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Yeow YJ, Yu CC, Cheung YC, Chen SC. A cohort study of mammography-guided vacuum-assisted breast biopsy in patients with compressed thin breasts (≦ 3 cm). Asian J Surg 2023; 46:4296-4301. [PMID: 37150735 DOI: 10.1016/j.asjsur.2023.04.074] [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: 09/27/2022] [Revised: 01/28/2023] [Accepted: 04/18/2023] [Indexed: 05/09/2023] Open
Abstract
OBJECTIVES In the women with compressed thin thickness (≦ 3 cm), mammographic guiding vacuum-assist breast biopsy (MG-VABB) is a technical challenge. We herein report their performance of MG-VABB on suspicious microcalcification by modern mammography. METHODS We retrospectively reviewed the consecutive MG-VABB in our hospital from February 2019 to January 2021. All the patients received biopsy because of suspicious microcalcifications discovered by mammography and had at least one-year post-biopsy follow-up. RESULTS We reviewed 745 consecutive patients revealing 195 with compressed thin breasts ≦ 3 cm (mean age: 50.12 ± 7.0; breast thickness: 24.99 mm range 11.6-30 mm). Of the 191 patients received biopsy, the microcalcification retrieval rate was 97.9%. Using the half-open notch biopsy or horizontal needle approach, the biopsies were technically achieved in 30.4% and 9.4% of patients respectively. Regarding to the gold standard of surgicohistology, the cancer sensitivities was 88.46% and the atypia upgrade rate was 16.67%. There was no statistical difference of the procedure time between stereotactic guided and tomosynthesis guided. CONCLUSIONS The modern MG-VABB has technically improve the performance of biopsy to the patients with compressed thin breasts (≦ 3 cm), revealing approximate results to those breasts > 3 cm. The diagnosis helps the management of suspicious microcalcifications discovered by mammography.
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Affiliation(s)
- Yun-Jen Yeow
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, 5 Fuxing St., Guishan, Taoyuan, Taiwan
| | - Chi-Chang Yu
- Medial college of Chang Gung University, 5 Fuxing Sr., Guishan, Taoyuan, Taiwan; Department of General Surgery, Chang Gung Memorial Hospital, Taiwan
| | - Yun-Chung Cheung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, 5 Fuxing St., Guishan, Taoyuan, Taiwan; Medial college of Chang Gung University, 5 Fuxing Sr., Guishan, Taoyuan, Taiwan.
| | - Shin-Cheh Chen
- Medial college of Chang Gung University, 5 Fuxing Sr., Guishan, Taoyuan, Taiwan; Department of General Surgery, Chang Gung Memorial Hospital, Taiwan
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Keum H, Park HY, Kang B, Jung JH, Kim WW, Lee J. Comparison of margin status assessment between intraoperative digital and conventional specimen mammography in breast cancer: A preliminary study. Asian J Surg 2022; 46:1931-1936. [PMID: 36253258 DOI: 10.1016/j.asjsur.2022.09.094] [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: 06/20/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although breast surgeons can request frozen section biopsies to evaluate margin status in breast-conserving surgery (BCS), specimen imaging is also a useful assessment tool. Intraoperative digital specimen mammography (IDSM) has recently been introduced in Korea. To estimate the clinical role of IDSM, this study compared the clinicopathologic factors of patients whose specimen was assessed with IDSM with those assessed using conventional specimen mammography (CSM). METHODS From October to December 2021, 78 breast cancer patients who underwent BCS were included in this study. The obtained specimens were assessed using IDSM (n = 44) and CSM (n = 34). Clinicopathologic factors included margin involvement status in specimen mammography and the results of frozen section biopsies. The radiation dose emitted from the specimen after mammography was measured using a portable device. RESULTS There were no significant differences in clinicopathological factors between the two groups, except the type of surgery for axillary lymph nodes. The closest distance from the margin to tumor was longer in the CSM group than in the IDSM group, although the difference was not statistically significant (p = 0.894). Margin involvement was accurately detected using IDSM due to the absence of compression (p < 0.001). In addition, the sensitivity and accuracy of IDSM were higher, and the false-negative rate was lower. CONCLUSION Both specimen mammography methods were highly accurate in evaluating the margin involvement status. However, the margin status could be examined more precisely using IDSM because the specimen was not compressed to perform the examination. Because the IDSM system was installed in the operating room, it not only shortened performing routes but also reduced the operating time by providing immediate results.
