; Melià, A; Gil-Gil, M; Clèries, R; Pareja, L; Sanz, X; Bustins, M; Borrás, J M; Ribes, J

    2017-04-01

    Although complete tumor resection is accepted as the best means to reduce recurrence, reoperations after lumpectomy are a common problem in breast cancer. The aim of this study was to assess the reoperation rates after primary breast conserving surgery in invasive breast cancer cases diagnosed in Catalonia, Spain, between 2005 and 2011 and to identify variations based on patient and tumour characteristics. Women with invasive incident breast cancer identified from the Patient's Hospital Discharge Database [174.0-174.9 codes of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the primary diagnosis] and receiving primary breast conserving surgery were included in the study and were followed up to 3 and 12 months by collecting information about repeat breast cancer surgery. Reoperation rates after primary breast conserving surgery decreased from 13.0 % in 2005 to 11.7 % in 2011 at 3 months and from 14.2 % in 2005 to 12.9 % in 2011 at 12 months' follow-up. While breast conservation reoperations saw a slight, non-significant increase in the same period (from 5.7 to 7.3 % at 3 months, and from 6.0 to 7.5 % at 12 months), there was a significant decrease in radical reoperation (from 7.3 to 4.4 % at 3 months and from 8.2 to 5.4 % at 12 months). Overall, additional breast surgeries decreased among younger women. Despite the rise of breast conserving surgery, reoperation rates following initial lumpectomy in Catalonia decreased by 10 % at 3 and 12 months' follow-up, remaining low and almost unchanged. Ultimately, there was also a significant decrease in mastectomies.

  17. Implication for second primary cancer from visible oral and oropharyngeal premalignant lesions in betel-nut chewing related oral cancer.

    Science.gov (United States)

    Liu, Shyun-Yu; Feng, I-Jung; Wu, Yu-Wei; Chen, Ching-Yuan; Hsiung, Chao-Nan; Chang, Hsueh-Wei; Lin, Che-Yi; Chang, Min-Te; Yu, Hsi-Chien; Lee, Sheng-Yang; Yen, Ching-Yu

    2017-07-01

    Visible oral and oropharyngeal premalignant lesions may be used to monitor for a second primary oral cancer. To control for bias, we focused on the visible oral and oropharyngeal premalignant lesions of patients with oral cancer with a positive betel-nut chewing habit. Visible oral and oropharyngeal premalignant lesions that can predict second primary oral cancers were studied. Nine hundred ninety-seven patients with positive betel-nut chewing habits and oral cancer were enrolled in this retrospective cohort study. We analyzed the relevance of their visible oral and oropharyngeal premalignant lesion incidence and relative clinicopathological variables to the development of a second primary oral cancer. Second primary oral cancer risk was significantly higher in patients with positive visible oral and oropharyngeal premalignant lesions (P betel-nut chewing habit with oral cancer, especially young patients with heterogeneous leukoplakia. © 2017 Wiley Periodicals, Inc.

  18. Re-resection rates and risk characteristics following breast conserving surgery for breast cancer and carcinoma in situ

    DEFF Research Database (Denmark)

    Kryh, C G; Pietersen, C A; Rahr, Hans

    2014-01-01

    OBJECTIVES: To examine the frequency of re-resections and describe risk characteristics: invasive carcinoma or carcinoma in situ (CIS), palpability of the lesion, and neoadjuvant chemotherapy. RESULTS: 1703 breast conserving surgeries were performed: 1575 primary breast conserving surgeries (BCS)...

  19. Is the necrosis/wall ADC ratio useful for the differentiation of benign and malignant breast lesions?

    Science.gov (United States)

    Durur-Subasi, Irmak; Durur-Karakaya, Afak; Karaman, Adem; Seker, Mehmet; Demirci, Elif; Alper, Fatih

    2017-05-01

    To determine whether the necrosis/wall apparent diffusion coefficient (ADC) ratio is useful for the malignant-benign differentiation of necrotic breast lesions. Breast MRI was performed using a 3-T system. In this retrospective study, calculation of the necrosis/wall ADC ratio was based on ADC values measured from the necrosis and from the wall of malignant and benign breast lesions by diffusion-weighted imaging (DWI). By synchronizing post-contrast T1 weighted images, the separate parts of wall and necrosis were maintained. All the diagnoses were pathologically confirmed. Statistical analyses were conducted using an independent sample t-test and receiver operating characteristic analysis. The intraclass and interclass correlations were evaluated. A total of 66 female patients were enrolled, 38 of whom had necrotic breast carcinomas and 28 of whom had breast abscesses. The ADC values were obtained from both the wall and necrosis. The mean necrosis/wall ADC ratio (± standard deviation) was 1.61 ± 0.51 in carcinomas, and it was 0.65 ± 0.33 in abscesses. The area under the curve values for necrosis ADC, wall ADC and the necrosis/wall ADC ratio were 0.680, 0.068 and 0.942, respectively. A wall/necrosis ADC ratio cut-off value of 1.18 demonstrated a sensitivity of 97%, specificity of 93%, a positive-predictive value of 95%, a negative-predictive value of 96% and an accuracy of 95% in determining the malignant nature of necrotic breast lesions. There was a good intra- and interclass reliability for the ADC values of both necrosis and wall. The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating breast carcinomas from abscesses using DWI. Advances in knowledge: ADC values of the necrosis obtained by DWI are valuable for malignant-benign differentiation in necrotic breast lesions. The necrosis/wall ADC ratio appears to be a reliable and promising tool in the breast imaging field.

  20. Diffusion-weighted imaging-guided MR spectroscopy in breast lesions using readout-segmented echo-planar imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kun; Chai, Weimin; Zhan, Ying; Luo, Xianfu; Yan, Fuhua [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ruijin Hospital, Shanghai (China); Fu, Caixia [Siemens MRI Center, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen (China); Shen, Kunwei [Shanghai Jiao Tong University School of Medicine, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai (China)

    2016-06-15

    To investigate the feasibility and effectiveness of diffusion-weighted imaging (DWI)-guided magnetic resonance spectroscopy (MRS) using readout-segmented echo-planar imaging (RS-EPI) to characterise breast lesions. A total of 258 patients with 258 suspicious breast lesions larger than 1 cm in diameter were examined using DWI-guided, single-voxel MRS with RS-EPI. The mean total choline-containing compound (tCho) signal-to-noise ratio (SNR) and concentration were used for the interpretation of MRS data. T-tests, χ{sup 2}-tests, receiver operating characteristic (ROC) curve analyses and Pearson correlations were conducted for statistical analysis. Histologically, 183 lesions were malignant, and 75 lesions were benign. Both the mean tCho SNR and concentration of malignant lesions were higher than those of benign lesions (6.23 ± 3.30 AU/mL vs. 1.26 ± 1.75 AU/mL and 3.17 ± 2.03 mmol/kg vs. 0.86 ± 0.83 mmol/kg, respectively; P < 0.0001). For a tCho SNR of 2.0 AU/mL and a concentration of 1.76 mmol/kg, the corresponding areas under the ROC curves were 0.93 and 0.90, respectively. The mean tCho SNR and concentration negatively correlated with apparent diffusion coefficients calculated from RS-EPI, with correlation coefficients of -0.54 and -0.48, respectively. DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions. (orig.)

  1. An endodontic-periodontal lesion with primary periodontal disease: a case report on its bacterial profile.

    Science.gov (United States)

    Fujii, Rie; Muramatsu, Takashi; Yamaguchi, Yukiko; Asai, Tomohiro; Aida, Natsuko; Suehara, Masataka; Morinaga, Kazuki; Furusawa, Masahiro

    2014-01-01

    The microflora in the periodontal pockets can affect the dental pulp and cause endodontic-periodontal lesions or retrograde pulpitis. Here we report an endodontic-periodontal lesion together with its bacterial profile. The lesion occurred in the maxillary right first molar of a 40-year-old woman who presented at our hospital complaining of a violent toothache since the previous night. Clinically, the tooth was caries-free and an electric pulp test showed it to be vital. The tooth showed signs of advanced periodontitis and the periodontal pocket was deep, reaching the apex of the palatal root. The clinical diagnosis was an endodontic-periodontal lesion with primary periodontal disease. Subsequent endodontic treatment comprised pulp extirpation and root canal filling, followed by periodontal treatment consisting of scaling and root planing. The tooth was finally restored with a full metal crown. No further signs of periodontal disease or periapical lesions have been observed to date. Bacteria were sampled from the root canal and periodontal pocket for a microbiological assessment using 16S rRNA gene-based PCR. Microbiologically, the profile of the bacterial species from the palatal root canal was similar to that from the periodontal pocket of the palatal root. Porphyromonas gingivalis, Fusobacterium nucleatum and Eikenella corrodens were detected in both samples. The occurrence of bacteria common to both sites in this patient further supports the proposition that periodontal disease is the definitive source of root canal infections. The present results suggest that a bacterial examination would be helpful in confirming and supporting the clinical diagnosis in such lesions.

  2. Primary neuroendocrine carcinoma of the breast: report of 2 cases and literature review

    Directory of Open Access Journals (Sweden)

    Fernando Collado-Mesa, MD

    2017-03-01

    Full Text Available Neuroendocrine tumors of the breast are very rare accounting for less than 0.1% of all breast cancers and less than 1% of all neuroendocrine tumors. Focal neuroendocrine differentiation can be found in different histologic types of breast carcinoma including in situ and invasive ductal or invasive lobular. However, primary neuroendocrine carcinoma of the breast requires the expression of neuroendocrine markers in more than 50% of the cell population, the presence of ductal carcinoma in situ, and the absence of clinical evidence of concurrent primary neuroendocrine carcinoma of any other organ. Reports discussing the imaging characteristics of this rare carcinoma in different breast imaging modalities are scarce. We present 2 cases of primary neuroendocrine carcinoma of the breast for which mammography, ultrasound, and magnetic resonance imaging findings and pathology findings are described. A review of the medical literature on this particular topic was performed, and the results are presented.

  3. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique.

    Science.gov (United States)

    Kemoli, A M; van Amerongen, W E

    2011-03-01

    To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from 30 rural schools in Kenya participated in the study. Three examiners selected a total of 1,280 suitable proximal carious lesions in primary molars after examining 6,002 children from 30 schools randomly selected out of 142 schools in two divisions. Seven operators randomly paired on a daily basis with eight assistants restored the lesions. An explanation was provided for any cavity that was not restored. Pre-and post-operative radiographs of the cavities were also taken for evaluation. The examiner's choice of suitable proximal cavities restorable using the ART approach was related to the decision made to either restore or not during the operative stage. The radiographic findings of the selected cavities were also compared to the decision made by the operator. The results obtained were used to determine the examiner's accuracy in selecting suitable proximal cavities for restoration using the ART approach. The majority of the children recruited in the study were excluded due to absenteeism, pulpal-exposure or anxiety during the operative stage. Only 804 children received one restoration in their primary molars. The examiner's accuracy in selecting suitable ART-restorable cavities clinically was 94.9% and based on radiographic analysis was 91.7%. A trained and diligent examiner has a very good chance of selecting proximal carious lesions restorable with the use of ART approach, without the threat of dental pulpal-involvement during the excavation of caries.

  4. Evaluation of AgNoR scores in aspiration cytology smears of breast lesions and their correlation with histopathology

    Directory of Open Access Journals (Sweden)

    N Nepal

    2014-09-01

    Full Text Available Background: Breast cancer is the leading cause of cancer-related deaths in Asia. The number of intra-nuclear silver stained structures, termed AgNORs, is significantly higher in malignant cells than in normal, reactive or benign cells. The main purpose of this study was to evaluate the AgNOR scores in aspiration cytology smears of breast lesions and their correlation with histopathology.Materials and Methods: This was a prospective study conducted over a period of 24 months from October, 2009 to 2011. A total of 40 cases were included in the study, including fine needle aspiration and biopsy. AgNOR stain was done in both cytology and histopathology slides and scoring was done and analyzed.Results: The mean AgNOR counts were 1.734 for benign cases and 4.508 for malignant cases. Statistically significant ‘P’ value < 0.05 for both benign and malignant cases was observed. The AgNOR dots morphology was homogenous, symmetric with regular contours in both FNAC and histopathology slides of benign breast lesion. In malignant breast lesions, the dots were asymmetric with irregular contours and were aggregated, smaller and more scatteredConclusion: The mAgNOR counts were significantly higher in smears from malignant breast lesions than in those from benign. These results were similar to those obtained for tissue sections and were comparable to established data. Both AgNOR counts and SAPA score gave similar results done in this study, indicating that SAPA is also as convenient, reproducible and rapid method of AgNOR evaluation.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11592 Journal of Pathology of Nepal; Vol.4,No. 8 (2014 649-653

  5. Towards an in-plane methodology to track breast lesions using mammograms and patient-specific finite-element simulations

    Science.gov (United States)

    Lapuebla-Ferri, Andrés; Cegoñino-Banzo, José; Jiménez-Mocholí, Antonio-José; Pérez del Palomar, Amaya

    2017-11-01

    In breast cancer screening or diagnosis, it is usual to combine different images in order to locate a lesion as accurately as possible. These images are generated using a single or several imaging techniques. As x-ray-based mammography is widely used, a breast lesion is located in the same plane of the image (mammogram), but tracking it across mammograms corresponding to different views is a challenging task for medical physicians. Accordingly, simulation tools and methodologies that use patient-specific numerical models can facilitate the task of fusing information from different images. Additionally, these tools need to be as straightforward as possible to facilitate their translation to the clinical area. This paper presents a patient-specific, finite-element-based and semi-automated simulation methodology to track breast lesions across mammograms. A realistic three-dimensional computer model of a patient’s breast was generated from magnetic resonance imaging to simulate mammographic compressions in cranio-caudal (CC, head-to-toe) and medio-lateral oblique (MLO, shoulder-to-opposite hip) directions. For each compression being simulated, a virtual mammogram was obtained and posteriorly superimposed to the corresponding real mammogram, by sharing the nipple as a common feature. Two-dimensional rigid-body transformations were applied, and the error distance measured between the centroids of the tumors previously located on each image was 3.84 mm and 2.41 mm for CC and MLO compression, respectively. Considering that the scope of this work is to conceive a methodology translatable to clinical practice, the results indicate that it could be helpful in supporting the tracking of breast lesions.

