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.
Friday, 9 April 2010
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
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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
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