scholarly journals Mammography in detection clinically occult breast carcinoma

2007 ◽  
Vol 54 (3) ◽  
pp. 27-32
Author(s):  
I.V. Golubicic ◽  
T.M. Pavlovic ◽  
N. Borojevic ◽  
R. Dodic ◽  
N. Miletic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Mammography Screening ◽  
Statistical Significance ◽  
Screening Mammography ◽  
Legal Obligation ◽  
Nonpalpable Breast Cancer ◽  
Occult Breast Carcinoma ◽  
Adequate Surgery ◽  
Asymptomatic Women

Aim: The significance of mammography in detection of nonpalpable breast cancer Material and methods: This prospective study was conducted at the Institute for oncology and radiology of Serbia in Belgrade. It involved 198 asymptomatic women with performed screening mammography, 154 specimen mammography, out of witch 38 had stereotaxic mark, "ex tempore" biopsy, while 44 women had "ex tempore" biopsy and adequate surgery. Results: Screening mammography revealed suspect microcalcifications in 148 cases, impaired structural tissue in 59 and focal condensation in 55 cases. Histologic examination verified breast carcinoma in 80 patients with very statistical significance of ductal type, especially comedo subvariant (p<0.001). Pleomorphic microcalcifications smaller than 0.5 mm of grouped or segmented form are statistically very significant for malignity (p<0,001) as well as associated microcalcifications with altered architectony and focal tissue condensation (p<0.001). Conclusion: Mammography has great significance in detection of occult breast carcinoma which are not only preinvasive, but also microinvasive and invasive. This fact leads to the neccesity of introduction of legal obligation for mammography screening, especially for women aged between 50 and 70 years.

scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

Mammographic Screening at Age 40 or 45? What Difference Does it Make? the Potential Impact of American Cancer Society Mammography Screening Guidelines

2017 ◽  
Vol 83 (8) ◽  
pp. 847-849
Author(s):  
Crystal E. Fancher ◽  
Anthony Scott ◽  
Ahkeel Allen ◽  
Paul Dale
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Disease Free Survival ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Cancer Society ◽  
Free Survival ◽  
Screening Guidelines ◽  
Potential Impact ◽  
Disease Free

This is a 10-year retrospective chart review evaluating the potential impact of the most recent American Cancer Society mammography screening guidelines which excludes female patients aged 40 to 44 years from routine annual screening mammography. Instead they recommend screening mammography starting at age 45 with the option to begin screening earlier if the patient desires. The institutional cancer registry was systematically searched to identify all women aged 40 to 44 years treated for breast cancer over a 10-year period. These women were separated into two cohorts: screening mammography detected cancer (SMDC) and nonscreening mammography detected cancer (NSMDC). Statistical analysis of the cohorts was performed for lymph node status (SLN), five-year disease-free survival, and five-year overall survival. Women with SMDC had a significantly lower incidence of SLN positive cancer than the NSMDC group, 9 of 63 (14.3%) versus 36 of 81 (44 %; P < 0.001). The five-year disease-free survival for both groups was 84 per cent for SMDC and 80 per cent for NSMDC; this was not statistically significant. The five-year overall survival was statistically significant at 94 per cent for the SMDC group and 80 per cent for the NSMDC group (P < 0.05). This review demonstrates the significance of mammographic screening for early detection and treatment of breast cancer. Mammographic screening in women aged 40 to 44 detected tumors with fewer nodal metastases, resulting in improved survival and reaffirming the need for annual mammographic screening in this age group.

scholarly journals Breast cancer mortality and screening mammography in New Zealand: Incidence-based and aggregate analyses

2018 ◽  
Vol 26 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Richard Taylor ◽  
Marli Gregory ◽  
Kerry Sexton ◽  
Jessica Wharton ◽  
Nisha Sharma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Breast Cancer Mortality ◽  
Primary Treatment ◽  
Screening Mammography ◽  
Randomized Controlled ◽  
Before And After ◽  
Incident Cases

