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
Saturday, 10 April 2010
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
Risk of carcinoma after subsequent excision of benign papilloma initially diagnosed with an ultrasound (US)-guided 14-gauge core needle biopsy: a prospective observational study
Risk of carcinoma after subsequent excision of benign papilloma initially diagnosed with an ultrasound (US)-guided 14-gauge core needle biopsy: a prospective observational study
Jung Min Chang, Woo Kyung Moon, Nariya Cho, Wonshik Han, Dong-Young Noh, In-Ae Park & Eun-Jung Jung
European Radiology 2010; 20;5:1093-1100
Link to Journal
Results:
Of the 114 patients, 87 eventually underwent surgery: among the 100 supposed benign papillomas, surgical excision revealed fibrocystic change or no residual lesion in nine cases, intraductal papilloma in 74, atypical papilloma in 13, papillary ductal carcinoma in situ (DCIS) in three and one invasive papillary carcinoma. The upgrade rate for an atypical papilloma or papilloma with adjacent foci of atypical ductal hyperplasia (ADH) and malignancy was 13% (95% CI = 7.1–21.2%) and 4% (95% CI = 1.1–9.9%), respectively. The mean lesion size (P = 0.041) was significantly larger when lesions were upgraded to malignancy. Other features were not significantly associated with pathological underestimation (P > 0.05).
Conclusion:
Surgical excision should be considered for benign intraductal papillomas above 1.5 cm in size
Jung Min Chang, Woo Kyung Moon, Nariya Cho, Wonshik Han, Dong-Young Noh, In-Ae Park & Eun-Jung Jung
European Radiology 2010; 20;5:1093-1100
Link to Journal
Results:
Of the 114 patients, 87 eventually underwent surgery: among the 100 supposed benign papillomas, surgical excision revealed fibrocystic change or no residual lesion in nine cases, intraductal papilloma in 74, atypical papilloma in 13, papillary ductal carcinoma in situ (DCIS) in three and one invasive papillary carcinoma. The upgrade rate for an atypical papilloma or papilloma with adjacent foci of atypical ductal hyperplasia (ADH) and malignancy was 13% (95% CI = 7.1–21.2%) and 4% (95% CI = 1.1–9.9%), respectively. The mean lesion size (P = 0.041) was significantly larger when lesions were upgraded to malignancy. Other features were not significantly associated with pathological underestimation (P > 0.05).
Conclusion:
Surgical excision should be considered for benign intraductal papillomas above 1.5 cm in size
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
Link to Journal
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
Fritz K. W. Schaefer, A. Waldmann, A. Katalinic, C. Wefelnberg, M. Heller, W. Jonat & I. Schreer
European Radiology 2010; 20;5:1085-1092
Link to Journal
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
Tuesday, 30 March 2010
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
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
Link to Journal
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
Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results
Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results
Katja C. Siegmann, Tanja Xydeas, Ralph Sinkus, Bernhard Kraemer, Ulrich Vogel & Claus D. Claussen
Eur Radiol (2010) 20: 318–325
Link to Journal
In this study, the com-bination of MRE and CE-MRI could increase the diagnostic performance of breast MRI.
Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.
Katja C. Siegmann, Tanja Xydeas, Ralph Sinkus, Bernhard Kraemer, Ulrich Vogel & Claus D. Claussen
Eur Radiol (2010) 20: 318–325
Link to Journal
In this study, the com-bination of MRE and CE-MRI could increase the diagnostic performance of breast MRI.
Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.
US-guided diffused optical tomography: a promising functional imaging technique in breast lesions
US-guided diffused optical tomography: a promising functional imaging technique in breast lesions
Shan-Shan You, Yu-Xin Jiang, Qing-Li Zhu, Ji-Bin Liu, Jing Zhang, Qing Dai, He Liu & Qiang Sun
Eur Radiol 2010 20;2:293-302
Link to Journal
Results: There were 96 benign lesions and 118 malignant lesions. The total haemoglobin concentration (THC) of all 214 lesions was calculated from DOT. The average THC in benign lesions was 125.5 ± 83.4 µmol/L, and in malignant lesions 222.2 ± 87.2 µmol/L. The THC of malignant lesions was significantly higher than that of benign lesions (p < 0.05).
When a THC of 140 µmol/L was used as the cutoff value for differentiating breast cancer from benign lesions, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DOT were 83.9%, 66.7%, 76.2%, 75.6% and 77.1%, respectively.
Our study demonstrated that THC was significantly higher in malignant lesions than in benign lesions.
Conclusion: US-guided diffused optical tomography, a noninvasive functional imaging technique, has potential utility in differentiating breast cancer from benign lesions
Shan-Shan You, Yu-Xin Jiang, Qing-Li Zhu, Ji-Bin Liu, Jing Zhang, Qing Dai, He Liu & Qiang Sun
Eur Radiol 2010 20;2:293-302
Link to Journal
Results: There were 96 benign lesions and 118 malignant lesions. The total haemoglobin concentration (THC) of all 214 lesions was calculated from DOT. The average THC in benign lesions was 125.5 ± 83.4 µmol/L, and in malignant lesions 222.2 ± 87.2 µmol/L. The THC of malignant lesions was significantly higher than that of benign lesions (p < 0.05).
When a THC of 140 µmol/L was used as the cutoff value for differentiating breast cancer from benign lesions, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of DOT were 83.9%, 66.7%, 76.2%, 75.6% and 77.1%, respectively.
Our study demonstrated that THC was significantly higher in malignant lesions than in benign lesions.
Conclusion: US-guided diffused optical tomography, a noninvasive functional imaging technique, has potential utility in differentiating breast cancer from benign lesions
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