Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 71
Filter
1.
Article in English | WPRIM | ID: wpr-918218

ABSTRACT

Objective@#This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients. @*Materials and Methods@#This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I–III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival. @*Results@#Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm2 /m2 and 72.0 ± 46.0 cm2 , respectively. The mean value of the delta SMI was -0.9 cm2 /m2 and the delta VAT was 0.5 cm2 . The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937–1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995–1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766–1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989–1.014; p = 0.848, respectively). @*Conclusion@#Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

2.
Journal of Breast Cancer ; : 377-388, 2021.
Article in English | WPRIM | ID: wpr-891286

ABSTRACT

Purpose@#To evaluate the accuracy of magnetic resonance imaging (MRI)-guided breast biopsy. @*Methods@#We retrospectively reviewed the clinical data of 111 consecutive patients referred for MRI-guided breast biopsy after mammography and breast ultrasound between May 2009 and April 2019. After excluding 37 patients without follow-up images (> 2 years), 74 patients (74 lesions) were finally included. We reviewed the histologic results of MRI-guided biopsy and subsequent surgery, post-biopsy management, and breast cancer development during followup. We investigated the false-negative rate, ductal carcinoma in situ (DCIS) underestimation, atypical ductal hyperplasia (ADH) underestimation rate, and technical failure rate of MRIguided biopsy. @*Results@#Among 74 scheduled MRI-guided biopsies, six were canceled because biopsy was deemed unnecessary, while three failed due to technical difficulties (technical failure rate:3/68, 4.4%). MRI-guided biopsy was performed in 65 patients, of which 18 patients were diagnosed with malignant lesions, 46 with benign lesions, and one with ADH bordering on DCIS. Subsequent surgery (n = 27) showed DCIS underestimation in three cases (3/7, 43%), ADH underestimation in two cases (1/2, 50%), as well as seven concordant benign and 11 concordant malignant lesions. The overall false-negative rate was 4.3% (2/46). Thirty-eight out of 48 benign lesions were followed-up (median period, 5.8 years; interquartile range, 4.1 years) without subsequent surgery. Thirty-seven concordant benign lesions were stable (n = 27) or disappeared (n = 10); however, the size of one discordant benign lesion increased on follow-up MRI and it was diagnosed as DCIS after 1 year. @*Conclusion@#MRI-guided biopsy is an accurate method for exclusion of malignancy with a very low false-negative rate.

3.
Journal of Breast Cancer ; : 218-228, 2021.
Article in English | WPRIM | ID: wpr-891275

ABSTRACT

Purpose@#Interest in unenhanced magnetic resonance imaging (MRI) screening for breast cancer is growing due to concerns about gadolinium deposition in the brain and the high cost of contrast-enhanced MRI. The purpose of this report is to describe the protocol of the Diffusion-Weighted Magnetic Resonance Imaging Screening Trial (DWIST), which is a prospective, multicenter, intraindividual comparative cohort study designed to compare the performance of mammography, ultrasonography, dynamic contrast-enhanced (DCE) MRI, and diffusion-weighted (DW) MRI screening in women at high risk of developing breast cancer. @*Methods@#A total of 890 women with BRCA mutation or family history of breast cancer and lifetime risk ≥ 20% are enrolled. The participants undergo 2 annual breast screenings with digital mammography, ultrasonography, DCE MRI, and DW MRI at 3.0 T. Images are independently interpreted by trained radiologists. The reference standard is a combination of pathology and 12-month follow-up. Each image modality and their combination will be compared in terms of sensitivity, specificity, accuracy, positive predictive value, rate of invasive cancer detection, abnormal interpretation rate, and characteristics of detected cancers. The first participant was enrolled in April 2019. At the time of manuscript submission, 5 academic medical centers in South Korea are actively enrolling eligible women and a total of 235 women have undergone the first round of screening. Completion of enrollment is expected in 2022 and the results of the study are expected to be published in 2026.Discussion: DWIST is the first prospective multicenter study to compare the performance of DW MRI and conventional imaging modalities for breast cancer screening in high-risk women. DWIST is currently in the patient enrollment phase.

