Elastographic Evaluation of Indeterminate Breast Masses on Ultrasound

Objective To evaluate the diagnostic accuracy of elastography for breast cancer identification in patients with indeterminate lesions on ultrasound. Methods This prospective, descriptive study included patients with indeterminate breast lesions in the ultrasound and with indication for percutaneous or surgical biopsy. The elastography was evaluated by qualitative analysis and by two methods for the semi quantitative analysis. Results We evaluated 125 female patients with 159 lesions, with a mean age of 47 years, and a range of 20–85 years. Ultrasound has shown to be a method with good sensitivity (98.1%), but with a lower specificity (40.6%). On the elastography qualitative analysis, the specificity and accuracy were of 80.2% and 81.8% respectively. The mean size of the lesions showed no difference in classification by elastography. For the semiquantitative elastography, the mean values of the malignant lesions were statistically higher when compared with the subcutaneous tissue or the adjacent fibroglandular tissue. The analysis of the receiver operating characteristic (ROC) curves for these two semiquantitative methods showed that both are considered satisfactory, with an area under the curve above 0.75 and statistical significance (p < 0.0001). The best results were obtained when using the findings of combined conventional ultrasound and qualitative elastography, with 100% sensitivity and 63.2% specificity. Conclusions Elastography can be a useful complementary method, increasing the specificity and diagnostic accuracy of conventional ultrasound for the diagnosis of breast cancer in patients with indeterminate breast lesions.

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Neoadjuvant Chemotherapy for Breast Cancer: Evaluation by PET / CT

QJM ◽

10.1093/qjmed/hcab106.065 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rania Ali Maarouf ◽

Amgad S Abdel-Rahman ◽

Samar Ibrahim Mohamed

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Therapeutic Response ◽

Left Breast ◽

Breast Lesions ◽

Mean Values ◽

Pet Ct ◽

The Mean ◽

Neo Adjuvant Chemotherapy ◽

Fdg Pet Ct

Abstract Background Breast cancer (BC)is the most commonly occurring cancer in women and the second most common cancer overall.An increase in the rate of breast preservation has come to be expected because of tumor reduction using neo-adjuvant chemotherapy (NAC) for locally advanced cancer and it is important to accurately determine the effects of NAC. Patients and Methods This study was conducted on 30 female patients with histopathologically confirmed breast cancer referred for a PET/CT scan aiming to demonstrate the role of 18F-FDG PET/CT in detecting the pathological response to NAC in BC patients. Results No statistically significant differences were found between the baseline number of lesions and that after three cycles of chemotherapy. Also, no statistically significant differences were found between the mean values of baseline and after three cycles of chemotherapy of both liver activity and size of right breast lesions. Meanwhile, the mean values of SUV of right and left breast lesions as well as the size of left breast lesions were significantly lower after three cycles of chemotherapy when compared to their baseline values. And no statistically significant differences were found between complete and partial therapeutic response in the right breast lesions as well as between complete and no therapeutic response in the left breast lesions as regards baseline SUV and SUV after 3 cycles of chemotherapy. Conclusion It can be concluded that FDG-PET/CT is useful for evaluation of neo-adjuvant chemotherapy for breast cancer. However, more studies are needed to validate the results of the current study.

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Determination of carcinoembryonic antigen and cancer antigen values with the radioimmunoassay method in healthy females dogs

Veterinární Medicína ◽

10.17221/6810-vetmed ◽

2013 ◽

Vol 58 (No. 5) ◽

pp. 277-283 ◽

Cited By ~ 9

Author(s):

V. Ledecky ◽

A. Valencakova-Agyagosova ◽

J. Lepej ◽

Z. Frischova ◽

S. Hornak ◽

...