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Affiliation(s)
- Heejung Keum
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Ho Yong Park
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Byeongju Kang
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jin Hyang Jung
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Wan Wook Kim
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jeeyeon Lee
- Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
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Lee H, Kim SH, Kang BJ, Lee JM. Clinical Utility of MicroPure US Imaging for Breast Microcalcifications. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:876-886. [PMID: 36238918 PMCID: PMC9550630 DOI: 10.3348/jksr.2021.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 08/26/2021] [Indexed: 06/16/2023]
Abstract
Purpose To evaluate the performance of MicroPure US imaging to detect and characterize microcalcifications. Materials and Methods A total of 171 lesions with suspicious microcalcifications seen on mammography and B-mode US were included and simultaneously evaluated using MicroPure US imaging. The size of microcalcifications was divided into small (punctate, amorphous, fine pleomorphic, and fine linear) and large (coarse heterogeneous), and the extent was divided into narrow (grouped) and wide (others). MicroPure US imaging visibility was divided into four types based on the number of microcalcifications on the two images: B > M (more on B-mode), B = M (similar), B < M (more on MicroPure), and negative. Triple pairwise comparison was used to evaluate the imaging features according to the MicroPure US imaging visibility. Results Among the 171 lesions examined, 157 lesions (91.8%) were detected by MicroPure US imaging. The proportion of Breast Imaging Reporting and Data System (BI-RADS) category 4A was significantly higher in the MicroPure positive group, and that of category 4B was significantly higher in the MicroPure negative group (p = 0.035). The other imaging features did not differ. Among the positive MicroPure subgroups, all features showed no significant difference. Conclusion MicroPure US imaging demonstrated 91.8% positivity in detecting microcalcifications on B-mode US. MicroPure US imaging visibility correlated with the BI-RADS category of microcalcifications.
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Kang J, Han K, Song I, Kim KS, Jang WS, Kim MJ, Yoo Y. Real-Time Ultrasound Detection of Breast Microcalcifications Using Multifocus Twinkling Artifact Imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:1300-1308. [PMID: 34928792 DOI: 10.1109/tmi.2021.3136901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Detecting microcalcifications (MCs) in real time is important in the guidance of many breast biopsies. Due to its capability in visualizing biopsy needles without radiation hazards, ultrasound imaging is preferred over X-ray mammography, but it suffers from low sensitivity in detecting MCs. Here, we present a new nonionizing method based on real-time multifocus twinkling artifact (MF-TA) imaging for reliably detecting MCs. Our approach exploits time-varying TAs arising from acoustic random scattering on MCs with rough or irregular surfaces. To obtain the increased intensity of the TAs from MCs, in MF-TA, acoustic transmit parameters, such as the transmit frequency, the number of focuses and f-number, were optimized by investigating acoustical characteristics of MCs. A real-time MF-TA imaging sequence was developed and implemented on a programmable ultrasound research system, and it was controlled with a graphical user interface during real-time scanning. From an in-house 3D phantom and ex vivo breast specimen studies, the MF-TA method showed outstanding visibility and high-sensitivity detection for MCs regardless of their distribution or the background tissue. These results demonstrated that this nonionizing, noninvasive imaging technique has the potential to be one of effective image-guidance methods for breast biopsy procedures.
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Alshafeiy T, Patrie J, Al-Shatouri M. Positive Predictive Value for the Malignancy of Mammographic Abnormalities Based on the Presence of an Ultrasound Correlate. Ultrasound Int Open 2022; 8:E8-E14. [PMID: 35847968 PMCID: PMC9286874 DOI: 10.1055/a-1832-1808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 04/18/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose
To compare the outcomes of different mammographic lesions based on
the presence of an ultrasound (US) correlate and to estimate how often targeted
US can identify such lesions.
Materials and Methods
This retrospective study included all consecutive
cases from 2010 to 2016, with Breast Imaging Reporting and Database System
(BI-RADS) categories 4 & 5 who underwent US as part of their diagnostic
workup. We compared the incidence of malignancy between lesions comprising a US
correlate that underwent US-guided core needle biopsy (CNB) and those without a
correlate that underwent stereotactic CNB.
Results
833 lesions met the study criteria and included masses
(64.3%), architectural distortion (19%), asymmetries
(4.6%), and calcifications (12.1%). The CNB-based positive
predictive value (PPV) was higher for lesions with a US correlate than for those
without (40.2% [36.1, 44.4%] vs. 18.9% [14.5,
23.9%], respectively) (p<0.001). Malignancy odds for masses,
asymmetries, architectural distortion, and calcifications were greater by 2.70,
4.17, 4.98, and 2.77 times, respectively, for the US-guided CNB
(p<0.001, p=0.091, p<0.001, and p=0.034,
respectively). Targeted US identified a correlate to 66.3% of the
mammographic findings. The odds of finding a correlate were greater for masses
(77.8%) than architectural distortions (53.8%) (p<0.001)
or calcifications (24.8%) (p<0.001).
