Tuberculosis mamaria. Reporte de dos casos / Breast tuberculosis. Report of two cases

Resumen Se presentan los casos de dos pacientes con tu berculosis (TB) mamaria, una de ellas también con compromiso pleural y ganglionar. Ambas HIV nega tivas, sin antecedentes de TB previa, con lesiones mamarias de largo tiempo de evolución. Las dos pre sentaron buena evolución con tratamiento antifímico. La TB mamaria es una afección muy poco frecuente de difícil diagnóstico. Se presentan los casos con el fin de plantear su diagnóstico diferencial en pa cientes con mastitis crónicas y/o lesiones nodulares o ulceradas de la mama. Se recomienda el manejo multidisciplinario.

Abstract Two cases of mammary tuberculosis (TB) are present ed, one of them with additional pleural and lymph node involvement. Both were HIV-negative, with no history of previous TB, with long-standing breast lesions. Both presented a successful outcome with antituberculosis treatment. Breast TB is a very rare pathology that is dif ficult to diagnose. The cases are presented to consider their differential diagnosis in patients with chronic mas titis and/or nodular or ulcerated lesions of the breast. Multidisciplinary management is recommended.

Triple negative breast cancer originating from a cystic lesion

Malignant neoplasm diagnosed after radiological evaluation of a simple breast cyst is rare. This report described the case of a young patient with an initial simple cystic lesion, whom, in 18-month follow-up examinations, showed a change in the imaging pattern of the cyst, and underwent biopsy, where a triple negative carcinoma was identified. In addition, the diagnosis occurred during pregnancy, which makes the present report even rarer.

Tratamento exitoso de pioderma gangrenoso após mamoplastia redutora: relato de caso / Successful treatment of pyoderma gangrenosum after reducing mammoplasty: a case report

RESUMO Introdução: O pioderma gangrenoso é uma doença inflamatória rara caracterizada pela presença de lesões ulceradas. A etiologia é desconhecida, mas aparentemente relaciona-se com fatores imunológicos. Os autores relatam um caso de pioderma gangrenoso no pós-operatório de uma mamoplastia redutora, o tratamento e a importância do diagnóstico precoce para obtenção de um bom resultado estético. Métodos: Trata-se de uma paciente de 18 anos que desenvolveu pioderma gangrenoso após uma mamoplastia redutora. Os sintomas iniciais foram a formação de bolhas de coloração violácea e lesões ulceradas em ambas mamas. Suspeitou-se a doença e a paciente foi tratada prontamente com prednisolona. Foram realizadas culturas, biópsias e exames sanguíneos. Realizou-se terapia hiperbárica e suporte nutricional. Foram realizados curativos diários com fator de crescimento epidérmico. Após 60 dias de acompanhamento foi possível conseguir uma cicatrização adequada da feridas e bons resultados estéticos. Resultados: O diagnóstico precoce associado a uma terapia sistêmica imunossupressora e cuidados locais rigorosos foram fundamentais para a estabilização da doença. A associação com terapia hiperbárica e o suporte nutricional contribuíram para a epitelização das lesões e o controle do quadro clínico. A aproximação das bordas da ferida com sutura subdérmica e posterior sutura intradérmica foram possíveis devido à recuperação da derme e estabilização da doença. Conclusão: O diagnóstico precoce de pioderma gangrenoso é fundamental para conseguir a estabilização da doença. É possível atingir bons resultados estéticos baseados em 4 elementos: corticoide sistêmico precoce, curativos locais diários com fator de crescimento epidérmico, suporte nutricional e terapia hiperbárica.

Abstract Introduction: Pyoderma gangrenosum is a rare inflammatory disease characterized by the presence of ulcerated lesions. The etiology is unknown but apparently relates to immunological factors. The authors report a case of pyoderma gangrenosum in the postoperative period of a reduction mammoplasty, treatment, and the importance of early diagnosis to obtain a good aesthetic result. Methods: This is an 18-year-old patient who developed pyoderma gangrenosum after a reduction mammoplasty. The initial symptoms were the formation of violet blisters and ulcerated lesions in both breasts. The disease was suspected, and the patient was promptly treated with prednisolone. Cultures, biopsies and blood tests were performed. Hyperbaric therapy and nutritional support were performed. Daily dressings with epidermal growth factors were performed. After 60 days of follow-up, it was possible to achieve adequate wound healing and good aesthetic results. Results: Early diagnosis associated with systemic immunosuppressive therapy and rigorous local care were fundamental for disease stabilization. The association with hyperbaric therapy and nutritional support contributed to the lesion's epithelialization and the clinical picture control. The approximation of the wound edges with subdermal suture and the subsequent intradermal suture was possible due to the recovery of the dermis and stabilization of the disease. Conclusion: Early diagnosis of pyoderma gangrenosum is essential to achieve stabilization of the disease. It is possible to achieve good aesthetic results based on four elements: early systemic corticosteroids, daily local dressings with epidermal growth factor, nutritional support, and hyperbaric therapy.

