Application value of S-Detect combined with contrast-enhanced ultrasound in the Breast Imaging Reporting and Data System 4 breast lesions / 中华超声影像学杂志

Objective:To assess the value of S-Detect and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of Breast Imaging Reporting and Data System(BI-RADS) 4 breast lesions.Methods:A total of 104 breast lesions in 100 patients diagnosed as BI-RADS category 4 by conventional ultrasound were prospectively enrolled, and all of them were received S-Detect and CEUS examination at the same time. Taking pathology as the gold standard, ROC curve was constructed to compare the diagnostic efficacy of conventional ultrasound, S-Detect, CEUS and their combination.Results:Among the 104 BI-RADS category 4 breast lesions, 63 were benign and 41 were malignant. The sensitivities of conventional ultrasound, S-Detect, CEUS and S-Detect combined with CEUS were 73.17%, 87.80%, 87.80%, 90.24%; the specificities were 57.14%, 60.32%, 68.25%, 77.78%; the positive predictive values were 52.63%, 59.02%, 64.29% and 72.55%; the negative predictive values were 76.60%, 88.37%, 89.59% and 92.45%; the accuracies were 63.46%, 71.15%, 75.96% and 82.69%; and the areas under the ROC curve (AUC) were 0.652, 0.741, 0.780 and 0.840. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of S-Detect and CEUS diagnosis were improved compared with conventional ultrasound. The AUC of combined diagnosis was higher than that of S-Detect, CEUS alone, and the differences were statistically significant(all P<0.05). The AUC of CEUS was higher than that of conventional ultrasound, and the difference was statistically significant ( P<0.05). There were no significant differences in AUC between any two of other groups (all P>0.05). Conclusions:The combined application of S-Detect and CEUS could achieve complementary advantages, which is of great significance for the differential diagnosis of benign and malignant in BI-RADS 4 breast lesions.

Comparison of Mammography, Sonography, Fine-Needle Aspiration Cytology, and Excision Biopsy for the Diagnosis of Breast Lesions

Background and Objective: Problem of invasive tests in breast lesion diagnosis can be addressed by comparing noninvasive tests with final Histopathological diagnosis obtained a?er excision biopsy. Present study was carried out to study diagnos?c u?lity of mammography, sonography, FNAC compared to excision biopsy for diagnosis of breast lesions Methods: Prospec?ve Observa?onal study was carried out among 81 women with Breast related symptoms. Digital Mammography Machine, ACUSON S3000TM Ultrasound System; FNAC and surgery for excision Biopsy were used. Sensi?vity, Specificity, Accuracy, Posi?ve and Nega?ve Predic?ve values were measured and p<0.05 was considered as sta?s?cally significant. Results: Sonography and FNAC composite have sensi?vity, specificity, accuracy, posi?ve and nega?ve predic?ve values 100.00%, 81.40%, 90.12%, 82.61% and 100.00% respec?vely. Mammography+FNAC (97.3%) is not as sensi?ve as Sonography+FNAC (100%), Sonography combined with FNAC is equally sensi?ve to excision biopsy (100%) and therefore can be used for screening purpose. Conclusion: Contrary to present guidelines which consider Mammography as most important screening tool for Breast Cancer, combina?on of Sonography and FNAC can be considered equally reliable.

Nueva clasificación de las lesiones papilares de la mama incluidas en la quinta actualización (2019) de la clasificación OMS de tumores de la mama / New classification of papillary breast lesions included in the fifth update (2019) of the WHO classification of breast tumors / Nova classificação das lesões papilares da mama incluídas na quinta atualização (2019) da classificação OMS de tumores da mama

En el más reciente número de esta revista se publicó el estudio titulado "Lesiones papilares de mama: estudio clínico-patológico y sobrepronóstico en 144 casos de Medellín, Colombia", donde se hace un excelente acercamiento sobre este tipo de lesiones. Se conoce que las lesiones papilares de la mama son entidades poco frecuentes en la práctica cotidiana, con una representación del 10% de las entidades benignas y solo un 1% de las entidades malignas. Su manifestación clínica habitual es la secreción serosanguinolenta, unilateral, sin masas palpables y en los estudios de imagen suelen mostrarse como lesiones únicas o múltiples de localización retroareolar. El diagnostico anatomopatologico no es sencillo en estudios por punción, bien sea con aguja fina o por aguja gruesa y, por lo general, se requiere de la escisión de la lesión para obtener un diagnóstico más certero.