Conclusion
The success of targeted US in identifying a correlate varies
significantly according to the type of mammographic lesion. The PPV of lesions
with a US correlate was significantly higher than that of those with no
correlate. However, the PPV of lesions with no US correlate is high enough
(18.9%) to warrant a biopsy.
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Affiliation(s)
| | - James Patrie
- Biostatistics, University of Virginia, Charlottesville, United States
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van Bekkum S, Dams FEM, Westenend PJ, van Rosmalen J, Menke-Pluijmers MBE, Kock MCJM. Ten years follow-up of histologically benign calcifications in the breast after vacuum-assisted stereotactic biopsy (VASB): Is additional mammographic follow-up warranted? Breast 2021; 59:135-143. [PMID: 34242963 PMCID: PMC8271159 DOI: 10.1016/j.breast.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This study assessed the short-term and the long-term breast cancer rate in patients with benign histopathologic results after a vacuum-assisted stereotactic biopsy (VASB) for calcifications. Methods In a retrospective cohort study, all consecutive patients who had a benign diagnosis after VASB to analyze breast calcifications. Data of breast cancer development at short-term (four years) and long-term follow-up was gathered. Breast cancer rates in our cohort were compared to the breast cancer incidence in the general population. Results Of 1376 patients who underwent VASB to analyze breast calcifications, 823 had a benign histopathologic diagnosis. During short-term follow-up, eight patients developed breast cancer. During the mean long-term follow-up period of 9.3 ± 3.1 years, 22 patients were diagnosed with ipsilateral breast cancer. The incidence rate of breast cancer after benign biopsy was comparable to the rate in the general population. Conclusion In patients with VASB-confirmed benign calcifications of the breast, we found no excess incidence of ipsilateral breast cancer during ten years follow-up. Therefore, in patients with an increased risk of breast cancer (due to a history of breast cancer or familial risk) annual mammography should be sufficient. Patients with a population-based risk may be monitored via biennial mammography by the national screening program. More frequent screening would provide no benefit. 1% developed ipsilateral breast cancer in four-year follow-up after biopsy. 3% developed ipsilateral breast cancer in ten-years follow-up after biopsy. No statistically significant excess incidence of breast cancer after benign calcifications. A benign histopathologic result after VASB can be considered a safe decision tool.
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Affiliation(s)
- Sara van Bekkum
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, Netherlands
| | - Francina E M Dams
- Department of Radiology, Albert Schweitzer Hospital, Dordrecht, Netherlands
| | - Pieter J Westenend
- Department of Pathology, Laboratory of Pathology, Dordrecht, Netherlands
| | | | | | - Marc C J M Kock
- Department of Radiology, Albert Schweitzer Hospital, Dordrecht, Netherlands.
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Wu J, Kong R, Tian S, Li H, Liu JS, Xu Z, Zou BS, Wu KN, Kong LQ. Advances in Ultrasound-Guided Vacuum-Assisted Biopsy of Breast Microcalcifications. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1172-1181. [PMID: 33549383 DOI: 10.1016/j.ultrasmedbio.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Microcalcification is one of the significant indications for or can even be the sole mammographic feature of breast cancer, especially occult breast cancer. Biopsy and pathologic examination are the most important methods used to identify the nature of suspicious microcalcifications. Stereotactic vacuum-assisted breast biopsy (S-VAB) is the most commonly used biopsy method for microcalcifications currently because of the high detection rate of mammography for microcalcifications. However, in recent years, several clinical studies have gradually found that ultrasound-guided vacuum-assisted breast biopsy (US-VAB) could be an alternative to S-VAB for microcalcifications to some extent, and has its own advantages of flexibility, real-time performance, comfort and high accessibility compared with mammography. An overview of US-VAB of microcalcifications is provided with respect to success rate, diagnostic accuracy, advantages and limitations. On the basis of numerous studies and clinical experience, US-VAB proved to be a valid alternative to S-VAB, with comparable diagnostic accuracy if the microcalcification foci could be detected by ultrasound. And for patients with ultrasound-invisible microcalcifications who are not suitable for or tolerable of S-VAB, US-VAB combined with mammography localization of microcalcifications can also be considered.