Keyword(s):

Carcinoembryonic Antigen ◽

Statistical Significance ◽

Average Weight ◽

Cancer Antigen ◽

Cancer Markers ◽

Mean Values ◽

The Mean ◽

Radioimmunoassay Method ◽

Healthy Females

The aim of this study was to determine reference values of carcinoembryonic antigen and cancer antigen in 32 clinically healthy bitches. The average age of the bitches in each group was as follows: small breeds 3.50 ± 2.30, medium breeds 3.83 ± 3.21, large breeds 6.00 ± 3.22 and giant breeds 2.40 ± 2.43. The average weight in each group was as follows: 1st group 7.94 kg ± 1.84, 2nd group 22.38 kg ± 2.77, 3rd group 35.94 kg ± 7.16, and 4th group 52.75 kg ± 5.04. The cancer markers were determined using human kits. The mean values of the carcinoembryotic antigen markers ± SD were as follows: 1st group 0.18 ± 0.03, 2nd group 0.20 ± 0.03, 3rd group 0.22 ± 0.01, 4th group 0.18 ± 0.04. The statistical significance for the carcinoembryonic antigen markers was P = 0.0042**. The values of cancer antigen markers ± SD were: 4.90 ± 1.04, 4.80 ± 1.13, 5.90 ± 1.22, and 4.72 ± 0.97, respectively. The cancer antigen values were statistically insignificant (P = 0.1762). Based on obtained values of the mean 95%, we expect a standard for carcinoembryonic antigen of 0.00–0.23 ng/ml and for cancer antigen 0.0–7.00 IU/ml. The results of the present study show that it is possible to use human kits for the determination of carcinoembryonic antigen and cancer antigen in clinically healthy bitches using the radioimmunoassay method.

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BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0043-6 ◽

2019 ◽

Vol 50 (1) ◽

Cited By ~ 2

Author(s):

Rabab Yasin ◽

Enas Abd El Ghany

Keyword(s):

Breast Cancer ◽

Developing Countries ◽

Statistical Significance ◽

Breast Mri ◽

Excision Biopsy ◽

Breast Lesions ◽

Common Cancer ◽

Contrast Enhanced ◽

Histopathological Result ◽

Contrast Enhanced Mri

Abstract Background Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions. Results Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827). Conclusion CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.

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Automated Breast Cancer Detection in Digital Mammograms of Various Densities via Deep Learning

Journal of Personalized Medicine ◽

10.3390/jpm10040211 ◽

2020 ◽

Vol 10 (4) ◽

pp. 211 ◽

Cited By ~ 1

Author(s):

Yong Joon Suh ◽

Jaewon Jung ◽

Bum-Joo Cho

Keyword(s):

Breast Cancer ◽

Deep Learning ◽

Operating Characteristic ◽

Meta Analysis ◽

Characteristic Curve ◽

Malignant Lesion ◽

Model Performance ◽

Mean Values ◽

The Mean ◽

Deep Learning Model

Mammography plays an important role in screening breast cancer among females, and artificial intelligence has enabled the automated detection of diseases on medical images. This study aimed to develop a deep learning model detecting breast cancer in digital mammograms of various densities and to evaluate the model performance compared to previous studies. From 1501 subjects who underwent digital mammography between February 2007 and May 2015, craniocaudal and mediolateral view mammograms were included and concatenated for each breast, ultimately producing 3002 merged images. Two convolutional neural networks were trained to detect any malignant lesion on the merged images. The performances were tested using 301 merged images from 284 subjects and compared to a meta-analysis including 12 previous deep learning studies. The mean area under the receiver-operating characteristic curve (AUC) for detecting breast cancer in each merged mammogram was 0.952 ± 0.005 by DenseNet-169 and 0.954 ± 0.020 by EfficientNet-B5, respectively. The performance for malignancy detection decreased as breast density increased (density A, mean AUC = 0.984 vs. density D, mean AUC = 0.902 by DenseNet-169). When patients’ age was used as a covariate for malignancy detection, the performance showed little change (mean AUC, 0.953 ± 0.005). The mean sensitivity and specificity of the DenseNet-169 (87 and 88%, respectively) surpassed the mean values (81 and 82%, respectively) obtained in a meta-analysis. Deep learning would work efficiently in screening breast cancer in digital mammograms of various densities, which could be maximized in breasts with lower parenchyma density.

