MRI in the Early Detection of Breast Cancer in Women with High Genetic Risk

2006 ◽  
Vol 92 (6) ◽  
pp. 517-523 ◽  
Author(s):  
Giovanna Trecate ◽  
Daniele Vergnaghi ◽  
Siranuosh Manoukian ◽  
Silvana Bergonzi ◽  
Gianfranco Scaperrotta ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
False Positive ◽  
Genetic Risk ◽  
Brca2 Mutation ◽  
False Negative ◽  
Conventional Imaging ◽  
High Genetic Risk ◽  
Second Look ◽  
Positive Results

Aims and background Women with BRCA1 or BRCA2 germline mutations have an elevated risk of developing breast and/or ovarian cancer. Because of the early onset of the disease, screening of this group of women should start at an earlier age than in the general population. The association of breast magnetic resonance imaging (BMRI) and ultrasonography (US) with mammography (MX) and clinical breast examination (CBE) in the regular surveillance of these individuals has been proposed and seems to improve the early detection of breast cancer. Methods Within a multicenter study started by the Istituto Superiore di Sanita (Rome), at the Istituto Nazionale Tumori of Milan (INT) we enrolled 116 women at high genetic risk for breast cancer; they were either BRCA1 or BRCA2 mutation carriers or had a strong family history of breast cancer. They underwent CBE, MX, US and BMRI once a year. Results Between June 2000 and April 2005, at INT 12 cancers were detected among the 116 screened individuals (10%). In this subgroup, 1 patient refused BMRI and in 2 cases US was not performed. With BMRI we found 11 cancers and 6 of them were detectable only by this technique. In these 6 cases, the size of the disease was less than 1 cm and MX was false negative due to irregularly nodular parenchyma in 4 cases and scar tissue or prosthesis in the other 2. US was not performed in 2 cases and was false negative in 4 cases. Three false positive results were found with BMRI: 1 case was considered suspect but related to hormonal influences; 1 case with the same pattern was sent for second-look US, which gave a negative result and BMRI review after 6 months showed normalization of the parenchyma; in the third case histology revealed the presence of adenosis. No false positive results were registered for MX. Conclusions The aim of secondary prevention is the detection of cancer at its earliest stage. BMRI screening in women with BRCA1 or BRCA2 mutations or at high familiar risk appears to be highly sensitive and may detect mammographically occult disease. The accuracy of MR imaging is higher than that of conventional imaging but the technique is flawed by a lower specificity. In order to avoid unnecessary biopsies we believe that the combination of BMRI and conventional imaging can be very useful in screening women with a high genetic risk of breast cancer, especially with second-look evaluation by means of US when BMRI yields the only positive diagnostic result. Second-look US has been demonstrated to be of critical importance both in recognizing false positive BMRI results and in guiding biopsies, when necessary.

False-Negative and False-Positive Results in FDG-PET and PET/CT in Breast Cancer

PET Clinics ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 289-298 ◽  
Author(s):  
Rakesh Kumar ◽  
Neerja Rani ◽  
Chetan Patel ◽  
Sandip Basu ◽  
Abass Alavi
Keyword(s):  
Breast Cancer ◽  
False Positive ◽  
Fdg Pet ◽  
False Negative ◽  
Pet Ct ◽  
Positive Results

Ductal lavage of non-fluid yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high genetic risk for breast cancer

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 9535-9535
Author(s):  
A. W. Kurian ◽  
M. A. Mills ◽  
K. W. Nowels ◽  
S. K. Plevritis ◽  
B. M. Sigal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Risk ◽  
Brca2 Mutation ◽  
Ductal Lavage ◽  
Brca1 And Brca2 ◽  
High Genetic Risk ◽  
Mutation Carriers

Ductal lavage of non-fluid yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high genetic risk for breast cancer

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 9535-9535
Author(s):  
A. W. Kurian ◽  
M. A. Mills ◽  
K. W. Nowels ◽  
S. K. Plevritis ◽  
B. M. Sigal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Risk ◽  
Brca2 Mutation ◽  
Ductal Lavage ◽  
Brca1 And Brca2 ◽  
High Genetic Risk ◽  
Mutation Carriers

Selective Use of Intraoperative Touch Prep Analysis of Sentinel Nodes in Breast Cancer

