US of Breast Masses Categorized as BI-RADS 3, 4, and 5: Pictorial Review of Factors Influencing Clinical Management
Sughra Raza, Allison L. Goldkamp, Sona A. Chikarmane, and Robyn L. Birdwell
Radiographics 2010;30 1199-1213
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The ACR BI-RADS US lexicon descriptors are reviewed and illustrated, with emphasis on cases that present challenges in the assignment of BI-RADS US assessment categories
Friday, 10 September 2010
Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ
Radiologic-Pathologic Correlation of Ductal Carcinoma in Situ
Takayuki Yamada, Naoko Mori, Mika Watanabe, Izo Kimijima, Tadayuki Okumoto, Kazumasa Seiji, and Shoki Takahashi
Radiographics 2010;30 1183-1198
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The histopathologic features and classification of ductal carcinoma in situ are reviewed and correlated with radiologic findings, with an emphasis on magnetic resonance imaging features
Takayuki Yamada, Naoko Mori, Mika Watanabe, Izo Kimijima, Tadayuki Okumoto, Kazumasa Seiji, and Shoki Takahashi
Radiographics 2010;30 1183-1198
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The histopathologic features and classification of ductal carcinoma in situ are reviewed and correlated with radiologic findings, with an emphasis on magnetic resonance imaging features
Wednesday, 18 August 2010
Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use
Breast Cancer Risk by Breast Density, Menopause, and Postmenopausal Hormone Therapy Use
Karla Kerlikowske, Andrea J. Cook, Diana S.M. Buist, Steve R. Cummings, Celine Vachon, Pamela Vacek, and Diana L. Miglioretti
J Clin Oncol 28:3830-3837, 2010
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Purpose:
We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use.
Methods:
We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m2. Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density.
Results:
Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2).
Conclusion:
Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin
Karla Kerlikowske, Andrea J. Cook, Diana S.M. Buist, Steve R. Cummings, Celine Vachon, Pamela Vacek, and Diana L. Miglioretti
J Clin Oncol 28:3830-3837, 2010
Link to Journal
Purpose:
We determined whether the association between breast density and breast cancer risk and cancer severity differs according to menopausal status and postmenopausal hormone therapy (HT) use.
Methods:
We collected data on 587,369 women who underwent 1,349,027 screening mammography examinations; 14,090 women were diagnosed with breast cancer. We calculated 5-year breast cancer risk from a survival model for subgroups of women classified by their Breast Imaging Reporting and Data System (BIRADS) breast density, age, menopausal status, and current HT use, assuming a body mass index of 25 kg/m2. Odds of advanced (ie, IIb, III, IV) versus early (ie, I, IIa) stage invasive cancer was calculated according to BIRADS density.
Results:
Breast cancer risk was low among women with low density (BIRADS-1): women age 55 to 59 years, 5-year risk was 0.8% (95% CI, 0.6 to 0.9%) for non-HT users and 0.9% (95% CI, 0.7% to 1.1%) for estrogen and estrogen plus progestin users. Breast cancer risk was high among women with very high density (BIRADS-4), particularly estrogen plus progestin users: women age 55 to 59 years, 5-year risk was 2.4% (95% CI, 2.0% to 2.8%) for non-HT users, 3.0% (95% CI, 2.6% to 3.5%) for estrogen users, and 4.2% (95% CI, 3.7% to 4.6%) for estrogen plus progestin users. Advanced-stage breast cancer risk was increased 1.7-fold for postmenopausal HT users who had very high density (BIRADS-4) compared to those with average density (BIRADS-2).
Conclusion:
Postmenopausal women with high breast density are at increased risk of breast cancer and should be aware of the added risk of taking HT, especially estrogen plus progestin
Friday, 7 May 2010
RECIST revised: implications for the radiologist. A review article on the modified RECIST guideline
RECIST revised: implications for the radiologist. A review article on the modified RECIST guideline
Els L. van Persijn van Meerten, Hans Gelderblom & Johan L. Bloem
Eur Radiol (2010) 20: 1456–1467
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The purpose of this review article is to familiarize radiologists with the recently revised Response Evaluation Criteria in Solid Tumours (RECIST), used in many anticancer drug trials to assess response and progression rate.
The most important modifications are: a reduction in the maximum number of target lesions from ten to five, with a maximum of two per organ, with a longest diameter of at least 10 mm;
In lymph nodes (LNs) the short axis rather than the long axis should be measured, with normal LN measuring <10 mm, non- target LN ≥10 mm but <15 mm and target LN ≥15 mm;
Osteolytic lesions with a soft tissue component and cystic tumours may serve as target lesions;
An additional requirement for progressive disease (PD) of target lesions is not only a ≥20% increase in the sum of the longest diameter (SLD) from the nadir but also a ≥5 mm absolute increase in the SLD (the other response categories of target lesion are unchanged);
PD of non-target lesions can only be applied if the increase in non-target lesions is representative of change in overall tumour burden; detailed imaging guidelines
Els L. van Persijn van Meerten, Hans Gelderblom & Johan L. Bloem
Eur Radiol (2010) 20: 1456–1467
Link to Journal
The purpose of this review article is to familiarize radiologists with the recently revised Response Evaluation Criteria in Solid Tumours (RECIST), used in many anticancer drug trials to assess response and progression rate.