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Affiliation(s)
- Juan Wu
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Kong
- Department of Physics, Applied Optics Beijing Area Major Laboratory, Beijing Normal University, Beijing, China
| | - Shen Tian
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Li
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia-Shuo Liu
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Xu
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bao-Shan Zou
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai-Nan Wu
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-Quan Kong
- Department of Endocrine and Breast Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Tong W, Zhang X, Luo J, Pan F, Liang J, Huang H, Li M, Cheng M, Pan J, Zheng Y, Xie X. Value of multimodality imaging in the diagnosis of breast lesions with calcification: A retrospective study. Clin Hemorheol Microcirc 2020; 76:85-98. [PMID: 32538829 DOI: 10.3233/ch-200877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To assess the value of conventional ultrasound (US), contrast-enhanced ultrasound (CEUS) and mammography in the diagnosis of breast lesions with calcifications. METHODS A total of 87 breast lesions with calcification were subjected to US, CEUS and mammography and divided into 3 groups: Group A (all cases), Group A1 (31 cases who underwent US and CEUS first followed by mammography), and Group A2 (56 cases who underwent mammography first followed by US and CEUS). A receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of different methods in different groups. RESULTS In Group A, the area under the ROC curve (AUROC) of CEUS were 0.937, which were significantly higher than that of mammography (p < 0.05). In Group A1, the AUROC of CEUS were 0.842, which were not significantly different from that of US and mammography (p > 0.05). In Group A2, the AUROC of CEUS were 0.987, which were significantly higher than that of mammography and US (p < 0.05). CONCLUSION Based on the mammography results, the combination of US and CEUS might improve the diagnostic efficacy in breast lesions with calcification.
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Affiliation(s)
- Wenjuan Tong
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoling Zhang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jia Luo
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Fushun Pan
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jinyu Liang
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hui Huang
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Manying Li
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Meiqing Cheng
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jiamin Pan
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yanling Zheng
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoyan Xie
- Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Jung I, Han K, Kim MJ, Moon HJ, Yoon JH, Park VY, Kim EK. Annual Trends in Ultrasonography-Guided 14-Gauge Core Needle Biopsy for Breast Lesions. Korean J Radiol 2020; 21:259-267. [PMID: 32090518 PMCID: PMC7039722 DOI: 10.3348/kjr.2019.0695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/16/2019] [Indexed: 11/15/2022] Open
Abstract
Objective To examine time trends in ultrasonography (US)-guided 14-gauge core needle biopsy (CNB) for breast lesions based on the lesion size, Breast Imaging-Reporting and Data System (BI-RADS) category, and pathologic findings. Materials and Methods We retrospectively reviewed consecutive US-guided 14-gauge CNBs performed from January 2005 to December 2016 at our institution. A total of 22,297 breast lesions were included. The total number of biopsies, tumor size (≤ 10 mm to > 40 mm), BI-RADS category (1 to 5), and pathologic findings (benign, high risk, ductal carcinoma in situ [DCIS], invasive cancer) were examined annually, and the malignancy rate was analyzed based on the BI-RADS category. Results Both the total number of US scans and US-guided CNBs increased while the proportion of US-guided CNBs to the total number of US scans decreased significantly. The number of biopsies classified based on the tumor size, BI-RADS category, and pathologic findings all increased over time, except for BI-RADS categories 1 or 2 and category 3 (odds ratio [OR] = 0.951 per year, 95% confidence interval [CI]: 0.902, 1.002 and odds ratio = 0.979, 95% CI: 0.970, 0.988, respectively). Both the unadjusted and adjusted total malignancy rates and the DCIS rate increased significantly over time. BI-RADS categories 4a, 4b, and 4c showed a significant increasing trend in the total malignancy rate and DCIS rate. Conclusion The malignancy rate in the results of US-guided 14-gauge CNB for breast lesions increased as the total number of biopsies increased from 2005 to 2016. This trend persisted after adjusting for the BI-RADS category.