2005 ◽  
Vol 71 (11) ◽  
pp. 955-962 ◽  
Author(s):  
Rachel C. Forbes ◽  
Clovis Pitchford ◽  
Jean F. Simpson ◽  
Glen C. Balch ◽  
Mark C. Kelley
Keyword(s):  
Breast Cancer ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Nodal Metastasis ◽  
Axillary Lymph ◽  
Sentinel Nodes ◽  
Number Of Patients ◽  
The Impact ◽  
Positive Results

Imprint cytology (touch prep) is often used for intraoperative examination of sentinel nodes in breast cancer. This allows axillary lymph node dissection (ALND) to be performed immediately for tumor-positive nodes. We evaluated the accuracy of touch prep examination of sentinel nodes and its role in the surgical treatment of breast cancer. We analyzed 169 breast cancer patients who underwent 170 lymphatic mapping procedures with intraoperative touch prep examination. Results from the touch prep were correlated with histopathology and clinical variables. There were 115 true-negative, 35 true-positive, 15 false-negative, and 5 false-positive results. Touch prep had a sensitivity of 70 per cent and specificity of 96 per cent. Positive predictive value, negative predictive value, and diagnostic accuracy were all 88 per cent. The false-negative rate was 30 per cent and correlated with the size of the nodal metastasis and number of involved nodes, but not other patient factors. Touch prep is useful for the evaluation of sentinel nodes in breast cancer, but it has a lower sensitivity than initially reported, particularly in patients with micrometastases. False positive results occur, although they may be reduced after experience with the technique. We recommend that suspicious findings on touch prep should be confirmed by frozen section and that ALND only be performed for histologically documented metastases. We currently perform touch prep only in patients who are at high risk of nodal metastasis or will undergo mastectomy. This improves operative efficiency and limits the impact of false positive and negative results without dramatically increasing the number of patients who require a second surgical procedure.

scholarly journals Analysis of the causes of false negative and false positive results of preoperative axillary ultrasound in patients with early breast cancer – a single-centre study

2018 ◽  
Vol 22 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Tomasz Nowikiewicz ◽  
Adam Nowak ◽  
Magdalena Wiśniewska ◽  
Michał Wiśniewski ◽  
Magdalena Nowikiewicz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
False Positive ◽  
False Negative ◽  
Axillary Ultrasound ◽  
Single Centre ◽  
Centre Study ◽  
Single Centre Study ◽  
Positive Results

Clinical Value of Imaging Using Antibody to Alpha Fetoprotein in Germ Cell Tumours

1989 ◽  
Vol 28 (01) ◽  
pp. 29-33 ◽  
Author(s):  
R. N. Hitchins ◽  
A. J. Green ◽  
F. Searle ◽  
V. van Heyningen ◽  
K. D. Bagshawe ◽  
...  
Keyword(s):  
Germ Cell ◽  
False Positive ◽  
False Negative ◽  
Alpha Fetoprotein ◽  
Conventional Imaging ◽  
Drug Resistant ◽  
Germ Cell Tumours ◽  
True Negative ◽  
Imaging Methods ◽  
Positive Results

Germ cell tumours (GCT) producing alpha fetoprotein (aFP) can be imaged by external scintigraphy after intravenous administration of radiolabelled antibody directed against aFP. Antibody imaging (AI) by this method was used in an attempt to guide surgical resection of deposits of drug-resistant or recurrent GCT. 30 patients with GCT and raised aFP in whom site of tumour was not known were investigated by AI and conventional imaging methods. All but one were heavily pretreated. Where tumour appeared localised, resection was attempted. Tumour was found in all sites positive by both AI and conventional imaging. AI produced false-positive results in one of 30 patients and falsenegative results in 9 patients. Computerised tomography was false-positive in one case and false-negative in three. In these patients, AI gave true-negative and true-positive results, respectively. Of 11 patients with positive AI in whom resection was attempted, 6 achieved sustained complete response with up to 5 years follow-up. We conclude AI and conventional imaging methods to be complementary in selection for surgery of patients with drug-resistant or recurrent GCT.

