Diagnostic Breast Imaging and Breast Cancer Staging

2019 ◽  
Author(s):  
Nidhi Sharma
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Breast Imaging ◽  
Breast Mri ◽  
Cancer Staging ◽  
The United States ◽  
Patient Treatment ◽  
Architectural Distortion ◽  
Diagnostic Modality ◽  
Cancer Breast

This review is geared to provide surgeons practical insight on breast imaging, intended to improve breast cancer detection and staging. Breast cancer is a leading cause of death in women in the United States. The American Joint Committee on Cancer staging system provides a tumor-node-metastasis classification that helps in determining prognosis and patient treatment. There is an increasing role of radiologists in ascertaining the correct cancer stage. Screening mammography is the basic tool and most widely used modality to detect breast cancer. The diagnostic work-up of a patient recalled from screening is the next step in assessing the artifacts and benign findings from more suspicious lesions. Additional mammographic views, tomosynthesis, and ultrasonography play an important role in determining if the finding represents a true lesion and if so, to localize and determine its level of suspicion to be cancer. Breast MRI is used both as a screening tool and a diagnostic modality to help in cancer detection and treatment planning. Recognizing patterns of benign masses, malignant calcifications, architectural distortion, and masses via a multimodality approach is the essential first step in further diagnosis. A quick overview of common interventional breast procedures may serve as a practical reference for the readers. This review contains 10 figures, 8 tables, and 39 references. Key Words: breast cancer, breast MRI, breast ultrasonography, fibroadenoma, invasive ductal staging, male breast, mammograms, postoperative breast, screening

Diagnostic Breast Imaging and Breast Cancer Staging

2019 ◽  
Author(s):  
Nidhi Sharma
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Breast Imaging ◽  
Breast Mri ◽  
Cancer Staging ◽  
The United States ◽  
Patient Treatment ◽  
Architectural Distortion ◽  
Diagnostic Modality ◽  
Cancer Breast

This review is geared to provide surgeons practical insight on breast imaging, intended to improve breast cancer detection and staging. Breast cancer is a leading cause of death in women in the United States. The American Joint Committee on Cancer staging system provides a tumor-node-metastasis classification that helps in determining prognosis and patient treatment. There is an increasing role of radiologists in ascertaining the correct cancer stage. Screening mammography is the basic tool and most widely used modality to detect breast cancer. The diagnostic work-up of a patient recalled from screening is the next step in assessing the artifacts and benign findings from more suspicious lesions. Additional mammographic views, tomosynthesis, and ultrasonography play an important role in determining if the finding represents a true lesion and if so, to localize and determine its level of suspicion to be cancer. Breast MRI is used both as a screening tool and a diagnostic modality to help in cancer detection and treatment planning. Recognizing patterns of benign masses, malignant calcifications, architectural distortion, and masses via a multimodality approach is the essential first step in further diagnosis. A quick overview of common interventional breast procedures may serve as a practical reference for the readers. This review contains 10 figures, 8 tables, and 39 references. Key Words: breast cancer, breast MRI, breast ultrasonography, fibroadenoma, invasive ductal staging, male breast, mammograms, postoperative breast, screening

Molecular Breast Imaging: A Scientific Review

2021 ◽  
Author(s):  
Katie N Hunt
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Breast Mri ◽  
Cancer Staging ◽  
Scientific Review ◽  
Molecular Breast Imaging ◽  
Breast Cancer Staging ◽  
Fast Learning ◽  
Technical Advances ◽  
History Of

Abstract Molecular breast imaging (MBI) is a nuclear medicine technique that has evolved considerably over the past two decades. Technical advances have allowed reductions in administered doses to the point that they are now acceptable for screening. The most common radiotracer used in MBI, 99mTc-sestamibi, has a long history of safe use. Biopsy capability has become available in recent years, with early clinical experience demonstrating technically successful biopsies of MBI-detected lesions. MBI has been shown to be an effective supplemental screening tool in women with dense breasts and is also utilized for breast cancer staging, assessment of response to neoadjuvant chemotherapy, problem solving, and as an alternative to breast MRI in women who have a contraindication to MRI. The degree of background parenchymal uptake on MBI shows promise as a tool for breast cancer risk stratification. Radiologist interpretation is guided by a validated MBI lexicon that mirrors the BI-RADS lexicon. With short interpretation times, a fast learning curve for radiologists, and a substantially lower cost than breast MRI, MBI provides many benefits in the practices in which it is utilized. This review will discuss the current state of MBI technology, clinical applications of MBI, MBI interpretation, radiation dose associated with MBI, and the future of MBI.

Does insurance mix impact utilization of published care practices and guidelines among breast imaging sites?