  6. Can We Predict Phyllodes Tumor among Fibroepithelial Lesions with Cellular Stroma Diagnosed at Breast Core Needle Biopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hae Kyoung; Ko, Kyung Hee; Rho, Ji Young [Dept. of Radiology, CHA University College of Medicine, Seoul (Korea, Republic of); Moon, Hee Jung; Kim, Eun Kyung; Kim, Min Jung; Park, Byeong Woo [Dept. of Radiology, Yensei University College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    To evaluate the surgical outcomes of fibroepithelial lesion with cellular stroma (FELCS) diagnosed at sonography guided core needle biopsy of breast masses, and to determine whether the clinical and imaging features of this lesion could predict the presence of a phyllodes tumor. We retrospectively reviewed the pathologic results of sonography guided core needle biopsy of solid breast masses. A total of 55 FELCS diagnosed with this procedure that underwent subsequent surgical excision were included in this study; their medical records and radiologic images were retrospectively reviewed. The results of the surgical excision revealed 22 (40%) phyllodes tumors and 33 (60%) non-phyllodes tumors: 30 (54.6%) fibroadenomas, 1 (1.8%) adenosis, 1 (1.8%) fibrocystic changes and 1 (1.8%) fibroadenomatous hyperplasia. Lesion size and patient age were significantly different between phyllodes tumors and nonphyllodes tumors groups (32.2 {+-} 14.07 mm/22.4 {+-} 13.64 mm, p=0.0078, 43.5 {+-} 11.60 years/36.5 {+-} 10.25 years, p=0.0207). Among the sonographic features, only cleft was significantly more visible in phyllodes tumors than in non-phyllodes tumors (n=14 (70%)/n=6 (30%), p=0.0016). The size of the lesions, the age of the patients, and the sonographic features of cleft were the significant helpful variables to predict phyllodes tumors among FELCS diagnosed at breast core biopsy.

  7. Precursors and preinvasive lesions of the breast: the role of molecular prognostic markers in the diagnostic and therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Zografos George C

    2007-05-01

    Full Text Available Abstract Precursors and preinvasive lesions of the breast include atypical ductal hyperplasia (ADH, ductal carcinoma in situ (DCIS, and lobular neoplasia (LN. There is a significant debate regarding the classification, diagnosis, prognosis and management of these lesions. This review article describes the current theories regarding the pathogenesis and molecular evolution of these lesions. It reviews the implication of a variety of molecules in the continuum of breast lesions: estrogen receptors (ER-alpha and ER-beta, c-erb-B2 (Her2/neu, p53, Ki-67, bcl-2, E-cadherin, transforming growth factor-beta (TGF-beta, p27 (Kip1, p16 (INK4a, p21 (Waf1, vascular endothelial growth factor (VEGF. With respect to the aforementioned molecules, this article reviews their pathophysiological importance, and puts the stress on whether they confer additional risk for invasive breast cancer or not. This knowledge has the potential to be of importance in the therapeutic decisions presenting in the common clinical practice.

  8. Non-invasive optical estimate of tissue composition to differentiate malignant from benign breast lesions: A pilot study

    Science.gov (United States)

    Taroni, Paola; Paganoni, Anna Maria; Ieva, Francesca; Pifferi, Antonio; Quarto, Giovanna; Abbate, Francesca; Cassano, Enrico; Cubeddu, Rinaldo

    2017-01-01

    Several techniques are being investigated as a complement to screening mammography, to reduce its false-positive rate, but results are still insufficient to draw conclusions. This initial study explores time domain diffuse optical imaging as an adjunct method to classify non-invasively malignant vs benign breast lesions. We estimated differences in tissue composition (oxy- and deoxyhemoglobin, lipid, water, collagen) and absorption properties between lesion and average healthy tissue in the same breast applying a perturbative approach to optical images collected at 7 red-near infrared wavelengths (635-1060 nm) from subjects bearing breast lesions. The Discrete AdaBoost procedure, a machine-learning algorithm, was then exploited to classify lesions based on optically derived information (either tissue composition or absorption) and risk factors obtained from patient’s anamnesis (age, body mass index, familiarity, parity, use of oral contraceptives, and use of Tamoxifen). Collagen content, in particular, turned out to be the most important parameter for discrimination. Based on the initial results of this study the proposed method deserves further investigation.

  9. Comparison of the clinical and prognostic features of primary breast sarcomas and malignant phyllodes tumor.

    Science.gov (United States)

    Wang, Fang; Jia, Yan; Tong, Zhongsheng

    2015-02-01

    Primary breast sarcoma is a kind of extremely rare disease. Malignant phyllodes tumor represents a specific subset of breast soft tissue tumors. So till now, the classification and clinical management of primary breast sarcoma and malignant phyllodes tumor are controversial. The aim of this study is to explore the differences in clinical features, treatment, disease-free survival and overall survival between primary breast sarcoma and malignant phyllodes tumor group. A retrospective review of 35 cases with primary breast sarcoma and 70 cases with malignant phyllodes tumor registered from 1995 to 2010 was carried out in Tianjin Medical University Cancer Institute and Hospital. Prognosis in terms of disease-free survival and overall survival was evaluated. In primary breast sarcoma group, the result of univariate analysis demonstrated that surgical type, histopathological nodal status and local recurrence were significantly correlated with disease-free survival and overall survival. While, the result of monofactorial analysis showed the tumor size was significant prognostic indicator of disease-free survival and overall survival in malignant phyllodes tumor group. The Kaplan-Meier curves for 5-year disease-free survival rates and overall survival rates demonstrated that no significant difference was found between the primary breast sarcoma and malignant phyllodes tumor group (P = 0.702 and 0.772, respectively). The primary breast sarcoma patients had identical disease-free survival and overall survival compared with the malignant phyllodes tumor patients, which indicated that primary breast sarcoma and malignant phyllodes tumor patients should be treated with the same strategies. Surgical management is important for both the primary breast sarcoma and malignant phyllodes tumor patients. The role of the adjuvant radiotherapy and chemotherapy remains uncertain. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email

  10. [Five-year experience with the multidisciplinary evaluation of breast lesions according to the Decker radio-pathologic correlation system].

    Science.gov (United States)

    Cserni, Gábor; Ambrózay, Éva; Serfőző, Orsolya

    2017-07-01

    Lesions identified during breast imaging often require microscopic verification. Current recommendations imply the classification of radiological, clinical, cytology and core biopsy findings into one of five predefined categories. The Decker system also includes a classification of both the correlation between radiology and pathology and the actions required on this basis. To report on the five-year results of the implementation of the Decker system in our pretreatment multidisciplinary breast team. Retrospective analysis of patients operated on because of breast diseases or appearing at the multidisciplinary breast team during the period between 2000 and 2014. Of 1716 cases discussed, 1531 were solved by non-operative diagnostics, 157 required diagnostic excisions; 1122 cases (65%) proved to be malignant. Malignancy was diagnosed by core needle biopsies in 69% of the cases. The non-operative approach was unsuccessful, delayed or wrong in 14 cases. Breast lesions need to be evaluated in a multidisciplinary setting. The Decker-system is suitable for the recording and analysis of the correlation between radiologic/physical and microscopy findings, and of the ensuing diagnostic/therapeutic actions. Orv Hetil. 2017; 158(28): 1100-1108.

  11. Comparison of shear-wave and strain ultrasound elastography in the differentiation of benign and malignant breast lesions.

    Science.gov (United States)

    Chang, Jung Min; Won, Jae-Kyung; Lee, Kyoung-Bun; Park, In Ae; Yi, Ann; Moon, Woo Kyung

    2013-08-01

    The purpose of this article is to compare the diagnostic performances of shearwave and strain elastography for the differentiation of benign and malignant breast lesions. B-mode ultrasound and shear-wave and strain elastography were performed in 150 breast lesions; 71 were malignant. BI-RADS final assessment, elasticity values in kilopascals, and elasticity scores on a 5-point scale were assessed before biopsy. The results were compared using the area under the receiver operating characteristic curve (AUC). The AUC for shear-wave elastography was similar to that of strain elastography (0.928 vs 0.943). The combined use of B-mode ultrasound and either elastography technique improved diagnostic performance in the differentiation of benign and malignant breast lesions compared with the use of B-mode ultrasound alone (B-mode alone, AUC = 0.851; B-mode plus shear-wave elastography, AUC = 0.964; B-mode plus strain elastography, AUC = 0.965; p < 0.001). With the best cutoff points of 80 kPa on shear-wave elastography and a score between 3 and 4 on strain elastography, the sensitivity was higher in shear-wave elastography, and specificity was higher in strain elastography (95.8% vs 81.7%, p = 0.002; 93.7% vs 84.8%, p = 0.016). In cases of infiltrating ductal carcinoma, mean elasticity scores were lower in grade 3 than in grade 1 and 2 cancers (p = 0.017) with strain elastography causing false-negative findings. The diagnostic performance of shear-wave and strain elastography was similar. Either elastography technique can improve overall diagnostic performance in the differentiation of benign and malignant lesions when combined with B-mode ultrasound. However, the sensitivity and specificity of shear-wave and strain elastography were different according to lesion histologic profile, tumor grade, and breast thickness.

  12. Practicing breast self-examination among women attending primary ...

    African Journals Online (AJOL)

    Saadoon F. Al-Azmy

    2012-09-24

    examination (BSE), few women perform it ... factors associated with BSE, whereas practicing subjects (control) were compared with a randomly selected similar ... and discoloration of the breast were signs and symptoms of breast cancer.

  13. Primary pure squamous cell carcinoma of breast in a young female - a rare occurrence

    Directory of Open Access Journals (Sweden)

    P Raje

    2014-04-01

    Full Text Available Primary squamous cell carcinoma of breast is a rare disease. Incidence for primary SCC breast is 0.04-0.1 % of all malignancies of breast. A pure form of primary SCC breast is also described and its incidence is still less. Biologically it behaves differently and usually doesn’t metastasize to lymph nodes, though distant metastasis is more common. They occur usually in elderly women. Mean age of presentation is 54 years. We report the youngest patient so far - a 27 years old woman diagnosed initially as having fibrocystic disease and later as primary pure SCC breast. She did not have any other focus of malignancy in the body and is doing well 3-1/2 years post surgery and radiotherapy. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10322 Journal of Pathology of Nepal (2014 Vol. 4, 600-602

  14. Breast cancer in situ. From pre-malignant lesion of uncertain significance to well-defined non-invasive malignant lesion. The Danish Breast Cancer Cooperative Group Register 1977-2007 revisited

    DEFF Research Database (Denmark)

    Laenkholm, A.V.; Jensen, Maiken Brit; Kroman, N.

    2008-01-01

    In addition to nationwide standardized pathology forms for operable primary invasive breast cancer, the Danish Breast Cancer cooperative Group (DBCG) in 1982 introduced pathology forms for breast cancer in situ (CIS). The histological reporting form was used primarily for ductal cancer in situ...... receptor (ER) and Progesteron receptor (PR) status. Also mastectomy specimens were included. In 2004 the previous malignancy grading was replaced by the Van Nuys classification, and information on microcalcifications was introduced. The axillary status now included the sentinel node technique only. In 2006...

  15. Malignant amelanotic melanoma of the pleura without primary skin lesion:an autopsy case report.

    Science.gov (United States)

    Ohata, Yuichiro; Haga, Takayuki; Ogata, Sho; Nakanishi, Kuniaki; Kawai, Toshiaki

    2009-12-01

    Melanoma metastasizing to the lungs is common, but primary pulmonary or pleural melanoma is extremely rare. We present an autopsy case of malignant melanoma of the pleura without primary skin lesion in a 49-year-old man. A mass found in the right chest was diagnosed as spindle cell sarcoma by antemortem fine-needle aspiration cytology. At autopsy, a yellow-white tumor located primarily in the right visceral pleura (diagnosed as an amelanotic melanoma) was found to have invaded into the right lung, right parietal pleura, and right diaphragm, and to have metastasized into the left lung and visceral pleura, thyroid, and left adrenal gland. No primary site was found. The tumor cells were positive for S100 and focally positive for HMB-45, but negative for other markers. Immuno-histochemical examination for S100 and HMB-45 would thus appear to be useful for the diagnosis of an amelanotic melanoma.