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Affiliation(s)
- Inha Jung
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology and Research Institute of Radiological Science, Yonsei Biomedical Research Institute, Seoul, Korea
| | - Min Jung Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hyun Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Vivian Youngjean Park
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Kyung Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Kang J, Han K, Kim KS, Jang WS, Kim MJ, Yoo Y. 3D microcalcification detection using a color Doppler twinkling artifact with optimized transmit conditions: Preliminary results. Med Phys 2020; 47:6171-6178. [PMID: 32563207 DOI: 10.1002/mp.14342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Mammography is the only method that has been proven to detect breast microcalcifications (MCs), but the sensitivity of mammography varies according to breast density. This paper proposes an ultrasound (US) color Doppler twinkling artifact (CDTA) method with optimized transmit conditions to identify breast MCs without ionizing radiation. METHODS The transmit conditions for US color Doppler imaging (CDI) were optimized to enhance the sensitivity of the twinkling artifact (TA) that arises from random scattering on rough surfaces of breast MCs. To validate the proposed breast MC detection method, a chicken breast phantom with MC particles (groups of particles <400 μ m and <240 μ m ) was fabricated and scanned by a digital mammography system and an US research platform by an L11-5v linear array probe with a three-dimensional (3D) motion tracking system. RESULTS From the phantom experiment, the proposed 3D CDTA imaging method with optimized transmit conditions (i.e., a center frequency of 5.0 MHz, an f-number of 1.3, and a peak negative pressure of 1.83 MPa) successfully detected all 16 MC particles, comparable to detection with mammography. For a human breast surgical specimen in the ex vivo study, all 10 MC clusters, marked by a radiologist on the mammogram, were identified with the proposed 3D CDTA imaging method. CONCLUSIONS In the phantom and ex vivo breast specimen studies, the proposed 3D CDTA imaging method successfully detected MCs, and the spatial localization was highly correlated with the mammogram results. These results indicate that the proposed 3D CDTA imaging method has great potential for the detection of MCs without ionizing radiation.
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Affiliation(s)
- Jinbum Kang
- Department of Electronic Engineering, Sogang University, Seoul, 04107, Korea
| | - Kanghee Han
- Department of Electronic Engineering, Sogang University, Seoul, 04107, Korea
| | - Kang-Sik Kim
- Department of Health & Medical Equipment, Samsung Electronics Co. Ltd., Suwon, 16678, Korea
| | - Won Seuk Jang
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, 03722, Korea
| | - Min Jung Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, 03722, Korea
| | - Yangmo Yoo
- Department of Electronic Engineering, Sogang University, Seoul, 04107, Korea.,Department of Biomedical Engineering, Sogang University, Seoul, 04107, Korea
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An Iranian Woman with Parathyroid Adenoma and Palpable Breast Masses Due to Bilateral and Asymmetric Calcifications. Indian J Surg Oncol 2020; 11:112-117. [PMID: 33088144 DOI: 10.1007/s13193-020-01108-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022] Open
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Ultrasound-Guided Breast Biopsy: Improved Accuracy of 10-G Cable-Free Elite Compared With 14-G CCNB. J Surg Res 2019; 247:172-179. [PMID: 31761441 DOI: 10.1016/j.jss.2019.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Imaging-guided breast biopsy is crucial for breast lesion evaluation. We aim to make the first comprehensive comparison of two different ultrasound-guided breast biopsy devices: 14-G conventional core needle biopsy (CCNB) and the newly applied cable-free, low-vacuum-assisted 10-G breast biopsy system, Elite. METHODS We retrospectively collected patients with suspected breast cancer who underwent ultrasound-guided 14-G CCNB or 10-G Elite from October 2013 through March 2018 and compared the biopsy result with the result after operation. We analyzed the test performance of the two methods and their accuracy in immunohistochemistry assays mainly including estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki67. We also analyzed the accuracy of 10-G Elite with frozen sections. RESULTS Six hundred seventy-four patients who underwent 14-G CCNB and 592 patients who underwent 10-G Elite were finally included in the research. Negative predictive value with Elite was higher than with CCNB (Elite 86.5%, CCNB 41.7%, P < 0.001). Sensitivity (Elite 97.7%, CCNB 96.2%, P = 0.1), specificity (Elite 98.7%, CCNB 90.0%, P = 0.1), positive predictive value (Elite 99.8%, CCNB 99.7%, P = 0.7), and false negative rate (Elite 2.3%, CCNB 3.8%, P = 0.1) showed no difference between two devices. In terms of immunohistochemistry assay, Ki67 agreement of Elite was higher than that of CCNB (Elite 79.5%, CCNB 73.4%, P = 0.045). Estrogen receptor agreement (Elite 90.6%, CCNB 87.7%, P = 0.2), progesterone receptor agreement (Elite 83.9%, CCNB 80.9%, P = 0.3), and human epidermal growth factor receptor two agreement (Elite 94.2%, CCNB 93.5%, P = 0.7) showed no difference between Elite and CCNB. The rate of an inconclusive biopsy result was lower with Elite than with CCNB (Elite 1.5%, CCNB 3.3%, P = 0.045). CONCLUSIONS 10-G Elite has higher negative predictive value, higher Ki67 agreement, and lower inconclusive results than 14-G CCNB. Elite can be a reliable substitute for 14-G CCNB.
