Pseudoangiomatous Stromal Hyperplasia of the Breast in a Female Adolescent Presenting as Bilateral Gigantomastia / 한국유방암학회지

Pseudoangiomatous stromal hyperplasia (PASH) is a rare idiopathic proliferative mesenchymal breast disease related to hormonal imbalance, and thus extremely rare in children and adolescents. In addition, PASH manifests as a bilateral gigantomastia in some cases with no established cause or treatment. Here, we report a case of a rapidly developed PASH presenting with bilateral gigantomastia in a 14-year-old premenarchial female patient.Considering the patient’s age and emotions and the need for nipple-areolar complex repositioning, we performed reduction mammoplasty rather than total mastectomy despite the possibility of recurrence. Although some masses could not be completely removed, no complications, such as infection, wound dehiscence, or hematoma occurred postoperatively.The patient was stable during the 18-month follow-up period, although an evidence of recurrent and residual disease was noted upon ultrasonography.

Complications and management of breast augmentation using two different types of fillers: a case series

An advantage of breast augmentation with injectable fillers is that the desired size can be determined and achieved under local anesthesia with a short recovery time. However, a high complication rate is a critical disadvantage. Some fillers are challenging to remove, resulting in breast deformity and scarring. Five patients who underwent surgery to manage a foreign body in the breasts in 2021 were enrolled in this study. Two had copolyamide filler injections, while the other three had polyacrylamide hydrogel filler injections. A physical examination was performed, and preoperative and intraoperative photographs were obtained. Two patients underwent subcutaneous mastectomy because most of the filler had infiltrated into the normal breast tissue. In contrast, the other patients underwent filler removal and debridement because most of the filler had remained separate from the normal breast tissue. All patients who had a subcutaneous mastectomy and one who underwent only filler removal underwent immediate breast reconstruction with cohesive gel implants. The other patients rejected immediate reconstruction, and only filler removal was performed. All patients recovered without complications. We propose an algorithm for diagnosis and treatment based on our cases, which we hope can help clinicians manage the complications of filler injections for breast augmentation.

Usefulness of 3-Dimensional-Printed Breast Surgical Guides for Undetectable Ductal Carcinoma In Situ on Ultrasonography: A Report of 2 Cases / 한국유방암학회지

Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.

Usefulness of 3-Dimensional-Printed Breast Surgical Guides for Undetectable Ductal Carcinoma In Situ on Ultrasonography: A Report of 2 Cases / 한국유방암학회지

Tumor localization is challenging in the context of ductal carcinoma in situ (DCIS) treated with breast-conserving surgery. Conventional localization methods are generally performed under the guidance of ultrasonography or mammography and are rarely performed with magnetic resonance imaging (MRI), which is more sensitive than the aforementioned modalities in detecting DCIS. Here, we report the application of MRI-based individualized 3-dimensional (3D)-printed breast surgical guides (BSGs) for patients with breast cancer.We successfully resected indeterminate and suspicious lesions that were only detected using preoperative MRI, and the final histopathologic results confirmed DCIS with clear resection margins. MRI guidance combined with 3D-printed BSGs can be used for DCIS localization, especially for lesions easily detectable using MRI only.

Impact of Simulated Electronic Health Records on Informatics Competency of Students in Informatics Course / 대한의료정보학회지

Objectives@#Nursing has embraced online education to increase its workforce while providing flexible advanced education to nurse professionals. Faculty use virtual simulation and other adaptive learning technologies to enhance learning efficiency and student outcomes in online courses. The purpose of this study was to assess the impact of simulated Electronic Health Records (EHRs) on informatics competency in a graduate online informatics course. @*Methods@#A two-group independent measures study design was adopted to assess students’ perception of a simulated EHR while comparing differences in informatics competencies between an intervention group and a control group. A simulated EHR assignment was provided to students in the intervention group, and a paper assignment was provided to those in the control group. The informatics competency of the students was measured using the Self-Assessment of Informatics Competency Scale for Health Professionals (SICS). @*Results@#Students who were enrolled in a family nurse practitioner program in fall of 2019 participated in this study (n = 39). The students expressed positive perceptions of a simulated EHR experience. The SICS results indicated that students in the intervention (simulated EHR) group showed higher informatics competency than those in the control group. @*Conclusions@#The positive results of this study support incorporating simulated EHR exercises in online courses. Higher informatics competency in the intervention group implies that the use of simulated EHR facilitated learning of complicated informatics concepts.

