Mammographic screening for breast cancer: An invited review of the benefits and costs
Jon M. Greif
The Breast 2010. 19;4:260-267
Link to Journal
Mammographic screening is a proven method for reducing breast cancer mortality for women 40 years of age and older, but the best method for implementation of mammographic screening, particularly in the age group 40–49, remains controversial. The author, in an invited review, summarizes the data and offers guidance based on the best information available for women at risk for breast cancer, and their care providers, with particular emphasis on costs and benefits
Breast cancer is a global public health problem and the reader can decide for him or her self if the costs and benefits outweigh the risks associated with breast health screening programs. Many governments will continue to debate the costs and the pros and cons; however without population based screening, many women will continue to suffer needlessly throughout the world. Thus, I would like to offer the following conclusions based on one surgeon’s analysis of the literature regarding the benefits and costs of mammographic screening for breast cancer:
1. Women invited to participate in a regular program of mammographic screening, beginning at age 40 and continuing annually for as long as a woman is healthy can be expected to have a 19% reduction in breast cancer mortality compared with women not invited to participate in systematic mammographic breast cancer screening. In fact, 75% of all breast cancer deaths occur in the 20% of women not undergoing periodic screening mammography. Breast cancer screening saves lives, and, when considering the monetary costs to society of treating advanced breast cancer, may actually save money.
2. Screening mammography is less than 100% sensitive or 100% specific for detection of breast cancer, and so there will be false negatives and false positives. Following rigorous quality control guidelines will minimize the incidence of false negatives and false positives. Combining annual screening mammography with annual professional clinical breast exams and encouraging women to become familiar with their breasts through monthly breast self exam are likely also to reduce the impact of the falsely negative mammogram, and should be encouraged.
3. It may be desirable to examine alternatives to current screening strategies, but, hopefully, this does not translate into less effective breast cancer screening strategies that aim to simply reduce costs in the future. Improving efficiency in mammographic screening practices may be a successful cost saving strategy that does not sacrifice benefit.
4. The perfect breast cancer screening tool would be 100% sensitive and 100% specific, inexpensive and not harmful. Mammography is not that perfect tool, but, for now, is a very satisfactory and evidence-based procedure which can save lives, and should be made accessible to all women at risk for developing this dreaded disease.
Friday, 23 July 2010
Risk assessment, screening and prevention of breast cancer: A look at cost-effectiveness
Risk assessment, screening and prevention of breast cancer: A look at cost-effectiveness
Gail S. Lebovic, Alan Hollingsworth, Stephen A. Feig
The Breast 2010. 19;4:260-267
Link to Journal
Following consideration of the above review, it is clear that the cost-effectiveness surrounding the many clinical areas as they relate to breast cancer are difficult, if not impossible to fully assess. However, within the literature we begin to see an important framework for the future. This includes the importance of risk assessment for stratification of women of various ages, preventive measures including lifestyle, chemoprevention and surgery, as well as the continued support for the essential component of mammographic screening according to present guidelines. It is these measures taken together as a whole that ultimately will save lives with the most effective, efficient and most cost-effective approach to breast cancer throughout the world
Gail S. Lebovic, Alan Hollingsworth, Stephen A. Feig
The Breast 2010. 19;4:260-267
Link to Journal
Following consideration of the above review, it is clear that the cost-effectiveness surrounding the many clinical areas as they relate to breast cancer are difficult, if not impossible to fully assess. However, within the literature we begin to see an important framework for the future. This includes the importance of risk assessment for stratification of women of various ages, preventive measures including lifestyle, chemoprevention and surgery, as well as the continued support for the essential component of mammographic screening according to present guidelines. It is these measures taken together as a whole that ultimately will save lives with the most effective, efficient and most cost-effective approach to breast cancer throughout the world
Friday, 9 April 2010
Role of magnetic resonance imaging in managing selected women with newly diagnosed breast cancer
Role of magnetic resonance imaging in managing selected women with newly diagnosed breast cancer
S. Scomersi, M. Urbani, M. Tonutti, F. Zanconati, M. Bortul
The Breast 2010 19;2:115-119
Link to Journal
The purpose of this study is evaluation of therapeutic impact of magnetic resonance imaging (MRI) in breast cancer patients that cannot be imaged adequately with traditional radiology: dense breasts, microcalcifications suspicious for carcinoma in situ or discordance between mammography and ultrasound. A review was performed of 493 patients’ records: determination of breast MRI effect on clinical management was made for the selected 70 cases by analysing pre-MRI and post-MRI therapeutic plans. Analysis of final pathology was useful to determine if the change in surgical plan prompted by MRI was appropriate.