4.
Journal of Breast Cancer ; : 377-388, 2021.
Article in English | WPRIM | ID: wpr-898990

ABSTRACT

Purpose@#To evaluate the accuracy of magnetic resonance imaging (MRI)-guided breast biopsy. @*Methods@#We retrospectively reviewed the clinical data of 111 consecutive patients referred for MRI-guided breast biopsy after mammography and breast ultrasound between May 2009 and April 2019. After excluding 37 patients without follow-up images (> 2 years), 74 patients (74 lesions) were finally included. We reviewed the histologic results of MRI-guided biopsy and subsequent surgery, post-biopsy management, and breast cancer development during followup. We investigated the false-negative rate, ductal carcinoma in situ (DCIS) underestimation, atypical ductal hyperplasia (ADH) underestimation rate, and technical failure rate of MRIguided biopsy. @*Results@#Among 74 scheduled MRI-guided biopsies, six were canceled because biopsy was deemed unnecessary, while three failed due to technical difficulties (technical failure rate:3/68, 4.4%). MRI-guided biopsy was performed in 65 patients, of which 18 patients were diagnosed with malignant lesions, 46 with benign lesions, and one with ADH bordering on DCIS. Subsequent surgery (n = 27) showed DCIS underestimation in three cases (3/7, 43%), ADH underestimation in two cases (1/2, 50%), as well as seven concordant benign and 11 concordant malignant lesions. The overall false-negative rate was 4.3% (2/46). Thirty-eight out of 48 benign lesions were followed-up (median period, 5.8 years; interquartile range, 4.1 years) without subsequent surgery. Thirty-seven concordant benign lesions were stable (n = 27) or disappeared (n = 10); however, the size of one discordant benign lesion increased on follow-up MRI and it was diagnosed as DCIS after 1 year. @*Conclusion@#MRI-guided biopsy is an accurate method for exclusion of malignancy with a very low false-negative rate.

5.
Journal of Breast Cancer ; : 218-228, 2021.
Article in English | WPRIM | ID: wpr-898979

ABSTRACT

Purpose@#Interest in unenhanced magnetic resonance imaging (MRI) screening for breast cancer is growing due to concerns about gadolinium deposition in the brain and the high cost of contrast-enhanced MRI. The purpose of this report is to describe the protocol of the Diffusion-Weighted Magnetic Resonance Imaging Screening Trial (DWIST), which is a prospective, multicenter, intraindividual comparative cohort study designed to compare the performance of mammography, ultrasonography, dynamic contrast-enhanced (DCE) MRI, and diffusion-weighted (DW) MRI screening in women at high risk of developing breast cancer. @*Methods@#A total of 890 women with BRCA mutation or family history of breast cancer and lifetime risk ≥ 20% are enrolled. The participants undergo 2 annual breast screenings with digital mammography, ultrasonography, DCE MRI, and DW MRI at 3.0 T. Images are independently interpreted by trained radiologists. The reference standard is a combination of pathology and 12-month follow-up. Each image modality and their combination will be compared in terms of sensitivity, specificity, accuracy, positive predictive value, rate of invasive cancer detection, abnormal interpretation rate, and characteristics of detected cancers. The first participant was enrolled in April 2019. At the time of manuscript submission, 5 academic medical centers in South Korea are actively enrolling eligible women and a total of 235 women have undergone the first round of screening. Completion of enrollment is expected in 2022 and the results of the study are expected to be published in 2026.Discussion: DWIST is the first prospective multicenter study to compare the performance of DW MRI and conventional imaging modalities for breast cancer screening in high-risk women. DWIST is currently in the patient enrollment phase.

6.
Article in English | WPRIM | ID: wpr-875137

ABSTRACT

With the increase in the number of cases of silicone implant insertion either for cosmetic surgery or breast reconstruction after mastectomy, it is not unusual to encounter patients with silicone implants in clinical settings. Recently, the first case of breast implant-associated anaplastic large cell lymphoma was reported in Korea. In addition to previously known complications, such as implant rupture or contracture, the number of implant-associated imaging examinations has also increased. Considering this background, radiologists should have sufficient knowledge about the type of examination required in patients who have undergone implant insertion and imaging findings to correctly identify implant-associated complications. In this article, various complications of silicone implants are discussed, including various imaging findings, which radiologists should know.

