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El Graini S, El Hassouni F, Rouas L, Fathi K, Chat L, El Haddad S. Giant juvenile fibroadenoma: A case report. Int J Surg Case Rep 2024; 121:109897. [PMID: 38906040 PMCID: PMC11252914 DOI: 10.1016/j.ijscr.2024.109897] [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: 04/24/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Breast pathology in adolescents is rare and predominantly benign, with abnormalities including congenital anomalies, infections, mastodynia, nipple discharge, and mostly benign breast masses. Fibroepithelial tumors, the most common type, form a heterogeneous group that includes benign, borderline, and malignant entities such as phyllodes tumors. Differentiation of these tumors, especially various types of fibroadenomas, requires histopathological examination due to their similar radiological appearances and lesion heterogeneity. Recognizing the nature of these lesions is crucial to avoid missing malignant forms with metastatic potential. Giant juvenile fibroadenoma is a quite rare benign fibroepithelial tumour, that cannot be differentiate from phyllodes tumors before anatomopathological examination. CASE REPORT We report the case of a 14-year-old patient who presented with a rapidly enlarging mass in the left breast, and the diagnosis of giant juvenile adenofibroma was confirmed after surgical treatment. CLINICAL DISCUSSION Giant juvenile fibroadenomas occurs in adolescent girl and constitutes 0.5 % - 4 % of all fibroadenomas cases. When it exceeds 5 cm, weighs more than 500 g, or occupies more than 4/5 of the breast, it is considered as giant. It is characterized by a rapid increase in size, causing distortion and compression of the breast. Breast ultrasound is the first imaging modality, showing a large, well-limited hypo or iso echoic mass. The main differential diagnosis should be made with phyllodes tumors. The diagnosis is considered based on clinical and radiological features but is confirmed only after surgical excision of the mass and histological study. CONCLUSION The discovery of a breast mass in an adolescent should prompt further investigations to avoid overlooking a fibroepithelial tumour. The most probable diagnoses are giant juvenile fibroadenoma and phyllodes tumors.
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Affiliation(s)
- Soumya El Graini
- Radiology Department, Women and Children Hospital - Ibn Sina University Hospital, University Mohamed V, Rabat, Morocco.
| | - Fatima El Hassouni
- Department of Gyneco-Obstetrics-High-Risk Pregnancy-Cancerology, Souissi Maternity Hospital of Rabat, University Mohamed V, Rabat, Morocco
| | - Lamia Rouas
- Anatomo-pathology Department, Ibn Sina University Hospital, University Mohamed V, Rabat, Morocco
| | - Khalid Fathi
- Department of Gyneco-Obstetrics-High-Risk Pregnancy-Cancerology, Souissi Maternity Hospital of Rabat, University Mohamed V, Rabat, Morocco
| | - Latifa Chat
- Radiology Department, Women and Children Hospital - Ibn Sina University Hospital, University Mohamed V, Rabat, Morocco
| | - Siham El Haddad
- Radiology Department, Women and Children Hospital - Ibn Sina University Hospital, University Mohamed V, Rabat, Morocco
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Tao F, Hao Y, Wang D, Zhang W, Wang F. Clinical application and effect evaluation of acupoint thread embedding therapy and traditional Chinese medicine treatment based on menstrual cycle characteristics in the management of breast hyperplasia: An observational study. Medicine (Baltimore) 2024; 103:e38502. [PMID: 38941407 DOI: 10.1097/md.0000000000038502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
