Monoexponential, Biexponential, and stretched-exponential models using diffusion-weighted imaging: A quantitative differentiation of breast lesions at 3.0T.

BACKGROUND: Diffusion-weighted imaging (DWI) plays an important role in the differentiation of malignant and benign breast lesions. PURPOSE: To investigate the utility of various diffusion parameters obtained from monoexponential, biexponential, and stretched-exponential DWI models in the differential diagnosis of breast lesions. STUDY TYPE: Prospective. POPULATION: Sixty-one patients (age range: 25-68 years old; mean age: 46 years old) with 31 malignant lesions, 42 benign lesions, and 28 normal breast tissues diagnosed initially by clinical palpation, ultrasonography, or conventional mammography were enrolled in the study from January to September 2016. FIELD STRENGTH: 3.0T MR scanner, T1 WI, T2 WI, DWI (conventional and multi-b values), dynamic contrast-enhanced. ASSESSMENT: The apparent diffusion coefficient (ADC) was calculated by monoexponential analysis. The diffusion coefficient (ADCslow ), pseudodiffusion coefficient (ADCfast ), and perfusion fraction (f) were calculated using the biexponential model. The distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained using a stretched-exponential model. All parameters were compared for malignant tumors, benign tumors, and normal breast tissues. A receiver operating characteristic curve was used to compare the ability of these parameters, in order to differentiate benign and malignant breast lesions. STATISTICAL TESTS: All statistical analyses were performed using statistical software (SPSS). RESULTS: ADC, ADCslow , f, DDC, and α values were significantly lower in malignant tumors when compared with normal breast tissues and benign tumors (P < 0.05). However, ADC and f had higher area under the receiver operating characteristic curve (AUC) values (0.889 and 0.919, respectively). DATA CONCLUSION: The parameters derived from the biexponential and stretched-exponential DWI could provide additional information for differentiating between benign and malignant breast tumors when compared with conventional diffusion parameters. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;50:1461-1467.

Perfil epidemiológico, clínico, anátomo patológico e imunohistoquímico das pacientes com câncer de mama em Cuiabá (MT) / Epidemiological, clinical, pathological and immunohistochemical of patients with breast cancer in Cuiaba (MT), Brazil

Introdução: O Câncer de mama (CM) é a neoplasia maligna mais comum nas mulheres, sendo a primeira em incidência, depois do câncer de pele e uma das principais causas de morte por câncer feminino. Conhecer o perfil epidemiológico, clínico, anátomo patológico e imunohistoquímico dessa doença contribuirá para o desenvolvimento de estratégias para a prevenção e tratamento. O presente estudo tem por objetivo descrever o perfil epidemiológico, clínico, anátomo patológico e imunohistoquímico das pacientes com CM, assistidas em Cuiabá (MT). Método: É um estudo observacional e descritivo. Os dados foram coletados em formulário específico, diretamente com as pacientes em entrevistas e dos prontuários médicos em instituições de atendimento pelo Sistema Único de Saúde e em clínica de atendimento privado e de convênios médicos entre 2011 a 2013. Resultados: As pacientes com CM em Cuiabá apresentam semelhança com as pacientes descritas em outros estudos brasileiros em relação à idade, estado civil, etnia, escolaridade, índice de massa corpórea, quanto à forma de percepção e sintomas, quanto á menarca, número de filhos, amamentação, uso de contraceptivo hormonal, uso de terapia de reposição hormonal, consumo de bebida alcoólica, prática de atividade física e trauma emocional. Conclusão: As pacientes estudadas com CM em Cuiabá apresentam distribuição semelhantes às descritas em outras publicações brasileiras. Quando comparada a distribuição da etnia, comparada com aspectos clínicos, anátomo patológicos e imunohistoquímicos, não se observou diferença entre os grupos. Também não se observou diferença comparando estádio clínico com nível de escolaridade nem com peso corpóreo. Observou-se diferença na distribuição da doença quanto ao estádio clínico entre pacientes assistidas no Sistema Único de Saúde (SUS) comparada com as assistidas em consultórios privados e de convênios, sendo as assistidas em sistema privado e de convênios com diagnóstico em estádio clínico menor, comparada com as assistidas pelo SUS.

