Breast lesions: differential diagnosis using digital subtraction angiography.

To evaluate its potential for differentiating benign from malignant breast lesions, digital subtraction angiography of the breast (DSAB) was performed in 23 women with mammographic evidence of disease, and the results were compared with surgical biopsy findings. The DSAB technique employed breast immobilization with modest compression and bolus injection; following the injection of contrast material, 30-40 sequential subtraction images were obtained over a 5-minute interval. The average technical settings were 50 k Vp and 10 mAs, resulting in an estimated radiation dose to the breast of 0.05 mrad (0.5 mu Gy) per exposure. DSAB consistently demonstrated retention of contrast material and abnormal vasculature in malignant lesions but not in benign lesions. In the 22 breast lesions for which there was histopathologic correlation, DSAB correctly categorized eight of nine malignant and 11 of 13 benign lesions. Although this series is small, the initial results of DSAB suggest its potential for differentiating benign from malignant lesions.

Differentiation between benign and malignant disease of the breast using digital subtraction angiography of the breast.

The authors have investigated digital subtraction angiography (DSA) for the differential diagnosis of breast lesions detected initially by mammography. Eighteen patients scheduled for biopsy first underwent digital subtraction angiography of the breast (DSAB). Criteria for malignancy included the presence of abnormal vessels and a "blush" in the area of the lesion. A total of 17 lesions are currently available for histopathologic correlation. Although this is a small series, the initial results of DSAB suggest its potential utility for differentiating between benign and malignant lesions.

A device for positioning the breast during angiography.

A patient positioning device to be used during angiography of the breast that can easily be mounted and removed from an existing table top is described. The device facilitates patient positioning, provides good compression of the breast, and permits the placement of a water bolus during the studies.

Breast lesions examined by digital angiography. Work in progress.

Differentiation of benign from malignant lesions in screening for breast cancer is usually arrived at via surgical biopsy, an invasive and costly procedure. Digital subtraction angiography (DSA) of the breast is a less invasive procedure. DSA imaging patterns from 22 patients with malignant and benign lesions were compared with surgical biopsy findings. DSA examinations were performed with the breast in an immobilization device and contrast medium was injected into the superior vena cava. Images were produced with a low kilovoltage (50 kVp) to enhance contrast, and a technique yielding an average dose to the breast of less than 2 rad (0.02 Gy) was used. Preliminary clinical results demonstrate the potential of DSA for differentiation of benign and malignant lesions and justify further investigations of its use as an alternative to surgical biopsy.

Extraosseous osteogenic sarcoma of the breast: mammographic and pathologic findings.

An unusual primary extraosseous osteogenic sarcoma is described. The tumor's mammographic appearance was highly suggestive of the correct histologic diagnosis. This case supports the theory that these tumors originate from a totipotent cell.

Obstruction of the superior vena cava or its major tributaries demonstrated by bolus-injection excretory urography.

Three cases in which venous obstruction in the thorax was demonstrated by visualization of collateral circulation during bolus-injection excretory urography are presented. Visualization of these collateral vessels is highly suggestive of venous obstruction even if this condition is clinically unsuspected. The diagnosis may be confirmed by radionuclide venography, which is easily performed and noninvasive, and allows determination of the level of obstruction, as well as the degree of collateral flow.