7.
Journal of Breast Cancer ; : 554-560, 2021.
Article in English | WPRIM | ID: wpr-914826

ABSTRACT

Axillary ultrasonography (US) is the most commonly used imaging modality for nodal evaluation in patients with breast cancer. No Axillary Surgical Treatment in Clinically Lymph Node-Negative Patients after Ultrasonography (NAUTILUS) is a prospective, multicenter, randomized controlled trial investigating whether sentinel lymph node biopsy (SLNB) can be safely omitted in patients with clinically and sonographically node-negative T1–2 breast cancer treated with breast-conserving therapy. In this trial, a standardized imaging protocol and criteria were established for the evaluation of axillary lymph nodes. Women lacking palpable lymph nodes underwent axillary US to dismiss suspicious nodal involvement.Patients with a round hypoechoic node with effaced hilum or indistinct margins were excluded. Patients with T1 tumors and a single node with a cortical thickness ≥ 3 mm underwent US-guided biopsy. Finally, patients with negative axillary US findings were included. The NAUTILUS axillary US nodal assessment criteria facilitate the proper selection of candidates who can omit SLNB.

8.
Article in English | WPRIM | ID: wpr-741457

ABSTRACT

OBJECTIVE: To investigate whether a computer-aided diagnosis (CAD) system based on a deep learning framework (deep learning-based CAD) improves the diagnostic performance of radiologists in differentiating between malignant and benign masses on breast ultrasound (US). MATERIALS AND METHODS: B-mode US images were prospectively obtained for 253 breast masses (173 benign, 80 malignant) in 226 consecutive patients. Breast mass US findings were retrospectively analyzed by deep learning-based CAD and four radiologists. In predicting malignancy, the CAD results were dichotomized (possibly benign vs. possibly malignant). The radiologists independently assessed Breast Imaging Reporting and Data System final assessments for two datasets (US images alone or with CAD). For each dataset, the radiologists' final assessments were classified as positive (category 4a or higher) and negative (category 3 or lower). The diagnostic performances of the radiologists for the two datasets (US alone vs. US with CAD) were compared. RESULTS: When the CAD results were added to the US images, the radiologists showed significant improvement in specificity (range of all radiologists for US alone vs. US with CAD: 72.8–92.5% vs. 82.1–93.1%; p < 0.001), accuracy (77.9–88.9% vs. 86.2–90.9%; p = 0.038), and positive predictive value (PPV) (60.2–83.3% vs. 70.4–85.2%; p = 0.001). However, there were no significant changes in sensitivity (81.3–88.8% vs. 86.3–95.0%; p = 0.120) and negative predictive value (91.4–93.5% vs. 92.9–97.3%; p = 0.259). CONCLUSION: Deep learning-based CAD could improve radiologists' diagnostic performance by increasing their specificity, accuracy, and PPV in differentiating between malignant and benign masses on breast US.


Subject(s)
Breast , Dataset , Diagnosis , Humans , Information Systems , Learning , Prospective Studies , Retrospective Studies , Sensitivity and Specificity , Ultrasonography , Ultrasonography, Mammary
9.
Ultrasonography ; : 76-82, 2019.
Article in English | WPRIM | ID: wpr-731038