To evaluate the effectiveness of the combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment regimen in improving clinical symptoms, promoting tumor regression, controlling adverse reactions and complications, and enhancing patient satisfaction by comparing and analyzing the clinical data of 120 breast tumor patients. One hundred twenty patients with breast cancer were divided into a treatment group (60 cases) and a control group (60 cases) according to different treatment plans. Patients in the treatment group received a combination of acupoint embedding therapy and traditional Chinese medicine dialectical treatment based on different time points of the menstrual cycle. Including the proportion of reduction in the number of breast masses, the proportion of reduction in mass size, changes in pain severity scores, tumor regression rate, regression time, incidence of adverse reactions and complications, and patient satisfaction. Statistical software was used to analyze the data to evaluate differences between the 2 groups. In terms of clinical symptoms, the proportion of reduction in the number of breast masses in the treatment group averaged 50%, significantly higher than the 25% in the control group; the proportion of reduction in mass size averaged 40%, also higher than the 15% in the control group; and the improvement in pain severity scores was also superior to the control group. Regarding tumor regression, the tumor regression rate in the treatment group reached 85%, with an average regression time of 6.2 weeks, both significantly better than the 55% and 9.8 weeks in the control group. In terms of adverse reactions and complications, the incidence rate in the treatment group was relatively low, and no serious adverse events occurred. Patient satisfaction surveys showed that the treatment group had significantly higher satisfaction with treatment effectiveness, treatment process, and physician service attitude compared to the control group. Based on clinical data from 120 breast tumor patients, the results of this study indicate that breast tumor patients treated with a specific treatment regimen have significant advantages in improving clinical symptoms, tumor regression, controlling adverse reactions and complications, and patient satisfaction. This treatment regimen has high clinical application value and deserves further promotion.
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Affiliation(s)
- Fan Tao
- Department of Traditional Chinese Medicine, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Yaming Hao
- Department of Traditional Chinese Medicine, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Dan Wang
- Department of Traditional Chinese Medicine, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Weichen Zhang
- Department of Traditional Chinese Medicine, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Feng Wang
- School of Physical Education, Wuhan Business University, Wuhan, Hubei, China
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Cheshuk V, Anikusko M, Kozina V, Ulishchenko V, Malec M. VIRGINAL RECURRENT GIGANTOMASTIA (BREAST HYPERTROPHY). A CASE REPORT. Exp Oncol 2024; 46:73-76. [PMID: 38852049 DOI: 10.15407/exp-oncology.2024.01.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Indexed: 06/10/2024]
Abstract
Virginal gigantomastia (VGM) is a benign disease of the breasts without a clearly established etiology. The treatment of VGM remains a problem. The conservative treatment is not effective while surgery is too traumatic. Most specialists recommend subcutaneous mastectomy with immediate implant reconstruction or reduction mammoplasty. The reduction mammoplasty with adjuvant hormone therapy is a variant of treatment of young patients with a risk of recurrence. We present a case of a patient with VGM who was operated in 2014. Reduction mammoplasty was performed. After 9 years, the patient had a relapse and second surgery, resection of the breasts with reduction mammoplasty. Tissues with cysts, fibrosis, hamartomas, and fibroadenomas were dissected. Histopathology revealed extensive fibrosis with hamartomas and fibroadenomas. The immunohistochemical examination of the breast tissue showed a high level (70%) of estrogen and progesterone receptors expression. We prescribed hormone therapy with tamoxifen 10 mg per day. Dynamic monitoring of the treatment result and control of the disease remission was carried out. Breast-conserving surgery performed in such patients can help alleviate the psychological, social, and physical disorders caused by VGM.
