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Karimova EJ, Slanetz PJ. Charged with Discharge: A Case-based Review of Nipple Discharge Using the American College of Radiology's Appropriateness Guidelines. JOURNAL OF BREAST IMAGING 2020; 2:275-284. [PMID: 38424981 DOI: 10.1093/jbi/wbaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Indexed: 03/02/2024]
Abstract
Nipple discharge, a relatively common presenting symptom for women of all ages, may be due to both benign and malignant conditions. Men can also present with nipple discharge, and when they do, they have a higher likelihood of malignancy than women. Radiologists vary in their evaluation of patients with nipple discharge, although the American College of Radiology practice guidelines for nipple discharge provides data-driven appropriate algorithms. In patients with physiologic discharge, imaging is not typically indicated. For those with pathologic nipple discharge, imaging typically starts with diagnostic mammography and retroareolar ultrasound for women over 40 years of age, diagnostic mammogram or ultrasound for women aged 30-39 years, and ultrasound for women younger than 30 years. Finally, contrast-enhanced breast MRI or galactography are usually reserved for identifying the cause of discharge when initial imaging with mammography and ultrasound is unrevealing.
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Affiliation(s)
- E Jane Karimova
- Brigham and Women's Hospital, Department of Radiology, Boston, MA
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Jafari SH, Saadatpour Z, Salmaninejad A, Momeni F, Mokhtari M, Nahand JS, Rahmati M, Mirzaei H, Kianmehr M. Breast cancer diagnosis: Imaging techniques and biochemical markers. J Cell Physiol 2018; 233:5200-5213. [PMID: 29219189 DOI: 10.1002/jcp.26379] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022]
Abstract
Breast cancer is a complex disease which is found as the second cause of cancer-associated death among women. Accumulating of evidence indicated that various factors (i.e., gentical and envirmental factors) could be associated with initiation and progression of breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of various diagnosis platforms, imaging techniques are main diagnosis approaches which could provide valuable data on patients with breast cancer. It has been showed that various imaging techniques such as mammography, magnetic resonance imaging (MRI), positron-emission tomography (PET), Computed tomography (CT), and single-photon emission computed tomography (SPECT) could be used for diagnosis and monitoring patients with breast cancer in various stages. Beside, imaging techniques, utilization of biochemical biomarkers such as proteins, DNAs, mRNAs, and microRNAs could be employed as new diagnosis and therapeutic tools for patients with breast cancer. Here, we summarized various imaging techniques and biochemical biomarkers could be utilized as diagnosis of patients with breast cancer. Moreover, we highlighted microRNAs and exosomes as new diagnosis and therapeutic biomarkers for monitoring patients with breast cancer.
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Affiliation(s)
- Seyed Hamed Jafari
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Saadatpour
- Radiology Specialist at Bozorgmehr Imaging Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Salmaninejad
- Drug Applied Research Center, Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran
| | - Fatemeh Momeni
- General Practitioner, Medical Researcher, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Mokhtari
- Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Javid Sadri Nahand
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Rahmati
- Department of Medical Biotechnology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Kianmehr
- Department of Medical Physics, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Kim Y, Kang BJ, Kim SH, Lee EJ. Prospective Study Comparing Two Second-Look Ultrasound Techniques: Handheld Ultrasound and an Automated Breast Volume Scanner. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2103-2112. [PMID: 27503758 DOI: 10.7863/ultra.15.11076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/24/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The aim of this study was to compare the diagnostic performance of handheld ultrasound (US) and an automated breast volume scanner (ABVS) as second-look US techniques subsequent to preoperative breast magnetic resonance imaging (MRI). METHODS We prospectively enrolled patients with breast cancer who underwent handheld US and ABVS examinations as second-look US modalities for additional suspicious lesions found via preoperative breast MRI. We reviewed each second-look US modality independently and evaluated the detection rate of each modality. We then analyzed the correlation between the detection rate and the MRI factors (size, distance, and enhancement type). RESULTS From March to September 2014, both types of second-look US examinations were performed on 40 patients with breast cancer who had 76 additional suspicious lesions detected via preoperative breast MRI. The detection rate of the ABVS was higher than that of handheld US for the second-look examination (94.7% versus 86.8%; P< .05). Among the 76 total lesions, 7 were only identified by the ABVS, 1 was only found by handheld US, and 3 were not detected by either the ABVS or handheld US. When we analyzed the correlation between the detection rate and MRI factors, the only meaningful factor was the enhancement type. The ability to detect a nonmass lesion was lower than the ability to detect a mass-type lesion (P < 0.05) for both the ABVS and handheld US. CONCLUSIONS For a second-look US examination subsequent to preoperative breast MRI in patients with breast cancer, the ABVS is a more efficient modality than handheld US for preoperative evaluations. However, both techniques have limitations in detecting nonmass lesions.