  16. Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications.

    Science.gov (United States)

    Scaperrotta, Gianfranco; Ferranti, Claudio; Capalbo, Emanuela; Paolini, Biagio; Marchesini, Monica; Suman, Laura; Folini, Cristina; Mariani, Luigi; Panizza, Pietro

    2016-01-01

    To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤ 1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture. Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤ 1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576). The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Breast Cancer Suspicion in a Transgender Male-to-Female Patient on Hormone Replacement Therapy Presenting with Right Breast Mass: Breast Cancer Risk Assessment and Presentation of a Rare Lesion

    Directory of Open Access Journals (Sweden)

    Krystina Tongson

    2017-01-01

    Full Text Available There has been an increasing use of hormonal therapy among male-to-female (MtF transgender individuals. This long-term hormone replacement therapy (HRT renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy. The patient additionally had a strong family history of breast cancer. Final pathology revealed lobular hyperplasia in the setting of gynecomastia and pseudoangiomatous stromal hyperplasia (PASH. Both pathology findings are rare in biological females, let alone in the setting of hormone replacement therapy in a MtF individual. While the number of reported cases of suspicious breast lesions in this population remains scarce, it presents both a diagnostic and therapeutic challenge due to the nature of the treatment course and the lack of research in this recently growing subgroup of patients.

  18. Lesiones benignas de mama que pueden simular un carcinoma en estudios imagenológicos Benign breast lesions that mimic carcinoma in diagnostic imaging

    Directory of Open Access Journals (Sweden)

    Mariana Castro Barba

    2011-03-01

    Full Text Available La mayoría de las lesiones que se encuentran al realizar estudios mamarios son benignas. Muchas de ellas tienen un aspecto típico y definido, ya sea en mamografía o ecografía y no requieren de evaluaciones adicionales. Existe un grupo de entidades benignas que, sin embargo, puede simular un carcinoma en las imágenes. Los radiólogos debemos conocer las características de las mismas y tenerlas en cuenta como posibles diagnósticos diferenciales de una imagen de alta sospecha.Most of the lesions found during breast imaging exams are benign. Many of them have a typical and definite appearance on mammography and ultrasound, and require no further evaluation. However, some benign lesions cannot be differentiated from carcinomas, given their suspicious and less specific radiological features. Radiologists should be aware of the imaging characteristics of these lesions and include them in the differential diagnosis of a malignant-appearing finding.

  19. Contrast-Enhancing Meningeal Lesions Are Associated with Longer Survival in Breast Cancer-Related Leptomeningeal Metastasis.

    Science.gov (United States)

    Regierer, Anne Constanze; Stroux, Andrea; Kühnhardt, Dagmar; Dieing, Annette; Lehenbauer-Dehm, Silvia; Flath, Bernd; Possinger, Kurt; Eucker, Jan

    2008-01-01

    BACKGROUND: Leptomeningeal metastasis (LM) is a devastating complication of advanced cancer. Despite aggressive therapy survival is very poor. METHODS: Data of all breast cancer patients with LM were retrospectively analyzed (n = 27). RESULTS: Median survival was 9 weeks. Patients with contrast-enhancing meningeal lesions (n = 11) detected by MRI had a median survival of 33 weeks versus 8 weeks for patients without contrast-enhancing lesions (n = 9; p = 0.0407). Patients who received systemic chemotherapy (n = 18) had a median survival of 15 weeks versus 7 weeks (n = 9; p = 0.0106). Patients undergoing radiotherapy (n = 8) had a median survival of 17 weeks as compared to 5 weeks for patients without radiotherapy (n = 18; p = 0.0188). In a multiple Cox regression analysis, lack of systemic therapy (hazard ratio, HR 89.5; p = 0.002) and negative hormone receptor status (HR 4.2; p = 0.027) emerged as significant main risk factors, together with contrast-enhancing lesion as effect modifier for systemic therapy (p = 0.03). CONCLUSION: Contrast-enhancing meningeal lesions, systemic therapy, and radiotherapy were significantly associated with longer survival. Patients with contrast-enhancing lesions who were treated systemically had the longest survival. Evidence is increasing that systemic therapy plays an important role and should be applied in breast cancer patients with LM.

  20. Incorporation of clinical data into a computerized method for the assessment of mammographic breast lesions

    Science.gov (United States)

    Huo, Zhimin; Giger, Maryellen L.

    2000-06-01

    We previously developed a computerized method to classify mammographic masses as benign or malignant. In this method, mammographic features that are similar to the ones used by radiologists are automatically extracted to characterize a mass lesion. These features are then merged by an artificial neural network (ANN), which yields an estimated likelihood of malignancy for each mass. The performance of the method was evaluated on an independent database consisting of 110 cases (60 benign and 50 malignant cases). The method achieved an Az of 0.91 from round-robin analysis in the task of differentiating between benign and malignant masses using the computer-extracted features only. As the most important clinical risk factor for breast cancer, age achieved a performance level (Az equals 0.79) similar to that (Az equals 0.77 and 0.80) of the computer-extracted spiculation features, which are the most important indicators for malignancy of a mass, in differentiating between the malignant and benign cases. In this study, age is included as an additional input feature to the ANN. The performance of the scheme (Az equals 0.93) is improved when age is included. However, the improvement is not found to be statistically significant. Our results indicated that age may be a strong feature in predicting malignancy of a mass. For this database, however, the inclusion of age may not have a strong impact on the determination of the likelihood for a mammographic mass lesion when the major mammographic characteristics (e.g., spiculation) of a mass are accurately extracted and analyzed along with other features using an artificial neural network.

  1. On a fractional order calculus model in diffusion weighted breast imaging to differentiate between malignant and benign breast lesions detected on X-ray screening mammography.

    Science.gov (United States)

    Bickelhaupt, Sebastian; Steudle, Franziska; Paech, Daniel; Mlynarska, Anna; Kuder, Tristan Anselm; Lederer, Wolfgang; Daniel, Heidi; Freitag, Martin; Delorme, Stefan; Schlemmer, Heinz-Peter; Laun, Frederik Bernd

    2017-01-01

    To evaluate a fractional order calculus (FROC) model in diffusion weighted imaging to differentiate between malignant and benign breast lesions in breast cancer screening work-up using recently introduced parameters (βFROC, DFROC and μFROC). This retrospective analysis within a prospective IRB-approved study included 51 participants (mean 58.4 years) after written informed consent. All patients had suspicious screening mammograms and indication for biopsy. Prior to biopsy, full diagnostic contrast-enhanced MRI examination was acquired including diffusion-weighted-imaging (DWI, b = 0,100,750,1500 s/mm2). Conventional apparent diffusion coefficient Dapp and FROC parameters (βFROC, DFROC and μFROC) as suggested further indicators of diffusivity components were measured in benign and malignant lesions. Receiver operating characteristics (ROC) were calculated to evaluate the diagnostic performance of the parameters. 29/51 patients histopathologically revealed malignant lesions. The analysis revealed an AUC for Dapp of 0.89 (95% CI 0.80-0.98). For FROC derived parameters, AUC was 0.75 (0.60-0.89) for DFROC, 0.59 (0.43-0.75) for βFROC and 0.59 (0.42-0.77) for μFROC. Comparison of the AUC curves revealed a significantly higher AUC of Dapp compared to the FROC parameters DFROC (p = 0.009), βFROC (p = 0.003) and μFROC (p = 0.001). In contrast to recent description in brain tumors, the apparent diffusion coefficient Dapp showed a significantly higher AUC than the recently proposed FROC parameters βFROC, DFROC and μFROC for differentiating between malignant and benign breast lesions. This might be related to the intrinsic high heterogeneity within breast tissue or to the lower maximal b-value used in our study.

  2. On a fractional order calculus model in diffusion weighted breast imaging to differentiate between malignant and benign breast lesions detected on X-ray screening mammography.

    Directory of Open Access Journals (Sweden)

    Sebastian Bickelhaupt

    Full Text Available To evaluate a fractional order calculus (FROC model in diffusion weighted imaging to differentiate between malignant and benign breast lesions in breast cancer screening work-up using recently introduced parameters (βFROC, DFROC and μFROC.This retrospective analysis within a prospective IRB-approved study included 51 participants (mean 58.4 years after written informed consent. All patients had suspicious screening mammograms and indication for biopsy. Prior to biopsy, full diagnostic contrast-enhanced MRI examination was acquired including diffusion-weighted-imaging (DWI, b = 0,100,750,1500 s/mm2. Conventional apparent diffusion coefficient Dapp and FROC parameters (βFROC, DFROC and μFROC as suggested further indicators of diffusivity components were measured in benign and malignant lesions. Receiver operating characteristics (ROC were calculated to evaluate the diagnostic performance of the parameters.29/51 patients histopathologically revealed malignant lesions. The analysis revealed an AUC for Dapp of 0.89 (95% CI 0.80-0.98. For FROC derived parameters, AUC was 0.75 (0.60-0.89 for DFROC, 0.59 (0.43-0.75 for βFROC and 0.59 (0.42-0.77 for μFROC. Comparison of the AUC curves revealed a significantly higher AUC of Dapp compared to the FROC parameters DFROC (p = 0.009, βFROC (p = 0.003 and μFROC (p = 0.001.In contrast to recent description in brain tumors, the apparent diffusion coefficient Dapp showed a significantly higher AUC than the recently proposed FROC parameters βFROC, DFROC and μFROC for differentiating between malignant and benign breast lesions. This might be related to the intrinsic high heterogeneity within breast tissue or to the lower maximal b-value used in our study.

  3. Usefulness of Diffusion-Weighted MR Imaging for Breast Lesions: Comparing the Apparent Diffusion Coefficient (ADC) Values and the Pathologic Results

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Hye Shin; Chang, Yun Woo; Choi, Kyung Hee; Kim, Hyun Joo; Hong, Seong Suk; Hwang, Jung Hwa; Kwon, Kui Hyang [Dept.of Radiology, Soonchunhyang University Hospital, Seoul (Korea, Republic of); Kim, Yong Bae [Dept. of Preventive Medicine, Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2011-04-15

    We wanted to evaluate the ability of the apparent diffusion coefficient (ADC) values to differentiate between benign and malignant breast lesions and the normal breast parenchyma. We used breast MRI, including DWI, to obtain images of 167 breast lesions (18 benign lesions and 149 malignant lesions) of 152 women (mean age: 48.6 years, range: 24-80 years). The mean ADC values of the malignant lesions were compared to those of the benign lesions and the normal parenchyma. We compared the ADC values of IDC, DCIS and other types of breast cancer and we also compared the ADC values with the nuclear grade of IDC. The mean ADC values of the malignant lesions were lower than those of the benign lesions and the normal parenchyma (p<0.001, respectively). The mean ADC value of IDC was lower than those of DCIS and other breast cancers (p<0.001, respectively). The mean ADC value of mucinous carcinoma among the other breast cancer was characteristic high compared with that of the normal parenchyma. There was no significant differentiation of the ADC values between the nuclear grades of IDC (p<0.828). The ADC threshold value of 0.98 X 10{sup -3} mm{sup 2}/s for discriminating between malignant and benign lesion showed a specificity of 53% and a sensitivity of 100%, and the ADC threshold value of 1.33 X 10{sup -3} mm{sup 2}/s showed a specificity of 93% and a sensitivity of 94% for discriminating between malignant and benign lesion.

  4. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth

    Directory of Open Access Journals (Sweden)

    Tatiane Fernandes Novaes

    2012-08-01

    Full Text Available The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344 of 76 children (4-12 years old were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen. Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm. The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  5. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth.

    Science.gov (United States)

    Novaes, Tatiane Fernandes; Matos, Ronilza; Celiberti, Paula; Braga, Mariana Minatel; Mendes, Fausto Medeiros

    2012-01-01

    The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344) of 76 children (4-12 years old) were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen). Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm). The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  6. Veliparib and Pegylated Liposomal Doxorubicin Hydrochloride in Treating Patients With Recurrent Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer or Metastatic Breast Cancer

    Science.gov (United States)

    2016-10-04

    Estrogen Receptor Negative; HER2/Neu Negative; Male Breast Carcinoma; Progesterone Receptor Negative; Recurrent Breast Carcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IV Breast Cancer; Triple-Negative Breast Carcinoma

  7. Accuracy of SIAscopy for pigmented skin lesions encountered in primary care: development and validation of a new diagnostic algorithm.

