Calcifications at Digital Breast Tomosynthesis: Imaging Features and                    Biopsy Techniques

Abstract Objective To describe BI-RADS features and evaluate conspicuity of breast cancer on digital breast tomosynthesis (DBT) according to their molecular profile. Materials and method Institutional review board was obtained for this retrospective study. Consecutive patients with histologically proven breast cancers who underwent digital breast tomosynthesis (DBT) with 2D synthetic mammography (SM) and digital mammography (DM) at the time of diagnosis were included. Morphological features and conspicuity of cancers on DM, SM and DBT were evaluated in consensus by two breast radiologists. Imaging features were compared across molecular subtypes (luminal, triple negative (TN) and HER2+) using Fisher’s exact test and between DBT and SM and DM using McNemar’s test. Conspicuity was compared between DBT and SM and DM using Wilcoxon matched pairs test and between each molecular subtype using the Wilcoxon test. Results One hundred and eleven consecutive patients were included. On DBT, TN cancers more frequently presented as masses with microlobulated margins (P = 0.04) while HER2 + cancers were more often associated with microcalcifications (P = 0.02). Greater conspicuity on DBT in comparison to DM was observed for cancers with low Ki67 (P = .015), less aggressive tumours (P = .005), positive ER (P = 0.005), positive PR (P = .005) or negative HER2 (P = .024), and for luminal molecular profiles (P = 0.012) while no difference was observed between the two techniques for TN (P = .73) and HER+ (P = .79) tumours. Conclusion DBT reveals specific features of breast cancers according to their molecular characteristics. In comparison with DM, DBT improves conspicuity of luminal subtype cancers and tumours demonstrating less aggressive features on pathology.

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Imaging Features of Breast Periductal Stromal Tumor: A Case Report

Frontiers in Oncology ◽

10.3389/fonc.2021.577227 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ning Ding ◽

Ying Jiang ◽

Haimin Liu ◽

Fuling Zheng ◽

Shenling Zhu ◽

...

Keyword(s):

Blood Flow ◽

Digital Breast Tomosynthesis ◽

Stromal Tumor ◽

Imaging Features ◽

Breast Tomosynthesis ◽

Palpable Mass ◽

Full Field ◽

Full Field Digital Mammography ◽

The Right ◽

Biphasic Tumor

Breast periductal stromal tumor (PDST) is a rare biphasic tumor, with both benign ductal epithelium and non-phyllodes sarcomatous stroma. Its imaging features were rarely reported due to the rarity. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the right breast. Presurgery imaging evaluations of full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and ultrasonography (US) were performed. The imaging features include the following: 1. multiple solid lobulated lesions comprising nearly the entire right breast; 2. hypoechoic heterogeneous masses with internal separations and abundant blood flow; 3. FFDM and DBT showed multiple irregular high-density masses with lobulated margin, partially integrated. The patient underwent extended mastectomy of the right breast. The surgical pathology confirmed a PDST. After excision of the mass, she was followed up in the outpatient clinic for 25 months without local recurrence or distant metastasis.

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Architectural Distortion (Radial Scar)

10.1093/med/9780190270261.003.0030 ◽

2018 ◽

Author(s):

Reni S. Butler

Keyword(s):

Digital Breast Tomosynthesis ◽

Radial Scar ◽

Architectural Distortion ◽

Imaging Features ◽

Imaging Evaluation ◽

Breast Tomosynthesis ◽

Complex Sclerosing Lesion ◽

High Risk Lesion ◽

Histological Confirmation ◽

Management Recommendations

Radial scars are benign lesions of the breast characterized pathologically by a fibroelastic core containing entrapped ducts and lobules that radiate outwards in a stellate pattern. This chapter, highlighting radial scar as a cause of architectural distortion, reviews its imaging features and differential diagnosis on mammography, digital breast tomosynthesis, ultrasound, and MRI; its diagnostic workup using multiple modalities; and its histological confirmation with image-guided core needle biopsy. The particular challenge of radial scar presenting as architectural distortion seen only with tomosynthesis is discussed, along with an algorithm for imaging evaluation and biopsy guidance in this setting. As radial scar, which is histologically related to complex sclerosing lesion and radial sclerosing lesion, is considered a high-risk lesion, management recommendations are also reviewed.

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