The most important modifications are: a reduction in the maximum number of target lesions from ten to five, with a maximum of two per organ, with a longest diameter of at least 10 mm;
In lymph nodes (LNs) the short axis rather than the long axis should be measured, with normal LN measuring <10 mm, non- target LN ≥10 mm but <15 mm and target LN ≥15 mm;
Osteolytic lesions with a soft tissue component and cystic tumours may serve as target lesions;
An additional requirement for progressive disease (PD) of target lesions is not only a ≥20% increase in the sum of the longest diameter (SLD) from the nadir but also a ≥5 mm absolute increase in the SLD (the other response categories of target lesion are unchanged);
PD of non-target lesions can only be applied if the increase in non-target lesions is representative of change in overall tumour burden; detailed imaging guidelines
Contrast-enhanced ultrasound in the characterisation of breast masses: utility of quantitative analysis in comparison with MRI
Contrast-enhanced ultrasound in the characterisation of breast masses: utility of quantitative analysis in comparison with MRI
Natalia Caproni, Francesca Marchisio, Annarita Pecchi, Barbara Canossi, Rachele Battista, Piero D’Alimonte & Pietro Torricelli
Eur Radiol (2010) 20: 1384–1395
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CE-US quantitative analysis offers an objective and reproducible assessment of lesion vascularisation, with good correlation with the results of MRI
Natalia Caproni, Francesca Marchisio, Annarita Pecchi, Barbara Canossi, Rachele Battista, Piero D’Alimonte & Pietro Torricelli
Eur Radiol (2010) 20: 1384–1395
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CE-US quantitative analysis offers an objective and reproducible assessment of lesion vascularisation, with good correlation with the results of MRI
Saturday, 10 April 2010
Triple-negative breast cancer: correlation between imaging and pathological findings
Triple-negative breast cancer: correlation between imaging and pathological findings
Eun Sook Ko, Byung Hee Lee, Hyun-A Kim, Woo-Chul Noh, Min Suk Kim & Sang-Ah Lee
European Radiology 2010; 20;5:1111-1117
Link to Journal
Results:
Triple-negative breast cancers showed a high histological grade. On mammography, triple-negative breast cancers usually presented with a mass (43/87, 49%) or with focal asymmetry (19/87, 22%), and were less associated with calcifications. On ultrasound, the cancers were less frequently seen as non-mass lesions (12/87, 14%), more likely to have circumscribed margins (43/75, 57%), were markedly hypoechoic (36/75, 57%) and less likely to show posterior shadowing (4/75, 5%). Among the three types of breast cancers, ER-negative/PR-negative/HER2-positive breast cancers most commonly had associated calcifications (52/65, 79%) on mammography and were depicted as non-mass lesions (21/65, 32%) on ultrasound
Conclusion:
Our results suggest that the imaging findings might be useful in diagnosing triple-negative breast cancer
Eun Sook Ko, Byung Hee Lee, Hyun-A Kim, Woo-Chul Noh, Min Suk Kim & Sang-Ah Lee
European Radiology 2010; 20;5:1111-1117
Link to Journal
Results:
Triple-negative breast cancers showed a high histological grade. On mammography, triple-negative breast cancers usually presented with a mass (43/87, 49%) or with focal asymmetry (19/87, 22%), and were less associated with calcifications. On ultrasound, the cancers were less frequently seen as non-mass lesions (12/87, 14%), more likely to have circumscribed margins (43/75, 57%), were markedly hypoechoic (36/75, 57%) and less likely to show posterior shadowing (4/75, 5%). Among the three types of breast cancers, ER-negative/PR-negative/HER2-positive breast cancers most commonly had associated calcifications (52/65, 79%) on mammography and were depicted as non-mass lesions (21/65, 32%) on ultrasound
Conclusion:
Our results suggest that the imaging findings might be useful in diagnosing triple-negative breast cancer
Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions
Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions
Pascal A. T. Baltzer, Matthias Benndorf, Matthias Dietzel, Mieczyslaw Gajda, Oumar Camara & Werner A. Kaiser
European Radiology 2010; 20;5:1101-1110
Link to Journal
Results:
This study examined 81 lesions (27 benign, 54 malignant). Sensitivity of ueMRM was 93% (observer 1) and 86% (observer 2), respectively. Sensitivity of ceMRM was 96.5% (observer 1) and 98.3% (observer 2). Specificity was 85.2% (ueMRM) and 92.6% (ceMRM) for both observers. The differences between both methods and observers were not significant (P ≥ 0.09). Lesion size measurements did not differ significantly among all sequences analyzed. Tumor visibility was worse using ueMRM for both benign (P < 0.001) and malignant lesions (P = 0.004)
Conclusion:
Sensitivity and specificity of ueMRM in mass lesions equal that of ceMRM. However, a reduced lesion visibility in ueMRM may lead to more false-negative findings
Pascal A. T. Baltzer, Matthias Benndorf, Matthias Dietzel, Mieczyslaw Gajda, Oumar Camara & Werner A. Kaiser
European Radiology 2010; 20;5:1101-1110
Link to Journal
Results:
This study examined 81 lesions (27 benign, 54 malignant). Sensitivity of ueMRM was 93% (observer 1) and 86% (observer 2), respectively. Sensitivity of ceMRM was 96.5% (observer 1) and 98.3% (observer 2). Specificity was 85.2% (ueMRM) and 92.6% (ceMRM) for both observers. The differences between both methods and observers were not significant (P ≥ 0.09). Lesion size measurements did not differ significantly among all sequences analyzed. Tumor visibility was worse using ueMRM for both benign (P < 0.001) and malignant lesions (P = 0.004)
Conclusion:
Sensitivity and specificity of ueMRM in mass lesions equal that of ceMRM. However, a reduced lesion visibility in ueMRM may lead to more false-negative findings
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