    Science.gov (United States)

    Emery, Jon D; Hunter, Judith; Hall, Per N; Watson, Anthony J; Moncrieff, Marc; Walter, Fiona M

    2010-09-25

    Diagnosing pigmented skin lesions in general practice is challenging. SIAscopy has been shown to increase diagnostic accuracy for melanoma in referred populations. We aimed to develop and validate a scoring system for SIAscopic diagnosis of pigmented lesions in primary care. This study was conducted in two consecutive settings in the UK and Australia, and occurred in three stages: 1) Development of the primary care scoring algorithm (PCSA) on a sub-set of lesions from the UK sample; 2) Validation of the PCSA on a different sub-set of lesions from the same UK sample; 3) Validation of the PCSA on a new set of lesions from an Australian primary care population. Patients presenting with a pigmented lesion were recruited from 6 general practices in the UK and 2 primary care skin cancer clinics in Australia. The following data were obtained for each lesion: clinical history; SIAscan; digital photograph; and digital dermoscopy. SIAscans were interpreted by an expert and validated against histopathology where possible, or expert clinical review of all available data for each lesion. A total of 858 patients with 1,211 lesions were recruited. Most lesions were benign naevi (64.8%) or seborrhoeic keratoses (22.1%); 1.2% were melanoma. The original SIAscopic diagnostic algorithm did not perform well because of the higher prevalence of seborrhoeic keratoses and haemangiomas seen in primary care. A primary care scoring algorithm (PCSA) was developed to account for this. In the UK sample the PCSA had the following characteristics for the diagnosis of 'suspicious': sensitivity 0.50 (0.18-0.81); specificity 0.84 (0.78-0.88); PPV 0.09 (0.03-0.22); NPV 0.98 (0.95-0.99). In the Australian sample the PCSA had the following characteristics for the diagnosis of 'suspicious': sensitivity 0.44 (0.32-0.58); specificity 0.95 (0.93-0.97); PPV 0.52 (0.38-0.66); NPV 0.95 (0.92-0.96). In an analysis of lesions for which histological diagnosis was available (n = 111), the PCSA had a significantly

  8. Primary Leiomyosarcoma of Breast in an Adolescent Girl: A Case Report and Review of the Literature

    Science.gov (United States)

    Rane, Swapnil Ulhas; Batra, Charu; Saikia, Uma Nahar

    2012-01-01

    Leiomyosarcoma of the breast is a rare neoplasm, primarily reported in older women. Only 44 cases have been reported in world literature and to the best of our knowledge, no case has been reported from India till date. We report a case of primary breast leiomyosarcoma in an adolescent girl who underwent a lumpectomy for rapidly increasing lump in the left breast. Here we report the histological findings and immunohistochemical profile of this entity, along with a review of existing literature. PMID:22953134

  9. Does variability in carotenoid composition and concentration in tissues of the breast and reproductive tract in women depend on type of lesion?

    National Research Council Canada - National Science Library

    Czeczuga-Semeniuk, E; Wołczyński, S

    2008-01-01

    .... The study objective was to compare the carotenoid content in benign and malignant lesions of the breast, ovary and uterus, and to demonstrate quantitative and qualitative similarities or differences...

  10. Semi-quantitative and qualitative assessment of breast ultrasound elastography in differentiating between malignant and benign lesions.

    Science.gov (United States)

    Alhabshi, Sharifah Majedah Idrus; Rahmat, Kartini; Abdul Halim, Nurazidawati; Aziz, Suraya; Radhika, Sridharan; Gan, Gek Choo; Vijayananthan, Anushya; Westerhout, Caroline Judy; Mohd-Shah, Mohammad Nazri; Jaszle, Saladina; Harlina Mohd Latar, Nani; Muhammad, Rohaizak

    2013-04-01

    The purpose of this study was to evaluate the diagnostic value of qualitative and semi-quantitative assessment of ultrasound elastography in differentiating between benign and malignant breast lesions. This prospective study was conducted in two tertiary medical centers. Consecutive B-mode ultrasound and real-time elastographic images were obtained for 67 malignant and 101 benign breast lesions in 168 women. Four experienced radiologists analyzed B-mode ultrasound alone and B-mode ultrasound combined with elastography independently. Conventional ultrasound findings were classified according to the American College of Radiology Breast Imaging Reporting and Data System classification. The elastographic assessment was based on qualitative and semi-quantitative parameters (i.e., strain pattern, width ratio, strain ratio). The sensitivity and specificity of combined elastography and conventional ultrasound were significantly higher than that of conventional ultrasound alone. The sensitivity, specificity, positive predictive value and negative predictive value was 97%, 61.4%, 62.5% and 96.8%, respectively, for conventional ultrasound and 100%, 93%, 99% and 90%, respectively, for combined technique. The semi-quantitative assessment with strain ratio and width ratio in elastography were the most useful parameters in differentiating between benign and malignant breast lesions. Cut-off point values for width ratio of more than 1.1 and strain ratio of more than 5.6 showed a high predictive value of malignancy with specificities of 84% and 76%, respectively (p technique also had the best results in detecting carcinoma and could reduce the need of unnecessary biopsy for benign lesions with indeterminate or equivocal features. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Nonpalpable breast lesion. Stereotaxic core needle aspiration biopsy with a single pass.

    Science.gov (United States)

    Vega, A; Arrizabalaga, R; Garijo, F; Guerra, I

    1995-03-01

    One hundred and fifty-six patients with suspect nonpalpable breast lesion underwent stereotaxic core needle aspiration biopsy (SCNAB) with a single pass in an upright "add-on" stereotaxic device using a manual 1.6-mm needle (16 G), to determine whether the results were comparable to results of SCNAB with a multiple-pass technique. Of the 69 carcinomas, 51 (74%) were correctly diagnosed and definitive surgical therapy, without surgical biopsy, was performed in 42 of the 50 invasive carcinomas (84%) and in 9 of the 19 noninvasive carcinomas (47%). Ten noninvasive carcinomas and 4 invasive carcinomas, discovered by microcalcifications or distortion on the mammograms, form 78% of the false-negative results. There were no false-positive results. Vasovagal reactions occurred in 11% of the procedures. Although the results were acceptable in patients with invasive carcinoma, more than one needle pass is necessary for greater diagnostic accuracy of SCNAB, especially in patients with only microcalcifications or distortion on the mammogram.

  12. Intra-and interobserver reproducibility of shear wave elastography for evaluation of the breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji [Dept. of Radiology, Gil Hospital, Gachon University of Medicine and Science, Incheon (Korea, Republic of); Kim, Hak Hee [Dept. of Radiology, and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-03-15

    To evaluate reproducibility of shear wave elastography (SWE) for breast lesions within and between observers and compare the reproducibility of SWE features. For intraobserver reproducibility, 225 masses with 208 patients were included; and two consecutive SWE images were acquired by each observer. For interobserver reproducibility, SWE images of the same mass were obtained by another observer before surgery in 40 patients. Intraclass correlation coefficients (ICC) were used to determine intra- and interobserver reproducibility. Intraobserver reliability for mean elasticity (Emean) and maximum elasticity (Emax) were excellent (ICC = 0.803, 0.799). ICC for SWE ratio and minimum elasticity (Emin) were fair to good (ICC = 0.703, 0.539). Emean showed excellent ICC regardless of histopathologic type and tumor size. Emax, SWE ratio and Emin represented excellent or fair to good reproducibility based on histopathologic type and tumor size. In interobserver study, ICC for Emean, Emax and SWE ratio were excellent. Emean, Emax and SWE ratio represented excellent ICC irrespective of histopathologic type. ICC for Emean was excellent regardless of tumor size. SWE ratio and Emax showed fair to good interobserver reproducibility based on tumor size. Emin represented poor interobserver reliability. Emean in SWE was highly reproducible within and between observers.

  13. DCE-MRI and DWI Integration for Breast Lesions Assessment and Heterogeneity Quantification

    Directory of Open Access Journals (Sweden)

    C. Andrés Méndez

    2012-01-01

    Full Text Available In order to better predict and follow treatment responses in cancer patients, there is growing interest in noninvasively characterizing tumor heterogeneity based on MR images possessing different contrast and quantitative information. This requires mechanisms for integrating such data and reducing the data dimensionality to levels amenable to interpretation by human readers. Here we propose a two-step pipeline for integrating diffusion and perfusion MRI that we demonstrate in the quantification of breast lesion heterogeneity. First, the images acquired with the two modalities are aligned using an intermodal registration. Dissimilarity-based clustering is then performed exploiting the information coming from both modalities. To this end an ad hoc distance metric is developed and tested for tuning the weighting for the two modalities. The distributions of the diffusion parameter values in subregions identified by the algorithm are extracted and compared through nonparametric testing for posterior evaluation of the tissue heterogeneity. Results show that the joint exploitation of the information brought by DCE and DWI leads to consistent results accounting for both perfusion and microstructural information yielding a greater refinement of the segmentation than the separate processing of the two modalities, consistent with that drawn manually by a radiologist with access to the same data.

  14. Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring.

    Science.gov (United States)

    Sadigh, Gelareh; Carlos, Ruth C; Neal, Colleen H; Dwamena, Ben A

    2012-05-01

    There has been controversy regarding the accuracy of breast ultrasound elastography (USE) compared to conventional B-mode Ultrasound (USB). The purpose of this study was to conduct a direct comparative effectiveness analysis of USB versus USE or their combination in differentiating breast lesions through systematically reviewing recent literature. An extensive literature search of PubMed and other medical and general purpose databases from inception through August 2011 was conducted. Published studies that reported a direct comparison of the diagnostic performance of USE, using elasticity score versus USB, using breast imaging reporting and data system (BIRADS) for characterization of focal breast lesions were included. Summary diagnostic performance measures were assessed for each of the tests and their combination using bivariate generalized linear mixed modeling. The two tests were combined as: (1) conjunctive, where the outcome of the combination of tests is positive only if both test results are positive; (2) disjunctive, where the outcome of a combination of tests is negative only if both tests are negative. Twenty nine studies provided relevant information on 5,511 breast masses (2,065 cancers, 3,446 benign lesions). Sensitivity of USB, USE, and their conjunctive and disjunctive combinations were 96% (95% credible interval (CrI), 93-98%), 79% (95% CrI, 74-83%), 73% (95% CrI, 67-78%), and 99% (95% CrI, 98-99%), respectively. Specificity of USB, USE, and their conjunctive and disjunctive combinations were 70% (95% CrI, 55-83%), 88% (95% CrI, 82-92%), 97% (95% CrI, 95-99%), and 56% (95% CrI, 43-69%), respectively. The application of USE as a single test is not superior to USB alone. However, in low risk patients it is recommended to perform an USE following a positive USB result to decrease the rate of unnecessary biopsies.

  15. Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN

    DEFF Research Database (Denmark)

    Rindal, D Brad; Gordan, Valeria V; Litaker, Mark S

    2010-01-01

    To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use.......To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use....

  16. Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T.

    Science.gov (United States)

    An, Yeong Yi; Kim, Sung Hun; Kang, Bong Joo

    2017-01-01

    To determine the added value of qualitative analysis as an adjunct to quantitative analysis for the discrimination of benign and malignant lesions in patients with breast cancer using diffusion-weighted imaging (DWI) with readout-segmented echo-planar imaging (rs-EPI). A total of 99 patients with 144 lesions were reviewed from our prospectively collected database. DWI data were obtained using rs-EPI acquired at 3.0 T. The diagnostic performances of DWI in the qualitative, quantitative, and combination analyses were compared with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Additionally, the effect of lesion size on the diagnostic performance of the DWI combination analysis was evaluated. The strongest indicators of malignancy on DWI were a heterogeneous pattern (P = 0.005) and an apparent diffusion coefficient (ADC) value 1 cm group (80% vs. 95.6%, P = 0.034). Qualitative analysis of tumor morphology was diagnostically applicable on DWI using rs-EPI. This qualitative analysis adds value to quantitative analyses for lesion characterization in patients with breast cancer.

  17. Localization techniques for guided surgical excision of non-palpable breast lesions.

    Science.gov (United States)

    Chan, Benjamin K Y; Wiseberg-Firtell, Jill A; Jois, Ramesh H S; Jensen, Katrin; Audisio, Riccardo A

    2015-12-31

    Breast cancer is the most common form of cancer and the second leading cause of death amongst women in Europe. Amongst five invasive cancers per 1000 women detected in screening, 2.7 were Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal from the earliest available date up to 30 March 2015. We also handsearched recent conference proceedings and sought information from experts in the field. Two review authors, BC and RJ, independently screened by title and abstract the studies we had identified through the search strategy; when this was inconclusive, they examined the full-text article for inclusion. We resolved any discrepancies regarding eligibility by discussion with a third review author, RA. Three review authors, BC, JW, and RJ, independently extracted data using a standardized data sheet. We performed all analyses using Review Manager (RevMan) or the R meta package, and in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. We reported results via a graphical assessment using forest plots showing the study estimates. We considered and discussed additional subgroup and sensitivity analyses. We identified 11 randomized controlled trials (RCTs) that met the inclusion criteria of this Cochrane review and included eight trials in the meta-analyses. Six RCTs compared radioguided occult lesion localization (ROLL) versus WGL, and two RCTs compared radioactive iodine ((125)I) seed localization (RSL) versus WGL. Of the three remaining trials, one RCT compared cryo-assisted techniques (CAL) versus WGL, one compared intraoperative ultrasound-guided lumpectomy (IOUS) versus WGL, and one compared modified ROLL technique in combination with methylene dye (RCML) versus WGL. Of the trials we included in the meta-analysis, there were a total of 1273 participants with non-palpable breast lesions (627 participants (WGL); 443 participants (ROLL); and 203 participants (RSL)). The participant population varied

  18. Dynamic contrast-enhanced MR imaging in screening detected microcalcification lesions of the breast: is there any value?