Breast MRI added clinical information in 52.9% of patients that resulted in 44.3% of management changes that were judged as appropriate in 83.9% of cases. Breast MRI provides additional useful information, but causes more extensive surgery (40%) with no proven prognostic benefit. MRI should be considered optional in the clinical staging of breast cancer and performed in selected cases.
S. Scomersi, M. Urbani, M. Tonutti, F. Zanconati, M. Bortul
The Breast 2010 19;2:115-119
Link to Journal
The purpose of this study is evaluation of therapeutic impact of magnetic resonance imaging (MRI) in breast cancer patients that cannot be imaged adequately with traditional radiology: dense breasts, microcalcifications suspicious for carcinoma in situ or discordance between mammography and ultrasound. A review was performed of 493 patients’ records: determination of breast MRI effect on clinical management was made for the selected 70 cases by analysing pre-MRI and post-MRI therapeutic plans. Analysis of final pathology was useful to determine if the change in surgical plan prompted by MRI was appropriate.
Breast MRI added clinical information in 52.9% of patients that resulted in 44.3% of management changes that were judged as appropriate in 83.9% of cases. Breast MRI provides additional useful information, but causes more extensive surgery (40%) with no proven prognostic benefit. MRI should be considered optional in the clinical staging of breast cancer and performed in selected cases.
Freehand versus ultrasound-guided core biopsies of the breast: reducing the burden of repeat biopsies in patients presenting to the breast clinic
Freehand versus ultrasound-guided core biopsies of the breast: reducing the burden of repeat biopsies in patients presenting to the breast clinic
S.T. Ward, J.A. Shepherd, H. Khalil
The Breast 2010 19;2:105-108
Link to Journal
In our breast unit a significant proportion of core biopsies are performed freehand sometimes necessitating a repeat biopsy under image guidance. The aims of this study were to establish the proportion of patients undergoing freehand core biopsies who proceeded to a repeat procedure and to determine any factors associated with a missed freehand biopsy. Four hundred and ten core biopsies over 21 months were included in the analysis. Demographic details, position and size of the lump, breast volume and lesion depth were recorded.
Twenty-four percent freehand biopsies were repeated under ultrasound guidance. The histological classification of two-thirds of the repeat biopsies were upgraded, suggesting that the lesion had been previously missed. Multivariate analysis showed that missed freehand biopsies were strongly associated with deep lesions. If all lumps sited at a depth of 6 mm or more were selected for US-guided core biopsy, the workload for the ultrasound department would increase by just less than a half and would have the effect of reducing the freehand biopsy miss rate by almost two-thirds.
Core biopsies should be performed under ultrasound guidance. A freehand technique could be limited to superficial lesions. Depth is more predictive for a missed biopsy than lesion size or breast volume
S.T. Ward, J.A. Shepherd, H. Khalil
The Breast 2010 19;2:105-108
Link to Journal
In our breast unit a significant proportion of core biopsies are performed freehand sometimes necessitating a repeat biopsy under image guidance. The aims of this study were to establish the proportion of patients undergoing freehand core biopsies who proceeded to a repeat procedure and to determine any factors associated with a missed freehand biopsy. Four hundred and ten core biopsies over 21 months were included in the analysis. Demographic details, position and size of the lump, breast volume and lesion depth were recorded.
