scholarly journals P91 Phyllodes Tumours: Looking for Predictive Features from Multidisciplinary Assessments

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Aneeshya Kandiyil ◽  
Yue Guan ◽  
Yue Guan
Keyword(s):  
Multidisciplinary Approach ◽  
Final Diagnosis ◽  
Breast Lesions ◽  
Uncertain Malignant Potential ◽  
Comprehensive Knowledge ◽  
Triple Assessment ◽  
Key Characteristics ◽  
Adequate Sampling ◽  
Management Approaches ◽  
Phyllodes Tumours

Abstract Introduction The breast triple assessment enables rapid evaluation of breast abnormalities. Lesions are assessed via the assessments based on clinical examination, imaging and histological sampling. Fibroepithelial lesions (FELs) are amongst the most common breast lesions of uncertain malignant potential. They encompass a spectrum of entities ranging from benign fibroadenomas (FA) to malignant phyllodes tumours (PT), with contrasting clinical management approaches. Unfortunately, the distinction between various FELs is often difficult, despite recent diagnostic advances. This is especially so between FAs and PTs. Nevertheless, understanding how to prioritise key characteristics of PTs, both radiologically and histologically may ease this challenge. In our opinion, a multidisciplinary approach including radiological input is probably the most helpful in reaching an accurate diagnosis. Methods We, retrospectively studied data from breast lesions which were initially diagnosed pre-operatively as R3/B3 FELs, and those with a final diagnosis of PT on excision. 71 suitable cases were identified from 2009 to 2019. Information was extracted from reports made by specialists at the pre-operative and post-excision stages. Statistical analysis will be applied to quantify the significance of features evaluated. Results Preliminary results suggest diagnoses made by pathologists on pre-operative samples correlated well with the eventual final diagnosis made on post-operative specimens. Adequate sampling appears to be a significant factor in influencing the pre-operative core biopsy diagnosis. Conclusion We anticipate to acquire a comprehensive knowledge of various predictive features of PTs, and the correlation between the key radiological features, thereby allowing accurate pre-operative diagnosis of these interesting and challenging lesions.

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

1997 ◽  
Vol 36 (08) ◽  
pp. 282-288 ◽  
Author(s):  
T. Atasever ◽  
A. Özdemir ◽  
I. Öznur ◽  
N. I. Karabacak ◽  
N. Gökçora ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Lower Sensitivity ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Combined Use ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
Benign Breast Lesions ◽  
Palpable Breast ◽  
Metastatic Sites

Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

scholarly journals Strain Elastography: A Valuable Additional Method to BI-RADS?

2018 ◽  
Vol 39 (05) ◽  
pp. 526-534 ◽  
Author(s):  
Xin-Bao Zhao ◽  
Ji-Yi Yao ◽  
Xin Zhou ◽  
Shao-Yun Hao ◽  
Wen Mu ◽  
...  
Keyword(s):  
Classification System ◽  
Diagnostic Performance ◽  
Final Analysis ◽  
Daily Practice ◽  
Strain Ratio ◽  
Final Diagnosis ◽  
Ratio Method ◽  
Breast Lesions ◽  
Sensitivity Specificity ◽  
Histological Results

Abstract Background Breast lesions classified as BI-RADS-US 3 are probably benign and observation was recommended, while a considerable number of BI-RADS-US 4 lesions were benign, resulting in excessive biopsies. We focus exclusively on BI-RADS-US 3 and 4 lesions and hypothesize that improved diagnostic performance can be achieved by integrating real-time elastography (strain ratio) into the BI-RADS-US classification system. Method From April 2010 to September 2015, 1071 lesions were included in the final analysis. After the conventional ultrasound examination, the BI-RADS-US (2013) classification was used to evaluate the lesions. Then the strain ratios were calculated, and the final diagnosis was made on the basis of histological results. The sensitivity, specificity, accuracy, PPV and NPV were calculated and the AUCs were compared. Additionally, an analysis of the diagnostic performance expressed by the pretest and posttest probability of disease (POD) was performed in BI-RADS-US 3 and 4A lesions. Results With the cutoff point of 2.98, the sensitivity, specificity and accuracy of the strain ratio method were 86.9 %, 86.6 % and 82.6 %, respectively. In BI-RADS-US 3 lesions, a suspicious strain ratio significantly modified the POD from 1.3 % to a posttest POD of 29.8 %. In BI-RADS-US 4A lesions, a suspicious strain ratio significantly modified the POD from 8.5 % to a posttest POD of 48.7 %. Conclusion Ultrasonographic elastography (strain ratio) yields additional diagnostic information in the evaluation of BI-RADS-US 3 and 4 breast lesions. The strain ratios should be integrated into the BI-RADS-US classification system and into daily practice.

