Localization of impalpable breast lesions: What are we aiming at?
Brian Mucci, Robert Shaw, Jean Lauder, Russell Pickard
The Breast Volume 18, Issue 4, August 2009, Pages 267-269
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As a quality control target for wire placement in clinically occult breast lesions success in traversing the lesion in both planes in 90% of procedures is measurable and achievable with clinical relevance. We believe that this could be an improvement on the current European target of 95% of wires being within 10 mm of the lesion
Sunday, 13 September 2009
Tuesday, 16 June 2009
Quality of mammography screening in the Milan programme: Evidence of improved sensitivity based on interval cancer proportional incidence and radiolog
Quality of mammography screening in the Milan programme: Evidence of improved sensitivity based on interval cancer proportional incidence and radiological review
Pirola Maria Elena, Houssami Nehmat, Maltagliati Ermes, Ceresa Piera, Quattrocchi Maria, Marinoni Guia, Caimi Francesco, Villa Roberto, Falda Giovanni, Gaffuri Isabella, Ciatto Stefano
The Breast 18, (3), June 2009: 208-210
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Interval cancer (IC) incidence and review-based initial evaluation of Milan service screening (ASLMI1) suggested suboptimal performance. We report results in a subsequent screening round to further determine screening quality.
Programme sensitivity is now within recommended European standards. Performance indicators improved relative to initial evaluation. Both increasing experience and formal training of radiologists are likely to have contributed to this improvement
Pirola Maria Elena, Houssami Nehmat, Maltagliati Ermes, Ceresa Piera, Quattrocchi Maria, Marinoni Guia, Caimi Francesco, Villa Roberto, Falda Giovanni, Gaffuri Isabella, Ciatto Stefano
The Breast 18, (3), June 2009: 208-210
Link to Journal
Interval cancer (IC) incidence and review-based initial evaluation of Milan service screening (ASLMI1) suggested suboptimal performance. We report results in a subsequent screening round to further determine screening quality.
Programme sensitivity is now within recommended European standards. Performance indicators improved relative to initial evaluation. Both increasing experience and formal training of radiologists are likely to have contributed to this improvement
An evaluation of a 10-gauge vacuum-assisted system for ultrasound-guided excision of clinically benign breast lesions
An evaluation of a 10-gauge vacuum-assisted system for ultrasound-guided excision of clinically benign breast lesions
Zhi Li Wang, Jun Lai Li, Li Su, Yong Feng Zhang, Jie Tang
The Breast 18, (3), June 2009: 192-196
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The aim of this study was to evaluate a 10-gauge vacuum-assisted system for the excision of clinically benign breast lesions.
The minimal excision of 245 lesions in 162 patients was performed with VACORA vacuum-assisted system under the guidance of ultrasound between July 2007 and April 2008. The lesions were category 3 lesions as determined by ultrasound imaging according to Breast Imaging Reporting and Data System (BI-RADS) (n = 208) or had been confirmed as benign by a previous core-needle biopsy (n = 37).
As many as 244 lesions were demonstrated to be benign and one case was demonstrated to be malignant by pathology after resection. In the 244 benign lesions, 220 lesions were excised completely as demonstrated by the follow-up ultrasound examination. The malignant lesion was managed with surgical excision.
The 10-gauge vacuum-assisted system is highly successful for the excision of benign breast lesions; it is an alternative tool for minimal treatment of benign breast lesions
Zhi Li Wang, Jun Lai Li, Li Su, Yong Feng Zhang, Jie Tang
The Breast 18, (3), June 2009: 192-196
Link to Journal
The aim of this study was to evaluate a 10-gauge vacuum-assisted system for the excision of clinically benign breast lesions.
The minimal excision of 245 lesions in 162 patients was performed with VACORA vacuum-assisted system under the guidance of ultrasound between July 2007 and April 2008. The lesions were category 3 lesions as determined by ultrasound imaging according to Breast Imaging Reporting and Data System (BI-RADS) (n = 208) or had been confirmed as benign by a previous core-needle biopsy (n = 37).