Twenty-four percent freehand biopsies were repeated under ultrasound guidance. The histological classification of two-thirds of the repeat biopsies were upgraded, suggesting that the lesion had been previously missed. Multivariate analysis showed that missed freehand biopsies were strongly associated with deep lesions. If all lumps sited at a depth of 6 mm or more were selected for US-guided core biopsy, the workload for the ultrasound department would increase by just less than a half and would have the effect of reducing the freehand biopsy miss rate by almost two-thirds.
Core biopsies should be performed under ultrasound guidance. A freehand technique could be limited to superficial lesions. Depth is more predictive for a missed biopsy than lesion size or breast volume
Thursday, 21 January 2010
Long-term follow-up-findings in mammography and ultrasound after intraoperative radiotherapy (IORT) for breast cancer
Long-term follow-up-findings in mammography and ultrasound after intraoperative radiotherapy (IORT) for breast cancer
M. Ruch, J. Brade, C. Schoeber, U. Kraus-Tiefenbacher, A. Schnitzer, D. Engel, F. Wenz, M. Sütterlin, S.O. Schoenberg, K. Wasser
The Breast Volume 18, Issue 5, October 2009, Pages 327-334
Link to Journal
In early postoperative follow-up studies the radiologist is confronted with large and partially organized wound cavities in most cases after IORT. In further follow-ups, fat necroses arise from those cavities, and about 60% of patients show likewise large oil cysts on late follow-up mammograms. As a frequent phenomenon wound cavities appear sonographically as liquid lesions with pronounced polypoid inner wall thickening. Furthermore, a prolonged parenchymal scarring has to be expected after IORT. No specific factors were found, which might influence the incidence or the value of these structural alterations after IORT
M. Ruch, J. Brade, C. Schoeber, U. Kraus-Tiefenbacher, A. Schnitzer, D. Engel, F. Wenz, M. Sütterlin, S.O. Schoenberg, K. Wasser
The Breast Volume 18, Issue 5, October 2009, Pages 327-334
Link to Journal
In early postoperative follow-up studies the radiologist is confronted with large and partially organized wound cavities in most cases after IORT. In further follow-ups, fat necroses arise from those cavities, and about 60% of patients show likewise large oil cysts on late follow-up mammograms. As a frequent phenomenon wound cavities appear sonographically as liquid lesions with pronounced polypoid inner wall thickening. Furthermore, a prolonged parenchymal scarring has to be expected after IORT. No specific factors were found, which might influence the incidence or the value of these structural alterations after IORT
Comparison of interval breast cancer rates for two-versus single-view screening mammography: A population-based study
Comparison of interval breast cancer rates for two-versus single-view screening mammography: A population-based study
A. Seigneurin, C. Exbrayat, J. Labarère, M. Colonna
The Breast Volume 18, Issue 5, October 2009, Pages 284-288
Link to Journal
Two-view mammography for first and subsequent screens is associated with lower rates of interval breast cancer. This is at the expense of an increased number of women being recalled for further assessment after subsequent screens
A. Seigneurin, C. Exbrayat, J. Labarère, M. Colonna
The Breast Volume 18, Issue 5, October 2009, Pages 284-288
Link to Journal
Two-view mammography for first and subsequent screens is associated with lower rates of interval breast cancer. This is at the expense of an increased number of women being recalled for further assessment after subsequent screens
Sunday, 13 September 2009
Localization of impalpable breast lesions: What are we aiming at?