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Diagnostic Accuracy of Magnetic Resonance Spectroscopy (MRS) in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

10.53350/pjmhs211571847 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1847-1849

Author(s):

Adnan Ahmed ◽

Jawad Ali Memon ◽

Muhammad Sibtain Shah ◽

Hafeez ur Rehman ◽

Tahir Baig ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

Resonance Spectroscopy ◽

Breast Lesions ◽

Female Patients ◽

Malignant Breast

Background and Aims: Breast cancer is the prime cause of mortality among women of both developing and developed world. Out of 34.6% of female cancer patients, malignant breast cancer being the most common cancer found in Pakistan. The current study aims to evaluate the diagnostic accuracy of magnetic resonance spectroscopy in diagnosing malignant breast lesions taking histopathology as a gold standard. Materials and Methods: This cross-sectional study was carried out on 135 female patients with suspicious palpable lesions for malignancy referred from surgical OPD of Liaquat University of Medical and Health Sciences, Jamshoro during the period from October 2020 to March 2021. Magnetic resonance spectroscopy (MRS) dynamic enhanced images taken with contrast on 1.5 Tesla MRI machines were assessed based on kinetic and morphology. Malignancy biomarker was assessed with choline peak (Cho) allowed by MRS. The Single-voxel technique was utilized in order to evaluate the diagnostic performance of MRS in breast lesions malignancy. A comparison was made between MRS and biopsy findings. Results: Out of 135 female patients, 118 (87.40%) were malignant lesions patients assessed by MRS while histopathologically proven patients were 104 (77.33%). The calculated mean age of all the malignant patients was 48.3 ± 14.5 years with a range of 40-79 years. The diagnostic parameters of MRS such as specificity, accuracy, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) was 74%, 88.2%, 93%, 77.8%, and 93.1% respectively while taking histopathology as a gold standard. Conclusion: MRS must be utilized as a primary imaging technique for the diagnosis of breast lesions malignancy due to its higher specificity, sensitivity, and accuracy in breast lumps characterization. MRS was found to be specific 74%, sensitive 88.2%, and accurate 93% in malignant breast cancer diagnosis. Keywords: MRS, Malignant breast lesions, Histopathology

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Contrast Enhanced Mammography: The added value in the assessment of Suspicious Breast Lesions

QJM ◽

10.1093/qjmed/hcaa068.001a ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

R Abdullah ◽

L Abdelmonem ◽

N Nasry ◽

M Ayoub

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Malignant Tumors ◽

High Energy ◽

Added Value ◽

Breast Lesions ◽

Predictive Values ◽

Dense Breasts ◽

Contrast Enhanced

Abstract Background Breast cancer in women is a major public health problem throughout the world, being the second most common cancer worldwide. Sonomammography has been always recommended as the basic breast imaging modality for early detection and diagnosis of breast cancer. Some malignant tumors have been missed, specially in dense breasts, and high false-negative rate have been reported. Contrast enhanced spectral mammography is a new modality, used to depict the tumor vascularity and neoangiogenesis; a classic sign of malignant tumors. Aim of Work The purpose of this study is to determine the added value of dual energy contrast mammography to sono-mammography in the assessment of suspicious breast lesions. Patients and Methods 36 patients were included in the study, referred from outpatient clinics in private settings and from Demerdash Hospitals. Contrast enhanced spectral mammography CESM was performed by using a digital mammography unit (Seno DS; GE, Buc, France) that had been adapted to obtain two images for each view: a low-energy image (below the k edge of iodine, 33.2 keV) and a high-energy image (above the k edge of iodine) at 45 to 49 kVp. Results: CEDM versus sonomammography shows p (0.021) value less than 0.05. Also the area under the ROC curve was higher for MX+CEDM (94.4%) than that was for sonomammography (63.8%) compared to pathology analysis with 100% sensitivity, 88.2 % specificity, 90.48 %PPV and 100 % NPV in diagnosis of suspicious lesions. Conclusion The diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma has proven to be superior to sonomammography alone. CEDM had a better diagnostic accuracy mainly due to improved positive and negative predictive values (Positive predictive value about 90.48, negative predictive value 100). The role of CEDM in detection of multifocal / multicentric carcinomas with particular interest for the assessment of the extent of disease specially in dense breasts is appreciated.