    Science.gov (United States)

    Uematsu, Takayoshi; Yuen, Sachiko; Kasami, Masako; Uchida, Yoshihiro

    2007-07-01

    To prospectively evaluate whether dynamic contrast-enhanced magnetic resonance (MR) imaging findings can help predict the presence of malignancy when screening detected microcalcification lesions, and its contribution to patient management of stereotactic vacuum-assisted breast biopsy (SVAB). Dynamic contrast-enhanced breast MR imaging was performed when screening 100 detected microcalcification lesions not visualized by ultrasonography with 11-gauge SVAB. Definitive surgery was performed on all patients with the biopsy resulting in the diagnosis of breast cancer or atypical ductal hyperplasia (ADH). Positive predictive values (PPVs) and negative predictive values (NPVs) were calculated on the basis of a BI-RADS (Breast Imaging Reporting and Data System) category and the absence or presence of contrast uptake in the area of microcalcification. The BI-RADS mammography category correlated with the diagnosis of breast cancer (ADH excluded): category 3 = 7% (4/55); category 4 = 48% (13/27); category 5 = 94% (17/18). After dynamic contrast-enhanced MR imaging, three of four malignancies with BI-RADS mammography category 3 were diagnosed as true positive. Therefore, the PPV of BI-RADS mammography category 3 with MR imaging was 1.8% (1/55). The PPV of contrast uptake of MR imaging was 86% (32/37), significantly higher than the 67% (30/45) PPV of BI-RADS mammography 4 and 5 (P = 0.033). The NPV of BI-RADS mammography 3 was 93% (51/55) versus 97% (61/63) NPV of MR imaging (P = 0.167). In the evaluation of screening detected microcalcification lesions, dynamic contrast-enhanced breast MR imaging provides additional information with high PPV and NPV, and may therefore offer an alternative to SVAB for women who do not want to undergo SVAB with equivocal findings following full diagnostic mammographic assessment, but breast MR imaging with imperfect PPV and NPV cannot replace SVAB. Dynamic contrast-enhanced breast MR imaging can demonstrate malignant microcalcifications

  19. Elevated expression of the myc gene in human benign and malignant breast lesions compared to normal tissue.

    Science.gov (United States)

    Spandidos, D A; Pintzas, A; Kakkanas, A; Yiagnisis, M; Mahera, H; Patra, E; Agnantis, N J

    1987-01-01

    Expression of the c-myc gene in human breast lesions and in adjacent normal tissue was studied by immunohistochemical analysis. The previously described monoclonal antibody Myc1-9E10 (1) which recognizes the p62 c-myc protein was used in paraffin tissue sections. A total of 101 cases of breast disease examined included 38 simple and complex cystic disease, 18 simple and hyperplastic fibroadenomas, 36 ductal and lobular carcinomas and 9 in situ carcinomas. Whereas the adjacent normal tissue was slightly positive, 25 out of 38 cystic disease, 7 out of 18 fibroadenoma, 36 out of 36 carcinoma and 9 out of 9 in situ carcinoma specimens showed moderate to high levels of p62 c-myc expression as indicated by staining intensity. These results suggest that the c-myc protein may play a role in breast neoplasia.

  20. Identification of error making patterns in lesion detection on digital breast tomosynthesis using computer-extracted image features

    Science.gov (United States)

    Wang, Mengyu; Zhang, Jing; Grimm, Lars J.; Ghate, Sujata V.; Walsh, Ruth; Johnson, Karen S.; Lo, Joseph Y.; Mazurowski, Maciej A.

    2016-03-01

    Digital breast tomosynthesis (DBT) can improve lesion visibility by eliminating the issue of overlapping breast tissue present in mammography. However, this new modality likely requires new approaches to training. The issue of training in DBT is not well explored. We propose a computer-aided educational approach for DBT training. Our hypothesis is that the trainees' educational outcomes will improve if they are presented with cases individually selected to address their weaknesses. In this study, we focus on the question of how to select such cases. Specifically, we propose an algorithm that based on previously acquired reading data predicts which lesions will be missed by the trainee for future cases (i.e., we focus on false negative error). A logistic regression classifier was used to predict the likelihood of trainee error and computer-extracted features were used as the predictors. Reader data from 3 expert breast imagers was used to establish the ground truth and reader data from 5 radiology trainees was used to evaluate the algorithm performance with repeated holdout cross validation. Receiver operating characteristic (ROC) analysis was applied to measure the performance of the proposed individual trainee models. The preliminary experimental results for 5 trainees showed the individual trainee models were able to distinguish the lesions that would be detected from those that would be missed with the average area under the ROC curve of 0.639 (95% CI, 0.580-0.698). The proposed algorithm can be used to identify difficult cases for individual trainees.

  1. Can concurrent core biopsy and fine needle aspiration biopsy improve the false negative rate of sonographically detectable breast lesions?

    Directory of Open Access Journals (Sweden)

    Chang Tsai-Wang

    2010-07-01

    Full Text Available Abstract Background The aims of this study were to determine the accuracy of concurrent core needle biopsy (CNB and fine needle aspiration biopsy (FNAB for breast lesions and to estimate the false-negative rate using the two methods combined. Methods Over a seven-year period, 2053 patients with sonographically detectable breast lesions underwent concurrent ultrasound-guided CNB and FNAB. The sonographic and histopathological findings were classified into four categories: benign, indeterminate, suspicious, and malignant. The histopathological findings were compared with the definitive excision pathology results. Patients with benign core biopsies underwent a detailed review to determine the false-negative rate. The correlations between the ultrasonography, FNAB, and CNB were determined. Results Eight hundred eighty patients were diagnosed with malignant disease, and of these, 23 (2.5% diagnoses were found to be false-negative after core biopsy. After an intensive review of discordant FNAB results, the final false-negative rate was reduced to 1.1% (p-value = 0.025. The kappa coefficients for correlations between methods were 0.304 (p-value p-value p-value Conclusions Concurrent CNB and FNAB under ultrasound guidance can provide accurate preoperative diagnosis of breast lesions and provide important information for appropriate treatment. Identification of discordant results using careful radiological-histopathological correlation can reduce the false-negative rate.

  2. Usefulness of ultrasound elastography in reducing the number of Breast Imaging Reporting and Data System category 3 lesions on ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya; Lim, Ji He; Moon, Woo Kyung [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2014-04-15

    To evaluate the negative predictive value (NPV) of ultrasound (US) elastography for non-palpable Breast Imaging Reporting and Data System (BI-RADS) category 3 lesions on ultrasonography and to determine whether US elastography is helpful in reducing the number of BI-RADS category 3 lesions on ultrasonography. Two hundred seventy-six consecutive, non-palpable BI-RADS category 3 lesions in 256 women who underwent US elastography and US-guided core biopsy, and who had at least 12 months of follow-up data, comprised our study group. The BI-RADS final assessment category and elasticity score were prospectively and independently classified. The rate of malignancy and NPV according to the elasticity score were analysed. We also investigated whether there was a subset of BI-RADS category 3 lesions that were of benign histology but negative on elastography. Of the 276 non-palpable BI-RADS category 3 lesions, three lesions (1.0%) were finally confirmed as ductal carcinomas in situ. No cancers were found in the remaining 273 lesions with benign biopsy histology at a mean follow-up of 39.4 months (range, 12 to 72 months). The NPV of a negative elasticity score (elasticity score of 1) was 99.3% (165 of 166). If BI-RADS category 3 lesions showing a negative elasticity score were downgraded to BI-RADS category 2, 60.4% (165 of 273) of them with benign histology could have been safely followed without biopsy with an increased malignancy rate from 1% (3 of 276) to 1.8% (2 of 110), which is not significantly higher (P=0.626). US elastography has the potential to reduce the number of BI-RADS category 3 lesions on ultrasonography.

  3. The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women.

    Science.gov (United States)

    Vourtsis, Athina; Kachulis, Aspasia

    2017-08-21

    This study aimed to evaluate automated breast ultrasound (ABUS) compared to hand-held traditional ultrasound (HHUS) in the visualisation and BIRADS characterisation of breast lesions. From January 2016 to January 2017, 1,886 women with breast density category C or D (aged 48.6±10.8 years) were recruited. All participants underwent ABUS and HHUS examination; a subcohort of 1,665 women also underwent a mammography. The overall agreement between HHUS and ABUS was 99.8 %; kappa=0.994, pvisualisation and characterisation of breast lesions. ABUS seemed to outperform HHUS in the detection of architectural distortion on the coronal plane and can supplement mammography in the detection of non-calcified carcinomas in women with dense breasts. • The new generation of ABUS yields comparable results to HHUS. • ABUS seems superior to HHUS in detecting architectural distortions. • In dense breasts, supplemental ABUS to mammography detects additional cancers.

  4. Application of Localization and Needle Placement Guided by Mammographic, Ultrasound and Fiberoptic Ductoscopy for Resection of Non-palpable Breast Lesions.

    Science.gov (United States)

    Yuan, Zhu; Qu, Xiang; Zhang, Zhong-Tao; Jiang, Wen G

    2017-08-01

    To evaluate the usefulness of localization needles under mammographic, ultrasound or fiberoptic ductoscopy guidance for non-palpable breast lesions. Eighty-three patients undergoing needle localization and biopsy of non-palpable breast lesions under mammographic, ultrasound or fiberoptic ductoscopy guidance from June 2013 to December 2014 in Beijing Friendship Hospital were included in the study. The preoperative imaging assessment, application of localization needles, surgical operation and pathological examination were recorded and analyzed retrospectively. A total of 83 localization and biopsies were carried out, of which 27 were performed under mammographic guidance, 32 under ultrasound guidance and 24 under fiberoptic ductoscopy guidance. Twenty-seven cases of breast microcalcifications were localized under mammographic guidance and surgically removed, of which eight cases were pathologically diagnosed as malignant. Thirty-two cases of non-palpable breast lesions were localized under ultrasound guidance and 30 pathologically diagnosed, of these, four cases were pathologically diagnosed as malignant. Twenty-four cases of intraductal space-occupying lesions were localized under ductoscopy guidance and surgically removed, of which five cases were pathologically diagnosed as malignant. Utilization of localization needles under mammographic, ultrasound or fiberoptic ductoscopy guidance for non-palpable breast lesions is a safe and effective procedure, and is helpful in the diagnosis of breast cancer. With the help of this procedure, more malignant lesions can be localized and surgically removed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  5. Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Chunling; Liu, Zaiyi; Zhang, Jine; He, Hui; Zhang, Shuixing; Liang, Changhong [Guangdong General Hospital/Guangdong Academy of Medical Sciences, Department of Radiology, GuangZhou (China); Wang, Kun [Guangdong General Hospital/Guangdong Academy of Medical Sciences, Department of Breast Cancer, Cancer Center, GuangZhou (China); Chan, Queenie [Philips Healthcare, 6/F, Core Building 1, 1 Science Park East Avenue, Hong Kong Science Park, Shatin, New Territories, Hong Kong (China)

    2016-11-15

    To compare diagnostic performance for breast lesions by quantitative parameters derived from intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and to explore whether correlations exist between these parameters. IVIM and DCE MRI were performed on a 1.5-T MRI scanner in patients with suspicious breast lesions. Thirty-six breast cancers and 23 benign lesions were included in the study. Quantitative parameters from IVIM (D, f and D*) and DCE MRI (K{sup trans}, K{sub ep}, V{sub e} and V{sub p}) were calculated and compared between malignant and benign lesions. Spearman correlation test was used to evaluate correlations between them. D, f, D* from IVIM and K{sup trans}, K{sub ep}, V{sub p} from DCE MRI were statistically different between breast cancers and benign lesions (p < 0.05, respectively) and D demonstrated the largest area under the receiver-operating characteristic curve (AUC = 0.917) and had the highest specificity (83 %). The f value was moderately statistically correlated with V{sub p} (r = 0.692) and had a poor correlation with K{sup trans} (r = 0.456). IVIM MRI is useful in the differentiation of breast lesions. Significant correlations were found between perfusion-related parameters from IVIM and DCE MRI. IVIM may be a useful adjunctive tool to standard MRI in diagnosing breast cancer. (orig.)