Sonographic features that can be used to differentiate between small triple-negative breast cancer and fibroadenoma

PURPOSE: Our study investigated whether any sonographic findings could be useful for differentiating between small triple-negative breast cancer (TNBC) and fibroadenoma. METHODS: This retrospective study was approved by our Institutional Review Board, which waived the requirement for patient consent. From January 2009 to December 2010, the sonographic features of 181 pathologically proven TNBC tumors and 172 fibroadenomas measuring less than or equal to 2 cm in the longest dimension were reviewed and analyzed according to the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. Mean tumor roundness was also measured using in-house software. RESULTS: The median longest lesion dimension was 16 mm (range, 13 to 18 mm) in TNBCs and 13 mm (range, 10 to 16 mm) in fibroadenomas. In comparison to fibroadenomas, small TNBC tumors presented with a higher incidence of irregular shapes (66.9%), noncircumscribed margins (91.7%), hypoechoic echotexture (59.1%), posterior acoustic enhancement (65.2%), and associated features (24.4%). Most TNBCs were classified as BI-RADS category 4 (65.2%) or 5 (28.2%). The mean tumor roundness of small TNBCs was greater than that of fibroadenomas (60%±12% vs. 53%±13%). Multivariate analysis showed that older patient age, irregular shape, nonparallel orientation, posterior acoustic enhancement, associated features, a BI-RADS final assessment category of 4 or 5, and greater tumor roundness were significant independent factors indicative of TNBCs. CONCLUSION: TNBC tumors tend to demonstrate more suspicious sonographic features and greater tumor roundness than fibroadenomas. These features may have the potential to help differentiate between small TNBCs and fibroadenomas.

Complex Hemangioma of the Breast: Case Report, with Imaging Findings

Vascular tumors in the breast are rare, and most can be classified as being either angiosarcomas or hemangiomas. Hemangiomas are benign vascular tumors that are usually identified incidentally. Here, we are reporting on a case of a complex hemangioma of the breast, and describing the mammography, ultrasonography, and magnetic resonance imaging findings for this patient.

Second-look ultrasonography for MRI-detected suspicious breast lesions in patients with breast cancer

PURPOSE: The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer. METHODS: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed. RESULTS: Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology. CONCLUSION: We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions.

Magnetic Resonance Imaging of Breast Cancer Patients with BRCA Mutation

PURPOSE: To evaluate the MRI findings of breast cancer with BRCA mutation. MATERIALS AND METHODS: We collected information of the breast cancer patients who underwent the test for BRCA gene mutation as well as preoperative breast MRI from January 2007 to December 2010. A total of 185 patients were enrolled; 33 of these patients had BRCA mutations and 152 patients did not. Among them, a total of 231 breast cancers were detected. Images of the 47 breast cancers with BRCA mutation and of the 184 breast cancers without mutations were evaluated to compare the morphologic and enhancement features on MRI. RESULTS: With MR imaging, there were no significant difference in morphologic characteristic between two groups. However, enhancement pattern in the group with BRCA mutation were more likely to have persistent enhancement (p < 0.233), and LN metastasis was more common in breast cancers without BRCA mutation. Breast cancers with BRCA 2 mutation tend to show more persistent enhancement pattern than BRCA 1 mutation. CONCLUSION: In breast cancer patients with BRCA mutation, MRI didn't show significant difference in morphologic characteristics, however breast cancers with BRCA gene mutation carriers tend to have benign morphologic features on MRI, such as Type 1 kinetic curve enhancement.

MR imaging of hepatic lymphangioma / 대한간학회지

No abstract available.