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Palliation of ulcerative breast lesions with radiation.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.199 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 199-199

Author(s):

Prashant Vempati ◽

Miriam Knoll ◽

Kavita Vyas Dharmarajan ◽

Sheryl Green ◽

Amy Tiersten ◽

...

Keyword(s):

Breast Cancer ◽

Breast Lesion ◽

Radiation Treatment ◽

Academic Medical Center ◽

Previous History ◽

Chemotherapeutic Agents ◽

Breast Lesions ◽

Median Dose ◽

History Of ◽

The Mean

199 Background: Patients with advanced breast cancer may experience ulcerative breast lesions. Breast cancer with ulcerative lesions has been shown to severely affect a patient’s quality of life (QoL). The role of palliative radiation therapy (RT) in the management of ulcerative breast lesions needs to be further explored. Methods: IRB-approval was obtained to retrospectively review the radiation treatment records for all patients who underwent palliative RT for breast cancer at our urban academic medical center. A total of 13 patients were identified, and we herein report their demographics, treatment characteristics, and clinical outcomes. Results: The mean age of the patients receiving palliative RT for ulcerative breast cancer was 64 years. All patients had stage IV disease when they were evaluated for RT. All patients received prior systemic chemotherapy with a mean of four chemotherapeutic agents, the most common of which was Capecitabine. The mean radiation dose received for palliative RT was 27.54 Gy in 11 fractions with a median dose of 30 Gy in 15 fractions. Six (46%) of the patients received prior RT to the same breast, with a median dose of 59.5 Gy in 31 fractions. Among these six patients, the average interval between initial RT and ulcerative breast lesion was 69.5 months. The median overall survival in all patients since ulcerative breast lesion was 5 months and the mean survival did not differ between patients with previous history of RT and RT-naïve patients (4.50 vs. 4.57; p = 0.95). Six out of the 9 (69%) patients who received ≥ 30 Gy reported clinical improvement, whereas none of the 4 patients who received < 30 Gy reported any benefit. There were no radiation-associated toxicities reported by patients. Conclusions: These data suggest that palliative RT ( ≥ 30 Gy) is an efficacious treatment for ulcerative breast cancer with minimal toxicity. Prior RT should not be a contraindication as patients with previous history of RT have similar outcomes compared to RT-naïve patients.

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Diagnostic Accuracy of Ultrasonography for Evaluation Solid Breast Lesions – A Systematic Review

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v5i3.786 ◽

2021 ◽

Author(s):

Syed Muhammad Yousaf Farooq ◽

Guido C Robot ◽

Syeda Khadija Tul Sughra Murrium ◽

Aima Gilani ◽

Hafiz Syed Arsalan Gilani ◽

...

Keyword(s):

Breast Cancer ◽

Public Health Problem ◽

High Sensitivity ◽

Breast Lesions ◽

Major Public Health Problem ◽

Cross Sectional ◽

Malignant Breast ◽

The Mean ◽

Methods Analytical ◽

Key Terms

Breast cancer in women in both developed and developing countries is the most common cancer, and remains a major public health problem. Methods: Analytical cross-sectional studies and only highquality studies were included. The searched databases were: Pub Med (2008-2020), Google scholar (2008-2020) and science direct (20082020). The key terms searched were ultrasound imaging, Breast solid mass or lesions, papillary lesions, Fibro-adenoma, breast cancer. Using these key terms, researchers found total 101 studies from the above-mentioned databases. Among these researchers found 56 studies from Google scholars, 11 from science direct and 34 from Pub Med. After this, researchers separated the relevant and irrelevant data. Results: Table 1 shows the Descriptive results of age from 12 studies, 17641 individuals. The mean age was 46.14697 SD 10.56736. The mean Sensitivity was 91.0200 and mean specificity was 89.35. The pooled results of 8 studies and 2612 individuals, out of 2612 individuals we found 1220 (46.71) benign lesions and 1392 (53.29%) malignant lesions are also shown. Conclusions: In conclusion, Ultrasound can differentiate benign and malignant breast lesions to great extent. This technique has the potential ability to altering the handling of cases in where a biopsy may be recommended, but the risk of carcinoma is known to be relatively low. Ultrasound accuracy is recommended as the first option for follow-up examinations of lesions because of its high sensitivity and ability to detect lesions outside of breast density.

