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

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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

Influence of additional breast ultrasound on cancer detection in a cohort study for quality assurance in breast diagnosis—analysis of 102,577 diagnostic procedures

Influence of additional breast ultrasound on cancer detection in a cohort study for quality assurance in breast diagnosis—analysis of 102,577 diagnostic procedures
Fritz K. W. Schaefer, A. Waldmann, A. Katalinic, C. Wefelnberg, M. Heller, W. Jonat & I. Schreer
European Radiology 2010; 20;5:1085-1092

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Results:
In total, 62,006 additional USs were performed, in which 116 mammographically and clinically occult breast cancers were diagnosed (detection rate: 1.9/1,000 examinations), while mammography alone (40,551 examinations) revealed 903 cancers (22.3/1,000). Of all 1,019 breast cancer findings, 12.8% were detected because of the combination of mammography and US. In the group with ACR III/IV, 15.9% of cancers were found by supplemental US compared with mammography alone.

Conclusion:
The addition of US to mammography vs. mammography alone resulted in a significant (P  < 0.01) increase in breast cancer detection rate

Breast tomosynthesis in clinical practice: initial results

Breast tomosynthesis in clinical practice: initial results
Hendrik J. Teertstra, Claudette E. Loo, Maurice A. A. J. van den Bosch, Harm van Tinteren, Emiel J. T. Rutgers, Sara H. Muller & Kenneth G. A. Gilhuijs
Eur Radiol (2010) 20: 16–24

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The purpose of this study was to assess the potential value of tomosynthesis in women with an abnormal screening mammogram or with clinical symptoms. Mammography and tomosynthesis investigations of 513 woman with an abnormal screening mammogram or with clinical symptoms were prospectively classified according to the ACR BI-RADS criteria. Sensitivity and specificity of both techniques for the detection of cancer were calculated.

In 112 newly detected cancers, tomosynthesis and mammography were each false- negative in 8 cases (7%). In the false- negative mammography cases, the tumor was detected with ultrasound (n = 4),    MRI (n = 2), by recall after breast tomosynthesis interpretation (n = 1), and after prophylactic mastectomy (n = 1). Combining the results of mammography and tomosynthesis detected 109 cancers. Therefore in three patients, both mammography and tomosynthesis missed the carcinoma.

The sensitivity of both techniques for the detection of breast cancer was 92.9%, and the specificity of mammography and tomosynthesis was 86.1 and 84.4%, respectively.

Tomosynthesis can be used as an additional technique to mammography in patients referred with an abnormal screening mammo- gram or with clinical symptoms. Additional lesions detected by tomosynthesis, however, are also likely to be detected by other techniques used in the clinical work-up of these patients

Computer aids and human second reading as interventions in screening mammography

In the European Journal of Cancer -
Computer aids and human second reading as interventions in screening mammography: Two systematic reviews to compare effects on cancer detection and recall rate
Paul Taylor and Henry W.W. Potts
European Journal of Cancer 44, 6, April 2008, Pages 798-807

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The evidence that double reading with arbitration enhances screening is stronger than that for single reading with CAD