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Zhang W, Xu C, Li R, Cui G, Wang M, Wang M. Correlation analysis between ultrasonography and mammography with other risk factors related to breast cancer. Oncol Lett 2019; 17:5511-5516. [PMID: 31186771 PMCID: PMC6507439 DOI: 10.3892/ol.2019.10246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/04/2019] [Indexed: 01/14/2023] Open
Abstract
Value and correlation analysis between ultrasound and mammography in the diagnosis and other risk factors related to breast cancer were explored. A total of 1,473 patients who underwent breast color ultrasonography and molybdenum target X-ray examination in Binzhou Medical University Hospital from March 2017 to August 2018 were collected, and the patient's ultrasound and mammography results were compared, also the pathological biopsy was used as the reference golden criteria to calculate the value of both test methods and the value of combined diagnosis in breast cancer. The risk factors associated with breast cancer were analyzed. Among the 1,473 patients, 387 breast cancer patients were detected by ultrasonography, 351 by mammography and 339 cases by combined diagnosis. A total of 314 cases were diagnosed as breast cancer after pathological biopsy. However, there were significant differences in tumor size, stages, and BI-RADS grades (P<0.05). There was no significant difference in the diagnostic efficacy between ultrasonography and mammography (P>0.05), however, the diagnostic efficacy of ultrasonography combined with mammography was significantly better than the two single tests (P<0.05). After logistic regression analysis, there was no significant correlation between residence address, height, blood type, ethnicity, or education with breast cancer (P>0.05). However, age, fertility status, and BMI were all risk factors related to breast cancer (OR>1; P<0.05). In conclusion, ultrasonography combined with mammography can effectively improve the early diagnosis rate of breast cancer, however, the patient's age, birth status, and BMI may affect the results of ultrasonography and mammography. In clinical practice, it is necessary to determine the imaging results in combination with the actual situation of the patients to improve the diagnosis rate of breast cancer.
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Affiliation(s)
- Wenxiao Zhang
- Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
| | - Cui Xu
- Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
| | - Rui Li
- Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
| | - Guanghe Cui
- Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
| | - Minmin Wang
- Department of Health Management, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
| | - Min Wang
- Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong 256600, P.R. China
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Hrkac Pustahija A, Ivanac G, Brkljacic B. US and MRI in the evaluation of mammographic BI-RADS 4 and 5 microcalcifications. ACTA ACUST UNITED AC 2018; 24:187-194. [PMID: 30091708 DOI: 10.5152/dir.2018.17414] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The aim of this study was to assess diagnostic accuracies of ultrasonography (US) and magnetic resonance imaging (MRI) in lesions that manifest as mammographic BI-RADS 4 and 5 microcalcifications, in the setting of conjoined use of mammography, US, and MRI. METHODS Patients with mammographic BI-RADS 4 or 5 microcalcifications, without additional findings, were included in this prospective study. All patients subsequently underwent breast US and MRI. Histopathologic diagnosis, obtained by US-guided core-needle biopsy or surgical excision, served as a reference standard. Diagnostic accuracies of US and MRI were calculated, and positive predictive value for different MRI BI-RADS imaging features were determined. RESULTS The study group consisted of 113 women with 125 areas of suspicious microcalcifications. MRI reached sensitivity, specificity, positive predictive value 3 (PPV3), and negative predictive value (NPV) of 100%, 70.1%, 67.6%, and 100%, respectively. Statistically significant differences in MRI morphologic features and kinetic enhancement curves were observed between malignant and benign microcalcifications. Sensitivity, specificity, PPV3, and NPV for US were: 85.4%, 66.2%, 61.2%, and 87.9%. There was statistically significant difference in presentation of malignant and benign microcalcifications at US. CONCLUSION In the setting of conjoined use of mammography, US, and MRI, MRI can reliably exclude malignancy in suspicious microcalcifications. Thus, negative MRI findings may influence the decision to biopsy the microcalcifications.