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Affiliation(s)
- Yoonsoo Kim
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Eun Jae Lee
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
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Nicholson BT, Harvey JA, Patrie JT, Mugler JP. 3D-MR Ductography and Contrast-Enhanced MR Mammography in Patients with Suspicious Nipple Discharge; a Feasibility Study. Breast J 2015; 21:352-62. [DOI: 10.1111/tbj.12417] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Brandi T Nicholson
- Department of Radiology & Medical Imaging; University of Virginia; Charlottesville Virginia
| | - Jennifer A Harvey
- Department of Radiology & Medical Imaging; University of Virginia; Charlottesville Virginia
| | - James T Patrie
- Department of Public Health Sciences; University of Virginia; Charlottesville Virginia
| | - John P Mugler
- Department of Radiology & Medical Imaging; University of Virginia; Charlottesville Virginia
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5
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Manifestaciones intratorácicas del cáncer de mama. RADIOLOGIA 2011; 53:7-17. [DOI: 10.1016/j.rx.2010.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 06/22/2010] [Accepted: 07/07/2010] [Indexed: 11/30/2022]
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6
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Intrathoracic manifestations of breast cancer. RADIOLOGIA 2011. [DOI: 10.1016/s2173-5107(11)70001-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nekhlyudov L, Kiarsis K, Elmore JG. MRI of the breast: does the internet accurately report its beneficial uses and limitations? Breast J 2009; 15:189-93. [PMID: 19292806 DOI: 10.1111/j.1524-4741.2009.00695.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
As consumer use of the Internet for medical information grows, continuing evaluation of the medical content on the Internet is needed. We evaluated Internet sites describing breast magnetic resonance imaging (MRI), an emerging technology tool in breast cancer diagnosis and screening. We searched Google for sites describing breast MRI and abstracted the affiliation, content, media type, readability, and quality of 90 most popular unique sites. Over half (56%) of the sites were commercially sponsored. The content varied by site and included medical and procedural facts, information about clinical trials, grants and journal articles, as well as human interest stories. Most (82%) sites described potentially beneficial uses of breast MRI, such as further evaluation of newly diagnosed breast cancers (58%); screening women at high risk for breast cancer (54%); evaluation of abnormal breast findings (48%); screening women with dense breasts (48%) or implants (27%); and surveillance for breast cancer recurrences (24%). Approximately half (56%) of the sites described the limitations of breast MRI, most commonly false positive findings (44%) and costs (24%). Website quality, including the display of contact information, sponsorship, currency of information, authorship, and references varied. The reading level was close to high school graduate. Internet sites describing breast MRI were mostly commercially sponsored, more often described the potential beneficial uses of the procedure than its limitations, and were of variable quality and high reading level. With the lack of enforceable standards for display of medical information on the Internet, providers should encourage patients to direct their searches to the most credible sites.
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Affiliation(s)
- Larissa Nekhlyudov
- Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts 02215, USA.
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Lux MP, Ackermann S, Bani MR, Nestle-Krämling C, Goecke TO, Niederacher D, Bodden-Heidrich R, Bender HG, Beckmann MW, Fasching PA. Age of uptake of early cancer detection facilities by low-risk and high-risk patients with familial breast and ovarian cancer. Eur J Cancer Prev 2006; 14:503-11. [PMID: 16284494 DOI: 10.1097/00008469-200512000-00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Some 5-10% of all cases of breast cancer and ovarian cancer have a hereditary genesis. In the setting of an interdisciplinary cancer genetics clinic, a study of the age at which patients first take advantage of early cancer detection (ECD) facilities was conducted in order to assess the influence of familial risk on health issues. METHODS The study included 556 women who fulfilled the inclusion criteria (IC) for genetic analysis of the BRCA1 and BRCA2 genes, as well as 205 who did not meet these criteria but attended the primary consultation. RESULTS Consulters who met the inclusion criteria took advantage of nearly all methods of ECD at an earlier time than women who did not. A comparison of consulters with or without breast cancer showed that those without breast cancer participated in all methods of ECD at an earlier time. CONCLUSION Methods of improving and increasing participation in ECD facilities, and of encouraging women who are at risk to start on such programs at a younger age, need to be discussed. In this study, familial risk already resulted in a younger age of uptake of ECD facilities.