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Affiliation(s)
- V Cheshuk
- Bogomolets National Medical University, Kyiv, Ukraine
| | - M Anikusko
- Kyiv City Clinical Oncology Center, Kyiv, Ukraine
| | - V Kozina
- Kyiv City Clinical Oncology Center, Kyiv, Ukraine
| | - V Ulishchenko
- Bogomolets National Medical University, Kyiv, Ukraine
| | - M Malec
- Kyiv City Clinical Oncology Center, Kyiv, Ukraine
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Szar M, Dendy CB, Hillenbrand K. Breast Conditions (Disorders) in Children. Pediatr Rev 2023; 44:665-667. [PMID: 37907414 DOI: 10.1542/pir.2022-005534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Madison Szar
- Brody School of Medicine at East Carolina University, Greenville, NC
- ECU Health Medical Center, Greenville, NC
| | - Colby B Dendy
- Brody School of Medicine at East Carolina University, Greenville, NC
| | - Karin Hillenbrand
- Brody School of Medicine at East Carolina University, Greenville, NC
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Sergesketter AR, Geng Y, Tian WM, Langdell HC, Shammas RL, Knackstedt R, Rezak K. The Influence of Age on Complications After Correction of Congenital Breast Deformities: A National Analysis of the Pediatric and Adult NSQIP Data Sets. Aesthet Surg J 2023; 43:1273-1282. [PMID: 37157865 DOI: 10.1093/asj/sjad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Timing of surgical intervention is controversial among patients seeking correction of congenital breast deformities. OBJECTIVES This study aimed to assess the influence of age on 30-day complications and unplanned healthcare utilization after reconstruction of congenital breast deformities. METHODS Female patients undergoing breast reconstruction for congenital breast deformities and Poland syndrome were identified on the basis of International Classification of Diseases (ICD) codes in the 2012 to 2021 pediatric and adult National Surgical Quality Improvement Project (NSQIP) data sets. Complications based on age at correction were compared, and multivariate logistic regression was used to identify predictors of overall and wound healing complications. RESULTS Among 528 patients meeting inclusion criteria, mean (SD) age at surgical correction was 30.2 (13.3) years. Patients most commonly underwent implant placement (50.5%), mastopexy (26.3%), or tissue expander placement (11.6%). Across the cohort, overall incidence of postoperative complications was 4.4%, most commonly superficial surgical site infection (1.0%), reoperation (1.1%), or readmission (1.0%). After multivariate adjustment, increasing age at time of correction was associated with higher incidence of wound complications [odds ratio (OR) 1.001; 95% confidence interval (CI) 1.0003-1.002; P = .009], in addition to BMI (OR 1.002; 95% CI 1.0007-1.004; P = .006) and tobacco use (OR 1.06; 95% CI 1.02-1.11; P = .003). CONCLUSIONS Breast reconstruction for congenital breast deformities may be safely undertaken at a young age with a low associated risk of postoperative complications. Large, multi-institutional studies are needed to assess the influence of surgical timing on psychosocial outcomes in this population.
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Brown MH, Joukhadar N. Commentary on: The Influence of Age on Complications After Correction of Congenital Breast Deformities: A National Analysis of the Pediatric and Adult NSQIP Datasets. Aesthet Surg J 2023; 43:1283-1284. [PMID: 37287194 DOI: 10.1093/asj/sjad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/09/2023] Open
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Suhail D, Faderani R, Kalaskar DM, Mosahebi A. Optimal strategies for addressing developmental breast asymmetry and the significance of symmetrical treatment: A systematic review. J Plast Reconstr Aesthet Surg 2023; 84:582-594. [PMID: 37441855 DOI: 10.1016/j.bjps.2023.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Approximately one quarter of women are affected by asymmetry as a result of abnormal breast development, which can lead to significant emotional distress. Despite this, there is currently no widely accepted approach for managing this prevalent condition. This systematic review aimed to review the available literature on the management of developmental breast asymmetry. METHODS A comprehensive search in MEDLINE, EMBASE, and CENTRAL databases was conducted for primary clinical studies reporting on the management of developmental breast asymmetry from 1962 to November 2022. The primary outcome measures were long-term aesthetic outcomes and patient-reported outcomes. RESULTS Eleven case series and 2 cohort studies were included, comprising a total of 1237 patients with a mean age of 26.5 years (range 14-65 years). Twelve studies (92%) addressed asymmetry through surgical means, using various augmentation and reduction procedures, whereas one study (8%) utilized external prostheses. Meta-analysis of the data was not deemed to be possible because of heterogeneity of data; a narrative synthesis of the literature was provided. CONCLUSIONS There is no consensus on how to manage developmental breast asymmetry. Furthermore, there is a lack of consistency in the classification of patients with developmental breast asymmetry and in the reporting of outcomes, highlighting the need for a consensus. Further research outlining long-term aesthetic and patient-reported outcomes is needed to understand which procedures provide optimal outcomes. In addition, external breast prosthesis is a promising nonsurgical alternative, and further studies into its efficacy are needed.