Differential diagnosis of benign and malignant breast lesions using quantitative synthetic magnetic resonance imaging / 南方医科大学学报

OBJECTIVE@#To investigate the value of quantitative synthetic magnetic resonance imaging (SyMRI) in distinguishing between benign and malignant breast lesions.@*METHODS@#We retrospectively collected data of preoperative conventional MRI and multi-dynamic multi-echo sequences from 95 patients with breast lesions showing mass-type enhancement on DCE-MRI, including 27 patients with benign lesions and 68 with malignant lesions. The MRI features of the lesions (shape, margin, internal enhancement pattern, time-signal intensity curve, and T2WI signal) were analyzed, and for each lesion, SyMRI-generated quantitative parameters including T1 and T2 relaxation time and proton density (PD) were measured before and after enhancement and recorded as T1p, T2p, PDp and T1e, T2e, and PDe, respectively. The relative change rate of each parameter was calculated. Logistic regression and all-subset regression analyses were performed for variable selection to construct diagnostic models of the breast lesions, and receiver-operating characteristic (ROC) analysis was used to assess the performance of each model for differentiation of benign and malignant lesions.@*RESULTS@#There were significant differences in the MRI features between benign and malignant lesions (P < 0.05). All the SyMRI-generated quantitative parameters, with the exception of T2e and Pdp, showed significant differences between benign and malignant lesions (P < 0.05). Among the constructed diagnostic models, the model based on all the DCE-MRI features combined with SyMRI parameters T2p and T1e (DCE-MRI+T2p+T1e) showed the best performance in the differential diagnosis malignant breast masses with an AUC of 0.995 (95% CI: 0.983-1.000).@*CONCLUSION@#Quantitative SyMRI can be used for differential diagnosis of benign and malignant breast lesions.

Study of Histomorphological Spectrum of Benign Breast Diseases in a Tertiary Care Centre of Mumbai

Breast, a modified sweat gland exhibits a wide spectrum of pathological lesions, usually presenting as palpable masses ranging from inflammatory to neoplastic lesions. Neoplastic lesions can be either benign or malignant. These lumps are always a cause of anxiety to the patients and their family members.1 Breast diseases are showing a rising trend worldwide. A number of studies have been done in order to know the magnitude of the problem. The present study was undertaken with an aim to determine the incidence and the histopathological spectrum of various benign breast lesions at our institute.METHODSThe present study of the breast lesions was performed in the department of pathology in a general teaching hospital and tertiary referral health care centre in Mumbai. The information and data from clinical records was collected and analysed.RESULTSA total of 953 cases of breast lesions was studied and analyzed over a period of 10 years and 10 months. Of the total 953 cases, 653 (68%) cases were benign lesions. Fibroadenoma (63%) was the commonest lesion followed by inflammatory lesions (12%) and benign phyllodes tumour (5.7%).CONCLUSIONSThe term “benign breast diseases” encompasses a heterogeneous group of lesions that may present with a wide range of symptoms or may be detected as incidental microscopic findings, and these are more frequent lesions of breast than malignant ones. Histopathological study plays important role to reach the correct diagnosis in certain benign breast diseases which mimic cancers clinically. Present study is in concordance with other studies showing fibroadenoma as commonest benign breast lesion.

A Correlative Study of Fine Needle Aspiration Cytology with Histopathology of Female Breast Lesions.

