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Katouli FS, Bayani L, Azizinik F, Fathi S, Seifollahi A, Bozorgabadi FZ. Spectrum of ultrasound findings in patients with history of breast conservative treatment. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1381-1389. [PMID: 37526634 DOI: 10.1002/jcu.23524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
Breast conservative treatment (BCT) is currently accepted as the standard treatment option for breast cancer. Targeted ultrasound helps detect recurrent lesions, postoperative changes, and scarring tissue. In this pictorial essay, we review the ultrasound features of benign (seroma, hematoma, fat necrosis, traumatic neuroma, fibrosis/scarring) and malignant (recurrence, new primary cancer) causes of palpable lumps after BCT and provide images from our patients to illustrate some typical findings of common pathologies. Ultrasound, especially as an adjunct to mammography, can make a specific diagnosis in most cases.
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Affiliation(s)
- Fatemeh Shakki Katouli
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Bayani
- Department of Radiology, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Azizinik
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Amiralam and Yas Hospitals, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Fathi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Seifollahi
- Pathology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zare Bozorgabadi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Rakhawy MMME, Soliman N, Elnahas W, Karam R, Abdel-Khalek AM. Prediction of local breast cancer recurrence after surgery: the added value of diffusion tensor imaging. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00831-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is considerable overlap between benign postoperative changes and recurrent breast cancer imaging features in patients surgically treated for breast cancer. This study aims to evaluate the value of adding multiple diffusion tensor imaging (DTI) parameters, including mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity, (AD), and relative anisotropy (RA) in differentiating breast cancer recurrence from postoperative changes in patients who were surgically treated for breast cancer and to also evaluate the role of these parameters in characterizing the different pathologies seen in the postoperative breast.
Results
This is a prospective study that was performed on female patients who were surgically treated for breast cancer. The study was done on 60 cases having 77 breast lesions. (Sixty-two of them were described as mass lesions and 15 of them were described as non-mass enhancement on MRI.) Among analyzed DTI parameters, MD showed the highest sensitivity (97.1%), specificity (88.1%), and accuracy (92.2%) in predicting recurrent breast cancer. FA, AD, and RD showed sensitivity (77.1%, 85.7%, and 88.6%) and specificity (83.3%, 83.3%, and 73.8%) in predicting recurrent breast cancer, respectively. The median MD values were lower in grade III recurrent breast cancers when compared to its values in recurrent grade II breast cancers and recurrent DCIS (0.6 × 10–3 mm2/s vs. 0.8 × 10–3 mm2/s and 0.9 × 10–3 mm2/s), respectively. FA also showed median values in grade III recurrent breast cancer higher than its values in grade II recurrent breast cancer and recurrent DCIS (0.6 vs. 0.5 and 0.39), respectively. The sensitivity, specificity, PPV, NPV, accuracy, F1 score, and MCC of DCE-MRI alone versus DCE-MRI plus combined DTI parameters were 88.6% versus 100%, 88.1% versus 90.5%, 86.1% versus 89.7%, 90.2% versus 100%, 88.3% versus 94.6%, 87.3% versus 94.6%, and 76.5% versus 90.1%, respectively.
Conclusions
DTI may play an important role as a complementary method to discriminate recurrent breast cancer from postoperative changes in patients surgically treated for previous breast cancer.
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