As many as 244 lesions were demonstrated to be benign and one case was demonstrated to be malignant by pathology after resection. In the 244 benign lesions, 220 lesions were excised completely as demonstrated by the follow-up ultrasound examination. The malignant lesion was managed with surgical excision.
The 10-gauge vacuum-assisted system is highly successful for the excision of benign breast lesions; it is an alternative tool for minimal treatment of benign breast lesions
Accuracy of stereotactic vacuum-assisted breast biopsy with a 10-gauge hand-held system
Accuracy of stereotactic vacuum-assisted breast biopsy with a 10-gauge hand-held system
C. Salem, R. Sakr, J. Chopier, C. Marsault, S. Uzan, E. Daraï
The Breast 18, (3), June 2009: 178-182
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The mean number of core specimens obtained per procedure was 9 (range 4–24). Complete radiological excision of the target lesion was achieved in 31.6% (91 of 288) with 91% of these lesions smaller than 10 mm (mean size 7 mm; range 4–20 mm). Under-estimation of ADH and DCIS was 18.2% (2 of 11) and 19.2% (9 of 47), respectively. There was no false negative result within a 3-year follow-up (from 2005 till date). Complications were mild and consisted of immediate bleeding and delayed hematomas
C. Salem, R. Sakr, J. Chopier, C. Marsault, S. Uzan, E. Daraï
The Breast 18, (3), June 2009: 178-182
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The mean number of core specimens obtained per procedure was 9 (range 4–24). Complete radiological excision of the target lesion was achieved in 31.6% (91 of 288) with 91% of these lesions smaller than 10 mm (mean size 7 mm; range 4–20 mm). Under-estimation of ADH and DCIS was 18.2% (2 of 11) and 19.2% (9 of 47), respectively. There was no false negative result within a 3-year follow-up (from 2005 till date). Complications were mild and consisted of immediate bleeding and delayed hematomas
Wednesday, 22 April 2009
High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer
High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer
Yoon Jung Choi, Eun Young Ko, Boo-Kyung Han, Jung Hee Shin, Seok Seon Kang, Soo Yeon Hahn
The Breast 18 (2009) 119–122
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US features known to accurately predict metastasis in axillary lymph nodes could be used at the time of the preoperative breast US to determine the need for FNA, SLN or ALND. Results of the present study indicate that a cortical thickness greater than 3 mm is the most reliable US feature predicting a metastasis, with sensitivity, specificity, PPV and NPV around 70%. For the L/S ratio, those parameters were only 52–65% accurate
Recent advances in high-resolution US allow examination of more detailed features of lymph nodes, such as cortex shape and internal hilar echogenicity, which may prove to be useful indicators of metastasis. Our results showed that the absence of a hilum had high specificity, but low sensitivity. Previous studies found that a hyperechogenic hilum indicated a benign lymph node, and loss of normal echogenicity had moderate to high specificity for metastasis
Yoon Jung Choi, Eun Young Ko, Boo-Kyung Han, Jung Hee Shin, Seok Seon Kang, Soo Yeon Hahn
The Breast 18 (2009) 119–122
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US features known to accurately predict metastasis in axillary lymph nodes could be used at the time of the preoperative breast US to determine the need for FNA, SLN or ALND. Results of the present study indicate that a cortical thickness greater than 3 mm is the most reliable US feature predicting a metastasis, with sensitivity, specificity, PPV and NPV around 70%. For the L/S ratio, those parameters were only 52–65% accurate
Recent advances in high-resolution US allow examination of more detailed features of lymph nodes, such as cortex shape and internal hilar echogenicity, which may prove to be useful indicators of metastasis. Our results showed that the absence of a hilum had high specificity, but low sensitivity. Previous studies found that a hyperechogenic hilum indicated a benign lymph node, and loss of normal echogenicity had moderate to high specificity for metastasis
Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach including axillary ultrasound scanning
Predicting the status of axillary lymph nodes in breast cancer: A multiparameter approach including axillary ultrasound scanning