Introduction: Breast Cancer (BC) is the most common malignancy in women, the first in incidence after skin cancer and a leading cause of female cancer death. Understand the epidemiological, clinical profile, anatomical pathology and immunohistochemical this disease contribute to the development of strategies for prevention and treatment. This study aims to describe the epidemiological, clinical profile, anatomical pathology and immunohistochemical of patients with BC, assisted in Cuiaba (MT), Brazil. Method: It is an observational study. Data were collected in a specific form, directly to the patient interviews and medical records in care institutions by the Unified Health System and private clinical care and health insurance between 2011 and 2013. Results: Patients with BC in Cuiabá present resemblance to the patients described in other Brazilian studies regarding age, marital status, ethnicity, education level, body mass index, how to perception and symptoms, as to the menarche, number of children, breastfeeding, contraceptive use hormonal, use of hormone replacement therapy, alcohol consumption, physical activity and emotional trauma. Conclusion: The patients studied with BC in Cuiaba present distribution similar to those described in other Brazilian publications. When compared by ethnicity and clinical, anatomical and pathological immunohistochemical, there was no difference between groups. Also there was no difference comparing clinical stage with education level or with body weight. There was difference in the distribution of the disease and the clinical stage of patients assisted in the Unified Health System (SUS) compared to those receiving care at private practices and agreements, and the assisted private system and agreements with diagnosis in lower clinical stage, compared with assisted by SUS.

The clinical value of postoperative aerobic exercise and psychological intervention on postoperative rehabilitation in patients with breast cancer / 中国基层医药

Objective To investigate the clinical values of postoperative aerobic exercise and psychological intervention in patients with breast cancer after operation.Methods One hundred patients with breast cancer admitted to our hospital were prospectively studied.All patients underwent modified radical mastectomy and were randomly assigned into observation group (50 cases)and control group (50 cases).The patients in the observation group were treated with aerobic exercise and psychological intervention,and the health education was given in the control group. The 3 -month postoperative self -rating anxiety scale score,self -rating depression scale score,shoulder mobility, degree of limb edema and 6 -month postoperative health related quality of life (SF -36)of the two groups were observed.Results There were no significant differences between the two groups in preoperative self -rating anxiety scale score,self -rating depression scale score,degree of limb edema and health related quality of life (all P >0.05).However,the self -rating anxiety scale score of the observation group three months after operation significantly decreased compared with the control group[(40.94 ±9.20)points vs.(45.84 ±8.79)points,t =2.722,P =0.008];self -rating anxiety scale score significantly decreased[(40.18 ±9.96)points vs.(45.28 ±8.67)points,t =2.730, P =0.008];the degree of limb edema was significantly reduced[(10.00 ±6.27)mL vs.(18.52 ±7.20)mL,t =6.313,P =0.000].The health related quality of life 6 months after operation was significantly improved[(78.70 ± 8.85)points vs.(72.02 ±9.76)points,t =3.584,P =0.001 ].Compared with the control group,the shoulder flexion,extension,abduction,external rotation and internal rotation of the observational group were significantly increased at 3 months after operation (all P <0.05 ).Conclusion Postoperative rehabilitation and psychological intervention contribute to the rapid recovery in patients with breast cancer after operation.

Breast fibroadenoma and breast invasive ductal carcinoma: A comparative study using 1HNMR-based serum metabonomics / 第二军医大学学报

Objective To explore the serum metabonomic difference between breast fibroadenoma patients and breast invasive ductal carcinoma patients using nuclear magnetic resonance 1H(1HNMR) spectroscopy, and to discuss the possibility of using it for differentiation of benign and malignant breast tumor before operation, Methods Eight clinically diagnosed breast fibroadenoma patients and 8 breast invasive ductal carcinoma patients were recruited and their sera were collected; 1HNMR was used to obtain the metabonomic characteristics, The data were processed using Simca-P software and analyzed with principle component analysis(PCA) and orthogonal signal correction partial least squares discrimination analysis(OPLS-DA), Results PCA and OPLS-DA analyses showed great differences in serum metabonomics between breast fibroadenoma and breast invasive ductal carcinoma, Compared with breast fibroadenoma patients, patients with invasive ductal carcinoma had higher levels of lipid, lactate and phosphocholine lglycerolphospholine, and lower levels of glutamine, taurine, creatine, and glucose, Conclusion Distinct difference exists in serum metabonomic profiles between breast adenoma patients and breast invasive ductal carcinoma patients, which may serve as the potential biomarkers to differentiate malignant tumors from benign ones in clinic.

Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: comparison with conventional DWI.

OBJECTIVES: To obtain perfusion as well as diffusion information in normal breast tissues and breast lesions from intravoxel incoherent motion (IVIM) imaging with biexponential analysis of multiple b-value diffusion-weighted imaging (DWI) and compare these parameters to apparent diffusion coefficient (ADC) obtained with monoexponential analysis in their ability to discriminate benign lesions and malignant tumors. MATERIALS AND METHODS: In this prospective study, informed consent was acquired from all patients. Eighty-four patients with 40 malignant tumors, 41 benign lesions, 30 simple cysts and 39 normal breast tissues were imaged at 1.5 T utilizing contrast-enhanced magnetic resonance imaging (MRI) and DWI using 12 b values (range: 0-1000 s/mm(2)). Tissue diffusivity (D), perfusion fraction (f) and pseudo-diffusion coefficient (D*) were calculated using segmented biexponential analysis. ADC (b = 0 and 1000 s/mm(2)) was calculated with monoexponential fitting of the DWI data. D, f, D* and ADC values were obtained for normal breast tissues, simple cysts, benign lesions and malignant tumors. Receiver operating characteristic analysis was performed for all DWI parameters. RESULTS: There was good interobserver agreement on the measurements between the 2 observers. D values were significantly different among malignant tumors, benign lesions, simple cysts and normal breast tissues (P = 0.000) and it was the same result for f, D* and ADC values. Further comparisons of these 4 parameters between every single pair were as the following. D and ADC values of malignant tumors were significantly smaller than those of benign lesions, simple cysts and normal tissues (P = 0.000, respectively). The f value of malignant tumors was significantly higher than that of benign lesions, simple cysts and normal breast tissues (P = 0.001, P = 0.000, and P = 0.000). D and ADC values demonstrated higher sensitivity and specificity in differentiating benign lesions and malignant tumors, with area under the curve (AUC) of 0.952 and 0.945, respectively, while f and D* with the lower AUC of 0.723 and 0.630, respectively. Combining f and D values had a sensitivity up to 98.75%. CONCLUSION: DWI response curves in malignant tumors, benign lesions and normal fibroglandular tissues are found to be biexponential fit in comparison with the monoexponential fit for simple cysts. IVIM provides separate quantitative measurement of D for cellularity and f and D* for vascularity and is helpful for differentiation between benign and malignant breast lesions.

Cáncer mamario triple negativo: ¿cómo se ve en imágenes? / Triple receptor-negative breast cancer: how is it seen on imaging findings?

Introduction. Triple-negative cancers (TNC) refers to any breast cancer that does not express the genes for estrogen receptor (ER), progesterone receptor (PR) or human epidermal grow factor, receptor type 2. Herceptin (HER2). They tend to be more aggressive; often being diagnosed in young patients, sometimes as interval cancers, they can grow to be large in size and patients frequently present initially with axillary metastases. They show a worse prognosis compared to other breast cancer tumors, with an increased risk of distant recurrence and death, especially in the first 5 years after diagnosis. Patients and methods. We conducted a descriptive, retrospective observational study of TNC cases diagnosed at our institution between March 2005 and June 2012 in order to identify their imaging features. Results. TNC may not be seen on mammography (Mx) if the parenchyma is dense (ACR types 3 and 4), mainly because they appear as masses or focal asymmetries without microcalcifications. Both on mammography and ultrasound (US) they can evoke a benign lesion. On US studies they frequently manifest as a solid single nodule, markedly hypoechoic with posterior acoustic enhancement and well-defined contours. They appear hypo/ avascular on color Doppler examinations (or vascularized in the periphery without central vessels) and various afferent pedicles may be present. Magnetic resonance imaging (MRI) clearly identifies suspicious lesions with some characteristic features: mass preferably with posterior and prepectoral location, markedly hyperintense on T2- weighted images with a ring-like pattern of contrast agent uptake, presenting washout curve, sometimes with septa increased uptake in the lesion center. Conclusion. Triple receptor-negative cancers often exhibit imaging features that distinguish them from other types of tumors.