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 150-150
Author(s):  
Anne Marie Murphy ◽  
Christine B. Weldon ◽  
Julia Rachel Trosman ◽  
Julian C. Schink ◽  
David Ansell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Breast Imaging ◽  
Response Rate ◽  
Private Insurance ◽  
Breast Mri ◽  
Test Results ◽  
Exact Test ◽  
Diagnostic Practices ◽  
Care Practices

150 Background: Significant variation exists across Metropolitan Chicago in the quality and timeliness measures for breast cancer detection (Rauscher GH 2014). We examined utilization of published care practices and guidelines at breast imaging sites in Chicago and compared them based on insurance mix. Methods: We conducted an IRB approved web survey of all 58 breast imaging sites in Chicago. Using guidelines (NCCN, NAPBC, ACR) and peer-reviewed literature (38 studies) we developed a survey of breast diagnostic practices. Results analyzed using simple frequencies and Fisher's exact test. Results: We achieved a response rate of 91% (53/58 sites): 27 sites with over 40% privately insured (PI) patients and 26 sites with over 60% Medicare, Medicaid, charity and self pay (MM) patients (IDPH 2012). Utilization of practices vary (Table). The use of breast MRI for diagnostic patients is 81% (17/21) of PI vs. 47% (8/17) of MM sites, p=0.04. Image guided biopsy is used by 81% (17/21) of PI vs. 25% (3/12) of MM sites, p=0.03. Clip placement at biopsy is done at 86% (18/21) of PI vs. 50% (6/12) of MM sites, p=0.04. Conclusions: Sites with higher rates of private insurance show better utilization of three published breast cancer diagnostic care practices. However, improvement is needed across sites, regardless of insurance mix, to provide care to all patients that is up-to-date on published breast cancer screening and diagnostic practices. [Table: see text]

Increased Use of MRI for Breast Cancer Surveillance and Staging is Not Associated with Increased Rate of Mastectomy

2009 ◽  
Vol 75 (10) ◽  
pp. 937-940
Author(s):  
Catherine M. Dang ◽  
Karen Zaghiyan ◽  
Scott R. Karlan ◽  
Edward H. Phillips
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Early Stage ◽  
Preoperative Staging ◽  
Breast Mri ◽  
Cancer Staging ◽  
Breast Conserving Surgery ◽  
Cancer Surveillance ◽  
Breast Cancer Staging ◽  
Time Period

The use of MRI in preoperative staging of breast cancer has escalated recently. Breast MRI has greater sensitivity than mammography, ultrasound, and clinical examination in cancer detection. Because of its variable specificity, however, there has been concern that increased MRI use will result in increased rates of mastectomy for early-stage breast cancer. We postulated that mastectomy rates are not affected by trends in MRI use. We performed a retrospective analysis of imaging tests ordered by surgeons at our breast center from 2003 to 2007. We also reviewed all breast cancer cases reported to the National Cancer Database from our institution during the same time period and categorized them as having been treated with mastectomy or breast-conserving surgery. From 2003 to 2007, the number of breast MRIs ordered annually by surgeons increased from 68 to 358. The rate of MRI use increased from 4.1 per every 100 patients seen to 5.7 and from 1.6 per every 100 new patients seen to 2.9. The percentage of women undergoing mastectomy for breast cancer remained unchanged during this 5-year interval. Therefore, although MRI use in breast cancer staging and surveillance has increased, mastectomy rates have not.

Imaging Approaches and Findings in the Reconstructed Breast: A Pictorial Essay

2011 ◽  
Vol 62 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Anabel M. Scaranelo ◽  
Bridgette Lord ◽  
Riham Eiada ◽  
Stefan O. Hofer
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Detection ◽  
Reconstructive Surgery ◽  
Genetic Screening ◽  
Breast Imaging ◽  
Breast Cancer Detection ◽  
Imaging Findings ◽  
Pictorial Essay ◽  
Reconstructed Breast

Advances in breast imaging over the last 15 years have improved early breast cancer detection and management. After treatment for breast cancer, many women choose to have reconstructive surgery. In addition, with the availability of widespread genetic screening for breast cancer, an increasing number of women are choosing prophylactic mastectomies and subsequent breast reconstruction. The purpose of this pictorial essay is to present the spectrum of imaging findings in the reconstructed breast.

scholarly journals Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.

2021 ◽  
Author(s):  
Wen-Pei Wu ◽  
Chih-Yu Chen ◽  
Chih-Wei Lee ◽  
Hwa-Koon Wu ◽  
Shou-Tung Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Contralateral Breast Cancer ◽  
Breast Mri ◽  
Contralateral Breast ◽  
Conventional Imaging ◽  
Metachronous Breast Cancer ◽  
Group B ◽  
Synchronous Breast Cancer

Abstract Background: Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods: In this case control analysis, we retrospectively collected two groups of patients for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results: Group A (n=733) comprised patients who underwent conventional preoperative imaging and group B (n=735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P=0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p=0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions: Combining pre-operative breast MRI evaluation resulted in an increase of contralateral synchronous breast cancer detection, and a numerical less subsequent contralateral metachronous breast cancer occurrence compared to conventional imaging alone.