ABSTRACT

PURPOSE: The purpose of this study was to investigate the final outcomes of magnetic resonance imaging (MRI)-identified additional lesions (MRALs) in breast cancer patients and the role of second-look ultrasound (SLUS) and imaging-guided interventions. METHODS: We analyzed breast cancer patients with MRALs on preoperative MRI between January and June 2012. MRALs were defined as additional lesions suspected on MRI but not suspected on mammograms or ultrasound. The malignancy rate of MRALs, MRI-based Breast Imaging Reporting and Database System (BI-RADS) category, positional relationship with the index cancer, MRI-concordant lesion visibility on SLUS, performance of imaging-guided interventions, and total mastectomy (TM) rates were evaluated for the confirmed lesions. RESULTS: Among the 119 confirmed lesions, SLUS and imaging-guided interventions were performed in 94 (79.0%) and 82 cases (68.9%), respectively. The malignancy rate was 68.1% (81 of 119), and was significantly higher in BI-RADS 4C-5 lesions than in 4A-4B lesions (94.6% vs. 56.1%, P < 0.01) and in ipsilateral same-quadrant lesions than in contralateral lesions (84.2% vs. 33.3%, P < 0.01). The lesion visibility rate on SLUS was 90.4%. The malignancy rate was not significantly different according to lesion visibility on SLUS. The TM rate in the 98 cases with ipsilateral MRALs was 37.8%, while it was significantly lower in patients who underwent an imaging-guided intervention than in those who did not (27.9% vs. 54.1%, P=0.017). CONCLUSION: MRALs show a high probability of malignancy, especially if they are ipsilateral. SLUS and imaging-guided interventions can eliminate many unnecessary TMs.


Subject(s)
Breast Neoplasms , Breast , Humans , Magnetic Resonance Imaging , Mastectomy, Simple , Ultrasonography
10.
Article in English | WPRIM | ID: wpr-916839

ABSTRACT

PURPOSE@#This study aimed to analyze the current practices of breast imaging among Korean radiologists.@*MATERIALS AND METHODS@#We invited members of the Korean Society of Breast Imaging (KSBI) working as breast radiologists to participate in a survey on the current practices in breast imaging, and investigated how quality assurance (QA), medical audits, and imaging-histologic discordance were conducted.@*RESULTS@#The survey involved 312 members of the KSBI, and 116 (37%) responded to the 21 questions in the questionnaire. Most of the respondents were women (87%), aged below 50 years (82.7%), and working at university or tertiary hospitals (68.1%), who had varying levels of experience in breast imaging. Of the 116 respondents, 114 (96.6%) followed the Breast Imaging Reporting and Data System (BI-RADS) to interpret breast imaging. Out of 116, 72 (62.1%) interpreted 20 or more mammograms per day, 84 (72.4%) performed 10–30 breast ultrasound scans per day, and 65 (56%) interpreted fewer than 5 breast MRI scans per day. Among the respondents, 82% performed mammography QA, 76.9% evaluated imaging-histologic correlations, and only 38.9% performed medical audits.@*CONCLUSION@#The institutions and working patterns of breast radiologists were diverse. Although many respondents did not conduct medical audits, most of them followed BI-RADS when interpreting breast imaging, performing QA, and evaluating imaging-histologic correlations.

11.
Article in English | WPRIM | ID: wpr-916812

ABSTRACT

PURPOSE@#To evaluate the criteria for predicting invasive lesions with preoperative breast MRI in ductal carcinoma in situ (DCIS) histopathologically diagnosed with biopsy.@*MATERIALS AND METHODS@#We retrospectively analyzed the preoperative MRI findings of 80 percutaneous biopsy-proven DCIS. The morphological type, enhancement distribution and kinetics, and extent of the lesions were analyzed. We compared the results of pure DCIS and DCIS with invasive lesions. We evaluated the MRI criteria for predicting DCIS with invasive lesions and assessed its diagnostic performance.@*RESULTS@#Of the 80 DCIS lesions analyzed, 27 contained co-existing invasive lesions and 49 were pure DCIS. No residual lesions after biopsy were seen in 4 cases. DCIS with invasive lesions showed washout kinetics more frequently and to a larger extent than did pure DCIS (p = 0.030 and p = 0.048, respectively). Using enhancement kinetics and the lesion cut-off value of 4 cm yielded the highest diagnostic performance, with 92.6% sensitivity and 93.8% negative predictive value for predicting invasive lesions.@*CONCLUSION@#Washout kinetics and the lesion extent of at least 4 cm are useful criteria for the prediction of co-existing invasive lesions in patients with DCIS diagnosed with biopsy.

12.
Article in English | WPRIM | ID: wpr-119937

ABSTRACT

PURPOSE: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. MATERIALS AND METHODS: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. RESULTS: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. CONCLUSION: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.