Breast lesions remain a major public health problem worldwide. Fine needle aspiration cytology (FNAC) has become one of the first-line investigations for the diagnosis of breast lumps. Although one of the major goals of FNAC is to differentiate benign from malignant lesions, in certain cases, this may not possible due to a lack of uniformity with regards to the reporting terminology used in breast cytology by pathologists worldwide, resulting in poor communication of results among health‑care providers. The present study aims to evaluate the role and diagnostic accuracy of FNAC in the evaluation of breast lesions using the National Cancer Institute (NCI) recommended terminology by correlating with histopathological examination (HPE) results.METHODSIn this retrospective study conducted over a period of two years, a total of 382 female patients with breast lesions underwent FNAC and was categorized according to the NCI guidelines. Of these, 156 cases had histopathological follow‑up and their FNAC diagnoses were compared. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) along with 95% confidence interval (95% CI) and accuracy of FNAC were calculated.RESULTSAmong the 156 cases, none were unsatisfactory (C1); 105 (67.1%) were benign (C2); 7 (4.4%) were atypical but probably benign (C3); 2 (1.1%) were suspicious favouring malignancy (C4); 43 (27.4%) were malignant (C5). Cyto-histopathological correlation was carried out. Of categories C2 and C3 (total of 112 cases), 109 were confirmed as benign (true negative) and the remaining 3 cases turned out to be malignant (false negative). Of categories C4 and C5 (total of 45 cases), all cases were confirmed as malignant (true positive) and none were benign (false positive). The present study showed a sensitivity, specificity, PPV, NPV and accuracy of 93.62% (95% CI, 82.46%–98.66%), 100% (95% CI, 96.67%–100%), 100% (95% CI, 92.5%–99.6%), 97.32% (95% CI, 92.4%–99.09%) and 98.08% respectively.CONCLUSIONSOur study concluded that FNAC is a rapid and effective method, and reporting of smears using NCI guidelines highly correlated with the histopathological diagnosis.

FNAC of Different Breast Lesions in Subset of Rural Areas of Sindh

Background: In the 1970’s the introduction of Fine Need Aspiration Cytology (FNAC) proved to be the key method for examining the nature and malignant potential of many palpable lesions like thyroid, salivary glands and lymphadenopathies. Breast pathologies is one of the entity that can also be diagnosed with FNAC. Breast cancer is the most common malignancy of women with overall 100,000 cases being reported annually around the globe. The most frequent lesion encountered using FNAC in breast is fibro-adenoma followed by fibrocystic disease, breast abscess, chronic inflammatory conditions and suspicious malignant masses. In current cross sectional study we tried to find frequency of different breast lesions by FNAC.Methodology and Results: 649 samples were recruited from the Vital Laboratory Larkana with different pathological lesions of breast during the year 2014 and 2015 by non-probability consecutive sampling. 613 (95%) were females and 32 (5%) were male withmean age of 30.812.8 years. Majority of case were of 20-39 years of age (55.8%). Most of the cases were diagnosed with benign lesions (329, 51%) followed by inflammatory lesions (132, 20.5%) and gynecomastia (15, 2.3%). Right breast was moreaffected (329, 51%). In present study we found a strong association of diagnosis with gender (p =0.000) and age (p =0.000).Conclusion: So in this study it isconcluded that large number of females with breast pathologies present with benign lesions like fibro-adenomaat the age of 20-39 years. It isalso concluded that in this age group mastitis and abscesses are common due to different risk factors

Role of Fine Needle Aspiration Cytology in Breast Lesions in Correlation with Histopathology – A 4 Years Study

