The Fat-glandular Interface and Breast Tumor Locations: Appearances on Ultrasound Tomography Are Supported by Quantitative Peritumoral Analyses

Abstract Objective To analyze the preferred tissue locations of common breast masses in relation to anatomic quadrants and the fat-glandular interface (FGI) using ultrasound tomography (UST). Methods Ultrasound tomography scanning was performed in 206 consecutive women with 298 mammographically and/or sonographically visible, benign and malignant breast masses following written informed consent to participate in an 8-site multicenter, Institutional Review Board-approved cohort study. Mass locations were categorized by their anatomic breast quadrant and the FGI, which was defined by UST as the high-contrast circumferential junction of fat and fibroglandular tissue on coronal sound speed imaging. Quantitative UST mass comparisons were done for each tumor and peritumoral region using mean sound speed and percentage of fibroglandular tissue. Chi-squared and analysis of variance tests were used to assess differences. Results Cancers were noted at the FGI in 95% (74/78) compared to 51% (98/194) of fibroadenomas and cysts combined (P < 0.001). No intra-quadrant differences between cancer and benign masses were noted for tumor location by anatomic quadrants (P = 0.66). Quantitative peritumoral sound speed properties showed that cancers were surrounded by lower mean sound speeds (1477 m/s) and percent fibroglandular tissue (47%), compared to fibroadenomas (1496 m/s; 65.3%) and cysts (1518 m/s; 84%) (P < 0.001; P < 0.001, respectively). Conclusion Breast cancers form adjacent to fat and UST localized the vast majority to the FGI, while cysts were most often completely surrounded by dense tissue. These observations were supported by quantitative peritumoral analyses of sound speed values for fat and fibroglandular tissue.

Download Full-text

Whole Breast Sound Speed Measurement from US Tomography Correlates Strongly with Volumetric Breast Density from Mammography

Journal of Breast Imaging ◽

10.1093/jbi/wbaa052 ◽

2020 ◽

Vol 2 (5) ◽

pp. 443-451

Author(s):

Mark Sak ◽

Peter Littrup ◽

Rachel Brem ◽

Neb Duric

Keyword(s):

Breast Density ◽

Sound Speed ◽

Three Dimensional ◽

Correlation Coefficients ◽

Mammographic Breast Density ◽

Data Sets ◽

Imaging Data ◽

Institutional Review ◽

Dense Tissue ◽

Screening Mammograms

Abstract Objective To assess the feasibility of using tissue sound speed as a quantitative marker of breast density. Methods This study was carried out under an Institutional Review Board–approved protocol (written consent required). Imaging data were selected retrospectively based on the availability of US tomography (UST) exams, screening mammograms with volumetric breast density data, patient age of 18 to 80 years, and weight less than 300 lbs. Sound speed images from the UST exams were used to measure the volume of dense tissue, the volume averaged sound speed (VASS), and the percent of high sound speed tissue (PHSST). The mammographic breast density and volume of dense tissue were estimated with three-dimensional (3D) software. Differences in volumes were assessed with paired t-tests. Spearman correlation coefficients were calculated to determine the strength of the correlations between the mammographic and UST assessments of breast density. Results A total of 100 UST and 3D mammographic data sets met the selection criteria. The resulting measurements showed that UST measured a more than 2-fold larger volume of dense tissue compared to mammography. The differences were statistically significant (P < 0.001). A strong correlation of rS = 0.85 (95% CI: 0.79–0.90) between 3D mammographic breast density (BD) and the VASS was noted. This correlation is significantly stronger than those reported in previous two-dimensional studies (rS = 0.85 vs rS = 0.71). A similar correlation was found for PHSST and mammographic BD with rS = 0.86 (95% CI: 0.80–0.90). Conclusion The strong correlations between UST parameters and 3D mammographic BD suggest that breast sound speed should be further studied as a potential new marker for inclusion in clinical risk models.

Download Full-text

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

Nuklearmedizin ◽

10.1055/s-0038-1629848 ◽

1997 ◽

Vol 36 (08) ◽

pp. 282-288 ◽

Cited By ~ 8

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.

Download Full-text

The Value of Ultrasonography Combined with Compression Technique in Differentiation between Benign and Malignant Breast Masses

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2001.44.4.539 ◽

2001 ◽

Vol 44 (4) ◽

pp. 539

Author(s):

Seong Kuk Yoon ◽

Ki Nam Lee ◽

Won Jung Jung ◽

Kyung Jin Nam

Keyword(s):

Compression Technique ◽

Breast Masses ◽

Malignant Breast

Download Full-text

Axial-Shear Strain Imaging for Differentiating Benign and Malignant Breast Masses

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2010.07.008 ◽

2010 ◽

Vol 36 (11) ◽

pp. 1813-1824 ◽

Cited By ~ 30

Author(s):

Haiyan Xu ◽

Min Rao ◽

Tomy Varghese ◽

Amy Sommer ◽

Sara Baker ◽

...