Subject(s)
Breast Neoplasms , Breast , Diagnosis , Korea , Magnetic Resonance Imaging , Mammography , Surveys and Questionnaires , Ultrasonography
13.
Journal of Breast Cancer ; : 301-307, 2016.
Article in English | WPRIM | ID: wpr-126239

ABSTRACT

PURPOSE: This study assessed the incidence and cancer rate of probably benign lesions detected on bilateral whole-breast screening ultrasound (US), which corresponded to US Breast Imaging Reporting and Data System (BI-RADS) category 3, and evaluated the proper management of those lesions. METHODS: This study was approved by the Institutional Review Board in our institution, which waived informed patient consent. We retrospectively reviewed US images of 1,666 patients who underwent bilateral whole-breast screening US as a supplemental screening test to negative screening mammography or screening US only. The incidence, clinical course, and cancer rate of screening US-detected probably benign lesions corresponding to US BI-RADS category 3 were investigated, and the size and multiplicity of screening US-detected category 3 lesions were evaluated. RESULTS: Probably benign lesions corresponding to US BI-RADS category 3 were detected in 689 of 1,666 patients (41.4%) who underwent screening US. Among them, 653 had follow-up US images for at least 24 months, and among these 653, 190 (29.1%) had multiple bilateral category 3 lesions. Moreover, 539 of 1,666 patients (32.4%) had lesions ≤1 cm in size and 114 of 1,666 (6.8%) had lesions >1 cm (median, 0.82 cm; range, 0.3–4.2 cm). Four of the 653 patients (0.6%) showed suspicious interval changes and were categorized into BI-RADS category 4. Biopsy analysis confirmed only one lesion as invasive ductal carcinoma at the 6-month follow-up; another lesion was an intraductal papilloma and the remaining two were fibroadenomas. Overall cancer rate of the screening US-detected BI-RADS category 3 lesions was 0.2%. CONCLUSION: The incidence of category 3 lesions detected on screening US only was very high, but the cancer rate was very low. Therefore, in an average-risk population, routine screening US is preferable over short-term follow-up for BI-RADS category 3 lesions detected on whole-breast screening US.


Subject(s)
Biopsy , Breast , Carcinoma, Ductal , Ethics Committees, Research , Fibroadenoma , Follow-Up Studies , Humans , Incidence , Information Systems , Mammography , Mass Screening , Papilloma, Intraductal , Retrospective Studies , Ultrasonography
14.
Journal of Breast Cancer ; : 330-333, 2016.
Article in English | WPRIM | ID: wpr-126235

ABSTRACT

Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare but pathologically distinct breast tumor. There have been some case reports on primary MCA of the breast; however, they have all focused on pathologic findings. Here, we report the radiologic findings of two cases of MCA along with a review of the literature. Breast MCA shows a circumscribed mass with some calcifications on mammography, an intracystic solid mass without increased vascularity or a vascular stalk on ultrasound, and a heterogeneously enhancing mass within a rim-enhancing cyst with intermediate signal intensity on T2-weighted magnetic resonance imaging. These radiologic findings and the presence of mucin in the percutaneous biopsy specimen should suggest the possibility of MCA in the differential diagnosis of a breast tumor.


Subject(s)
Biopsy , Breast Neoplasms , Breast , Cystadenocarcinoma, Mucinous , Diagnosis, Differential , Magnetic Resonance Imaging , Mammography , Mucins , Ultrasonography
15.
Article in English | WPRIM | ID: wpr-88084

ABSTRACT

Breast hamartomas are typically a benign condition and rarely develop into malignant lesions. The coexistence of carcinoma and a breast hamartoma is rare; only 15 cases have been reported in the literature. Here, we report a case of invasive ductal carcinoma associated with hamartoma in a 60-year-old woman. Mammography, ultrasonography and magnetic resonance imaging showed typical features of a breast hamartoma and a suspicious mass with microcalcifications arising within the hamartoma.


