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Moschetta M, Sardaro A, Nitti A, Telegrafo M, Maggialetti N, Scardapane A, Brunese MC, Lavelli V, Ferrari C. Ultrasound evaluation of ductal carcinoma in situ of the breast. J Ultrasound 2021; 25:41-45. [PMID: 33409862 PMCID: PMC8964906 DOI: 10.1007/s40477-020-00551-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To assess the role of ultrasound (US) in detecting and characterizing ductal carcinoma in situ (DCIS) of the breast and to investigate the correlation between ultrasonographic and biological features of DCIS. METHODS In total, 171 patients (mean age 44; range 39-62) with 178 lesions were retrospectively evaluated by two independent radiologists searching for US mass or non-mass lesions. Immunohistochemistry analysis was performed to determine estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. The US detection rate and pattern distribution among the lesion types were evaluated. The χ2 test was used to evaluate the correlation between the US findings and the biological factors. Statistical significance was indicated by p values < 0.05. Inter-observer agreement was calculated by Kohen's k test. RESULTS US detected 35% (63/178) of all lesions. Fifty-two (83%) lesions were classified as mass lesions, and 11 (17%) as non-mass lesions (p < 0.0001). Among the mass lesions, the most common shape was irregular (79%; p < 0.0001), with 45 (87%) lesions having indistinct margins. Hypoechogenicity was the most common echo pattern (49 cases, 94%; p < 0.0001). Microcalcifications were found in 23 cases (37%; p = 0.004) and were associated with mass lesions in 15 cases (65%) and with non-mass lesions in 8 cases (35%) (p = 0.21). An almost perfect inter-observer agreement (k = 0.87) was obtained between the two radiologists. A significant ER expression was found in mass lesions (83%; p < 0.0001), with no significant PR (p = 0.89) or HER2 expression (p = 0.81). Among the lesions with microcalcifications, only 7 out of 23 cases (30%) were positive for HER2 (p = 0.09). CONCLUSION DCIS represents a heterogeneous pathological process with variable US appearance (mass-like, non-mass-like, or occult). The most common US finding is represented by mass-type, hypoechogenic lesions with indistinct margins. A significant ER expression exists among mass-type lesions, while microcalcifications seem not to be associated with HER2 expression.
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Affiliation(s)
- Marco Moschetta
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | - Angela Sardaro
- grid.7644.10000 0001 0120 3326DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy
| | - Adriana Nitti
- grid.7644.10000 0001 0120 3326DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy
| | - Michele Telegrafo
- grid.7644.10000 0001 0120 3326DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Nicola Maggialetti
- grid.10373.360000000122055422Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Arnaldo Scardapane
- grid.7644.10000 0001 0120 3326DIM, Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy
| | - Maria Chiara Brunese
- grid.10373.360000000122055422Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Valentina Lavelli
- grid.7644.10000 0001 0120 3326DIM, Interdisciplinary Department of Medicine, Section of Nuclear Medicine, Aldo Moro University of Bari Medical School, Bari, Italy
| | - Cristina Ferrari
- grid.7644.10000 0001 0120 3326DIM, Interdisciplinary Department of Medicine, Section of Nuclear Medicine, Aldo Moro University of Bari Medical School, Bari, Italy
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Reginelli A, Silvestro G, Fontanella G, Sangiovanni A, Conte M, Nuzzo I, Calvanese M, Traettino M, Ferraioli P, Grassi R, Manzo R, Cappabianca S. Validation of DWI in assessment of radiotreated bone metastases in elderly patients. Int J Surg 2016; 33 Suppl 1:S148-53. [PMID: 27392721 DOI: 10.1016/j.ijsu.2016.06.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Bone metastases are commonly observed in oncologic patients with advanced disease. These metastases are considered the main cause of neoplastic pain, with more than half of oncologic patients experiencing neoplastic pain during the course of the disease due to bone involvement. Lung, breast, and prostate cancers are the primary causes of bone metastases. Magnetic resonance imaging (MRI), especially diffusion weighted imaging (DWI) sequences, is the focus of our research, as it has been proven to be an optimal predictive index to assess the radiation treatment in many patients. We included patients treated with standard fractioning of radiation therapy. First, we examined the irradiated lesions with the MRI-DWI technique, before treatment and 30 and 60 days after its completion. Then we combined the MRI results and clinical parameters in a table with a predictive score for the quality of life in patients with bone metastases. This was a significant predictor of the efficacy of radiation treatment, from both clinical and psychological points of view, as it can allow an early assessment of the response to RT and therefore better scheduling of the next therapeutic steps to be performed. The table of the score we proposed helped guide patient monitoring, enabling us to undertake, where possible, follow-up with therapeutic strategies tailored to each patient's needs.
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Affiliation(s)
- Alfonso Reginelli
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | | | - Giovanni Fontanella
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | - Angelo Sangiovanni
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | - Mario Conte
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | - Iolanda Nuzzo
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | | | - Marianna Traettino
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | - Piera Ferraioli
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
| | - Roberta Grassi
- Department of Radiotherapy, University of Sassari, Sassari, Italy.
| | - Roberto Manzo
- Department of Radiotherapy, Cardinale Ascalesi Hospital, Naples, Italy.
| | - Salvatore Cappabianca
- Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology and Radiotherapy, Second University of Naples, Naples, Italy.
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