Introducción. Los cánceres triple negativo (CTN) son aquellos que no presentan receptores de estrógeno, progesterona ni human epidermal grow factor, receptor type 2. Herceptin (HER2). Tienden a ser más agresivos; a menudo se diagnostican en pacientes jóvenes, a veces como cánceres de intervalo, llegan a ser de gran tamaño y más frecuentemente presentan metástasis axilares al momento del diagnóstico. Su pronóstico es peor que otros cánceres mamarios, existiendo una mayor probabilidad de recurrencia a distancia y de muerte, especialmente en los primeros 5 años. Pacientes y métodos. Se efectuó una revisión retrospectiva descriptiva de los casos de CTN diagnosticados en nuestra institución (periodo entre marzo de 2005 y junio de 2012) con el fin de identificar sus características imaginológicas. Resultados. Los CTN pueden quedar ocultos en mamografía (Mx) si el parénquima es denso (tipo ACR 3 y 4), puesto que aparecen principalmente como masas o asimetrías focales, sin microcalcificaciones. Tanto en Mx como en ultrasonido (US) pueden evocar una lesión de morfología benigna. En US se manifiestan frecuentemente como un nódulo sólido único, marcadamente hipoecogénico con refuerzo posterior, de contornos bastante circunscritos y que aparece hipo/avascular al Doppler color (o vascularizado en la periferia sin vasos centrales) y varios pedículos aferentes. La resonancia magnética (RM) identifica hallazgos claramente sospechosos con algunos elementos característicos: masa cuya localización es preferentemente posterior, pre-pectoral, marcadamente hiperintensa en T2 que capta el contraste en anillo y presenta curva de lavado, a veces con septos hipercaptantes en el centro de la lesión. Conclusión. Los CTN presentan a menudo características en imágenes que los diferencian de otros tipos de tumores.

Papillary carcinoma of the breast, report of 17 cases / 中华普通外科杂志

Objective To study the clinical characteristics,pathology,and treatment for papillary carcinoma of the breast.Methods The clinical data of 17 patients of papillary carcinoma of the breast admitted in the First Affiliated Hospital of Wen Zhou Medical College were retrospectively analyzed.Results Papillary carcinoma of the breast accounted for 0.64％ of all breast cancer cases hospitalized during last 10 years.All cases had palpable lumps in the breast.12 cases received modified radical mastectomy,2 cases received simple mastectomy,2 cases underwent breast conservation therapy,1 case underwent simple mastectomy plus sentinel lymph node biopsy.15 patients received postoperative chemotherapy,among those 5 cases also received radiotherapy.During a 32.5-month median follow-up ( 1 month to 8 years),one case with bone metastases died 2 years postoperatively and another one died of multimetastases 7 years later.Conclusions The prognosis of papillary carcinoma of the breast is closely related with its pathology type.For intraductal papillary carcinoma low-traumatic therapy is applicable,while in case of infiltrating papillary carcinoma or invasive micropapillary carcinoma ( IMPC ),more aggressive therapies like that adopted for infiltrating ductal carcinoma are recommended.

The value of high-frequency ultrasound in the diagnosis of breast cancer / 中国基层医药

1,while those with regular morphology,clear border,posterior echo enhanced,solid-cystic content,size

Clinicopathological analysis of 446 cases of breast cancer / 中国基层医药

Objective To understand the incidence and the clinicopathological characteristics of breast cancer in Bengbu area.Methods The clinicopathological datas of 446 cases of breast cancer were analyzed retrospectively,which included the clinical profile,tumor size,pathological grading,lymphatic metastasis,pTNM staging,hormonal receptor status and oncogene C-erbB-2 protein expression of some cases.Results Female was found in 99.6% of the patients.The average age was 49.76 years old.Most patients presented firstly by breast masses.The average time was 11.58 months from discovering the mass to final pathological diagnosis.The average longest diameter was 3.06cm.Invasive ductal carcinoma was found in 92.8%.Metastasis was found in 58.8%.Lymphatic metastasis rate was higher in extrinstic and posterior pectoralis monor.ER expression rate was 45.3% and PR,44.2%.The positive rate of C-erbB-2 was 81.4%.C-erbB-2 protein expression was found to be related to the status of ER and PR.Conclusion Breast cancer is more commonly found in middle and old women.Early discovery rate is lower and invasive carcinoma is diagnosed in most cases while metastasis is found in halof the cases.Carrying out breast cancer census is of important significance for prevention and treatment of breast cancer.