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Comparison of Different Algorithms in the Radiotherapy Plans of Breast Cancer

ITM Web of Conferences ◽

10.1051/itmconf/20182201048 ◽

2018 ◽

Vol 22 ◽

pp. 01048 ◽

Cited By ~ 1

Author(s):

Yonca Yahşi Çelen ◽

Atilla Evcin

Keyword(s):

Breast Cancer ◽

Dose Calculation ◽

Planning System ◽

Treatment Planning System ◽

Average Dose ◽

Mean Values ◽

Portal Dosimetry ◽

Calculation Algorithms ◽

Dose Calculation Algorithms ◽

The Mean

It is aimed to evaluate portal dosimetry results of planned breast cancer patients with intensity-modulated radiotherapy (YART) of Anisotropic Analytical Algorithm (AAA) and Pencil Beam Convolution (PBC) dose calculation algorithms. The plans of 10 treated patients will receive 6 MV photon energy and a total of 25 fractions of 50 Gray dose using the inverse YART technique, which is reverse planned in the Eclipse (ver.13.6) treatment planning system with Varian Trilogy Linear Accelerator prescribing. For each plan, dose was calculated after optimization using PBC and then AAA algorithms. The quality controls of the plans were made using the Electronic Portal Imaging Device (EPID) by creating individual verification plans for each algorithm. In addition, the maximum and average dose values in the target volume were compared in inverse YART plans calculated using PBC and AAA. When treatment plans generated by AAA and PBC dose calculation algorithms are analyzed using EPID, for the PBC algorithm, the mean values of VArea and VAvg are 98.15 ± 1.07, 0.40 ± 0.048 and 98.72 ± 1.13, 0.37 ± 0.051, respectively, for the AAA algorithm. The PTV Dmax value for the PBC algorithm is 109.3 ± 1.09 and the DAvg value is 101.7 ± 0.51. For the AAA algorithm, the PTV Dmax value is 110.6 ± 1.12 and the DAvg value is 102.9 ± 0.62. When the mean values of portal dosimetry VArea and VAvg evaluated using PBC and AAA algorithms were compared, the differences between the algorithms were not statistically significant (p> 0.05). Differences between the algorithms for PTV Dmax and DAvg values are not statistically significant (p> 0.05).

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The incidence and outcome of incidental breast lesions detected by computed tomography

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12518836439083 ◽

2010 ◽

Vol 92 (2) ◽

pp. 124-126 ◽

Cited By ~ 16

Author(s):

A Hussain ◽

A Gordon-Dixon ◽

H Almusawy ◽

P Sinha ◽

A Desai

Keyword(s):

Breast Cancer ◽

Computed Tomography ◽

Breast Lesion ◽

Chest Ct ◽

Ct Scans ◽

Breast Lesions ◽

Breast Cancers ◽

The Mean ◽

The Uk ◽

Symptomatic Breast

INTRODUCTION In the UK, the majority of breast cancers are diagnosed through symptomatic breast clinics and the breast screening programmes. With increased use of computed tomography (CT) to assess various pathologies, breast lesions are picked up incidentally. The aim of this study was to investigate the incidence and outcomes of breast lesions detected incidentally on CT scans. PATIENTS AND METHODS A retrospective study was conducted to assess the incidence and outcome of incidentally found breast lesions, which were detected on chest CT scans that were conducted for other pathologies during the period from February 2007 to October 2008. RESULTS A total of 432 chest CT scans were performed over 18 months. Thirty-three (7.63%) patients were found to have an incidental breast lesion. The mean age was 73 years (range, 50–86 years). Of these, 17 (52%) were benign, eight (24%) were primary breast cancer and the remaining eight (24%) had no definite pathology. The detection rate of breast cancer was 1.85%. CONCLUSIONS CT is emerging as an important contributor to the detection of occult breast lesions. Radiological awareness of incidental breast lesions is important so that appropriate referral to a specialised breast unit is made.

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