Background: Breast lesions are most common among women, where majority of the breast lesions are benign. Even though most of the breast lesions are benign; malignant lesions are most concern, as because they are commonest malignant lesions especially among western population. Fine Needle Aspiration Cytology (FNAC) has proved to be a safe cost effective, good screening and quick procedure for early diagnosis of palpable breast lesions. Aim: The aim of this present study is to diagnosis different categories of various breast lesions and correlation of FNAC and Histopathological diagnosis. Methods: This study was done on 224 breast lesions with palpable breast swellings referred to Department of Pathology, Government Medical College, Kadapa, Andhra Pradesh over a period of 4 years from January 2015 to December 2018. Lesions were categorised as per cytomorphological features obtained on FNAC. Histopathological correlation was assessed in all breast lesions, inclusive of all malignant cases. Results: Out of 224 breast lesions, 178 (79.46%) cases were categorized as Benign and 39 (17.4%) cases as malignant, 7 cases (3.12%) are inflammatory. Most common benign lesions are fibroadenoma i.e., 54%. Most common malignant lesions are Infiltrating duct cell carcinoma, it was 16.96%. Uncommon malignant lesion is medullary carcinoma, it was 0.44%. Out of 224 palpable breast lesions, 203 (90.63%) diagnosed by histopathology were consistent with FNAC. Conclusion: FNAC is safe, cost effective, good screening, quick outpatient procedure with high sensitivity & sensitivity and histopathology is a confirmatory diagnosis and especially it can help to confirm suspicious malignant cases.

Radiological and Cytological Correlation of Breast Lesions with Histopathological Findings in a Tertiary Care Hospital in Costal Karnataka

Introduction: Breast cancer is the leading cause of cancerdeaths among women worldwide. Breast cancer clinicallypresents as breast lump.Fine needle aspiration cytology(FNAC) and breast ultrasound (sonomammography) is pivotalin characterization of a breast lump as benign and malignantlesion. There is a need to study radiological and cytologicalcorrelation of breast lesions with histopathological findings toevaluate the diagnostic accuracy of sonomammography andFNAC.Material and Methods: A prospective, quantitativeand descriptive study was conducted in the departmentof Radiology, Father Muller Medical College Hospital,Mangalore. Patients who were evaluated for suspicious breastlump with a breast ultrasound, FNAC and biopsy from January2017 to December 2018 were included in the study.Results: In this study, diagnostic accuracy for breast FNAC(98.7%) was found to be better than that of sonomammography(92.5%). Fine needle aspiration cytology of breast lump playsan important role when it is difficult to determine the nature ofbreast lump by clinical and radiological examination. In thisstudy breast FNAC was found to have sensitivity of 98.4% andspecificity of 95.7%. Sonomammography had a sensitivity of90.6%and specificity of 97.8.Conclusion: Present study confirms the higher combinedsensitivity, specificity and accuracy for ultrasonography andfine needle aspiration cytology in categorisation of breast lumpas benign and malignant. USG is better indetection of benignlesions whereas cytology is better in case of malignancies.The triple assessment is an accurate, simple and cost-effectivemethod for the evaluation of breast cancer and can be appliedat our centre as a safe alternative for open biopsy when itis concordant and open biopsy must be reserved only fordiscordant results. This will subsequently reduce the numberofbreast biopsies significantly

Expression of VEGF in breast lesions: an immunohistochemical study

Background: Breast cancer is the most frequent cancer in India. During the last few years, several investigators have focused on tumor angiogenesis as a critical step in cancer development and progression. Among these, vascular endothelial growth factor (VEGF) is emerging as a prognostic marker in patients with several type of cancer including breast cancer. The aim of the study was to analyse the expression of VEGF in human breast cancer as compared to normal breast tissue and benign breast lesions by immunohistochemistry. Also, to assess the usefulness of VEGF as a predictor of aggressiveness of breast lesions.Methods: Formalin fixed paraffin embedded sections of 10 cases of normal breast tissue, 20 cases of benign breast lesions and 20 cases of malignant breast lesions were taken up for the study and subjected to immunohistochemistry using VEGF.Results: The intensity of VEGF immunostaining in normal breast, benign and malignant breast lesions was evaluated and scoring was graded as 0, 1+, 2+, 3+ and 4+. Statistical analysis was performed with Chi-Square test and significant differences were noted between these 3 groups (p value <0.05).Conclusions:VEGF expression correlated well with the grade and stage of tumor indicating that VEGF positive tumors are biologically aggressive and are associated with poor prognosis but little is known about the implication of genetic alterations of VEGF in benign breast lesions.