Tommaso Susini, Jacopo Nori, Simone Olivieri, Cecilia Molino, Giulia Marini, Simonetta Bianchi, Vania Vezzosi, Lorenzo Livi, Mario Mascalchi, Gianfranco Scarselli
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Axillary US along with tumor site within the breast and Ki-67 proliferation index allowed reliable prediction of axillary metastases risk. These findings still require prospective validation in a larger sample of women. If our preliminary results will be confirmed, this multiparameter evaluation may be used to optimize the selection of breast cancer patients candidate to sentinel lymph node biopsy or axillary lymph node dissection
Tommaso Susini, Jacopo Nori, Simone Olivieri, Cecilia Molino, Giulia Marini, Simonetta Bianchi, Vania Vezzosi, Lorenzo Livi, Mario Mascalchi, Gianfranco Scarselli
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Axillary US along with tumor site within the breast and Ki-67 proliferation index allowed reliable prediction of axillary metastases risk. These findings still require prospective validation in a larger sample of women. If our preliminary results will be confirmed, this multiparameter evaluation may be used to optimize the selection of breast cancer patients candidate to sentinel lymph node biopsy or axillary lymph node dissection
Patient-led breast cancer follow up
Patient-led breast cancer follow up
D. Chapman, E. Cox, P.D. Britton, G.C. Wishart
The Breast 2009 18 (2): 100-102
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The introduction of PLFU has been well received by patients at low risk of breast cancer recurrence or death without a marked increase in GP workload. The use of risk stratification allows low risk patients to undergo five-year mammographic surveillance without regular breast examination but with access to clinical input if necessary. It also allows time to be spent with those patients at higher risk of recurrence as well as an increasing flow of new referrals with symptomatic disease.
Introduction of this model will comply with NICE guidelines to reduce unnecessary breast cancer follow up and contribute to UK breast units achieving the government target to see all breast cancer referrals within two weeks in the near future. The introduction of PLFU should therefore be considered by all breast units in the UK
D. Chapman, E. Cox, P.D. Britton, G.C. Wishart
The Breast 2009 18 (2): 100-102
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The introduction of PLFU has been well received by patients at low risk of breast cancer recurrence or death without a marked increase in GP workload. The use of risk stratification allows low risk patients to undergo five-year mammographic surveillance without regular breast examination but with access to clinical input if necessary. It also allows time to be spent with those patients at higher risk of recurrence as well as an increasing flow of new referrals with symptomatic disease.
Introduction of this model will comply with NICE guidelines to reduce unnecessary breast cancer follow up and contribute to UK breast units achieving the government target to see all breast cancer referrals within two weeks in the near future. The introduction of PLFU should therefore be considered by all breast units in the UK
Ultrasound-guided vacuum assisted breast biopsy in the assessment of C3 breast lesions by ultrasound-guided fine needle aspiration cytology: Results a
Ultrasound-guided vacuum assisted breast biopsy in the assessment of C3 breast lesions by ultrasound-guided fine needle aspiration cytology: Results and costs in comparison with surgery
Francesca Abbate, Lorenzo Bacigalupo, Antuono Latronico, Chiara Trentin, Silvia Penco, Simona Menna, Giuseppe Viale, Enrico Cassano, Massimo Bellomi
The Breast 2009, 18 (2):73-77
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In our experience, US-guided VABB appears to be an accurate and cost-effective modality compared to surgery for the evaluation of lesions which are found to be C3 (indeterminate) at US-guided FNAC. In particular, considering the low percentage of malignant cases in this series (18/138 = 13%), surgical biopsy may be avoided in most cases. This diagnostic approach would allow surgery to be restricted to the treatment to malignant lesions and, in a few selected patients, to confirm or further investigate VABB findings.