The ultrasonographic features of fibrocystic breast disease / 中国医师杂志

Objective:To investigate the routine ultrasonographic findings of fibrinous breast disease lesions , and to provide the basis for the differential diagnosis of fibrocystic breast disease lesions and breast cancer.Methods:The two-dimensional ultrasonography , color doppler flow and elastography of 166 lesions in 144 patients with fibrocystic breast disease confirmed by pathology in Peking University Shenzhen Hospital from January 2015 to February 2021 were retrospectively analyzed.Results:The ultrasonographic characteristics of fibrocystic breast disease lesions were as follows: 74.1%(123/166) lesions were hypoechoic, 57.2%(95/166)lesions were irregular, 49.4%(82/166) lesions were incomplete, 90.4%(150/166) lesions were parallel, 25.9%(43/166) lesions showed small cysts, 24.1%(40/166) lesions showed coarse calcification or fine calcification, 65.1%(108/166) lesions showed no change in posterior echo, 90.4%(150/166) blood flow was poor. The elastography score of 98.2%(162/166) lesions was 2-3 points.Conclusions:The ultrasonographic features of fibrocystic breast tumor are hypoechoic, irregular shape, incomplete edge, with fine or coarse calcification, which are easy to be misdiagnosed as breast malignant tumor. However, the former is characterized by parallel growth, small cyst in the interior, no change in posterior echo, lack of blood supply and soft texture, which provide important basis for clinical differential diagnosis.

Clinical and pathological correlation in benign breast diseases in women

Background: Benign breast diseases are a common problem presenting in a day to day surgical practice. A combination of three tests i.e. clinical examination, radiological imaging and pathological examination is commonly used to accurately diagnose breast diseases. This study was aimed to know the clinico-pathological correlation in diagnosing benign breast diseases in women.Methods: A study of 30 female patients of benign breast disease was conducted by clinical examination and comparing its accuracy with the pathological findings.Results: The highest incidence of benign breast diseases was in the age group of 30-39 years (33.3%). The most common presenting symptom was lump (53.3%) in the breast. The most common quadrant involved was the upper outer quadrant (60%). Fibroadenoma (53.3%) was the most common lesion in this study. The clinical examination in cases of fibroadenoma had sensitivity and specificity of 87.5 % and 92.8% respectively. In cases of fibrocystic disease, clinical examination had sensitivity and specificity of 85.7 % and 91.3% respectively.Conclusions: Overall clinical breast examination had a sensitivity of 90% and specificity of 98% in this study. Hence, combination of all three diagnostic modalities i.e. clinical, radiological and pathological examination should be used. But in rural areas where radiological and pathological facilities are not available, clinical examination can also give us a fair amount of idea in diagnosing benign breast diseases.

Caracterización clínico-etiológica y bioquímica de pacientes con ginecomastia / Clinical- etiological and biochemical characterization of patients with gunecomastia

RESUMEN Introducción: La ginecomastia define el aumento benigno del tamaño de la glándula mamaria en el hombre. Objetivo: Determinar las características clínicas, etiológicas y bioquímicas de los pacientes con diagnóstico de ginecomastia atendidos en el servicio de Cirugía General. Método: Se realizó un estudio descriptivo de corte transversal en una muestra de 108 pacientes, mayores de 18 años, atendidos en el servicio de Cirugía General con diagnóstico de ginecomastia. El estudio se llevó a cabo en los Hospitales Mariano Pérez Balí y Celia Sánchez Manduley, entre septiembre 2015 y marzo 2017. Se determinó edad, características clínicas, etiología y perfil bioquímico de estos pacientes. Resultados: La edad media fue de 27,63 años siendo la afectación estética el principal motivo de consulta. Predominó la ginecomastia bilateral, el sobrepeso/obesidad, el grado IIa de la enfermedad, la etiología idiopática y el antecedente de ginecomastia puberal. La presencia de galactorrea, hiperprolactinemia, hipoandrogenismo e hiperestrogenemia fue mínima. Conclusiones: La ginecomastia bilateral de causa idiopática, en pacientes con sobrepeso/obesidad y niveles normales de hormonas hipofisarias y gonadales es la forma de presentación más frecuente de esta afección(AU)