Keyword(s):

Shear Strain ◽

Strain Imaging ◽

Breast Masses ◽

Axial Shear ◽

Malignant Breast

Download Full-text

Qualitative Diagnosis of Solid Breast Mass by Blood Flow in Solid Breast Mass Based on Color Doppler Ultrasound

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3682 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1608-1615

Author(s):

Ding Zuopeng ◽

Liu Weiyong ◽

Hu Chunmei ◽

Wang Tao ◽

Wang Mingming

Keyword(s):

Breast Cancer ◽

Blood Flow ◽

Differential Diagnosis ◽

Color Doppler ◽

Flow Characteristics ◽

Flow Distribution ◽

Color Doppler Ultrasound ◽

Blood Flow Distribution ◽

Breast Masses ◽

Malignant Breast

The incidence of breast cancer ranks first among female malignant tumor. With the increase of the sensitivity of color Doppler ultrasound blood flow, the blood flow distribution in and around the tumor can be clearly displayed, and the analysis of hemodynamic parameters is provided, which provides convenience for the study of tumor blood flow characteristics. Studies have shown that tumor cells can secrete a substance called angiogenesis factor, which makes the tumor site form a rich vascular network to promote tumor growth and metastasis. The tumor has many new blood vessels, abnormal structure, thin wall, lack of muscle layer, and is prone to form arteriovenous rash. These characteristics provide a pathological basis for color Doppler flow imaging (CDFI) for the diagnosis of breast cancer. This article discusses the role of two-dimensional sonographic features in the differential diagnosis of benign and malignant breast masses, CDFI was used to study the blood flow distribution and hemodynamic characteristics in benign and malignant breast masses; explore the value of blood flow characteristics and blood flow parameters in the differential diagnosis of breast masses. The experimental results show that the detection rate of blood flow signals and the classification of blood flow signals in the malignant group are higher than those in the benign group, mainly level II and III blood flow, and the irregular branched blood flow is more common, especially when the tumor appears penetrating blood flow supports the diagnosis of malignancy. PSV, RI and PI have a certain differential meaning in the diagnosis of benign and malignant breast masses. PSV, RI and PI of malignant masses are higher than benign masses. For tumors without obvious necrosis, the larger the tumor diameter, the richer the blood flow and the higher the blood flow grade is. The malignant tumors have more blood flow than the benign ones.

Download Full-text

Application of 3D and 2D quantitative shear wave elastography (SWE) to differentiate between benign and malignant breast masses

Scientific Reports ◽

10.1038/srep41216 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 7

Author(s):

Jie Tian ◽

Qianqi Liu ◽

Xi Wang ◽

Ping Xing ◽

Zhuowen Yang ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Breast Masses ◽

Malignant Breast

Download Full-text

2–14 Benign Versus Malignant Breast Masses: Optical Differentiation With US-Guided Optical Imaging Reconstruction

Breast Diseases A Year Book Quarterly ◽

10.1016/s1043-321x(06)80423-6 ◽

2006 ◽

Vol 17 (2) ◽

pp. 147-148

Author(s):

C.R.B. Merritt

Keyword(s):

Optical Imaging ◽

Breast Masses ◽

Imaging Reconstruction ◽

Malignant Breast

Download Full-text

Erdheim-Chester Disease Presenting as Bilateral Clinically Malignant Breast Masses

The American Journal of Surgical Pathology ◽

10.1097/pas.0b013e3181d39a3d ◽

2010 ◽

Vol 34 (4) ◽

pp. 584-588 ◽

Cited By ~ 27

Author(s):

Elena Provenzano ◽

Susan J. Barter ◽

Penelope A. Wright ◽

Parto Forouhi ◽

Richard Allibone ◽

...

Keyword(s):

Breast Masses ◽

Erdheim Chester Disease ◽

Malignant Breast ◽

Erdheim Chester ◽

Chester Disease

Download Full-text

Combination of shear wave elastography and BI-RADS in identification of solid breast masses

BMC Medical Imaging ◽

10.1186/s12880-021-00702-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xue Zheng ◽

Fei Li ◽

Zhi-Dong Xuan ◽

Yu Wang ◽

Lei Zhang

Keyword(s):

Shear Wave ◽

Breast Imaging ◽

Color Doppler ◽

Shear Wave Elastography ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Diagnostic Specificity ◽

Breast Masses ◽

Malignant Breast ◽

Grade Ii

Abstract Background To explore the value of quantitative shear wave elastography (SWE) plus the Breast Imaging Reporting and Data System (BI-RADS) in the identification of solid breast masses. Methods A total of 108 patients with 120 solid breast masses admitted to our hospital from January 2019 to January 2020 were enrolled in this study. The pathological examination served as the gold standard for definitive diagnosis. Both SWE and BI-RADS grading were performed. Results Out of the 120 solid breast masses in 108 patients, 75 benign and 45 malignant masses were pathologically confirmed. The size, shape, margin, internal echo, microcalcification, lateral acoustic shadow, and posterior acoustic enhancement of benign and malignant masses were significantly different (all P < 0.05). The E mean, E max, SD, and E ratio of benign and malignant masses were significantly different (all P < 0.05). The E min was similar between benign and malignant masses (P > 0.05). The percentage of Adler grade II-III of the benign masses was lower than that of the malignant masses (P < 0.05). BI-RADS plus SWE yielded higher diagnostic specificity and positive predictive value than either BI-RADS or SWE; BI-RADS plus SWE yielded the highest diagnostic accuracy among the three methods (all P < 0.05). Conclusion SWE plus routine ultrasonography BI-RADS has a higher value in differentiating benign from malignant breast masses than color doppler or SWE alone, which should be further promoted in clinical practice.

Download Full-text