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Affiliation(s)
- Michael Patrick Lux
- Department of Obstetrics and Gynecology, University Hospital, Erlangen, Germany.
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Medved M, Newstead GM, Abe H, Zamora MA, Olopade OI, Karczmar GS. High spectral and spatial resolution MRI of breast lesions: preliminary clinical experience. AJR Am J Roentgenol 2006; 186:30-7. [PMID: 16357373 DOI: 10.2214/ajr.04.1704] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In previous research, high spectral and spatial resolution (HiSS) echo-planar spectroscopic imaging (EPSI) was successfully applied to the human breast, obtaining improved contrast, anatomic detail, and sensitivity to contrast agents. To test HiSS in the clinical setting, we used HiSS MRI to image 30 women with suspicious breast lesions. SUBJECTS AND METHODS Women with suspicious breast lesions were scanned before and after contrast administration using EPSI at 1.5 T (0.63-mm in-plane resolution, 2.6-Hz spectral resolution). Images with intensity proportional to the water signal peak height in each voxel were synthesized and compared with standard clinical fat-saturated and early dynamic subtraction images. Pre- and postcontrast HiSS images were compared to assess the effect of the contrast agent on water resonance structure. RESULTS HiSS images scored significantly better than standard clinical images in lesion conspicuity, margin definition, and internal definition, even though they were acquired before contrast agent injection. Fat suppression was more complete and uniform and detail was shown on HiSS images more clearly than on conventional fat-saturation images. Thus, HiSS images often allowed easier evaluation of the lesion. Contrast agent-affected changes were often spatially and spectrally inhomogeneous. CONCLUSION HiSS scans were successfully integrated into standard clinical examinations and provided diagnostically useful images before contrast agent injection. Thus, it might be possible to characterize suspicious lesions on the basis of precontrast high-resolution spectral information. This information and information about the effect of contrast agents could potentially improve the specificity of breast MRI.
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Affiliation(s)
- Milica Medved
- Department of Radiology, The University of Chicago, 5841 S Maryland Avenue, MC 2026, Chicago, IL 60637, USA
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Komatsu S, Lee CJ, Ichikawa D, Hamashima T, Morofuji N, Shirono K, Hosokawa Y, Okabe H, Kurioka H, Yamagishi H, Oka T. Predictive value of the time-intensity curves on dynamic contrast-enhanced magnetic resonance imaging for lymphatic spreading in breast cancer. Surg Today 2006; 35:720-4. [PMID: 16133665 DOI: 10.1007/s00595-005-3032-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2004] [Accepted: 01/18/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE Dynamic contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a promising diagnostic modality in various breast cancer treatments. However, little is known about the correlation between the pattern of time to signal intensity curves (TIC) on the CE-MRI and clinicopathologic features. This study was designed to investigate these correlations and evaluate the predictive value of TIC on CE-MRI in order to identify high-risk patients. METHODS Between 2001 and 2003, 101 lesions were evaluated to detect malignancy on CE-MRI in 101 women who were suspected of having breast tumors based on either clinical findings or conventional imaging studies. Moreover, the clinicopathologic findings were compared with the pattern of TIC for the 69 surgically treated malignant lesions. RESULTS In detecting malignancy, the sensitivity, specificity, and accuracy were 78.7%, 88.5%, and 81.2%, respectively, in the 101 breast lesions. Especially for the 69 surgically treated malignant lesions, in comparison with breast cancer tumors with the benign pattern of TIC, the breast cancer tumors with a malignant pattern were found more frequently in lymphatic invasion (P < 0.01) and lymph node metastasis (P < 0.005), although no statistical correlation regarding the histological type, tumor size, vascular invasion, extensive intraductal component, hormone receptor status, or pathological stage was noted between the two groups. According to a logistic regression model, lymph node metastasis was found to be a significant independent variable. CONCLUSION The pattern of TIC could be used to predict lymphatic spreading associated with lymph node metastasis prior to surgery as well as to detect malignancy. Therefore, a more detailed evaluation should be made to identify the presence of lymphatic spreading in patients with a malignant pattern of TIC.