ABSTRACT Introduction: Gynecomastia defines the benign increase of the mammary gland size in men. Objective: To determine the clinical, etiological and biochemical characteristics of patients diagnosed with gynecomastia attended at the General Surgery service. Methods: A descriptive cross-sectional study was conducted in a sample of 108 patients over the age of 18 years, attended at the service of General Surgery with a diagnosis of gynecomastia. The study was carried out in ´´Mariano Perez Bali´´ and ´´Celia Sánchez Manduley´´ Hospitals from September 2015 to March 2017. The age, clinical characteristics, etiology, and biochemical profile of these patients were determined. Results: The mean age was 27.63 years and the aesthetic affectations were the main reason for consultation. There was a predominance of bilateral gynecomastia, overweight/obesity, grade IIa of the disease, idiopathic etiology and the history of pubertal gynecomastia. The presence of hyperprolactinemia, galactorrhea, hypoandrogenism and hyperstrogenism was minimal. Conclusions: Bilateral gynecomastia of idiopathic cause, in patients with overweight/obesity and normal levels of gonadal and pituitary hormones is the most common presentation of this condition(AU)

Family history of breast cancer and risk of benign breast diseases: an integrative literature review

Introduction: Some benign breast diseases (BBD) can determine an increased risk of developing breast cancer. Environmental factors related to lifestyle and family history of breast cancer may be associated with BBD development. However, the effect of family history of breast cancer on the risk of benign breast diseases is still unclear. Objective: To evaluate the association between family history of breast cancer and benign breast diseases. Methods: This is an integrative review that selected observational studies in different databases to analyze the association between BBD and family history of breast cancer, considering the different classification criteria for both benign diseases and family history. All studies were published between 1977 and 2016. A total of 13 studies were selected, among which ten are case-control and case-cohort studies; and three are cohort studies. Most studies received high or moderate quality classification according to the Newcastle-Ottawa assessment scale. Results: Family history of breast cancer was associated with the development of proliferative lesions and the presence of atypia, and it was more closely related to the development of benign diseases in young women, with a tendency to decrease with advancing age. Conclusion: Studies suggest there may be an association between family history of breast cancer and benign breast diseases; nevertheless, no statistically significant results were found in many case-control studies, and more robust prospective research is necessary to further clarify this association.

Ultrasonographic features and pathological diagnosis of breast disease with ultrasound classification as BI-RADS 4a / 中华内分泌外科杂志

Objective To summarize the characteristics of BI-RADS 4a breast diseases under ultrasonic examination referring to patients' clinical data and pathological reports.Methods 82 patients who were firstlydiagnosed and treated in the Affiliated Hospital of Jiangnan University were included.The ultrasonograms were retrospectively reviewed along with the correlated pathological and clinical findings.Results 48 (58.5％) cases were benign,among which fibroadenoma was the most common.34 cases (41.4％) were malignant,among which invasive ductal carcinoma was the most common.68 of the 82 cases were neoplastic disease (82.9％),6 (9.8％)were inflammatory disease,and 8(7.3％) were adenosis.Conclusions The patients who are graded BI-RADS 4a by ultrasonic examination may have completely different diseases.Beyond the most common benign diseases,few of them are malignancies with atypical,even ambiguous sonographic features.Therefore,in clinical practice,sonologists should set appropriate parameters of ultrasonic devices appropriately,and evaluate the sonographic features carefully,in order to make the correct grading and diagnosis.While for clinicians,it is necessary to learn to read the ultrasonographic features along with patients' manifestations,and finally reduce the misdiagosis and missed diagnosis of such diseases.

TREATMENT OF GIANT JUVENILE FIBROADENOMA: RESULT AFTER MINIMALLY INVASIVE APPROACH WITHOUT RECONSTRUCTIVE SURGERY / Tratamento do fibroadenoma gigante juvenil: abordagem minimamente invasiva sem cirurgia reconstrutora

Fibroadenomas are common benign tumors of the female breast. Those that present as rapidly growing breast tumors exceeding 5 cm in diameter or 500 g in weight in young female patients are commonly classified as giant juvenile fibroadenomas. These tumors are rare, and due to their excessive growth, they are usually enucleated to clarify a malignant origin, to differentiate from phyllodes tumor and to prevent persisting deformities of the breast. This report details the surgical approach to this clinical problem in a 14-year-old female with functional preservation of the breast and a good esthetic result.

