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Badan GM, Roveda Júnior D, Ferreira CAP, de Noronha Junior OA. Complete internal audit of a mammography service in a reference institution for breast imaging. Radiol Bras 2015; 47:74-8. [PMID: 25741052 PMCID: PMC4337155 DOI: 10.1590/s0100-39842014000200007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 10/25/2013] [Indexed: 11/22/2022] Open
Abstract
Objective Undertaking of a complete audit of the service of mammography, as recommended by
BI-RADS®, in a private reference institution for breast
cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of
results with those recommended by the literature. Materials and Methods Retrospective, analytical and cross-sectional study including 8,000 patients
submitted to mammography in the period between April 2010 and March 2011, whose
results were subjected to an internal audit. The patients were followed-up until
December 2012. Results The radiological classification of 7,249 screening mammograms, according to
BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%),
4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8
cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases.
Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%,
respectively. In the present study, the sensitivity of the method was 97.1% and
specificity, 97.4%. Conclusion The complete internal audit of a service of mammography is essential to evaluate
the quality of such service, which reflects on an early breast cancer detection
and reduction of mortality rates.
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Affiliation(s)
- Gustavo Machado Badan
- Specialist in Breast Imaging, MD, Second Assistant Physician, Santa Casa de São Paulo, Coordinator for the Unit of Interventional Procedures, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil
| | - Décio Roveda Júnior
- College Instructor, Director, Unit of Imaging Diagnosis at Santa Casa de São Paulo, Coordinator for the Unit of Radiology, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil
| | - Carlos Alberto Pecci Ferreira
- Physician Assistant, Coordinator for the Unit of Breast Imaging, Department of Medical Practice, School of Medical Sciences, Santa Casa de São Paulo, Coordinator for the Service of Mammography, FEMME - Laboratório da Mulher, São Paulo, SP, Brazil
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Bitencourt AGV, Lima ENP, Chojniak R, Marques EF, de Souza JA, Graziano L, Andrade WP, Osório CABDT. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas. Radiol Bras 2015; 47:67-73. [PMID: 25741051 PMCID: PMC4337160 DOI: 10.1590/s0100-39842014000200006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 12/12/2013] [Indexed: 01/09/2023] Open
Abstract
Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose
(18F-FDG) positron emission tomography/computed tomography (PET/CT)
performed with a specific protocol for assessment of breasts with
histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with
biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT
examination in prone position, with a specific protocol for assessment of breasts.
PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum
diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm). Invasive ductal
carcinoma was the most common histological type (n = 47; 79.7%).
At PET/CT, 53 (89.8%) of the lesions demonstrated anomalous concentrations of
18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5). A
statistically significant association was observed between higher values of
maximum SUV and histological type, histological grade, molecular subtype, tumor
diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated
good sensitivity and was associated with relevant histological/immunohistochemical
factors related to aggressiveness and prognosis of breast carcinomas.
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Affiliation(s)
| | | | - Rubens Chojniak
- PhD, MD, Director, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Elvira Ferreira Marques
- Physician Responsible for the Unit of Breast Imaging at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Juliana Alves de Souza
- Titular Physicians, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Luciana Graziano
- Titular Physicians, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wesley Pereira Andrade
- Master, Titular Physician, Department of Mastology, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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Villar VCFL, Seta MHD, de Andrade CLT, Delamarque EV, de Azevedo ACP. Evolution of mammographic image quality in the state of Rio de Janeiro. Radiol Bras 2015; 48:86-92. [PMID: 25987749 PMCID: PMC4433297 DOI: 10.1590/0100-3984.2014.0047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/15/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the evolution of mammographic image quality in the state of Rio de Janeiro on the basis of parameters measured and analyzed during health surveillance inspections in the period from 2006 to 2011. MATERIALS AND METHODS Descriptive study analyzing parameters connected with imaging quality of 52 mammography apparatuses inspected at least twice with a one-year interval. RESULTS Amongst the 16 analyzed parameters, 7 presented more than 70% of conformity, namely: compression paddle pressure intensity (85.1%), films development (72.7%), film response (72.7%), low contrast fine detail (92.2%), tumor mass visualization (76.5%), absence of image artifacts (94.1%), mammography-specific developers availability (88.2%). On the other hand, relevant parameters were below 50% conformity, namely: monthly image quality control testing (28.8%) and high contrast details with respect to microcalcifications visualization (47.1%). CONCLUSION The analysis revealed critical situations in terms of compliance with the health surveillance standards. Priority should be given to those mammography apparatuses that remained non-compliant at the second inspection performed within the one-year interval.