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Affiliation(s)
- Ana Hrkac Pustahija
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Gordana Ivanac
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Boris Brkljacic
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, University of Zagreb, School of Medicine, Zagreb, Croatia
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Relea A, Alonso J, González M, Zornoza C, Bahamonde S, Viñuela B, Encinas M. Usefulness of the twinkling artifact on Doppler ultrasound for the detection of breast microcalcifications. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.rxeng.2018.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Relea A, Alonso JA, González M, Zornoza C, Bahamonde S, Viñuela BE, Encinas MB. Usefulness of the twinkling artifact on Doppler ultrasound for the detection of breast microcalcifications. RADIOLOGIA 2018; 60:413-423. [PMID: 29907260 DOI: 10.1016/j.rx.2018.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/04/2018] [Accepted: 04/25/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine whether the twinkling artifact on Doppler ultrasound imaging corresponds to microcalcifications previously seen on mammograms and to evaluate the usefulness of this finding in the ultrasound management of suspicious microcalcifications. MATERIAL AND METHODS We used ultrasonography to prospectively examine 46 consecutive patients with groups of microcalcifications suspicious for malignancy identified at mammography, searching for the presence of the twinkling artifact to identify the microcalcifications. Once we identified the microcalcifications, we obtained core-needle biopsy specimens with 11G needles and then used X-rays to check the specimens for the presence of microcalcifications. We analyzed the percentage of detection and obtainment of microcalcifications by core-needle biopsy with this technique and the radiopathologic correlation. Microcalcifications that were not detected by ultrasound or discordant lesions were biopsied by stereotaxy at another center. We also used ultrasound guidance for preoperative marking with clips, usually orienting them radially. RESULTS We identified and biopsied 41 of the 46 lesions under ultrasound guidance, including 24 of 25 carcinomas (17 in situ). B-mode ultrasound was sufficient for biopsying the microcalcifications in 14 patients, although the presence of the twinkling artifact increased the number of microcalcifications detected and thus enabled more accurate preoperative marking. Thanks to the twinkling sign, we were able to identify 27 additional groups of microcalcifications (89% vs. 30%; p < 0.05). All the surgical specimens had margins free of disease. CONCLUSIONS The twinkling artifact is useful for microcalcifications in ultrasound examinations, enabling a significant increase in the yield of ultrasound-guided biopsies and better preoperative marking of groups of microcalcifications.
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Affiliation(s)
- A Relea
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España.
| | - J A Alonso
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - M González
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - C Zornoza
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - S Bahamonde
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - B E Viñuela
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - M B Encinas
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de Palencia, Palencia, España
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Huang XC, Hu XH, Wang XR, Zhou CX, Wang FF, Yang S, Wang GY. A comparison of diagnostic performance of vacuum-assisted biopsy and core needle biopsy for breast microcalcification: a systematic review and meta-analysis. Ir J Med Sci 2018; 187:999-1008. [DOI: 10.1007/s11845-018-1781-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/01/2018] [Indexed: 01/26/2023]
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18
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Park VY, Kim EK, Moon HJ, Yoon JH, Kim MJ. Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy. Ultrasonography 2017; 37:107-120. [PMID: 29169231 PMCID: PMC5885481 DOI: 10.14366/usg.17049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/17/2017] [Accepted: 08/19/2017] [Indexed: 11/04/2022] Open
Abstract
Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies.
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Affiliation(s)
- Vivian Youngjean Park
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun-Kyung Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hyun Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Jung Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Yao JP, Hao YZ, Chang Q, Geng CY, Chen Y, Zhao WP, Song Y, Zhou X. Value of Ultrasonographic Features for Assessing Malignant Potential of Complex Cystic Breast Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:699-704. [PMID: 28109002 DOI: 10.7863/ultra.16.05012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To assess the value of ultrasonography (US) features for determining the malignant potential of complex cystic lesions. METHODS Seventy-nine complex cystic lesions were reviewed retrospectively. They were classified into four types according to US features in type I, the masses have a thick outer wall, thick internal septa, or both; in type II, the masses are an intracystic type with one or more discrete solid mural lesions within a cyst; in type III, the masses contain mixed cystic and solid components and are at least 50% cystic portion in a mass; in type IV, there are predominantly (at least 50%) solid masses with eccentric or central cystic foci. Positive predictive values were calculated for all types. RESULTS The frequency of malignancy was higher among type III and IV lesions than among the other two types. Lesions with a diameter greater than or equal to 20 mm, margins not circumscribed, resistance index greater than or equal to 0.7, and axillary abnormal nodes had a high probability of malignancy. CONCLUSIONS US is an important adjunct to evaluate the malignant potential of complex cystic lesions.