Fibroadenomas são tumores benignos comuns da mama feminina. Aqueles que apresentam rápido crescimento excedendo a 5 centímetros de diâmetro ou que pesam mais que 500 gramas em mulheres jovens são classificados como fibroadenomas gigantes juvenis. Estes tumores são raros e, devido seu excessivo crescimento, são comumente enucleados para descartar uma origem maligna, diferenciar de tumores filóides e para evitar deformidades da mama. Este relato de caso detalha uma abordagem cirúrgica em uma adolescente de 14 anos com preservação da mama e bom resultado estético

The application of dynamic contrast enhanced MR with MIP in differentiating benign and malignant breast diseases / 实用放射学杂志

Objective To study the effects of the different phases of breast dynamic contrast enhanced MR with 3D MIP in reconstruction of breast vascular.To explore the reconstruction parameters of breast vascular in benign and malignant breast lesions.Methods All of 132 female patients with pathologically confirmed breast disease were enrolled,including 50 cases of benign lesions and 82 malignant cases.All of them underwent high temporal resolution dynamic enhanced MR scanning,with each phase of 20 s.All of the images were reconstructed by 3D MIP and analyzed.Results In both of benign and malignant lesions,the display rate of the internal thoracic artery was higher than that of the lateral thoracic artery and intercostal artery.The display rate of grade Ⅱ vessels of internal thoracic artery and intercostal artery were higher in malignant lesion(P=0.035,0.000).The grade Ⅰ and Ⅱ vessels of the internal thoracic artery and the lateral thoracic artery increased gradually with time delay.The vascular branches were showed in malignant lesions earlier than those in benign lesions,in the 20th seconds in which grade Ⅰ vessels could be displayed,and in the 60th seconds,internal thoracic artery in malignant lesions(96.3%)can be clearly displayed.For benign lesions,grade Ⅰ branch of the internal thoracic artery in patients(80%)could be displayed in the 120th seconds.Conclusion Breast dynamic contrast enhanced MR with 3D MIP can be used to display the blood vessels of the breast,which is of great value in the diagnosis of breast diseases.To achieve the best display effect,different enhanced phases should be selected to reconstruct the blood vessels based on the different enhancement patterns in benign and malignant lesions.

Observation on lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland and its influence on estradiol and progesterone / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland (HMG) and its influence on estradiol (E2) and progesterone (P).Methods:A randomized,single-blinded and controlled trial was conducted.A total of 124 cases conforming to the inclusion criteria were randomized by random number table into a treatment group and a control group,with 62 cases in each group.Patients in both groups received acupuncture therapy at the same acupoints,while patients in the treatment group received lower-reinforcing and upper-reducing method,and patients in the control group received even reinforcing-reducing manipulation.The treatment started around 10 d before menstruation and was conducted every other day.Patients received 5 treatments in each menstruation cycle for consecutive 3 cycles.The levels of E2,P and E2/P and clinical efficacy were measured before and after treatment.Results:After treatment,the breast lump size,pain intensity and concomitant symptoms score in both groups were substantially lower than those before treatment,showing statistical significances (all P＜0.01),and the improvement in the treatment group was higher than that in the control group,and the between-group comparisons showed statistical significances (all P＜0.01).After treatment,the overall effective rate was 91.9％ in the treatment group,higher than 72.6％ in the control group,and the between-group comparison showed a statistical significance (P＜0.01).After treatment,levels of E2,P and E2/P value showed no statistical significance when compared with those before treatment in the two groups (all P＞0.05).Conclusion:Lower-reinforcing and upper-reducing acupuncture method can effectively alleviate clinical symptoms and signs in HMG patients,and produce a better effect than even reinforcing-reducing manipulation.The majority of HMG patients' E2,P level and E2/P value were not beyond the normal ranges;therefore,acupuncture showed no substantial influence on E2 and P levels and E2/P value.