Telomerase Is a Highly Sensitive and Specific Molecular Marker in Fine-Needle Aspirates of Breast Lesions

1999 ◽  
Vol 17 (7) ◽  
pp. 2020-2020 ◽  
Author(s):  
Christopher Poremba ◽  
Kenneth R. Shroyer ◽  
Michael Frost ◽  
Raihanatou Diallo ◽  
Franz Fogt ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Final Diagnosis ◽  
Specific Marker ◽  
Breast Lesions ◽  
Cytologic Diagnosis ◽  
Histologic Diagnosis ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Highly Sensitive ◽  
Immortal Cells

PURPOSE: Telomerase has been detected in a majority of human malignant tumors, making telomerase activity (TA) one key difference between mortal and immortal cells. In this study, we evaluated in blind-trial fashion the association of TA with cytologic and final clinical/pathologic diagnosis in fine-needle aspirates (FNAs) of breast lesions. MATERIALS AND METHODS: In 172 FNAs, including 80 samples that were cytologically malignant, 18 that were atypical but not diagnostic for malignancy, and 74 that were cytologically benign, TA was determined by a modified nonradioactive telomeric repeat amplification protocol (TRAP) assay. Final diagnosis was made by pathologic examination of follow-up surgical material available for all the cytologically malignant samples, a majority of the cytologically atypical samples, and a portion of the cytologically benign samples. RESULTS: TA was detected in 85 of 172 samples. Comparison of the cytologic and histologic diagnoseswith TA showed that 80 of 87 samples from patients with breast cancer were telomerase-positive, resulting in a sensitivity of 92%. TA was found in four of five FNAs from carcinomas that were considered cytologically atypical but not diagnostic for malignancy. Eighty of 85 samples from patients with benign breast lesions were telomerase-negative, revealing a specificity of 94%. The five positive cases in this group were all fibroadenomas with low TA. Among the 18 cases with a cytologic diagnosis of atypia, there was a strong positive relationship between TRAP findings and histologic diagnosis. CONCLUSION: The detection of TA in FNAs of breast lesions is a highly sensitive and specific marker of malignancy and may be used as an adjunct in cases with an equivocal cytologic diagnosis.

scholarly journals Breast Lesions of Uncertain Malignant Potential: A Challenge for Surgeons

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Nancy Deslauriers ◽  
Sidéris Lucas ◽  
Dufresne Michel-Pierre ◽  
Mitchell Andrew ◽  
Drolet Pierre ◽  
...  
Keyword(s):  
Malignant Potential ◽  
Breast Lesions ◽  
Uncertain Malignant Potential

TRANSFOR-M: A unique transatlantic forestry Master program leading to a dual European and Canadian degree

2013 ◽  
Vol 89 (02) ◽  
pp. 205-210
Author(s):  
Brigitte Leblon ◽  
Heinrich Spiecker ◽  
Jorma Neuvonen ◽  
Marjoriitta Möttönen ◽  
Andreas Hamann ◽  
...  
Keyword(s):  
Environmental Management ◽  
English Language ◽  
Practical Experience ◽  
Graduate Degree ◽  
Language Program ◽  
Master Program ◽  
Key Characteristics ◽  
E Learning ◽  
Canadian Provinces ◽  
Management Approaches

To educate their students in modern sustainable forest and environmental management approaches sensitive to cultural and situational differences, three Canadian (Alberta, British Columbia, New Brunswick) and four European (Albert-Ludwigs- Universität, Freiburg, Germany; University of Eastern Finland, Joensuu, Finland; Swedish University of Agricultural Sciences, Umeå, Sweden; and Bangor University, Wales) universities have developed a new transatlantic forestry Master program leading to a dual European and Canadian post-graduate degree (TRANSFOR-M). The two-year English language program has the following key characteristics: 1) the optimal use of expertise at partner institutions to deliver effective, globally oriented programs in forestry and environmental management; 2) one intensive language course in the language of the host country for the Canadian students; 3) e-learning courses accessible among all partner institutions (and once tested through TRANSFOR-M, to a broader audience); 4) a “thesis” or research project report that is co-supervised by both a Canadian and a European professor; 5) access to work internships to provide practical experience in an international context and increase the employability of the graduate students and 6) two mandatory three-week field courses (one across the four European countries and one across the three Canadian provinces), where all program participants meet.

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