Útilidad de la ecografía intraoperatoria en la exéresis de las lesiones no palpables de la mama: experiencia y revisión de conjunto / Usefulness of intraoperative ultrasound in excision of non-lesions palpable of the breast: experience and overview

RESUMEN OBJETIVO: Presentar la experiencia de la unidad de mama de nuestro hospital con la utilización de la ecografía intraoperatoria en el tratamiento de las lesiones no palpables de mama. PACIENTES Y MÉTODO: Se incluyeron aquellas pacientes con lesiones no palpables de mama y ecovisibles. Intraoperatoriamente se localizó la lesión con la ecografía y se procedió a su exéresis, con comprobación ecográfica de su correcta extirpación con márgenes de seguridad. Se realizó estudio macroscópico en fresco de los márgenes marcados con tinta intraoperatoriamente. En caso de que los márgenes no fueran correctos se procedía a una ampliación de márgenes en el mismo acto quirúrgico. RESULTADOS: Desde el año 2012 se han intervenido 52 pacientes. En todas las pacientes se localizó la lesión con la ecografía. Se realizó tumorectomía a 24 pacientes y a 28 pacientes se les asoció la biopsia del ganglio centinela. El resultado patológico definitivo fue de 19 lesiones benignas y 33 lesiones malignas. A una paciente se le realizó mastectomía simple por presentar un carcinoma in situ extenso con microinfiltración no diagnosticado con las pruebas radiológicas preoperatorias. El resto de pacientes presentaron márgenes libres de tumor. CONCLUSIONES: La ecografía intraoperatoria es una técnica simple y fácil de desarrollar. Presenta una baja tasa de afectación de márgenes y es enteramente cirujano-controlada. Es confortable para el paciente y conlleva un bajo riesgo de complicaciones relacionadas con la técnica.

ABSTRACT OBJETIVE: To present the results of our hospital's experience with the utilization of intraoperative ultrasound in the treatment of non-palpable breast lesions. PATIENTS AND METHOD: We included those patients whose breast lesions were non-palpable yet simultaneously visible on ultrasound. The lesions were located intraoperatively with ultrasound and were removed with ultrasound verification of the proper security margins. An examination of the intraoperative macroscopic margins with ink was done. In cases with incorrect margins, a re-excision was done utilizing the same technique but with amplified margins. RESULTS: Dating from 2012, we have operated on 52 patients. In all cases, the lesions were discovered and localized by means of ultrasound. Lumpectomy was performed on 24 patients and we associated the sentinel node biopsy in 28 cases. Subsequent pathology reports determined that 19 lesions were benign and 33 lesions were malignant. There was one patient with a mastectomy because a long extensive ductal carcinoma in situ with microinfiltration that was not seeing during the preoperative study. CONCLUSIONS: Intraoperative ultrasound is an easy and simple technique that is entirely surgeon controlled and results in a low rate of positive margins. The procedure is comfortable for the patient and carries with it a low rate of complications.

Combination of BI-RADS for ultrasound and shear wave elastography in differential diagnosis of benign and malignant breast lesions / 上海交通大学学报（医学版）

Objective • To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system (BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography (SWE) to identify benign and malignant breast lesions. Methods • A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignant by BI-RADS classification criteria. Then all the masses were examined with shear wave elastography (SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions, the pathological results were used as the gold standard to construct the receiver operating characteristic (ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results • The area under curve (AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination (BI-RADS classification vs. combination: Z=2.883, P=0.002; SWE vs. combination: Z=4.081, P=0.000). Conclusion • The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.