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Affiliation(s)
- Dernas Suhail
- Hull York Medical School, University of York, York, UK.
| | - Ryan Faderani
- Department of Plastic Surgery, Royal Free Hospitals NHS Trust, London, UK
| | - Deepak M Kalaskar
- UCL Division of Surgery & Interventional Science, Royal Free Hospital, London, UK
| | - Afshin Mosahebi
- Department of Plastic Surgery, Royal Free Hospitals NHS Trust, London, UK
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Ueshima M, Matsuda S, Iwama M. A Case of Pediatric Breast Abscess Caused by Rarely Observed Bacteria in a Three-Year-Old Boy With an Inverted Nipple: Peptoniphilus harei, Actinotignum sanguinis, and Porphyromonas somerae. Cureus 2023; 15:e41011. [PMID: 37519494 PMCID: PMC10374975 DOI: 10.7759/cureus.41011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Mastitis and breast abscesses are most common in lactating women but can also be observed in non-lactating women, adolescent girls, and neonates. However, breast abscesses are extremely rare in young boys. Herein, we report the case of a three-year-old boy with a swollen and painful right nipple, later diagnosed with a breast abscess. In this case, we suspected that the patient's inverted nipple was the possible site of the infection. To our best knowledge, this is the first case report of breast abscess in a young boy after the neonatal period. Although Staphylococcus aureus is the most common pathogen, our patient showed three rare bacteria, namely, Peptoniphilus harei, Actinotignum sanguinis, and Porphyromonas somerae, in the culture of the aspirated pus. Furthermore, this case study is the first report of a breast abscess caused by Porphyromonas somerae.
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Affiliation(s)
- Manami Ueshima
- Department of Pediatrics, Kameda Medical Center, Kamogawa, JPN
| | - Satoshi Matsuda
- Department of Pediatric Surgery, Kameda Medical Center, Kamogawa, JPN
| | - Mayumi Iwama
- Department of Pediatrics, Kameda Medical Center, Kamogawa, JPN
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Mansouri G, Alkatout I, Iranpour M, Pourkhandani E, Allahqoli L. Unexpected presentation of accessory breast: vulvar accessory breast tissue: a case report. J Med Case Rep 2023; 17:189. [PMID: 37150807 PMCID: PMC10165762 DOI: 10.1186/s13256-023-03930-0] [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: 10/25/2022] [Accepted: 04/12/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND The accessory breast is composed of residual glandular mammary tissue that persists after normal embryonic development. The entity is so rare that it is easily neglected in the diagnosis of disease. CASE PRESENTATION We report a 24-year-old virgin Persian woman with a left-sided vulvar mass and no pain or discomfort until shortly before her presentation at our department. Ectopic breast tissue in the vulva was diagnosed. We performed wide local resection of the lesion. Pathological investigation of the lesion confirmed the presence of ectopic breast tissue with secretory changes. She had no specific developmental abnormalities and had no relevant family history. She was followed up for 10 months and had recovered fully by this time. CONCLUSION Accessory breast tissue should be considered as a diagnosis when a mass is seen along the embryonic milk line, especially if the clinical findings reveal changes in the mass accompanied by changes in sex hormones.
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Affiliation(s)
- Ghazal Mansouri
- Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Arnold-Heller-Str. 3, Haus 24, 24105, Kiel, Germany
| | - Maryam Iranpour
- Department of Pathology, Pathology and Stem Cell Research Center, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Pourkhandani
- Department of Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
- Obstetrics and Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran.