Subject(s)
Breast , Carcinoma, Ductal , Female , Hamartoma , Humans , Magnetic Resonance Imaging , Mammography , Middle Aged , Ultrasonography
16.
Article in English | WPRIM | ID: wpr-195470

ABSTRACT

BACKGROUND AND OBJECTIVES: To classify the metastases to the thyroid gland arising from non-thyroidal malignancies on ultrasound (US). MATERIALS AND METHODS: We enrolled 45 consecutive patients with metastases to the thyroid gland from 2005 to 2012. We classified metastases into 4 types; type I: diffuse non-mass forming lesion, type II: a solitary suspicious nodule, type III: multiple suspicious nodules, and type IV: nodule(s) with no suspicion. We subcategorized type I into two subtypes; type IA: diffusely infiltrative lesion, type IB: diffuse micronodulation. RESULTS: The most frequent primary malignancy of thyroid metastases was lung cancer. The patients with thyroid metastases were 26 (57.8%) in type I; type IA: 16 (35.6%), type IB: 10 (22.2%), 14 (31.1%) in type II, 3 (6.7%) in type III and 2 (4.4%) in type IV. Type I metastasis included 18 of 25 patients with lung cancer and all 3 patients with stomach cancer. Thirty patients (73.3%) having type IA, II or III revealed malignant findings on US, in contrast, 12 (26.7%) patients having type IB or IV revealed no suspicious findings. CONCLUSION: Type I (diffuse non-mass forming lesion) was the most common in thyroid metastases. A quarter of thyroid metastases revealed no suspicious findings on US. Thyroid metastases can be considered as a differential diagnosis, when diffuse non-mass forming lesions or nodules with no suspicion are revealed on thyroid US.


Subject(s)
Classification , Diagnosis, Differential , Humans , Lung Neoplasms , Neoplasm Metastasis , Stomach Neoplasms , Thyroid Gland , Ultrasonography
17.
Yonsei Medical Journal ; : 1352-1358, 2015.
Article in English | WPRIM | ID: wpr-185884

ABSTRACT

PURPOSE: To show the results of an audit of screening breast ultrasound (US) in women with negative mammography in a single institution and to analyze US-detected cancers within a year and interval cancers. MATERIALS AND METHODS: During the year of 2006, 1974 women with negative mammography were screened with US in our screening center, and 1727 among them had pathologic results or any follow up breast examinations more than a year. We analyzed the distribution of Breast Imaging Reporting and Data System (BI-RADS) category and the performance outcome through follow up. RESULTS: Among 1727 women (age, 30-76 years, median 49.5 years), 1349 women (78.1%) showed dense breasts on mammography, 762 (44.1%) had previous breast US, and 25 women (1.4%) had a personal history of breast cancers. Test negatives were 94.2% (1.627/1727) [BI-RADS category 1 in 885 (51.2%), 2 in 742 (43.0%)]. The recall rate (=BI-RADS category 3, 4, 5) was 5.8%. Eight cancers were additionally detected with US (yield, 4.6 per 1000). The sensitivity, specificity, and positive predictive value (PPV1, PPV2) were 88.9%, 94.6%, 8.0%, and 28.0%, respectively. Eight of nine true positive cancers were stage I or in-situ cancers. One interval cancer was stage I cancer from BI-RADS category 2. CONCLUSION: Screening US detected 4.6 additional cancers among 1000. The recall rate was 5.8%, which is in lower bound of acceptable range of mammography (5-12%), according to American College of Radiology standard.


Subject(s)
Adult , Aged , Breast/pathology , Breast Neoplasms/diagnosis , Female , Humans , Mammography/methods , Mass Screening/methods , Middle Aged , Sensitivity and Specificity , Ultrasonography/methods , Ultrasonography, Mammary
18.
Article in English | WPRIM | ID: wpr-81039