Pathologic basis and application progress of ultrasound elasticity imaging technique in differential diagnosis of benign and malignant breast lesions / 上海交通大学学报（医学版）

At present, breast cancer has become the most common female malignancy badly threatening health around the world, which suggests that early diagnosis and treatment are crucial. As a new ultrasound technique, ultrasonic elastography (UE) has developed rapidly and been applied widely. UE provides more significant information about tissue elasticity characteristics on the basis of B-mode ultrasound, and elasticity imagings show stiffness distribution of tissues directly. At the same time, tissue elasticity characteristics are closely associated with pathological component. Therefore, UE provides an important basis for clinical differential diagnosis of breast lesions. This paper reviews pathologic basis and application progress of UE in differential diagnosis of benign and malignant breast lesions.

Combination of BI-RADS for ultrasound and shear wave elastography in differential diagnosis of benign and malignant breast lesions / 上海交通大学学报（医学版）

Objective · To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system (BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography (SWE) to identify benign and malignant breast lesions. Methods · A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignant by BI-RADS classification criteria. Then all the masses were examined with shear wave elastography (SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions, the pathological results were used as the gold standard to construct the receiver operating characteristic (ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results · The area under curve (AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination (BI-RADS classification vs. combination: Z=2.883, P=0.002; SWE vs. combination: Z=4.081, P=0.000). Conclusion · The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.

The value of diffusion kurtosis imaging in diagnosing breast lesions and its diagnostic efficacy combined with diffusion weighted imaging / 中华放射学杂志

Objective@#To investigate the diagnostic value of diffusion kurtosis imaging (DKI) and its combination with DWI for differentiating benign and malignant breast lesions.@*Methods@#Eighty two patients with clinically suspected breast lesions from May 2016 to February 2017 in the Cancer Hospital of Chinese Academy of Medical Sciences were prospectively enrolled in the study. Mammary MRI was performed in all the all patients (89 lesions), and the pathology results were confirmed by surgery or biopsies. All of them underwent 3.0 T MR examinations, including conventional fat-suppression imaging, DWI, DKI and dynamic contrast-enhanced MR imaging (DCE-MRI). The ADC values, mean diffusivity (MD), and mean diffusion kurtosis (MK) values of lesions were obtained, and the lesion morphology, enhancement patterns, and time-signal intensity curve (TIC) types were observed. Independent-samples t test, Mann-Whitney U test were used for the comparison of DKI and DWI between benign and malignant breast lesions. The characteristics of the lesions, enhancement manners and TIC between benign and malignant lesions were analyzed with χ2 test. ROC was used to evaluate the efficacy of DKI and DWI parameters in the differential diagnosis of benign and malignant breast lesions.@*Results@#There was no statistically difference for major axis, fiber types (P>0.05, respectively). The shape of enhancement mode and TIC had statistical significance (P<0.05, respectively). The ADC and MD values were significantly lower in malignant than in benign lesions. Conversely, MK value was significantly higher in malignant lesions than in benign ones, there was a statistically significant difference between these parameters (P<0.05, respectively). Among ADC, MD and MK values, the area under the curve (AUC) of MD for differentiating the benign lesions from the malignancy had the highest diagnosis efficiency (0.975), which was higher than the AUC of MK (0.969) and ADC (0.873). Combing the parameters of DWI and DKI, the diagnostic performance was superior to the single parameter. The AUC of the combination of MD and MK was 0.977, and the parameters of DKI combined with ADC-value had a equal diagnosis efficiency for the combination of MD and MK, which the areas under the ROC curve was 0.978.@*Conclusion@#The parameters derived from DKI can be used to distinguish benign breast lesions from malignant, and the combination of DKI and DWI could obtain a better diagnostic performance than single parameter.