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
Link to Journal
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
Brian Mucci, Robert Shaw, Jean Lauder, Russell Pickard
The Breast Volume 18, Issue 4, August 2009, Pages 267-269
Link to Journal
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
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
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
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
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
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
Link to Journal
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
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
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
Link to Journal
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
Link to Journal
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
Friday, 19 December 2008
Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening
Predictive value of needle core biopsy diagnoses of lesions of uncertain malignant potential (B3) in abnormalities detected by mammographic screening
M E El-Sayed, E A Rakha, J Reed, A H S Lee, A J Evans, I O Ellis
Histopathology 2008, 53, 650–657
Link to Journal
Approximately 20% of needle core biopsy of screen-detected breast lesions classified as B3 are malignant on excision, and the likelihood of malignancy varies substantially between different histological subtypes
M E El-Sayed, E A Rakha, J Reed, A H S Lee, A J Evans, I O Ellis
Histopathology 2008, 53, 650–657
Link to Journal
Approximately 20% of needle core biopsy of screen-detected breast lesions classified as B3 are malignant on excision, and the likelihood of malignancy varies substantially between different histological subtypes
Lobular neoplasia: Core needle breast biopsy underestimation of malignancy in relation to radiologic and pathologic features
Viviana Londero, Chiara Zuiani, Anna Linda, Elena Vianello, Alessandro Furlan, Massimo Bazzocchi
The Breast 17 (2008) 623 - 630
Link to Journal
Purpose: to assess the positive predictive value (PPV) for malignancy of core needle biopsy (CNB) demonstrating lobular neoplasia.
Underestimation of malignancy was more likely in cases of LCIS, US-guided CNB, and lesions that were large and suspicious on imaging.
Viviana Londero, Chiara Zuiani, Anna Linda, Elena Vianello, Alessandro Furlan, Massimo Bazzocchi
The Breast 17 (2008) 623 - 630
Link to Journal
Purpose: to assess the positive predictive value (PPV) for malignancy of core needle biopsy (CNB) demonstrating lobular neoplasia.
Underestimation of malignancy was more likely in cases of LCIS, US-guided CNB, and lesions that were large and suspicious on imaging.
The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications
The value of a combination of wire localization and ultrasound-guided vacuum-assisted breast biopsy for clustered microcalcifications
Ki Seok Choo, Hee Suk Kwak, Young Tae Bae, Jee-Yeon Lee, Seung Ju Lee, Hyoung Il Seo, Su Bong Nam
The Breast 17 (2008) 611 - 616
Link to journal
Purpose: to introduce and evaluate the usefulness of the combination of wire localization and ultrasound (US)-guided, vacuum-assisted breast biopsy (VAB) to histologically diagnose mammographically detected clustered microcalcifications in the absence of sonographic and clinically palpable masses. Appears to be an accurate and useful method for diagnosing mammographically detected, clustered microcalcifications
Ki Seok Choo, Hee Suk Kwak, Young Tae Bae, Jee-Yeon Lee, Seung Ju Lee, Hyoung Il Seo, Su Bong Nam
The Breast 17 (2008) 611 - 616
Link to journal
Purpose: to introduce and evaluate the usefulness of the combination of wire localization and ultrasound (US)-guided, vacuum-assisted breast biopsy (VAB) to histologically diagnose mammographically detected clustered microcalcifications in the absence of sonographic and clinically palpable masses. Appears to be an accurate and useful method for diagnosing mammographically detected, clustered microcalcifications
Pain during vacuum-assisted breast biopsy: Are there any predictors?
Pain during vacuum-assisted breast biopsy: Are there any predictors?
George C. Zografos, Flora Zagouri, Theodoros N. Sergentanis, Afrodite Nonni, Philip Domeyer, Dimitra Koulocheri, Ioannis Flessas, Effrosyni Panopoulou, Dimosthenis Chrysikos, John Bramis
The Breast 17 (2008) 592e595
Link to Journal
Pain can be reduced by increased experience of the operator (shorter procedure times) and the avoidance of the luteal phase - timing is everything!
George C. Zografos, Flora Zagouri, Theodoros N. Sergentanis, Afrodite Nonni, Philip Domeyer, Dimitra Koulocheri, Ioannis Flessas, Effrosyni Panopoulou, Dimosthenis Chrysikos, John Bramis
The Breast 17 (2008) 592e595
Link to Journal
Pain can be reduced by increased experience of the operator (shorter procedure times) and the avoidance of the luteal phase - timing is everything!
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