Objective To investigate trends in breast cancer mortality in New Zealand women, to corroborate or negate a causal association with service screening mammography. Method Cumulated mortality rates from breast cancer deaths individually linked to incident cases diagnosed before and after screening commencement were compared, in women aged 50–64 (from 2001) and aged 45–49 and 65–69 (from 2006). Trends and differences in aggregate invasive breast cancer mortality (1975–2013) were assessed in relation to introduction of mammography screening targeting women aged 50–64 and 45–69. Joinpoint analysis was also undertaken. Results The reduction in incidence-based cumulated breast cancer mortality before and after the introduction of screening was −15% (p = 0.006) for women aged 45–69, and 17% (p = 0.005) for those aged 50–64. Aggregate mortality declined by −34% (2005–13 compared with 1992–98) in the age group 50–64, and by –28% among women aged 45–49 and –25% among women aged 65–74. For women aged 50–64 the 2-joinpoint model shows a 1990 turning point, from prior rising mortality to a mean −1.8% decline per annum, coinciding with improvements in primary treatment of breast cancer; and a steepening of the decline (−3.0% p.a.) from the late 1990s, coinciding with the introduction of service mammography screening. Conclusion Breast cancer mortality declines occurring since the advent of screening mammography in New Zealand are consistent with other incidence-based and aggregate studies of screening mammography in populations, individual-based cohort studies, and randomized controlled trials.

Early Detection of Ductal Breast Cancer: The Diagnostic Procedure for Grouped Microcalcifications

1979 ◽  
Vol 65 (5) ◽  
pp. 547-553 ◽  
Author(s):  
Günther Kindermann ◽  
Wulf Rummel ◽  
Jürgen Bischoff ◽  
Eberhard Paterok ◽  
Julius Weishaar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Diagnostic Procedure ◽  
Diagnostic Methods ◽  
Cystic Disease ◽  
Ductal Breast Cancer ◽  
Radiological Control ◽  
Occult Breast Carcinoma ◽  
Calcific Deposits

Mammography and xeroradiography for grouped microcalcifications are considered the most effective diagnostic methods to detect occult breast carcinoma. Radiography must direct the surgeon to excise the nonpalpable area. The removal of the tissue with grouped microcalcifications must be confirmed by intraoperative radiological control. The histologic preparation must be guided by radiographic controls. Tissue with calcific deposits is examined by step sections. The diagnostic success depends upon the cooperation between the radiologist, the surgeon, and the pathologist. Our results from 1964 to 1977 have shown a frequency of 14.4 % of occult carcinoma. Ductal or lobular carcinomata in situ have been diagnosed in 8.9%. In 9.9% of the patients, cystic disease with severe and atypical proliferations has been encountered.

Effect of Screening Mammography on Breast Cancer Detection and Mortality

2021 ◽  
pp. 164-169
Author(s):  
Myrlene Jeudy ◽  
Monique Swain ◽  
Mark Pearlman
Keyword(s):  
Breast Cancer ◽  
New England ◽  
Late Stage ◽  
Mammography Screening ◽  
Early Stage ◽  
Breast Cancer Incidence ◽  
The United States ◽  
Population Based ◽  
Screening Mammography ◽  
Trend Data

This widely discussed study by Bleyer and Welch published in The New England Journal of Medicine (NEJM) “The Effects of Three Decades of Screening Mammography on Breast Cancer Incidence” concluded that screening mammography leads to a substantial overdiagnosis of early breast cancer (estimated 69% increase) while only having a small effect on late-stage breast cancer (estimated 8% decrease). In a population-based observational study, the authors utilized trend data from the Surveillance, Epidemiology and End Results (SEER) database to examine trends on the incidence and stage of early- versus late-stage breast cancer at the time of diagnosis. They compared 2 time frames: prior to widespread mammography screening (1976–1978) and after mammography screening was introduced in the United States (2006––2008). This article reviews this NEJM article and describes several methodological assumptions by the authors that have been soundly criticized and the associated limitations. As a result of these limitations, there was an exaggeration of the overdiagnosis of early-stage disease with mammography and, more importantly, a substantial underestimate of the impact of mammography on decreasing late-stage breast cancer.

scholarly journals Mammography in asymptomatic women aged 40-49 years

2014 ◽  
Vol 48 (6) ◽  
pp. 931-939 ◽  
Author(s):  
Flávio Xavier Silva ◽  
Leila Katz ◽  
Alex Sandro Rolland Souza ◽  
Melania Maria Ramos Amorim
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Cross Sectional Study ◽  
Northeastern Brazil ◽  
Cross Sectional ◽  
Increased Risk ◽  
Grade Ii ◽  
Asymptomatic Women