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Affiliation(s)
| | - Marismary Horsth De Seta
- PhDs, Professors, Public Health Post-Graduation Program, Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Carla Lourenço Tavares de Andrade
- PhDs, Professors, Public Health Post-Graduation Program, Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Elizabete Vianna Delamarque
- Master, Research Assistant at Health Surveillance Collaboration Center - Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Rocha RD, Pinto RR, Tavares DPBA, Gonçalves CSA. Step-by-step of ultrasound-guided core-needle biopsy of the breast: review and technique. Radiol Bras 2013. [DOI: 10.1590/s0100-39842013000400010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ultrasound-guided core-needle biopsy has high sensitivity in the diagnosis of breast cancer. The present study is aimed at detailing the main steps of such procedure, including indications, advantages, limitations, follow-up and description of the technique, besides presenting a checklist including the critical steps required for an appropriate practice of the technique. In the recent years, an increasing number of patients have required breast biopsy, indicating the necessity of a proportional increase in the number of skilled professionals to carry out the procedures and histological diagnoses. A multidisciplinary approach involving the tripod clinical practice-radiology-pathology is responsible for the highest rate of accuracy of the technique and must always be adopted.
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Yamada AM, Melo ALKO, Lopes GP, Andrade Neto GBD, Monteiro VB, Soares RS. Bilateral breast swelling secondary to superior vena cava obstruction and subclavian vein thrombosis. Radiol Bras 2013. [DOI: 10.1590/s0100-39842013000400013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Superior vena cava syndrome is defined by a set of signs and symptoms secondary to superior vena cava obstruction caused principally by malignant diseases. The present report describes the case of an unusual clinical manifestation of this syndrome with bilateral breast swelling, and emphasizes the relevance of knowledge on mammographic signs of systemic diseases.
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Coeli GNM, Reis HFD, Bertinetti DR, Faria FM, Tiezzi DG, Oliveira TMGD. Mucinous carcinoma of the breast: iconographic essay with histopathological correlation. Radiol Bras 2013. [DOI: 10.1590/s0100-39842013000400011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The present essay is aimed at describing the most characteristic imaging findings of mucinous carcinoma of the breast, with emphasis on the patterns related to better prognosis. The authors selected cases of mucinous carcinoma of the breast whose images were available, highlighting the imaging findings suggestive of this subtype of breast cancer, either at mammography, ultrasonography or magnetic resonance imaging.
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Testa ML, Chojniak R, Sene LS, Damascena AS. Diffusion-weighted magnetic resonance imaging: biomarker for treatment response in oncology. Radiol Bras 2013. [DOI: 10.1590/s0100-39842013000300013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The authors report a case where a quantitative assessment of the apparent diffusion coefficient (ADC) of liver metastasis in a patient undergoing chemotherapy has shown to be an effective early marker for predicting therapeutic response, anticipating changes in tumor size. A lesion with lower initial ADC value and early increase in such value in the course of the treatment tends to present a better therapeutic response.
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Rodrigues DCN, Freitas-Junior R, Corrêa RDS, Peixoto JE, Tomazelli JG, Rahal RMS. Performance of diagnostic centers in the classification of opportunistic screening mammograms from the Brazilian public health system (SUS). Radiol Bras 2013. [DOI: 10.1590/s0100-39842013000300008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the performance of diagnostic centers in the classification of mammography reports from an opportunistic screening undertaken by the Brazilian public health system (SUS) in the municipality of Goiânia, GO, Brazil in 2010. Materials and Methods The present ecological study analyzed data reported to the Sistema de Informação do Controle do Câncer de Mama (SISMAMA) (Breast Cancer Management Information System) by diagnostic centers involved in the mammographic screening developed by the SUS. Based on the frequency of mammograms per BI-RADS® category and on the limits established for the present study, the authors have calculated the rate of conformity for each diagnostic center. Diagnostic centers with equal rates of conformity were considered as having equal performance. Results Fifteen diagnostic centers performed mammographic studies for SUS and reported 31,198 screening mammograms. The performance of the diagnostic centers concerning BI-RADS classification has demonstrated that none of them was in conformity for all categories, one center presented conformity in five categories, two centers, in four categories, three centers, in three categories, two centers, in two categories, four centers, in one category, and three centers with no conformity. Conclusion The results of the present study demonstrate unevenness in the diagnostic centers performance in the classification of mammograms reported to SISMAMA from the opportunistic screening undertaken by SUS.
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