Still the choice of using VABB to assess US visible C3 lesions might be excessive as core biopsy might be used as an alternative, more studies comparing VABB and core biopsy to assess C3 cases are needed before VABB may be recommended as the ideal option
Francesca Abbate, Lorenzo Bacigalupo, Antuono Latronico, Chiara Trentin, Silvia Penco, Simona Menna, Giuseppe Viale, Enrico Cassano, Massimo Bellomi
The Breast 2009, 18 (2):73-77
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In our experience, US-guided VABB appears to be an accurate and cost-effective modality compared to surgery for the evaluation of lesions which are found to be C3 (indeterminate) at US-guided FNAC. In particular, considering the low percentage of malignant cases in this series (18/138 = 13%), surgical biopsy may be avoided in most cases. This diagnostic approach would allow surgery to be restricted to the treatment to malignant lesions and, in a few selected patients, to confirm or further investigate VABB findings.
Still the choice of using VABB to assess US visible C3 lesions might be excessive as core biopsy might be used as an alternative, more studies comparing VABB and core biopsy to assess C3 cases are needed before VABB may be recommended as the ideal option
Sunday, 15 February 2009
Mammographic density estimation: Comparison among BI-RADS categories, a semi-automated software and a fully automated one
Mammographic density estimation: Comparison among BI-RADS categories, a semi-automated software and a fully automated one
Alberto Tagliafico, Giulio Tagliafico, Simona Tosto, Fabio Chiesa, Carlo Martinoli, Lorenzo E. Derchi, Massimo Calabrese
The Breast 18, 1, February 2009, Pages 35-40
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Part of the BIRADS report is an estimation of breast density in 4 grades from fatty to extremely dense (as an indicator of the sensitivity of mammography to pick up cancers). This study compared standard reading with that obtained from semi-automated and fully automated breast density reporting software. Fully automated was better than semi-automated, which was also better than conventional density estimation.
This technique has the potential to eliminate the reader variability in reading out density for a particular mammogram
Alberto Tagliafico, Giulio Tagliafico, Simona Tosto, Fabio Chiesa, Carlo Martinoli, Lorenzo E. Derchi, Massimo Calabrese
The Breast 18, 1, February 2009, Pages 35-40
Link to Journal
Part of the BIRADS report is an estimation of breast density in 4 grades from fatty to extremely dense (as an indicator of the sensitivity of mammography to pick up cancers). This study compared standard reading with that obtained from semi-automated and fully automated breast density reporting software. Fully automated was better than semi-automated, which was also better than conventional density estimation.
This technique has the potential to eliminate the reader variability in reading out density for a particular mammogram
Ultrasound guided percutaneous axillary lymph node core biopsy: How often is the sentinel lymph node being biopsied?
Ultrasound guided percutaneous axillary lymph node core biopsy: How often is the sentinel lymph node being biopsied?
P.D. Britton, E. Provenzano, S. Barter, M. Gaskarth, A. Goud, P. Moyle, R. Sinnatamby, M. Wallis, J.R. Benson, P. Forouhi, G.C. Wishart
The Breast 18, 1, 2009, 13-16
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This study aimed to establish the frequency of successful targeting of the SLN by ultrasound guided biopsy. False negative rate for CB of 30%. Reasons for false -ves - failure to sample the sentinel lymph node in 10 (45%) and failure to sample the metastatic disease in the sentinel node in 11 (55%). Better methods of identifying the sentinel lymph node and more adequate sampling are required
P.D. Britton, E. Provenzano, S. Barter, M. Gaskarth, A. Goud, P. Moyle, R. Sinnatamby, M. Wallis, J.R. Benson, P. Forouhi, G.C. Wishart
The Breast 18, 1, 2009, 13-16
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This study aimed to establish the frequency of successful targeting of the SLN by ultrasound guided biopsy. False negative rate for CB of 30%. Reasons for false -ves - failure to sample the sentinel lymph node in 10 (45%) and failure to sample the metastatic disease in the sentinel node in 11 (55%). Better methods of identifying the sentinel lymph node and more adequate sampling are required
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