  6. Solitary Pulmonary Lesion in Patients with History of Malignancy: Primary Lung Cancer or Metastatic Cancer?

    Science.gov (United States)

    Jin, Ke; Wang, Kexi; Zhang, Huizhong; Pan, Yuejiang; Cao, Dexiong; Wang, Minghui; Chen, Ju; Wu, Duoguang; Chen, Boshen; Xie, Xuan

    2018-02-07

    Defining the status of solitary pulmonary lesion (SPL) in patients with history of malignancy is important because primary lung cancer (PLC) or intrapulmonary metastasis might indicate different surgical strategies. The aim of this study is to identify factors related to the status of these lesions and construct a clinical model to estimate the pretest probability of PLC. From January 2005 to January 2016, 104 patients with previous malignancy and suitable for surgery were retrospectively studied. Univariate and multivariate analyses were performed to identify possible factors related to SPLs. A nomogram was constructed to differentiate PLC from intrapulmonary metastasis. Ninety-seven (93.3%) patients were diagnosed as malignant postoperatively, including 61 patients with intrapulmonary metastasis and 36 patients with PLC. Multivariate analysis showed that site of primary tumor [head and neck squamous cell cancer: odds ratio (OR) = 28.509, P = 0.006; genitourinary cancer: OR = 23.928, P = 0.012], negative lymph node status of primary tumor (OR = 3.154, P = 0.038), spiculation of SPL (OR = 3.972, P = 0.022), and central location of SPL (OR = 4.679, P = 0.026) were four independent factors differentiating PLC from intrapulmonary metastasis. All of these were included in the nomogram. The C-index of the nomogram for predicting probability was 0.82. Incidence of malignant SPLs was fairly high in patients with history of malignancy. A nomogram including site and lymph node status of primary tumor, and spiculation and location of SPL might be a good tool for differentiating PLC from intrapulmonary metastasis preoperatively and guiding treatment.

  7. Predicting lymphatic drainage patterns and primary tumour location in patients with breast cancer.

    Science.gov (United States)

    Blumgart, Evan I; Uren, Roger F; Nielsen, Poul M F; Nash, Martyn P; Reynolds, Hayley M

    2011-11-01

    Detailed knowledge of the lymphatic drainage of the breast is limited. Lymphoscintigraphy is a technique used during breast cancer treatment to accurately map patterns of lymphatic drainage from the primary tumour to the draining lymph nodes. This study aimed to create a statistical model to analyse the spread of breast cancer and primary tumour location using a large lymphoscintigraphy database, and visualise the results with a novel computational model. This study was based on lymphoscintigraphy data from 2,304 breast cancer patients treated at the Royal Prince Alfred Hospital Medical Centre in Sydney, Australia. Bayesian inferential techniques were implemented to estimate the probabilities of lymphatic drainage from each region of the breast to each draining node field, to multiple node fields, and to determine probabilities of tumour prevalence in each breast region. A finite element model of the torso and discrete model of the draining node fields were created to visualise these data and a software tool was developed to display the results ( www.abi.auckland.ac.nz/breast-cancer ). Results confirmed that lymphatic drainage is most likely to occur to the axillary node field, and that there is significant likelihood of drainage to the internal mammary node field. The likelihood of lymphatic drainage from the whole breast to the axillary, internal mammary, infraclavicular, supraclavicular and interpectoral node fields were 98.2, 35.3, 1.7, 3.1, and 0.7%, respectively; whilst the probability of lymphatic drainage to multiple node fields was estimated to be 36.4%. Additionally, primary tumours are most likely to develop in the upper regions of the breast. The models developed provide quantitative estimates of lymphatic drainage of the breast, giving important insights into understanding breast cancer metastasis and have the potential to benefit both clinicians and patients during breast cancer diagnosis and treatment.

  8. Whole-body FDG PET/CT is more accurate than conventional imaging for staging primary breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Riegger, C.; Heusner, T.A. [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); University of Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Herrmann, J.; Hahn, S.; Lauenstein, T. [University of Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Nagarajah, J.; Bockisch, A. [University of Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Hecktor, J.; Kuemmel, S. [University of Duisburg-Essen, Medical Faculty, Department of Gynecology and Obstetrics, Essen (Germany); Otterbach, F. [University of Duisburg-Essen, Institute of Pathology and Neuropathology, Essen (Germany); Antoch, G. [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany)

    2012-05-15

    This retrospective study aimed (1) to compare the diagnostic accuracy of whole-body FDG PET/CT for initial breast cancer staging with the accuracy of a conventional, multimodal imaging algorithm, and (2) to assess potential alteration in patient management based on the FDG PET/CT findings. Patients with primary breast cancer (106 women, mean age 57 {+-} 13 years) underwent whole-body FDG PET/CT and conventional imaging (X-ray mammography, MR mammography, chest plain radiography, bone scintigraphy and breast, axillary and liver ultrasonography). The diagnostic accuracies of FDG PET/CT and a conventional algorithm were compared. Diagnostic accuracy was assessed in terms of primary tumour detection rate, correct assessment of primary lesion focality, T stage and the detection rates for lymph node and distant metastases. Histopathology, imaging or clinical follow-up served as the standards of reference. FDG PET/CT was significantly more accurate for detecting axillary lymph node and distant metastases (p = 0.0125 and p < 0.005, respectively). No significant differences were detected for other parameters. Synchronous tumours or locoregional extraaxillary lymph node or distant metastases were detected in 14 patients (13%) solely by FDG PET/CT. Management of 15 patients (14%) was altered based on the FDG PET/CT findings, including 3 patients with axillary lymph node metastases, 5 patients with extraaxillary lymph node metastases, 4 patients with distant metastases and 3 patients with synchronous malignancies. Full-dose, intravenous contrast-enhanced FDG PET/CT was more accurate than conventional imaging for initial breast cancer staging due to the higher detection rate of metastases and synchronous tumours, although the study had several limitations including a retrospective design, a possible selection bias and a relevant false-positive rate for the detection of axillary lymph node metastases. FDG PET/CT resulted in a change of treatment in a substantial proportion of

  9. Effectiveness of core biopsy for screen-detected breast lesions under 10 mm: implications for surgical management.

    Science.gov (United States)

    Farshid, Gelareh; Downey, Peter; Pieterse, Steve; Gill, P Grantley

    2017-09-01

    Technical advances have improved the detection of small mammographic lesions. In the context of mammographic screening, accurate sampling of these lesions by percutaneous biopsy is crucial in limiting diagnostic surgical biopsies, many of which show benign results. Women undergoing core biopsy between January 1997 and December 2007 for core histology, 345 women (43.0%) were immediately cleared of malignancy and 300 (37.4%) were referred for definitive cancer treatment. A further 157 women (19.6%) required diagnostic surgical biopsy because of indefinite or inadequate core results or radiological-pathological discordance, and one woman (0.1%) needed further imaging in 12 months. The open biopsies were malignant in 46 (29.3%) cases. The positive predictive value of malignant core biopsy was 100%. The negative predictive value for benign core results was 97.7%, and the false-negative rate was 2.6%. The lesion could not be visualized after core biopsy in 5.1% of women and in 4.0% of women with malignant core biopsies excision specimens did not contain residual malignancy. Excessive delays in surgery because of complications of core biopsy were not reported. Even at this small size range, core biopsy evaluation of screen-detected breast lesions is highly effective and accurate. A lesion miss rate of 3.1% and under-representation of lesions on core samples highlight the continued need for multidisciplinary collaboration and selective use of diagnostic surgical biopsy. © 2015 Royal Australasian College of Surgeons.

  10. Hybrid ANN optimized artificial fish swarm algorithm based classifier for classification of suspicious lesions in breast DCE-MRI

    Science.gov (United States)

    Janaki Sathya, D.; Geetha, K.

    2017-12-01

    Automatic mass or lesion classification systems are developed to aid in distinguishing between malignant and benign lesions present in the breast DCE-MR images, the systems need to improve both the sensitivity and specificity of DCE-MR image interpretation in order to be successful for clinical use. A new classifier (a set of features together with a classification method) based on artificial neural networks trained using artificial fish swarm optimization (AFSO) algorithm is proposed in this paper. The basic idea behind the proposed classifier is to use AFSO algorithm for searching the best combination of synaptic weights for the neural network. An optimal set of features based on the statistical textural features is presented. The investigational outcomes of the proposed suspicious lesion classifier algorithm therefore confirm that the resulting classifier performs better than other such classifiers reported in the literature. Therefore this classifier demonstrates that the improvement in both the sensitivity and specificity are possible through automated image analysis.

  11. Imaging breast lesions using the Twente Photoacoustic Mammoscope: ongoing clinical experience

    NARCIS (Netherlands)

    Heijblom, M.; Piras, D.; Xia, W.; van Hespen, Johannes C.G.; Klaase, J.M.; van den Engh, F.M.; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang

    2012-01-01

    Current imaging modalities are often not able to detect early stages of breast cancer with high imaging contrast. Visualizing malignancy-associated increased hemoglobin concentrations might improve breast cancer diagnosis. Photoacoustic imaging can visualize hemoglobin in tissue with optical

  12. A simple classification system (the Tree flowchart) for breast MRI can reduce the number of unnecessary biopsies in MRI-only lesions

    Energy Technology Data Exchange (ETDEWEB)

    Woitek, Ramona; Spick, Claudio; Schernthaner, Melanie; Kapetas, Panagiotis; Bernathova, Maria; Furtner, Julia; Pinker, Katja; Helbich, Thomas H.; Baltzer, Pascal A.T. [Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy, Vienna (Austria); Rudas, Margaretha [Medical University of Vienna, Clinical Institute of Pathology, Vienna (Austria)

    2017-09-15

    To assess whether using the Tree flowchart obviates unnecessary magnetic resonance imaging (MRI)-guided biopsies in breast lesions only visible on MRI. This retrospective IRB-approved study evaluated consecutive suspicious (BI-RADS 4) breast lesions only visible on MRI that were referred to our institution for MRI-guided biopsy. All lesions were evaluated according to the Tree flowchart for breast MRI by experienced readers. The Tree flowchart is a decision rule that assigns levels of suspicion to specific combinations of diagnostic criteria. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy. To assess reproducibility by kappa statistics, a second reader rated a subset of 82 patients. There were 454 patients with 469 histopathologically verified lesions included (98 malignant, 371 benign lesions). The area under the curve (AUC) of the Tree flowchart was 0.873 (95% CI: 0.839-0.901). The inter-reader agreement was almost perfect (kappa: 0.944; 95% CI 0.889-0.998). ROC analysis revealed exclusively benign lesions if the Tree node was ≤2, potentially avoiding unnecessary biopsies in 103 cases (27.8%). Using the Tree flowchart in breast lesions only visible on MRI, more than 25% of biopsies could be avoided without missing any breast cancer. (orig.)

  13. Identification of Chromosomes Alterations in Primary Breast Cancer Using Premature Chromosome Condensation

    National Research Council Canada - National Science Library

    Griffin, Constance

    2000-01-01

    .... We are developing a new method, premature chromosome condensation (PCC),using mitotic Xenopus extracts that will allow us to obtain G-banded karyotypes from primary, uncultured breast cancer specimens...

  14. Lymphosarcoma of the Breast

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... Lymphoma of the female breast is rarely a primary lesion. It may be found without manifestations of the disease elsewhere in the body. The types include the reticular cell, the histiocytic, the mixed and the follicular type of lesion. Usually the disease disseminates to the other parts of the body, but should it be ...

  15. Bisphosphonate use and risk of recurrence, second primary breast cancer, and breast cancer mortality in a population-based cohort of breast cancer patients.

    Science.gov (United States)

    Malone, Kathleen E; Korde, Larissa A; Doody, David R; Hsu, Li; Porter, Peggy L

    2017-12-18

    Studies of bisphosphonate use and breast cancer recurrence have produced conflicting results. Analyses of large adjuvant trials suggest that bisphosphonates reduce recurrence risk only in postmenopausal women. We assessed the effect of non-cancer treatment related bisphosphonate use on breast cancer outcomes in a population-based prognostic cohort of women with early stage invasive breast cancer (n=1813; median follow-up 11.8 years). Using medical record, interview, and cancer registry data, information was assembled on risk factors, cancer treatment, medication use, and outcomes. Statistical analyses utilized Cox proportional hazards regression models. Bisphosphonate use was associated with a significantly decreased risk of a breast cancer event (locoregional/distant recurrence or second primary breast cancer) (HR ever use = 0.65, 95% CI 0.47-0.90). Reduced risks were observed in both pre/peri and postmenopausal women, in both ER-negative and ER-positive breast cancers, and for both earlier and later recurrences. Bisphosphonate use was also associated with a significantly decreased risk of breast cancer mortality (HR 0.40, 95% CI 0.23-0.69). Bisphosphonate use was associated with a reduction in risk of breast cancer events and improved breast cancer specific survival in women with early stage breast cancer. We hypothesize that the benefit of bisphosphonates on breast cancer outcomes may be present primarily in women with low bone density and regardless of menopausal status. Our findings suggest further consideration of bone density status as a modifier of bisphosphonate's potential beneficial benefits on breast cancer outcomes is warranted. Copyright ©2017, American Association for Cancer Research.

  16. Could HER2 Heterogeneity Open New Therapeutic Options in Patients with HER2-Primary Breast Cancer

    Science.gov (United States)

    2016-10-01

    metastases in patients with HER2-negative primary breast cancer using the 89Zr-DFO-trastuzumab PET/CT. Ulaner et al, Journal of Nuclear Medicine 2016, e...HER2-negative primary breast cancer using 89Zr-DFO-trastuzumab, Ulaner et al, Annual Meeting of the Society of Nuclear Medicine and Molecular...and presentations  Journal publications. Ulaner et al, Journal of Nuclear Medicine 2016, e-published ahead of print, PMID: 27151988  Books or other

  17. Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

    Directory of Open Access Journals (Sweden)

    Rachel E. Ellsworth

    2015-01-01

    Full Text Available Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome ( P = 0.009. In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance.