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Affiliation(s)
- Shuhei Komatsu
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
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Lux MP, Ackermann S, Nestle-Krämling C, Goecke TO, Niederacher D, Bodden-Heidrich R, Bender HG, Beckmann MW, Fasching PA. Use of intensified early cancer detection in high-risk patients with familial breast and ovarian cancer. Eur J Cancer Prev 2005; 14:399-411. [PMID: 16030432 DOI: 10.1097/00008469-200508000-00014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A prospective follow-up study was carried out to evaluate the influence of risk and genetic counselling on use of early cancer detection. Five hundred and fifty-six subjects who fulfilled inclusion criteria for a genetic analysis of the BRCA1/2 genes (the high-risk group A) and 205 who did not fulfil the inclusion criteria (the lower risk group B) attended primary consultation in the interdisciplinary cancer genetic clinic. Information about participation in the early cancer detection programme was documented. Information about changes in use after consultation could be evaluated from 349 women (94 group B and 255 group A). Methods such as monthly self-palpation, breast palpation by gynaecologist, ultrasound of the breast, transvaginal ultrasound and pelvic examination had all been commonly used. Consultees at higher risk used mammography less often than women at lower risk. Magnetic resonance imaging of the breast was used rarely. Most methods were used more often at the recommended interval by women at higher risk during the follow-up period. In conclusion, at present intensified early cancer detection programmes for women at risk provide a less invasive option than chemoprevention or prophylactic surgery. Although the methods are used at high frequency it seems feasible to motivate women at risk to participate. This can be done by providing information and counselling in the cancer genetic clinic.
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Affiliation(s)
- M P Lux
- Department of Obstetrics and Gynecology, University Hospital Erlangen, Universitaetsstrasse 21-23, 91054 Erlangen, Germany.
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Beran L, Liang W, Nims T, Paquelet J, Sickle-Santanello B. Correlation of targeted ultrasound with magnetic resonance imaging abnormalities of the breast. Am J Surg 2005; 190:592-4. [PMID: 16164928 DOI: 10.1016/j.amjsurg.2005.06.019] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2005] [Revised: 06/10/2005] [Accepted: 06/10/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of the breast is highly sensitive for cancer. However, MRI frequently detects additional lesions that mandate further evaluation. The intent of this study was to assess the ability of targeted ultrasound to identify additional lesions detected on MRI in patients undergoing evaluation for breast cancer. METHODS Between January 1, 1999, and July 15, 2004, 270 women underwent breast MRI at Grant Medical Center. MRI was obtained in 191 women during evaluation for documented or suspected breast cancer. Fifty-two patients had additional suspicious lesions on MRI, prompting targeted ultrasound; these patients constituted our study population. RESULTS Seventy-five additional suspicious lesions were detected on breast MRI in 52 women. Two women underwent mastectomy without targeted ultrasound. Targeted ultrasound identified 65 of the remaining 73 lesions (89%). Eight lesions (11%) were not visible on targeted ultrasound. CONCLUSION Targeted ultrasound can be a reliable method to correlate MRI abnormalities in breast cancer patients.