Automatic detection of various patterns of calcification distribution on mammograms: a graph convolution network approach (Preprint)

2021 ◽  
Author(s):  
Melissa Min-Szu Yao ◽  
Hao Du ◽  
Mikael Hartman ◽  
Wing P. Chan ◽  
Mengling Feng
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Automatic Detection ◽  
Ground Truth ◽  
Architectural Distortion ◽  
Breast Cancers ◽  
Convolutional Network ◽  
Mammographic Images

UNSTRUCTURED Purpose: To develop a novel artificial intelligence (AI) model algorithm focusing on automatic detection and classification of various patterns of calcification distribution in mammographic images using a unique graph convolution approach. Materials and methods: Images from 200 patients classified as Category 4 or 5 according to the American College of Radiology Breast Imaging Reporting and Database System, which showed calcifications according to the mammographic reports and diagnosed breast cancers. The calcification distributions were classified as either diffuse, segmental, regional, grouped, or linear. Excluded were mammograms with (1) breast cancer as a single or combined characterization such as a mass, asymmetry, or architectural distortion with or without calcifications; (2) hidden calcifications that were difficult to mark; or (3) incomplete medical records. Results: A graph convolutional network-based model was developed. 401 mammographic images from 200 cases of breast cancer were divided based on calcification distribution pattern: diffuse (n = 24), regional (n = 111), group (n = 201), linear (n = 8) or segmental (n = 57). The classification performances were measured using metrics including precision, recall, F1 score, accuracy and multi-class area under receiver operating characteristic curve. The proposed achieved precision of 0.483 ± 0.015, sensitivity of 0.606 (0.030), specificity of 0.862 ± 0.018, F1 score of 0.527 ± 0.035, accuracy of 60.642% ± 3.040% and area under the curve of 0.754 ± 0.019, finding method to be superior compared to all baseline models. The predicted linear and diffuse classifications were highly similar to the ground truth, and the predicted grouped and regional classifications were also superior compared to baseline models. Conclusion: The proposed deep neural network framework is an AI solution to automatically detect and classify calcification distribution patterns on mammographic images highly suspected of showing breast cancers. Further study of the AI model in an actual clinical setting and additional data collection will improve its performance.

scholarly journals Methods Used in Computer-Aided Diagnosis for Breast Cancer Detection Using Mammograms: A Review

2020 ◽  
Vol 2020 ◽  
pp. 1-21 ◽  
Author(s):  
Saleem Z. Ramadan
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
The United States ◽  
Computer Aided Diagnosis ◽  
Current Level ◽  
Breast Cancer Detection ◽  
Cad Systems ◽  
Computer Aided ◽  
Detection And Diagnosis ◽  
Aided Diagnosis

According to the American Cancer Society’s forecasts for 2019, there will be about 268,600 new cases in the United States with invasive breast cancer in women, about 62,930 new noninvasive cases, and about 41,760 death cases from breast cancer. As a result, there is a high demand for breast imaging specialists as indicated in a recent report for the Institute of Medicine and National Research Council. One way to meet this demand is through developing Computer-Aided Diagnosis (CAD) systems for breast cancer detection and diagnosis using mammograms. This study aims to review recent advancements and developments in CAD systems for breast cancer detection and diagnosis using mammograms and to give an overview of the methods used in its steps starting from preprocessing and enhancement step and ending in classification step. The current level of performance for the CAD systems is encouraging but not enough to make CAD systems standalone detection and diagnose clinical systems. Unless the performance of CAD systems enhanced dramatically from its current level by enhancing the existing methods, exploiting new promising methods in pattern recognition like data augmentation in deep learning and exploiting the advances in computational power of computers, CAD systems will continue to be a second opinion clinical procedure.

scholarly journals Breast Imaging During Pregnancy and Lactation

2019 ◽  
Vol 1 (4) ◽  
pp. 342-351
Author(s):  
Lisa Abramson ◽  
Lindsey Massaro ◽  
J Jaime Alberty-Oller ◽  
Amy Melsaether
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Treatment Options ◽  
Nipple Discharge ◽  
Cancer Staging ◽  
Imaging Features ◽  
Breast Cancers ◽  
Bloody Nipple Discharge ◽  
Breast Cancer Staging ◽  
Pregnancy And Lactation

Abstract Breast imaging during pregnancy and lactation is important in order to avoid delays in the diagnosis and treatment of pregnancy-associated breast cancers. Radiologists have an opportunity to improve breast cancer detection by becoming familiar with appropriate breast imaging and providing recommendations to women and their referring physicians. Importantly, during pregnancy and lactation, both screening and diagnostic breast imaging can be safely performed. Here we describe when and how to screen, how to work up palpable masses, and evaluate bloody nipple discharge. The imaging features of common findings in the breasts of pregnant and lactating women are also reviewed. Finally, we address breast cancer staging and provide a brief primer on treatment options for pregnancy-associated breast cancers.

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