Tc-99m-Tetrofosmin Scintimammography: A Prospective Study in Primary Breast Lesions

1996 ◽  
Vol 35 (06) ◽  
pp. 225-229 ◽  
Author(s):  
H.-J. Gallowitsch ◽  
D. Kogler ◽  
E. Kresnik ◽  
P. Mikosch ◽  
I. Gomez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prospective Study ◽  
False Positive ◽  
Ductal Carcinoma ◽  
False Negative ◽  
Breast Cancer Diagnosis ◽  
High Rate ◽  
Histological Evaluation ◽  
Breast Lesions ◽  
Positive Results

SummaryDespite low specificity routine mammography is the method of choice to screen women for breast cancer. In addition high frequency ultrasonography (US) or magnetic resonance imaging (MRI) can improve breast cancer diagnosis. However there is a lack of conventional imaging to improve the high rate of false positive results that make biopsy or surgery necessary. Aim: The purpose of our study was to evaluate prospectively the sensitivity, specificity, PPV and NPV of scintimammography with a new cationic complex Tc-99m-tetrofosmin. Methods: Fourtyeight patients in whom mammography and/or high resolution ultrasonography (10MHz) revealed suspicious breast lesions were studied with Tc-99m-tetrofosmin scintimammography. In thirtyfour of them biopsy and/or surgery was performed for histological evaluation. After intravenous injection of 555 MBq Tc-99m-tetrofosmin dynamic images over three minutes (1 frame/10 sec.) planar images in anterior and lateral projections (5 min. p.i.) and SPECT imaging including 3-D-reconstruction (20 min. p.i.) were performed. Scintimammography was evaluated as negative, equivocal (+), probably (++) or definitely (+++) positive. Results: Scintimammography with Tc-99m-tetrofosmin was negative in 18 patients (17 t.n.; 1 f.n.) and positive in 16 patients (10 t.p., 6 f.p.). The false negative scintimammography was observed in a patient with infiltrating ductal carcinoma pT1, the false positive result in a patient with fibrocystic disease; all of the five fibroadenomas were also “false” positive. Sensitivity of Tc-99m-tetrofosmin scintimammography in this prospective study was 91 %, specificity 74%, PPV 63% and NPV 94%. Scintimammographic results in patients with suspicious breast lesion show, that Tc-99m-tetrofosmin accumulates in breast cancer as well as in fibroadenoma. However the high NPV of 94 % excludes breast cancer in suspicious mammographie lesions in a very high degree and therefore reduces the need of biopsy and/or surgery in most of these patients. Conclusion: Our first results show that scintimammography with Tc-99m-tetrofosmin might play a role as further diagnostic step before surgery for women in whom mammography and/or ultrasonography show suspicious lesions.

Reliability of Human Epidermal Growth Factor Receptor 2 Immunohistochemistry in Breast Core Needle Biopsies

2010 ◽  
Vol 28 (20) ◽  
pp. 3264-3270 ◽  
Author(s):  
Annette Lebeau ◽  
Andreas Turzynski ◽  
Susanne Braun ◽  
Wera Behrhof ◽  
Barbara Fleige ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Drug Administration ◽  
False Positive ◽  
Food And Drug Administration ◽  
False Negative ◽  
Growth Factor Receptor ◽  
Her2 Status ◽  
Core Needle ◽  
Epidermal Growth ◽  
Positive Results

Purpose Core needle biopsies (CNBs) are widely used to determine human epidermal growth factor receptor 2 (HER2) status in breast cancer. Recent publications reported up to 20% false-positive results on CNBs if immunohistochemistry (IHC) is compared with fluorescent in situ hybridization (FISH). To clarify, if confirmation of IHC positivity by FISH is generally required, we analyzed the reliability of IHC positivity on CNBs versus surgical specimens in a multi-institutional study. Patients and Methods Five pathologic laboratories contributed to this study by performing IHC on 500 CNBs and the corresponding surgical specimens overall. If IHC revealed score 2+ or 3+, HER2 status was confirmed by FISH in a central laboratory. We compared evaluation according to US Food and Drug Administration–approved scoring criteria and recently published American Society of Clinical Oncology (ASCO)–College of American Pathologists (CAP) guidelines. Results CNBs scored 3+ revealed five false-positive results if scoring followed the US Food and Drug Administration criteria (five of 40; 12.5%) and two false-positives in terms of the ASCO-CAP criteria (two of 33; 6.1%). IHC was false negative in one CNB only. By contrast, IHC on surgical specimens revealed five false-negative results, but only one false-positive result (one of 35; 2.9%) if scored following US Food and Drug Administration–approved criteria. With the aid of the ASCO-CAP criteria, false-positive IHC results were obtained in only one of the five participating institutions. Conclusion IHC 3+ scores on CNBs proved to be reliable in four of the five participating institutions if scoring followed the ASCO-CAP criteria. Therefore, accurate determination of HER2 status in breast cancer is possible on CNB using the common strategy to screen all cases by IHC and retest only 2+ scores by FISH. Prerequisites are quality assurance and the application of the new ASCO-CAP criteria.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

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