Breast involvement in panniculitis: report of 7 cases with literature review / 中华风湿病学杂志

Objective To analyze the clinical characteristics of patients with panniculitis who had breast involvement and to expand the understanding of the organ involvement of panniculitis.Methods The data of panniculitis patients with breast involvement were collected from our hospital during 2012.1.1 to 2017.7.1,including sex,age,clinical manifestations,laboratory tests,imaging examinations and treatments.Results A total of 7 panniculitis patients were included who had breast involvement.All patients were female,aged 28 to 45 years [mean,(35±6) years].Clinical manifestations included hypothermia (4/7),arthralgia (4/7),limb subcutaneous nodules (7/7) and breast nodules (7/7).Breast nodules occurred 1 to 4 months earlier than the limbs subcutaneous nodules in 6 cases and 11 years later than the limbs subcutaneous in 1 case.For laboratory tests:all patients had increased of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (7/7) while only 2 patients had elevation of white blood cell count (2/6).One patient had breast enhanced magnetic resonance imaging (MRI) scanning.Seven patients underwent biopsy of limb subcutaneous nodules.The pathological findings were all consistent with the pathological characteristics of panniculitis.Three cases had breast nodules biopsy,which showed inflammation and decrease of fat tissue,several kinds of cells infiltration and granuloma formation.Treatment with antibiotic failed while glucocorticoid and immunosuppressive agents treatment was effective.Conclusion Pancreatitis can have breast involvement,mostly in young women,with breast painful nodules in most patients early than limb subcutaneous nodules.Breast enhancement MRI scanning and nodules biopsy have important value in the diagnosis of breast panniculitis.For patients with breast nodules as the first symptom and fail to response to antibiotic treatment,clinicians need to be alert to breast panniculitis and perform pathological biopsy to reduce the chance of misdiagnosis.

PHYLLODES TUMORS OF THE BREAST: A RETROSPECTIVE EVALUATION OF CASES FROM THE HOSPITAL DO SERVIDOR PÚBLICO ESTADUAL DE SÃO PAULO / Tumor filoides de mama: avaliação retrospectiva de casos do Hospital do Servidor Público Estadual de São Paulo

Objective: To evaluate the clinical and pathological characteristics of phyllodes tumors, and to identify possible associated risk factors for relapses among patients from the Breast Surgery Department of the Hospital do Servidor Público Estadual of São Paulo (HSPE-SP). Methods: Retrospective, descriptive study of data from 52 patients, between 1976 and 2013. The following data were collected: age, tumor size, histological type, surgical margins, type of surgery performed, relapses and amount of time before relapse. Results: The mean age of the patients was 45.7 years old, the mean size of the tumor was 7.8 cm. A mastectomy was performed on 12 patients, and the others underwent a wide excision. Benign phyllodes tumors were found in 30 patients, and the others were found as follows: 11 with borderline tumors and 11 with malign phyllodes tumors. There was no statistical relevance with regard to the relapses and the characteristics evaluated. Conclusion: The sample studied has similar clinical and pathological characteristics as described in the scientific literature, with the mean age at diagnosis being 45 years old, the mean tumor size, 7.8 cm. The majority found were benign phyllodes tumors and 33% were from relapses. There was no statistical significance between the evaluated variables and the risk for relapse.

Objetivo: Avaliar as características clínicas e patológicas do tumor filoides e identificar fatores relacionados com risco de recidivas em pacientes acompanhadas no ambulatório de Mastologia do Hospital do Servidor Público Estadual de São Paulo (HSPE-SP). Método: Estudo retrospectivo descritivo de dados de 52 pacientes, entre 1976 e 2013, dentre os quais: idade, tamanho do tumor, tipo histológico, margens cirúrgicas, tipo de cirurgia, recidivas e tempo para recidiva. Resultados: A idade média das pacientes foi 45,7 anos. O tamanho médio do tumor foi de 7,8 cm. O tratamento em 12 pacientes foi a mastectomia, e as demais 40 a excisão ampla. O tipo histológico encontrado em 30 pacientes foi tumores benignos, 11 malignos e 11 de variedade borderline. Após o seguimento médio de 53,93 meses, observaram-se 17 recidivas. Não houve relevância estatística entre a recorrência local e as variáveis avaliadas. Conclusões: A amostra avaliada tem características clínicas e patológicas condizentes com a literatura, com média de idade de 45 anos, tamanho do tumor de 7,8 cm, sendo encontrados na maioria tumor filoides benigno e 33% de recidivas. Não houve significância estatística entre características avaliadas e o risco de recidiva.