ABSTRACT

OBJECTIVE: To evaluate the relationship between response categories assessed by magnetic resonance imaging (MRI) or pathology and survival outcomes, and to determine whether there are prognostic differences among molecular subtypes. MATERIALS AND METHODS: We evaluated 174 patients with biopsy-confirmed invasive breast cancer who had undergone MRI before and after neoadjuvant chemotherapy, but before surgery. Pathology findings were classified as a pathologic complete response (pCR) or a non-pCR, and MRI findings were designated as a radiologic CR (rCR) or a non-rCR. We evaluated overall and subtype-specific associations between clinicopathological factors including the assessment categories and recurrence, using the Cox proportional hazards model. RESULTS: There were 41 recurrences (9 locoregional and 32 distant recurrences). There were statistically significant differences in recurrence outcomes between patients who achieved a radiologic or a pCR and patients who did not achieve a radiologic or a pCR (recurrence hazard ratio, 11.02; p = 0.018 and recurrence hazard ratio, 3.93; p = 0.022, respectively). Kaplan-Meier curves for recurrence-free survival showed that triple-negative breast cancer was the only subtype that showed significantly better outcomes in patients who achieved a CR compared to patients who did not achieve a CR by both radiologic and pathologic assessments (p = 0.004 and 0.001, respectively). A multivariate analysis found that patients who achieved a rCR and a pCR did not display significantly different recurrence outcomes (recurrence hazard ratio, 2.02; p = 0.505 and recurrence hazard ratio, 1.12; p = 0.869, respectively). CONCLUSION: Outcomes of patients who achieved a rCR were similar to those of patients who achieved a pCR. To evaluate survival difference according to molecular subtypes, a larger study is needed.


Subject(s)
Adult , Aged , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Female , Humans , Kaplan-Meier Estimate , Magnetic Resonance Imaging , Middle Aged , Neoadjuvant Therapy , Neoplasm Recurrence, Local , Prognosis , Proportional Hazards Models , Receptor, ErbB-2/genetics , Receptors, Estrogen/genetics , Receptors, Progesterone/genetics , Remission Induction
19.
Article in English | WPRIM | ID: wpr-90699

ABSTRACT

We present a 53-year-old woman with a large chest wall mass in the interpectoral space, which was eventually confirmed as a lipogranuloma resulting from hydrogel implant rupture. Ultrasonography (US) showed reduced implant volume with surrounding peri-implant fluid collection, suggesting the possibility of implant rupture. A heterogeneously hypoechoic mass was found between the pectoralis major and minor muscles adjacent to the ruptured implant. On magnetic resonance imaging (MRI), there was a large mass in the left interpectoral space of the upper inner chest wall. The mass showed slightly high signal intensity (SI) on pre-contrast T1-weighted image (WI) with mixed iso and high SI on T2-WI. The signal of the mass was suppressed using the water suppression technique but not with the fat suppression technique on T2-WI. The mass showed diffuse enhancement upon contrast enhancement. The enhancing kinetics showed persistent enhancement pattern. US-guided core needle biopsy revealed a lipogranuloma and removal confirmed a ruptured PIP hydrogel implant.


Subject(s)
Biopsy, Large-Core Needle , Breast , Female , Humans , Hydrogels , Kinetics , Magnetic Resonance Imaging , Middle Aged , Muscles , Rupture , Thoracic Wall , Thorax , Ultrasonography , Water
20.
Article in English | WPRIM | ID: wpr-203190

ABSTRACT

OBJECTIVE: To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic performance, and priority rank. MATERIALS AND METHODS: During a 22-month period, we prospectively enrolled 100 cases of specimen FFDM mammography (Brestige(R)), which was performed alone or in combination with a post-processing algorithm developed by the manufacturer: group A (SMA), specimen mammography without application of "Mammogram enhancement ver. 2.0"; group B (SMB), specimen mammography with application of "Mammogram enhancement ver. 2.0". Two sets of specimen mammographies were randomly reviewed by five experienced radiologists. Image quality, lesion detection, diagnostic performance, and priority rank with regard to image preference were evaluated. RESULTS: Three aspects of image quality (overall quality, contrast, and noise) of the SMB were significantly superior to those of SMA (p < 0.05). SMB was significantly superior to SMA for visualizing calcifications (p < 0.05). Diagnostic performance, as evaluated by cancer score, was similar between SMA and SMB. SMB was preferred to SMA by four of the five reviewers. CONCLUSION: The post-processing algorithm may improve image quality with better image preference in FFDM than without use of the software.


Subject(s)
Adult , Aged , Algorithms , Breast Neoplasms/diagnostic imaging , Calcinosis/diagnostic imaging , Female , Humans , Mammography/methods , Middle Aged , Prospective Studies , Radiographic Image Enhancement/methods , Sensitivity and Specificity , Software
SELECTION OF CITATIONS
SEARCH DETAIL