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Affiliation(s)
- LeAnn Beran
- Department of Surgery, Grant Medical Center, 285 E State Street, Suite 300, Columbus, OH 43215, USA
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Fischer DR, Wurdinger S, Boettcher J, Malich A, Kaiser WA. Further Signs in the Evaluation of Magnetic Resonance Mammography. Invest Radiol 2005; 40:430-5. [PMID: 15973134 DOI: 10.1097/01.rli.0000167138.52283.aa] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To increase accuracy and reliability of magnetic resonance breast imaging, a new evaluation method might be helpful. The recently suggested evaluation method (Fischer U, et al) resulted in a relevant number of equivocal cases (3 or 4 points). Additional morphologic and dynamic signs as an extension of this score were evaluated. METHOD AND MATERIALS One hundred thirty-two histologically verified lesions were evaluated by 3 radiologists double-blinded using 2 evaluation methods: 1) method 1 (according to Fischer, et al): 2pt: initial signal increase >100%, washout, centripetal enhancement, 1pt: initial signal increase 50-100%, plateau phenomenon, centrifugal inhomogeneous enhancement, irregular borders, linear, stellar or dendritic structure; and 2) method 2 (according to Malich, et al): 3pt: hook sign (sign of pectoral invasion), 2pt: unifocal edema, blooming. 1pt: hypointensity in T2, lymph nodes >10 mm, skin thickening, adjacent vessels, a lesion's distorted inner architecture, disruption of the mamillary edge; -1pt: isointensity in T2, no edema, enhancing septations; -3pt: hyperintensity in T2, non enhancing septations. Method 1 judged a lesion to be malignant if 5 or more points were given and benign if 2 or less points were given, respectively. Method 2 (mean value of 3 radiologists) was tested in those cases in which a clear possible decision using method 1 was not sufficiently possible. RESULTS Method 1 alone resulted in a negative predictive value of 96.8% and a positive predictive value of 90.8% (without carcinoma in situ), a sensitivity of 83.1%, a specificity of 58.8%, and revealed uncertain results (3 and 4 points) in 29 cases (out of 132; 22%). Adding the new scoring system in these 29 equivocal cases and an increase of 2 or more points by using method 2 is supposed to be a sign of malignancy; findings suggest a sensitivity of 90.9% and a specificity of 60% if an increase of maximum 1 is observed in benign lesions. In conclusion, our results show that Göttingen score alone has a sensitivity of 83.1%, a specificity of 58.8%; the second evaluation method reveals a sensitivity of 90.9% and a specificity of 60% in equivocal cases of Göttingen score. Göttingen score then reaches in all cases and second, adding the second evaluation method in equivocal cases, a sensitivity of 97% and a specificity of 76.5%. CONCLUSION The application of a second evaluation method in those cases remaining unclear in Göttingen score can lead to a decrease of uncertainty and a higher sensitivity and specificity of diagnosis in MR mammography. In this study, Göttingen score reaches a sensitivity of 83.1% and a specificity of 58.8%, increasing to a sensitivity of 97% and a specificity of 76.5% when being extended by a second evaluation method in unclear cases.
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Affiliation(s)
- Dorothee R Fischer
- Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, Jena, Germany.
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Golshan M, Fung BB, Wiley E, Wolfman J, Rademaker A, Morrow M. Prediction of breast cancer size by ultrasound, mammography and core biopsy. Breast 2004; 13:265-71. [PMID: 15325659 DOI: 10.1016/j.breast.2004.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2004] [Revised: 05/26/2004] [Accepted: 05/27/2004] [Indexed: 11/29/2022] Open
Abstract
Neoadjuvant chemotherapy and non-surgical tumor ablation rely upon imaging studies to determine tumor size. In this study the accuracy of ultrasound (US) mammography and core biopsy in determining tumor size was examined in 202 patients with Stages I and II breast cancer. The most accurate single modality for determining tumor size was mammography with a correlation coefficient of 0.66, followed by US (r = 0.48) and core biopsy (r = 0.28). Size measurements were less accurate in lobular than ductal cancers. The combination of the three modalities understaged 25% of the tumors > 1cm in size, and overstaged 10% of those < 1cm. The inability to accurately determine tumor size has important implications for the use of non-surgical ablation.
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Affiliation(s)
- M Golshan
- Department of Surgery, Lynn Sage Breast Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Plevritis SK, Ikeda DM. Ethical issues in contrast-enhanced magnetic resonance imaging screening for breast cancer. Top Magn Reson Imaging 2002; 13:79-84. [PMID: 12055452 DOI: 10.1097/00002142-200204000-00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Breast magnetic resonance imaging (MRI) screening has been shown to detect early breast cancer. The main challenge ahead for breast MRI screening is to prove its effectiveness in reducing breast cancer mortality. While this challenge is commonly viewed as a scientific, technological, and clinical one, it also carries ethical components. This article is concerned with the risks and benefits of MRI screening that should be explained to screening participants and discusses the evidence needed by policy makers who ultimately will determine a just allocation of health care resources to MRI breast cancer screening.
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Affiliation(s)
- Sylvia K Plevritis
- Department of Radiology, Stanford University, Stanford, California, USA.
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Current awareness. NMR IN BIOMEDICINE 2002; 15:75-86. [PMID: 11840556 DOI: 10.1002/nbm.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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