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.
Showing posts with label breast cancer. Show all posts
Showing posts with label breast cancer. Show all posts
Friday, 9 April 2010
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
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
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
Friday, 19 December 2008
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.
Lower recurrence risk through mammographic screening reduces breast cancer treatment costs
Lower recurrence risk through mammographic screening reduces breast cancer treatment costs
Lea Kauhava, Pirjo Immonen-Räihä, Ilmo Parvinen, Kaija Holli, Liisa Pylkkänen, Anne Kaljonen, Hans Helenius, Pauliina Kronqvist, Pekka J. Klemi
The Breast 17 (2008) 550–554
Link to Journal
The high risk and high costs of breast cancer recurrence are reasons why interventions should be developed that can prevent or delay disease recurrence and reduce the costs of breast cancer care. The present study showed that screening saves costs by early detection of breast cancer with reduced risk of recurrence
Lea Kauhava, Pirjo Immonen-Räihä, Ilmo Parvinen, Kaija Holli, Liisa Pylkkänen, Anne Kaljonen, Hans Helenius, Pauliina Kronqvist, Pekka J. Klemi
The Breast 17 (2008) 550–554
Link to Journal
The high risk and high costs of breast cancer recurrence are reasons why interventions should be developed that can prevent or delay disease recurrence and reduce the costs of breast cancer care. The present study showed that screening saves costs by early detection of breast cancer with reduced risk of recurrence
Thursday, 9 October 2008
Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique: Initial observations
Evaluation of breast lesions with contrast-enhanced ultrasound using the microvascular imaging technique: Initial observations
He Liu, Yu-Xin Jiang, Ji-Bin Liu, Qing-Li Zhu, Qiang Sun
The Breast 17 (2008) 532 - 539
Link to Journal
The aim of the paper was to evaluate the usefulness of contrast-enhanced ultrasound using the microvascular imaging technique in the diagnosis of breast lesions. Conventional and contrast-enhanced ultrasound using the microvascular imaging technique were performed after administration of SonoVue. The peripheral enhancement pattern was suggestive of malignancy, with a sensitivity of 39.5%, specificity of 98.3%, PPV of 94.4%, NPV of 69.4%, and accuracy of 73.8%. Homogeneous, regional, and heterogeneous enhancement patterns did not show meaningful diagnostic information
He Liu, Yu-Xin Jiang, Ji-Bin Liu, Qing-Li Zhu, Qiang Sun
The Breast 17 (2008) 532 - 539
Link to Journal
The aim of the paper was to evaluate the usefulness of contrast-enhanced ultrasound using the microvascular imaging technique in the diagnosis of breast lesions. Conventional and contrast-enhanced ultrasound using the microvascular imaging technique were performed after administration of SonoVue. The peripheral enhancement pattern was suggestive of malignancy, with a sensitivity of 39.5%, specificity of 98.3%, PPV of 94.4%, NPV of 69.4%, and accuracy of 73.8%. Homogeneous, regional, and heterogeneous enhancement patterns did not show meaningful diagnostic information
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