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Wang J, Zhang DD, Cheng JM, Chen HY, Yang RJ. Giant juvenile fibroadenoma in a 14-year old Chinese female: A case report. World J Clin Cases 2023; 11:1808-1813. [PMID: 36969997 PMCID: PMC10037279 DOI: 10.12998/wjcc.v11.i8.1808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/04/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND A giant juvenile fibroadenoma (GJF) is a rare, benign breast tumor that affects females < 18 years of age. GJFs are generally suspected based on a palpable mass. GJFs influence breast shape and mammary gland development via the pressure effect from their enormous size.
CASE SUMMARY Herein we report a case involving a 14-year-old Chinese female with a GJF in the left breast. GJF is a rare, benign breast tumor that usually occurs between 9 and 18 years of age and accounts for 0.5%-4.0% of all fibroadenomas. In severe cases, breast deformation may occur. This disease is rarely reported in Chinese people and has a high clinical misdiagnosis rate due to the absence of specific imaging features. On July 25, 2022, a patient with a GJF was admitted to the First Affiliated Hospital of Dali University. The preoperative clinical examination and conventional ultrasound diagnosis needed further clarification. The mass was shown to be an atypical lobulated mass during the operation and confirmed to be a GJF based on pathologic examination.
CONCLUSION GJF is also a rare, benign breast tumor in Chinese women. Evaluation of such masses consists of a physical examination, radiography, ultrasonography, computer tomography, and magnetic resonance imaging. GJFs are confirmed by histopathologic examination. Mastectomy is not selected when the patient benefits from a complete resection of the mass with breast reconstruction and an uneventful recovery.
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Affiliation(s)
- Jing Wang
- Department of Ultrasound, First Affiliated Hospital of Dali University (The People’s Fourth Hospital of Yunnan Province), Dali 671000, Yunnan Province, China
| | - Dai-Di Zhang
- Department of Ultrasound, First Affiliated Hospital of Dali University (The People’s Fourth Hospital of Yunnan Province), Dali 671000, Yunnan Province, China
- Department of Ultrasound, School of Clinical Medicine, Dali University, Dali 671000, Yunnan Province, China
| | - Jia-Mao Cheng
- Department of Anatomy, College of Basic Medicine, Dali University, Dali 671000, Yunnan Province, China
| | - Hai-Yan Chen
- Department of Ultrasound, First Affiliated Hospital of Dali University (The People’s Fourth Hospital of Yunnan Province), Dali 671000, Yunnan Province, China
- Department of Ultrasound, School of Clinical Medicine, Dali University, Dali 671000, Yunnan Province, China
| | - Rong-Jiao Yang
- Department of Ultrasound, First Affiliated Hospital of Dali University (The People’s Fourth Hospital of Yunnan Province), Dali 671000, Yunnan Province, China
- Department of Ultrasound, School of Clinical Medicine, Dali University, Dali 671000, Yunnan Province, China
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Norelius R. Juvenile Benign Diseases of the Breast. Surg Clin North Am 2022; 102:1065-1075. [DOI: 10.1016/j.suc.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jacinto JGP, Häfliger IM, Christen M, Paris JM, Seefried FR, Drögemüller C. Is a heterozygous missense variant in SGSH the cause of a syndromic form of congenital amastia in an Original Braunvieh calf? Anim Genet 2022; 53:530-531. [PMID: 35535008 DOI: 10.1111/age.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Joana G P Jacinto
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia (Bologna), Italy.,Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Irene M Häfliger
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Matthias Christen
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | - Julia M Paris
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
| | | | - Cord Drögemüller
- Vetsuisse Faculty, Institute of Genetics, University of Bern, Bern, Switzerland
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Faast A, Ikeda DM, Pittman S, DeMartini W, Kozlov A. FDG Avid Abnormalities in the Breast: Breast Cancer Mimics. CURRENT RADIOLOGY REPORTS 2021. [DOI: 10.1007/s40134-021-00383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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