  18. Cluster analysis of signal-intensity time course in dynamic breast MRI: does unsupervised vector quantization help to evaluate small mammographic lesions?

    Energy Technology Data Exchange (ETDEWEB)

    Leinsinger, Gerda; Schlossbauer, Thomas; Scherr, Michael; Lange, Oliver; Reiser, Maximilian; Wismueller, Axel [Institute for Clinical Radiology University of Munich, Munich (Germany)

    2006-05-15

    We examined whether neural network clustering could support the characterization of diagnostically challenging breast lesions in dynamic magnetic resonance imaging (MRI). We examined 88 patients with 92 breast lesions (51 malignant, 41 benign). Lesions were detected by mammography and classified Breast Imaging and Reporting Data System (BIRADS) III (median diameter 14 mm). MRI was performed with a dynamic T1-weighted gradient echo sequence (one precontrast and five postcontrast series). Lesions with an initial contrast enhancement {>=}50% were selected with semiautomatic segmentation. For conventional analysis, we calculated the mean initial signal increase and postinitial course of all voxels included in a lesion. Secondly, all voxels within the lesions were divided into four clusters using minimal-free-energy vector quantization (VQ). With conventional analysis, maximum accuracy in detecting breast cancer was 71%. With VQ, a maximum accuracy of 75% was observed. The slight improvement using VQ was mainly achieved by an increase of sensitivity, especially in invasive lobular carcinoma and ductal carcinoma in situ (DCIS). For lesion size, a high correlation between different observers was found (R{sup 2} = 0.98). VQ slightly improved the discrimination between malignant and benign indeterminate lesions (BIRADS III) in comparison with a standard evaluation method. (orig.)

  19. Primary hydatid disease of the breast clinically masquerading as a galactocele: A case report.

    Science.gov (United States)

    Siddiqui, Bushra; Faridi, Shahbaz Habib; Arif, Sayeedul Hasan; Aslam, Mohammad

    2015-01-01

    We report a rare case of a 30-year-old breastfeeding woman who presented to our surgical outpatient department with complaints of a gradually enlarging lump in her left breast for the last 2 months. She also complained of difficulty in breastfeeding for 1 week. On examination, the right breast was normal but there was a 4 cm × 4 cm retroareolar soft lump in her left breast. Examination of the bilateral axilla was normal. A provisional diagnosis of galactocele was made and the patient was subjected to ultrasonic mammography and fine needle aspiration cytology (FNAC). Ultrasonic mammography of the left breast showed a heterogeneous, hypoechoic lesion with thick septations and internal echoes suggestive of a complex cystic lesion, leading to a differential diagnosis of either hydatid cyst or breast abscess. On FNAC, the aspirate was not milky and cytological examination was performed, which revealed hydatid scolices, hooklets, foamy macrophages and granular debris, leading to the final diagnosis of hydatid cyst of the breast. The patient was investigated further but there were no cysts at any other site. Chemotherapy with albendazole was started and surgery was performed after 1 month. Histopathology further confirmed the diagnosis. Owing to the rarity of presentation, this case is being reported here.

  20. Genomic and phenotypic profiles of two Brazilian breast cancer cell lines derived from primary human tumors

    DEFF Research Database (Denmark)

    Corrêa, Natássia C R; Kuasne, Hellen; Faria, Jerusa A Q A

    2013-01-01

    Breast cancer is the most common type of cancer among women worldwide. Research using breast cancer cell lines derived from primary tumors may provide valuable additional knowledge regarding this type of cancer. Therefore, the aim of this study was to investigate the phenotypic profiles of MACL-1...... and MGSO-3, the only Brazilian breast cancer cell lines available for comparative studies. We evaluated the presence of hormone receptors, proliferation, differentiation and stem cell markers, using immunohistochemical staining of the primary tumor, cultured cells and xenografts implanted...

  1. Estrogen receptor-positive primary squamous cell carcinoma of the breast

    Directory of Open Access Journals (Sweden)

    Abby M. Pribish, BS

    2017-06-01

    Full Text Available Pure primary squamous cell carcinoma of the breast (SCCB represents around 0.1% of breast carcinomas. Diagnosis requires independence from adjacent skin without metastatic disease. SCCB is often large at presentation with nonspecific mammographic and ultrasound findings. It is typically hormone receptor negative and aggressive. Mastectomy and adjuvant chemotherapy is the most common treatment, although treatment guidelines are not well established. We present a case of pure primary SCCB detected by high risk screening mammogram and treated with breast conserving surgery, chemotherapy, and radiation. We discuss clinical, radiologic, and pathologic findings.

  2. Primary breast actinomyces simulating malignancy: A case diagnosed by fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Renu Thambi

    2012-01-01

    Full Text Available We report a case of primary actinomycosis of breast diagnosed by fine needle aspiration cytology (FNAC in a postmenopausal lady who presented with a clinical impression of malignancy. Resolution of infection while conserving the breast was achieved by timely diagnosis and effective antibiotic therapy. The literature reports that primary actinomycosis of the breast is very rare after menopause, with only very few cases found after extensive search. It is imperative that this condition should be considered in the differential diagnosis of malignancy. The effectiveness of cell block sections in the final diagnosis is also highlighted.

  3. Concordance between pre-operative and post-operative assessments of primary caries lesion depth: results from The Dental PBRN

    Science.gov (United States)

    Nascimento, Marcelle M.; Bader, James D.; Qvist, Vibeke; Litaker, Mark S.; Williams, O. Dale; Rindal, Brad; Fellows, Jeffrey L.; Gilbert, Gregg H.; Gordan, Valeria V.

    2010-01-01

    Summary This study investigated the concordance between pre- and post-operative assessments of primary caries lesions depths by dentists from The Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org). A total of 229 DPBRN dentists collected data on 8,351 consecutive restorations inserted due to primary caries in 5,810 patients. Dentists estimated the pre-operative depth of caries lesions based on the diagnostic methods they typically used. The pre-operative depth was then compared to the post-operative depth, which dentists determined using actual clinical observation. Both estimated and observed depths were recorded as being in the outer ½ (E1) or inner ½ (E2) of enamel, or in the outer ⅓ (D1), middle ⅓ (D2) or inner ⅓ (D3) of dentin. Most restorations were placed to treat lesions that were pre-operatively assessed as extending to the D1 (53%) and D2 (25%) depths. Of the restored caries lesions, 10% were pre-operatively assessed as being limited to E2 depth and 3% to E1 depth. The majority of the restored enamel lesions were located on occlusal surfaces. Pre-operative estimates of caries lesion depth were more concordant with post-operative depths when the lesion was at an advanced stage: 88% concordance at the D3 depth; compared to 54% concordance at the E1 depth. DPBRN dentists can discriminate caries lesions at different depths, but the accuracy of their depth assessments was higher for dentin than for enamel lesions. In general, DPBRN dentists were more likely to underestimate than to overestimate depth of caries lesions, and the extent of underestimation was greater for enamel than for dentin lesions. PMID:20672722

  4. Primary hormone treatment in postmenopausal women with breast cancer.

    Science.gov (United States)

    Maciá Escalante, S; Pons Sanz, V; Rodríguez Lescure, A; Ballester Navarro, I; Carrato Mena, A

    2006-05-01

    Clinical benefits of hormone therapy in patients with hormone-sensitive tumors have been clearly established. Postmenopausal women with positive hormone receptors represent the largest group of patients in whom early stage breast cancer is diagnosed. Third-generation aromatase inhibitors (letrozole, anastrozole, and exemestane) are active and well tolerated in postmenopausal women with hormone-sensitive metastasic or locally advanced breast cancer as first or second line treatment. These are also valuable agents in the neoadjuvant setting in postmenopausal women, and even as single treatment in localized breast tumors in women not amenable to surgery.

  5. GATA3 immunohistochemistry expression in histologic subtypes of primary breast carcinoma and metastatic breast carcinoma cytology.

    Science.gov (United States)

    Deftereos, Georgios; Sanguino Ramirez, Angela M; Silverman, Jan F; Krishnamurti, Uma

    2015-09-01

    GATA3 plays a role in cell proliferation and differentiation in many tissues, including breast, and it has been suggested that GATA3 expression correlates with ER expression. However, little is known on GATA3 expression in various subtypes of breast carcinoma, its utilization in cytology, and on how GATA3 performs in comparison with GCDFP-15 and mammaglobin. Eighty-four histology cases of breast carcinoma of various subtypes, including 28 triple-negative breast carcinomas, along with 20 cytology cases of metastatic breast carcinoma and 12 cytology cases of ER-positive metastatic gynecologic malignancies, were stained for GATA3, GCDFP-15, and mammaglobin. In non-triple-negative breast carcinomas (n=56), GATA3 showed 100% sensitivity, higher than GCDFP-15 (42.8%; Pcytology cases, 100% stained with GATA3, higher than GCDFP-15 (20%; Pgynecologic malignancies. Thus, in working up ER-positive metastatic malignancies GATA3 demonstrates specificity for breast.

  6. Caring for survivors of breast cancer: perspective of the primary care physician.

    Science.gov (United States)

    Smith, S L; Wai, E S; Alexander, C; Singh-Carlson, S

    2011-10-01

    Increasing numbers of women are surviving breast cancer, and survivorship care is becoming more complex. Primary care physicians provide care for most survivors of breast cancer in the Canadian province of British Columbia. The present study offers insight into the confidence of primary care physicians in their abilities to provide such care. It also explores potential ways to assist those providers in enhancing this aspect of their practice. A questionnaire was mailed to 1000 primary care physicians caring for survivors of breast cancer. The questionnaire explored the perspectives of the responding physicians on their ability to manage various aspects of survivorship care for breast cancer patients, identified preferences for the content and format of communication from oncologists at the time of transition from active oncology treatment to survivorship, and determined the means most commonly used to obtain knowledge about breast cancer. This 1-page, 31-item checkbox and open-answer questionnaire assessed the perceptions of primary care physicians about the care of breast cancer survivors after completion of active treatment and their personal preferences for resources providing information about breast cancer. The questionnaire response rate was 59%. Primary care physicians reported being most confident in screening for recurrence and managing patient anxiety; they were least confident in managing lymphedema and providing psychosocial counselling. Compared with physicians following fewer survivors of breast cancer, those who followed more breast cancer survivors had higher confidence in managing the biomedical aspects of follow-up and in providing counselling about nutrition and exercise. Most physicians found discharge letters from oncologists to be useful. Point-form discharge information was preferred by 43%; detailed description, by 19%; and both formats, by 38%. The most useful information items identified for inclusion in a discharge letter were a diagnosis

  7. Primary chondrosarcoma of breast - cytology with histopathological correlation: A rare case report with review of literature

    Directory of Open Access Journals (Sweden)

    Sankappa P. Sinhasan

    2014-01-01

    Full Text Available Malignant mesenchymal tumors of the breast other than angiosarcoma are extremely rare and comprise <0.5% of breast tumors. Primary chondrosarcoma of the breast is an extremely rare entity and only 10 cases are reported as single case reports in literature until date. A diagnosis of primary mammary sarcoma can be established only after excluding metaplastic carcinomas and malignant phyllodes by extensive sampling for evidence of in situ or invasive carcinoma. Here, we report a primary chondrosarcoma of breast in a 55-year-old lady diagnosed precisely on fine-needle aspiration cytology and confirmed by histopatholigcal examination after total mastectomy. We emphasize on diagnostic difficulties encountered in cytology smears and discuss differential diagnoses.

  8. Effect of gadolinium injection on diffusion-weighted imaging with background body signal suppression (DWIBS) imaging of breast lesions.

    Science.gov (United States)

    Moschetta, Marco; Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe

    2014-12-01

    Diffusion-weighted imaging with background body signal suppression (DWIBS) provides both qualitative and quantitative imaging of breast lesions and are usually performed before contrast material injection (CMI). This study aims to assess whether the administration of gadolinium significantly affects DWIBS imaging. 200 patients were prospectively evaluated by MRI with STIR, TSE-T2, pre-CMI DWIBS, contrast enhanced THRIVE-T1 and post-CMI DWIBS sequences. Pre and post-CMI DWIBS were analyzed searching for the presence of breast lesions and calculating the ADC value. ADC values of ≤1.44×10(-3) mm(2)/s were considered suspicious for malignancy. This analysis was then compared with the histological findings. Sensitivity, specificity, diagnostic accuracy (DA), positive predictive value (PPV) and negative (NPV) were calculated for both sequences and represented by ROC analysis. Pre and post-CMI ADC values were compared by using the paired t test. In 150/200 (59%) patients, pre and post-CMI DWIBS indicated the presence of breast lesions, 53 (35%) with ADC values of >1.44×10(-3) mm(2)/s and 97 (65%) with ADC≤1.44×10(-3) mm(2)/s. Pre-CMI and post-DWIBS sequences obtained the same sensitivity, specificity, DA, PPV and NPV values of 97%, 83%, 89%, 79% and 98%. The mean ADC value of benign lesions was 1.831±0.18×10(-3) mm(2)/s before and 1.828±0.18×10(-3) mm(2)/s after CMI. The mean ADC value of the malignant lesions was 1.146±0.16×10(-3) mm(2)/s before and 1.144±0.16×10(-3) mm(2)/s after CMI. No significant difference was found between pre and post CMI ADC values (p>0.05). DWIBS imaging is not influenced by CMI. Breast MR protocol could be modified by placing DWIBS after dynamic contrast enhanced sequences in order to maximize patient cooperation. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Identifying microcalcifications in benign and malignant breast lesions by probing differences in their chemical composition using Raman spectroscopy.