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Affiliation(s)
- Jin-Peng Yao
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu-Zhi Hao
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qing Chang
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Cheng-Yun Geng
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Chen
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wen-Peng Zhao
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Song
- Department of Ultrasonography, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiang Zhou
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography: approaches to interpretation and biopsy. Br J Radiol 2016; 90:20160594. [PMID: 27648482 DOI: 10.1259/bjr.20160594] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This article discusses the significance of microcalcifications on mammography and the changes in technology that have influenced management; it also describes a pragmatic approach to investigation of microcalcification in a UK screening programme.
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Affiliation(s)
- Louise Wilkinson
- 1 Department of Breast Imaging, St Georges Hospital, Tooting, London.,2 Department of Pathology, St Georges Hospital, Tooting, London.,3 Breast Unit, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Val Thomas
- 1 Department of Breast Imaging, St Georges Hospital, Tooting, London.,2 Department of Pathology, St Georges Hospital, Tooting, London.,3 Breast Unit, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Nisha Sharma
- 1 Department of Breast Imaging, St Georges Hospital, Tooting, London.,2 Department of Pathology, St Georges Hospital, Tooting, London.,3 Breast Unit, Leeds Teaching Hospital NHS Trust, Leeds, UK
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Szynglarewicz B, Kasprzak P, Biecek P, Halon A, Matkowski R. Screen-detected ductal carcinoma in situ found on stereotactic vacuum-assisted biopsy of suspicious microcalcifications without mass: radiological-histological correlation. Radiol Oncol 2016; 50:145-52. [PMID: 27247546 PMCID: PMC4852961 DOI: 10.1515/raon-2016-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/26/2016] [Indexed: 11/17/2022] Open
Abstract
Background Commonly identified on screening mammography breast microcalcifications are the predominant manifestation of ductal carcinoma in situ (DCIS). The aim of this study was to investigate the association between clinico-radiological features and histological findings in patients with screen-detected DCIS. Patients and methods Consecutive 127 patients with pure DCIS found on stereotactic vacuum-assisted biopsy of screen-detected suspicious microcalcifications without mass entered the study. Patient age, type and distribution of microcalcifications, DCIS nuclear grade (NG) and the presence of comedonecrosis were investigated. Association between parameters was statistically analysed with P < 0.05 as a significance level. Results. Powdery microcalcifications were most often clustered while regional were most common of casting-type (P < 0.001). High, intermediate and low NG of DCIS was significantly related to casting-type, crushed stone-like and powdery microcalcifications, respectively (P < 0.01). Low and intermediate NG DCIS were the most common in clustered and grouped microcalcifications while high NG DCIS was the most often when regional distribution was observed (P < 0.05). Comedonecrosis was significantly more common in high NG DCIS (P < 0.01). The association between comedonecrosis and type of microcalcifications was not significant, but with their distribution was close to the significance level (P = 0.07). Patient age was not significantly related to imaging or histological findings. Conclusions The association between pattern of mammographic microcalcifications and histological findings related to more aggressive disease can be helpful in optimal surgery planning in patients with screen-detected DCIS, regarding the extent of breast intervention and consideration of synchronous sentinel node biopsy.
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Affiliation(s)
| | - Piotr Kasprzak
- Department of Breast Imaging, Lower Silesia Oncology Centre, Wroclaw, Poland
| | - Przemyslaw Biecek
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Agnieszka Halon
- Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, Poland
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Park AY, Seo BK, Cho KR, Woo OH. The Utility of MicroPure™ Ultrasound Technique in Assessing Grouped Microcalcifications without a Mass on Mammography. J Breast Cancer 2016; 19:83-6. [PMID: 27066098 PMCID: PMC4822112 DOI: 10.4048/jbc.2016.19.1.83] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/18/2016] [Indexed: 11/30/2022] Open
Abstract
The term "grouped microcalcifications" refers to the smallest arrangement of a relatively few calcifications noted on mammography, and has a wide range of clinical associations. For the pathologic diagnosis of suspicious-looking grouped microcalcifications without an associated mass, a mammography-guided procedure should be considered, because visualization of microcalcifications by conventional ultrasound (US) is limited. A mammography-guided procedure requires radiation exposure, is associated with pain, and is more time-consuming to perform than an US-guided procedure. However, an innovative US technology called MicroPure™ (Toshiba Medical Systems Corp., Tokyo, Japan) imaging improves detection and visualization of microcalcifications. We demonstrate the early clinical experience with and utility of MicroPure US examination of 10 breast lesions involving grouped microcalcifications without a mass on mammography screening.
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Affiliation(s)
- Ah Young Park
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Bo Kyoung Seo
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Kyu Ran Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ok Hee Woo
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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