Comparison of mammography with automated breast ultrasound system for detecting breast lesions / 中国肿瘤临床

Objective:To compare the clinical utility of mammography with automated breast ultrasound system (ABUS) for detecting breast lesions. Methods:Data of 142 patients with 149 breast lesions who underwent both mammography and ABUS in Tianjin Medi-cal University Cancer Institute and Hospital were collected from Jnly 2016 to September 2016. The detection rates of the two methods were then determined. Results:The overall detection rate using ABUS was significantly higher than that of mammography (mammog-raphy: 87.2% vs. ABUS: 98.0%, P<0.05). However, no significant difference was observed in breast cancer detection rates between mammography and ABUS (mammography:91.1%vs. ABUS:97.0%, P<0.05). Moreover, the benign lesion detection rate was significant-ly higher in ABUS than in mammography (mammography:79.2%, vs. ABUS:100%, P<0.05). In dense breasts, the detection rates of overall lesions, breast cancers, and benign lesions for ABUS were 97.7%, 96.5%, and 100.0%, respectively;whereas those for mammog-raphy were 86.0%, 90.6%, and 77.3%, respectively (P<0.05). Owing to overlapping dense breast tissue and deep anatomic location, sev-eral lesions were missed on mammography. Conversely, most lesions missed on ABUS presented as calcifications. Conclusion:Com-pared with mammography, ABUS can detect more lesions especially in dense breasts. However, ABUS failed to detect calcifications, whereas mammography had distinct advantages in this regard. Overall, the two methods had potential supplementary value for breast cancer screening.

An application analysis of ADC of MRI in surgical resection of high risk breast lesions / 中国医学装备

Objective:To study the effect of apparent diffusion coefficient(ADC) of MRI in surgical resection of high risk breast lesions.Methods: 244 patients with high risk breast lesions(235 breast lesions) were enrolled this study, and the lesion region and the ADC of MRI in contralateral normal breast were analyzed and compared.Results: In the 224 patients, all of the 235 breast lesions received puncture or relevant surgery confirmation. In the 235 lesions, there were 158 lump lesions, and the ADC of malignant lesion was (1.04±0.2)×10-3mm2/s, the ADC of benign lesion was(1.47±0.32)×10-3mm2/s, and the difference of the two ADCs was significant(t=14.964, P<0.05). In non-lump lesions were 77, the ADC of malignant lesion was(1.18±0.33×10-3mm2/s, the ADC of benign lesion was(1.51±0.3)×10-3mm2/s, and the difference between them was significant(t=9.243,P<0.05). The cut-off of ADC was determined according to receiver operating characteristic(ROC) curve, and it was identified as malignance when ADC was less than 1.25×10-3mm2/s. Besides, the sensitivity and the specificity were 78.1% and 77.8%, respectively, and the area under the ROC curve was 0.817.Conclusion: The ADC value of patients with high-risk breast lesions who received surgical resection is lower than that of benign lesion, and the malignant and benign lesion can be identified according to cut-off value of ADC. And there is difference of ADC value between lump lesion and non-lump lesion. Besides, the cut-off value of ADC of lump lesion is smaller than that of non-lump lesion.

Value of prediction model for BI-RADS imaging features in nonpalpable calcified breast lesions / 实用放射学杂志