    Science.gov (United States)

    Haka, Abigail S; Shafer-Peltier, Karen E; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R; Feld, Michael S

    2002-09-15

    We have applied Raman spectroscopy to analyze the chemical composition of microcalcifications occurring in benign and malignant lesions in the human breast. Microcalcifications were initially separated into two categories based on their Raman spectrum: type I, calcium oxalate dihydrate, and type II, calcium hydroxyapatite. Type I microcalcifications were diagnosed as benign, whereas type II were subdivided into benign and malignant categories using principal component analysis, a statistical technique. Although type II microcalcifications are primarily composed of calcium hydroxyapatite, they also contain trace amounts of several biological impurities. Using principal component analysis, we were able to highlight subtle chemical differences in type II microcalcifications that correlate with breast disease. On the basis of these results, we believe that type II microcalcifications formed in benign ducts typically contain a larger amount of calcium carbonate and a smaller amount of protein than those formed in malignant ducts. Using this diagnostic strategy, we were able to distinguish microcalcifications occurring in benign and malignant ducts with a sensitivity of 88% and a specificity of 93%. This is a significant improvement over current X-ray mammography techniques, which are unable to reliably differentiate microcalcifications in benign and malignant breast lesions.

  10. Quantitative analysis of diffusion-weighted magnetic resonance imaging in malignant breast lesions using different b value combinations

    Energy Technology Data Exchange (ETDEWEB)

    Nilsen, Line B. [Oslo University Hospital, Department of Radiation Biology, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); University of Oslo, Faculty of Medicine, P.O. Box 1078, Oslo (Norway); Fangberget, Anne [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Division of Diagnostics and Intervention, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); Geier, Oliver [Oslo University Hospital, Department of Diagnostic Physics, The Interventional Centre, Division of Diagnostics and Intervention, P.O. Box 4950, Oslo (Norway); Seierstad, Therese [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Division of Diagnostics and Intervention, Norwegian Radium Hospital, P.O. Box 4959, Oslo (Norway); Buskerud University College, Department of Health Sciences, P.O. Box 7053, Drammen (Norway)

    2013-04-15

    To explore how apparent diffusion coefficients (ADCs) in malignant breast lesions are affected by selection of b values in the monoexponential model and to compare ADCs with diffusion coefficients (Ds) obtained from the biexponential model. Twenty-four women (mean age 51.3 years) with locally advanced breast cancer were included in this study. Pre-treatment diffusion-weighted magnetic resonance imaging was performed using a 1.5-T system with b values of 0, 50, 100, 250 and 800 s/mm{sup 2}. Thirteen different b value combinations were used to derive individual monoexponential ADC maps. All b values were used in the biexponential model. Median ADC (including all b values) and D were 1.04 x 10{sup -3} mm{sup 2}/s (range 0.82-1.61 x 10{sup -3} mm{sup 2}/s) and 0.84 x 10{sup -3} mm{sup 2}/s (range 0.17-1.56 x 10{sup -3} mm{sup 2}/s), respectively. There was a strong positive correlation between ADCs and Ds. For clinically relevant b value combinations, maximum deviation between ADCs including and excluding low b values (<100 s/mm{sup 2}) was 11.8 %. Selection of b values strongly affects ADCs of malignant breast lesions. However, by excluding low b values, ADCs approach biexponential Ds, demonstrating that microperfusion influences the diffusion signal. Thus, care should be taken when ADC calculation includes low b values. (orig.)

  11. 3D lacunarity in multifractal analysis of breast tumor lesions in dynamic contrast-enhanced magnetic resonance imaging.

    Science.gov (United States)

    Soares, Filipe; Janela, Filipe; Pereira, Manuela; Seabra, João; Freire, Mário M

    2013-11-01

    Dynamic contrast-enhanced magnetic resonance (DCE-MR) of the breast is especially robust for the diagnosis of cancer in high-risk women due to its high sensitivity. Its specificity may be, however, compromised since several benign masses take up contrast agent as malignant lesions do. In this paper, we propose a novel method of 3D multifractal analysis to characterize the spatial complexity (spatial arrangement of texture) of breast tumors at multiple scales. Self-similar properties are extracted from the estimation of the multifractal scaling exponent for each clinical case, using lacunarity as the multifractal measure. These properties include several descriptors of the multifractal spectra reflecting the morphology and internal spatial structure of the enhanced lesions relatively to normal tissue. The results suggest that the combined multifractal characteristics can be effective to distinguish benign and malignant findings, judged by the performance of the support vector machine classification method evaluated by receiver operating characteristics with an area under the curve of 0.96. In addition, this paper confirms the presence of multifractality in DCE-MR volumes of the breast, whereby multiple degrees of self-similarity prevail at multiple scales. The proposed feature extraction and classification method have the potential to complement the interpretation of the radiologists and supply a computer-aided diagnosis system.

  12. Computer-aided diagnosis for diagnostically challenging breast lesions in DCE-MRI based on image registration and integration of morphologic and dynamic characteristics

    Science.gov (United States)

    Retter, Felix; Plant, Claudia; Burgeth, Bernhard; Botella, Guillermo; Schlossbauer, Thomas; Meyer-Bäse, Anke

    2013-12-01

    Diagnostically challenging lesions comprise both foci (small lesions) and non-mass-like enhancing lesions and pose a challenge to current computer-aided diagnosis systems. Motion-based artifacts lead in dynamic contrast-enhanced breast magnetic resonance to diagnostic misinterpretation; therefore, motion compensation represents an important prerequisite to automatic lesion detection and diagnosis. In addition, the extraction of pertinent kinetic and morphologic features as lesion descriptors is an equally important task. In the present paper, we evaluate the performance of a computer-aided diagnosis system consisting of motion correction, lesion segmentation, and feature extraction and classification. We develop a new feature extractor, the radial Krawtchouk moment, which guarantees rotation invariance. Many novel feature extraction techniques are proposed and tested in conjunction with lesion detection. Our simulation results have shown that motion compensation combined with Minkowski functionals and Bayesian classifier can improve lesion detection and classification.

  13. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    National Research Council Canada - National Science Library

    Dobrosavljević, Aleksandar; Rakić, Snezana; Nikoli, Branka; Raznatović, Svetlana Janković; Dikić, Svetlana Dragojević; Milosević, Zorica; Jurisić, Aleksandar; Skrobić, Milica

    2016-01-01

    Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant...

  14. The influence of diffusion gradient direction on diffusion-weighted imaging of breast mass-like lesions at 3.0T.

    Science.gov (United States)

    Yao, Feifei; Li, Ying; Xiao, Yunfei; Zheng, Dandan; Zhang, Yan; Cheng, Jingliang

    2017-10-01

    Background It has been challenging to achieve ideal breast diffusion-weighted imaging (DWI). The optimization of diffusion gradient direction is of great importance. Purpose To evaluate the effect of diffusion gradient direction on the apparent diffusion coefficient (ADC) values of breast mass-like lesions and the visual grades of image quality, lesion visibility, and sharpness of breast contour at 3.0T. Material and Methods Sixty consecutive patients with mass-like lesions were enrolled in this study. In addition to typical breast magnetic resonance imaging (MRI) protocols, the breasts were scanned with conventional orthogonal DWI (c-DWI), tetrahedral DWI (t-DWI), and 3in1 DWI (3in1-DWI) sequences. The DW images were observed and visually graded by two radiologists independently. For ADC measurement, one radiographer manually selected the region of interest (ROI). Results For both readers, t-DWI had better image quality and sharpness of breast contour than c-DWI. Regarding lesion visibility, no significant differences were observed among three sequences. The mean ADC values were 1.462 × 10(-3), 1.490 × 10(-3), and 1.446 × 10(-3) mm(2) s(-1) for c-DWI, t-DWI, and 3in1-DWI, respectively. The ADC values extracted from both t-DWI and 3in1-DWI were not statistically different compared with those from c-DWI. In all DWI sequences, the ADC of malignant lesions was significantly reduced compared with benign lesions. Conclusion DWI with tetrahedral or 3in1 diffusion gradients is a more useful technique in clinical breast MRI than c-DWI because the image quality and sharpness of breast contour are improved. ADC is comparable to c-DWI.

  15. Locally-advanced primary neuroendocrine carcinoma of the breast: case report and review of the literature.

    Science.gov (United States)

    Angarita, Fernando A; Rodríguez, Jorge L; Meek, Eugenio; Sánchez, Jesus O; Tawil, Mauricio; Torregrosa, Lilian

    2013-06-05

    Primary neuroendocrine carcinoma of the breast is a heterogeneous group of rare tumors with positive immunoreactivity to neuroendocrine markers in at least 50% of cells. Diagnosis also requires that other primary sites be ruled out and that the same tumor show histological evidence of a breast in situ component. Primary neuroendocrine carcinoma of the breast rarely presents as locally advanced disease and less frequently with such widespread metastatic disease as described herein. The review accompanying this case report is the first to provide an overview of all the cases of primary neuroendocrine carcinoma of the breast published in the literature and encompasses detailed information regarding epidemiology, histogenesis, clinical and histologic diagnosis criteria, classification, surgical and adjuvant treatment, as well as prognosis. We also provide recommendations for common clinical and histologic pitfalls associated with this tumor. We describe a case of a 51-year-old Hispanic woman initially diagnosed with locally-advanced invasive ductal carcinoma that did not respond to neoadjuvant treatment. After undergoing modified radical mastectomy the final surgical pathology showed evidence of alveolar-type primary neuroendocrine carcinoma of the breast. The patient was treated with cisplatin/etoposide followed by paclitaxel/carboplatinum. Thirteen months after surgery the patient is alive, but developed pulmonary, bone, and hepatic metastasis. The breast in situ component of primary neuroendocrine carcinoma of the breast may prevail on a core biopsy samples increasing the probability of underdiagnosing this tumor preoperatively. Being aware of the existence of this disease allows for timely diagnosis and management. Optimal treatment requires simultaneous consideration of both the neuroendocrine and breast in situ tumor features.

  16. Primary MALT Lymphoma of the Breast Treated with Definitive Radiation

    Directory of Open Access Journals (Sweden)

    Mohammad Hissourou III

    2016-01-01

    Full Text Available We are reporting a case of a 59-year-old woman, with a family history of breast cancer, who presented with extranodal marginal zone lymphoma (MALT of the left breast. She received definitive radiation therapy and remains without evidence of disease. Here, we present a case and review the current literature to determine the optimal treatment of this rare presentation of MALT.

  17. Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

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    Jomhori P

    2001-09-01

    Full Text Available Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam, chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent, no abnormal finding was detected. Five patients (6.66 percent had atopy. In the remaining 27 patients (36 percent, the following abnormalities were found: Iron deficiency in 6 patients (8 percent, diabetes mellitus in 6 patients (8 percent, hyperthyroidism in 4 patients (5.33 percent, hypothyroidism in 2 patients (2.66 percent, lymphoma in 3 patients (4 percent, chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent. Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

  18. Genomic Alterations in Sporadic Synchronous Primary Breast Cancer Using Array and Metaphase Comparative Genomic Hybridization

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    Arezou A. Ghazani

    2007-06-01

    Full Text Available Synchronous primary breast cancer describes the occurrence of multiple tumors affecting one or both breasts at initial diagnosis. This provides a unique opportunity to identify tissue-specific genomic markers that characterize each tumor while controlling for the individual genetic background of a patient. The aim of this study was to examine the genomic alterations and degree of similarity between synchronous cancers. Using metaphase comparative genomic hybridization and array comparative genomic hybridization (aCGH, the genomic alterations of 23 synchronous breast cancers from 10 patients were examined at both chromosomal and gene levels. Synchronous breast cancers, when compared to their matched counterparts, were found to have a common core set of genetic alterations, with additional unique changes present in each. They also frequently exhibited features distinct from the more usual solitary primary breast cancers. The most frequent genomic alterations included chromosomal gains of 1q, 3p, 4q, and 8q, and losses of 11q, 12q, 16q, and 17p. aCGH identified copy number amplification in regions that are present in all 23 tumor samples, including 1p31.3–1p32.3 harboring JAK1. Our findings suggest that synchronous primary breast cancers represent a unique type of breast cancer and, at least in some instances, one tumor may give rise to the other.

  19. Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN.

    Science.gov (United States)

    Rindal, D Brad; Gordan, Valeria V; Litaker, Mark S; Bader, James D; Fellows, Jeffrey L; Qvist, Vibeke; Wallace-Dawson, Martha C; Anderson, Mary L; Gilbert, Gregg H

    2010-12-01

    To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. A total of 228 DPBRN dentists recorded information on 5676 consecutive restorations inserted due to primary caries lesions on 3751 patients. Practitioner-investigators placed a mean of 24.9 (SD=12.4) restorations. Lesions were categorised as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categ