Cancer de mama: cirugía conservadora vs mastectomia radical / Breast cancer: conservative surgery versus radical mastectomy

Se realizó un estudio retrospectivo y comparativo tomando como universo 530 pacientes portadoras de cáncer de mama en las etapas I y II de la enfermedad, operadas en el servicio de Cirugía General del Hospital Clínico Quirúrgico "Abel Santamaría Cuadrado" de Pinar del Río, en el período de tiempo comprendido entre el 1ero. de Enero de 1988 y el 31 de Diciembre de 2003, las que fueron intervenidas por diferentes técnicas, 345 (65,09%) con proceder conservador y 185 (34,90%) con técnicas radicales (Patey, mastectomía total ampliada y mastectomía simple). El comportamiento de las recidivas locales fue significativo (p

Aimed at assessing breast cancer behaviour according to operative procedures a retrospective and comparative study was conducted taking as universe 530 female patients suffering from breast cancer (I and II stages of the disease) at Abel Santamaría University Hospital during the period of January 1st, 1998 and December 31, 2003 using different operative procedures, 345 (65.09 %) with conservative operative procedure and 185 (34.90 %) with radical mastectomy (Patey total wide mastectomy and simple mastectomy). Behaviour of local relapses was significant (p < 0.005) in favour of conservative operation 9.59 % and 18.37 % of radical operative procedures; a similar behaviour was present with distant metastases 8.11 % in those treated conservatively and 20.0 % in radical treatments. Global survival in 5 years favoured those patients who underwent conservative operation (90.47 %) in relation to those with radical mastectomy (73.64 %) p < 0.005.

Correlation of COX-2 and VEGF-C expressions in breast carcinoma with lymph node metastasis / 第三军医大学学报

Objective To investigate the expressions of COX-2 and VEGF-C in breast carcinoma and their correlation with lymphangiogenesis and lymph node metastasis. Methods The expressions of COX-2 and VEGF-C and D2-40 were evaluated in 46 cases of breast carcinoma by immunohistochemical staining SP methods. The lymphatic vessels density (LVD) in tumor was counted through the special marker D2-40. Results The positive rate of COX-2 and of VEGF-C was 73.91% (34/46) and 71.74% (33/46) respectively in breast carcinoma tissues. The positive rate of COX-2 and VEGF-C was 86.48% (32/37) and 81.08% (30/37), and LVD was (13.350?3.097)/?200 in the lymph node metastasis group, while that in non-lymph-node metastasis group was 22.22% (2/9), 33.33% (3/9) and (9.560?2.031)/?200 respectively, with significant difference between the two groups (P

Is Breast Cancer Incidence Rate Further Increasing in Korea? / 한국역학회지

Breast cancer ranks second to stomach cancer as a primary cancer site. An increasing trend in mortality and morbidity of breast cancet has been shown since 1980s. Studies on migrant populations, in which higher incidences were shown than population in their motherlands, indicated the importance of environmental factors on breast cancer development. Older age, family history of breast cancer, early menarche, late menopause, late full-term pregnancy, never-having had a breast-fed child, and postmenopausal obesity were idenrified as risk factors in Korea. These are not different from risk factors detected in western countries. Nevertheless, a

~(99m)Tc-tetrofosmin SPECT for the evaluation of suspicious palpable breast lesions / 中国癌症杂志

Purpose:To assess the value of 99m Tc tetrofosmin SPECT in discrimination of malignant from benign breast mass.Methods:The trial was prospective, blind and diagnostic. From 2000.6 to 2001.12, one hundred one consecutive patients with breast mass detected by clinical examination were included. After injection of 740 MBq 99m Tc tetrofosmin intravenously in the arm contralateral to the breast lesion, 99m Tc tetrofosmin SPECT was performed additional to the regular diagnostic procedure. All patients underwent operation within one week. Using histological assessment as a golden standard, we calculated sensitivity, specificity, positive and negative predictive value for 99m Tc tetrofosmin SPECT of the breast mass. Results:The sensitivity for palpable breast lesions was 86 3%, specificity 84.0%, positive and negative predictive value were 84.6% and 85.7% respectively. Conclusions:The results suggested that 99m Tc tetrofosmin SPECT is a valuable tool for the evaluation of palpable breast lesions.