Objective To improve the diagnostic accuracy of nonpalpable calcified breast lesions by establishing a Logistic multivariate prediction model to assess the probability of benign/malignant breast lesions.The proposed model is based on the clinical and BI-RADS-X-ray imaging features of patients with nonpalpable calcified breast lesions.Methods A total of 147 nonpalpable calcified breast lesions were analyzed retrospectively.Firstly, based on the personal experience,the X-ray imaging data of lesions were analyzed to obtain the BI-RADS categorization, and the ROC curve was plotted by comparison with pathology.Then the univariate and multivariate analysis was performed on the clinical and X-ray imaging features of pathology to select the independent factors related to benign/malignant features.Further,a Logistic regression model was built,the suitable cut-off point was determined, and the ROC curve was obtained.Finally,the comparisons of the diagnostic accuracy of breast lesions were made between the method using the BI-RADS categorization and the method using the Logistic regression model.Results The AUC of the BI-RADS method was 0.867 9.The univariate analysis showed that there exist statistical differences among clinical features of patients(age,location,and quadrant),as well as the BI-RADS-X-ray imaging features (distribution,morphological and gland density).Also,by using the multivariate Logistic regression equation,the statistical differences among age,quadrant and morphological difference can be observed.The AUC using the built Logistic regression model was 0.906 3.Conclusion The diagnostic accuracy of breast lesions using the Logistic model is higher than that using the BI-RADS categorization method.Therefore, the proposed model is valuable for obtaining accurate diagnosis of breast lesions.

The value of contrast-enhanced ultrasound combined with ultrasound elastography scores in differential diagnosis of breast imaging reporting and data system 3-4 breast lesions / 中华医学超声杂志（电子版）

Objective To explore the value of contrast-enhanced ultrasound (CEUS) scores, ultrasonic elastography (UE) and their combined scores in diagnosing breast lesions of breast imaging reporting and data system (BI-RADS) 3-4. Methods From October 2015 to March 2016, 60 BI-RADS 3-4 solid breast masses diagnosed by conventional ultrasound underwent UE and CEUS. According to the relevant indicators, all cases were scored and proved by surgical pathology. The diagnostic sensitivity, specificity and accuracy of CEUS scores, UE and their combined scores were evaluated, and the receiver operating characteristic (ROC) curve was drawn. Results Twenty-nine benign and 31 malignant lesions were confirmed by pathology. The area under the ROC curve of CEUS combined with UE scores was 0.971 which was higher than that of CEUS Scores and UE alone (0.916 and 0.908, respectively). Moreover, the sensitivity, specificity and accuracy were 87.1%, 96.6% and 92.0% for CEUS combined with UE Scores, 77.4%, 93.1% and 85.0% for CEUS Scores, 74.2%, 93.1% and 83.3% for UE, respectively. Conclusion CEUS combined with UE scores can improve the differetial diagnostic accuracy for BI-RADS 3-4 breast lesions.

An application analysis of ADC of MRI in surgical resection of high risk breast lesions / 中国医学装备

Objective:To study the effect of apparent diffusion coefficient(ADC) of MRI in surgical resection of high risk breast lesions.Methods: 244 patients with high risk breast lesions(235 breast lesions) were enrolled this study, and the lesion region and the ADC of MRI in contralateral normal breast were analyzed and compared.Results: In the 224 patients, all of the 235 breast lesions received puncture or relevant surgery confirmation. In the 235 lesions, there were 158 lump lesions, and the ADC of malignant lesion was (1.04±0.2)×10-3mm2/s, the ADC of benign lesion was(1.47±0.32)×10-3mm2/s, and the difference of the two ADCs was significant(t=14.964, P<0.05). In non-lump lesions were 77, the ADC of malignant lesion was(1.18±0.33×10-3mm2/s, the ADC of benign lesion was(1.51±0.3)×10-3mm2/s, and the difference between them was significant(t=9.243,P<0.05). The cut-off of ADC was determined according to receiver operating characteristic(ROC) curve, and it was identified as malignance when ADC was less than 1.25×10-3mm2/s. Besides, the sensitivity and the specificity were 78.1% and 77.8%, respectively, and the area under the ROC curve was 0.817.Conclusion: The ADC value of patients with high-risk breast lesions who received surgical resection is lower than that of benign lesion, and the malignant and benign lesion can be identified according to cut-off value of ADC. And there is difference of ADC value between lump lesion and non-lump lesion. Besides, the cut-off value of ADC of lump lesion is smaller than that of non-lump lesion.