OBJECTIVE To assess findings of mammography of and interventions resulting from breast cancer screening in women aged 40-49 years with no increased risk (typical risk) of breast cancer. METHODS This cross-sectional study evaluated women aged 40-49 years who underwent mammography screening in a mastology reference center in Recife, PE, Northeastern Brazil, between January 2010 and October 2011. Women with breast-related complaints, positive findings in the physical examination, or high risk of breast cancer were excluded. RESULTS The 1,000 mammograms performed were classified into the following Breast Imaging-Reporting and Data System (BI-RADS) categories BI-RADS 0, 232; BI-RADS 1, 294; BI-RADS 2, 294; BI-RADS 3, 16; BI-RADS 4A, 2; BI-RADS 5, 1. There was one case of grade II invasive ductal carcinoma and various interventions, including 469 ultrasound scans, 53 referrals to mastologists, 11 cytological examinations, and 8 biopsies. CONCLUSIONS Mammography screening in women aged 40-49 years with typical risk of breast cancer led to the performance of other interventions. However, it also resulted in increased costs without demonstrable efficacy in decreasing mortality.

scholarly journals Do we still need breast cancer screening in the era of targeted therapies and precision medicine?

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Rubina Manuela Trimboli ◽  
Paolo Giorgi Rossi ◽  
Nicolò Matteo Luca Battisti ◽  
Andrea Cozzi ◽  
Veronica Magni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Precision Medicine ◽  
Mammography Screening ◽  
Early Stage ◽  
Growth Factor Receptor ◽  
Relative Survival ◽  
Screening Mammography ◽  
Curative Intent ◽  
Novel Treatments ◽  
Systemic Treatments

Abstract Breast cancer (BC) is the most common female cancer and the second cause of death among women worldwide. The 5-year relative survival rate recently improved up to 90% due to increased population coverage and women’s attendance to organised mammography screening as well as to advances in therapies, especially systemic treatments. Screening attendance is associated with a mortality reduction of at least 30% and a 40% lower risk of advanced disease. The stage at diagnosis remains the strongest predictor of recurrences. Systemic treatments evolved dramatically over the last 20 years: aromatase inhibitors improved the treatment of early-stage luminal BC; targeted monoclonal antibodies changed the natural history of anti-human epidermal growth factor receptor 2-positive (HER2) disease; immunotherapy is currently investigated in patients with triple-negative BC; gene expression profiling is now used with the aim of personalising systemic treatments. In the era of precision medicine, it is a challenging task to define the relative contribution of early diagnosis by screening mammography and systemic treatments in determining BC survival. Estimated contributions before 2000 were 46% for screening and 54% for treatment advances and after 2000, 37% and 63%, respectively. A model showed that the 10-year recurrence rate would be 30% and 25% using respectively chemotherapy or novel treatments in the absence of screening, but would drop to 19% and 15% respectively if associated with mammography screening. Early detection per se has not a curative intent and systemic treatment has limited benefit on advanced stages. Both screening mammography and systemic therapies continue to positively contribute to BC prognosis.

CLASSIFICATION OF MAMMOGRAMS HAVING ARCHITECTURAL DISTORTION AND SPICULATED MASSES USING TEXTURE FEATURES

2021 ◽  
pp. 3-5
Author(s):  
D.B. Aghor ◽  
M.R. Banwaskar
Keyword(s):  
Breast Cancer ◽  
Texture Features ◽  
Screening Mammography ◽  
Support Vector ◽  
Architectural Distortion ◽  
Nonpalpable Breast Cancer ◽  
Current Systems ◽  
Aided Diagnosis ◽  
Mammogram Images

Architectural distortion is the third most common mammographic appearance of nonpalpable breast cancer, representing nearly 6% of abnormalities detected on screening mammography. Although its prevalence on mammography is small compared with calcication or visible mass, architectural distortion is also more difcult to diagnose because it can be subtle and variable in presentation. Early detection of breast cancer is possible by nding architectural distortion in monographic images. Spiculated masses account for about 14% of biopsied lesions and about 81% of these are malignant. Current CAD systems are dramatically better at detecting microcalcications than masses. The sensitivity is considerably lower for Spiculated Masses that are rated as "subtle" by radiologists Moreover, since current systems were devised with masses and calcications in mind, they don’t perform as well on other, less prevalent but still clinically signicant lesion types. In this paper, we propose a computer aided diagnosis system for distinguishing abnormal mammograms with architectural distortion or spiculated masses from normal mammograms. Five types of texture features GLCM, GLRLM, fractal texture, spectral texture and HOG features for the regions of suspicion are extracted. Support vector machine has been used as classier in this work. The proposed system yielded an overall accuracy of 97.29% for mammogram images collected from mini-MIAS database which is better as compared to existing methods.

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