Mastopatía diabética: a propósito de un caso clínico / Diabetic mastopathy: a clinical case

La mastopatía diabética es una lesión fibroinflamatoria de la mama muy infrecuente, que característicamente se presenta en mujeres premenopáusicas y está fuertemente asociada a diabetes mellitus tipo I. La patogénesis es desconocida, sin embargo, histopatológicamente se ha observado una reacción en el tejido conectivo similar al de algunas enfermedades autoinmunes. La clínica y exámenes complementarios pueden ser sugerentes de neoplasia, por lo que se requiere estudio histopatológico para establecer el diagnóstico definitivo.

Diabetic mastopathy is a very infrequent fibro-inflammatory lesion generally found in pre-menopausal women and is strongly associated with type 1 diabetes mellitus. Its pathogenesis is unknown; however its histopathology shows a connective tissue reaction similar to that of some auto-immune diseases. Its clinical presentation and complementary tests may suggest neoplasm, thus definitive diagnosis requires a histopathological study.

Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis

Microglandular adenosis (MGA) of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

Investigation of female breast disease in Zhengzhou / 实用医学杂志

Objective To investigate the prevalence and the related factors of female breast disease in Zhengzhou City, Henan Province, and to provide a targeted prevention guide for female breast disease. Methods A total of 6310 women were enrolled in this study. In addition to breast ultrasound, mammography and pathology assays were performed. Finally, the prevalence and influencing factors for female breast disease were analyzed. Results The prevalence of breast cancer and the total prevalence of breast diseases was 0.06% and 24.94%, respectively. The prevalence of female breast diseases was significantly correlated to age, educational level, occupa-tion, menstruation, reproductive age and a history of abortion. Logistic regression analysis showed that the occupa-tional type had a significant effect on the prevalence of female breast. Conclusion The prevalence of female breast disease is relatively high in Zhengzhou City, and it is affected by many factors. The targeted surveys and breast dis-ease screening should be conducted, and the secondary prevention of female breast disease should be strengthened.

Clinical value of MRI in the diagnosis of breast sclerosing adenosis / 实用放射学杂志

Objective To evaluate the value of M RI in the diagnosis of breast sclerosing adenosis.Methods 20 cases of breast sclerosing adenosis were analyzed retrospectively.MRI(T1WI,T2WI fat suppression),diffusion-weighted imaging(DWI)and dynamic contrast-enhanced scan were examined.The images were processed by ADW workstation.Apparent diffusion coefficient (ADC),time-signal intensity curve(TIC),maximum intensity projection(MIP)and plain MR features of the breast sclerosing adenosis were analyzed.Results All 20 cases showed iso-or low-intensity on T1WI and heterogeneous high-intensity on T2WI fat suppression.Among 20 cases,the ADC value were between(1.45-1.60)×10-3mm2/s in 12 cases,(1.25-1.45)×10-3mm2/s in 7 cases,(1.00-1.25)× 10-3mm2/s in 1 case.TIC curves were type Ⅰ in 18 cases,type Ⅱ in 2 cases and no case was type Ⅲ.Mass-like lesions were showed in 18 cases which displayed clearly on MIP image.Conclusion Combination of MRI,DWI,dynamic contrast-enhanced can greatly improve the diagnosis accuracy of breast sclerosing adenosis,to provide a reliable basis for clinical treatment.

Diagnostic Value of FFDM Combined with DBT in Breast Diseases / 现代医院

Objective To explore the diagnostic value of full-field digital mammography (FFDM) combined with digital breast tomosynthesis (DBT) in breast diseases.Methods 506 patients receiving mammary gland molybdenum target inspection from January 1, 2014 to December 31, 2014 were selected.The images from FFDM and DBT were analyzed, respectively.The breast imaging reports and pathological results were compared to investigate the sensitivity, specificity and accuracy of FFDM, DBT alone and combined use of DBT and FFDM.Results The results of preoperative mammography in the 506 women (bilateral breast) were as follows: FFDM combined with DBT detected 202 benign cases (39.9%) and 304 malignant cases (60.1%);FFDM alone detected 194 benign cases (38.3%) and 312 malignant cases (61.7%);DBT alone detected 187 benign cases (37.0%) and 319 malignant cases (63.0%).Pathologically, 214 benign cases (42.3%) were detected and 292 malignant cases (57.7%).In terms of the sensitivity, specificity and accuracy, The combined use of DBT combined with FFDM was the best, followed by FFDM alone and DBT alone.Conclusion The sensitivity, specificity and accuracy of FFDM combined with DBT for diagnosis are better than those of FFDM alone or DBT alone.