Analysis of the Diagnostic Efficacy of Breast Imaging Studies in Pathologically Confirmed Cases: Comparison of T-scan with Mammography and Ultrasonography

Objective: To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification. Methods: A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3–5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard. Results: The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities (p > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively (p < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively (p < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities (p > 0.05). Conclusion: The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification. Advances in knowledge: •CEUS is a better method in differentiation of breast lesions with calcification. •CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.

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Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

10.21203/rs.3.rs-36646/v3 ◽

2020 ◽

Author(s):

Yan Shen ◽

Jie He ◽

Miao Liu ◽

Jiaojiao Hu ◽

Yonglin Wan ◽

...

Keyword(s):

Shear Wave ◽

Breast Imaging ◽

Imaging Techniques ◽

Shear Wave Elastography ◽

Roc Curves ◽

Imaging Data ◽

Diagnostic Efficacy ◽

Predictive Values ◽

Small Breast ◽

Contrast Enhanced

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with the Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This retrospective study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: We reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. The BI-RADS classification values of the nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison of the pathology results. Receiver operating characteristic (ROC) curves were analyzed based on the CEUS patterns and shear-wave velocity values of the nodules. The sensitivity, specificity, positive and negative predictive values, accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign and malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. ROC analysis revealed that the best cut-off value for SWE was at 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both, CEUS and SWE were used, and remained unchanged when either one, CEUS or SWE was used; the highest and lowest levels were of category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusions: CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of the breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.Trial registration: Retrospectively registered.

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Reduction Mammoplasty

10.1093/med/9780190270261.003.0061 ◽

2018 ◽

Author(s):

Laura J. Horvath

Keyword(s):

Breast Imaging ◽

Reduction Mammoplasty ◽

Screening Mammography ◽

Breast Size ◽

Fat Necrosis ◽

Imaging Studies ◽

Breast Parenchyma ◽

Imaging Protocols ◽

History Of ◽

Management Recommendations

Reduction mammoplasty is a surgical procedure performed to decrease breast size. Breast parenchyma and skin are resected, and the nipple is repositioned to a more superior location on the smaller breast mound. The goals of the procedure are to alleviate a variety of physical and psychological complaints. Because women with a history of reduction surgery are commonly seen for screening mammography and other breast imaging studies, it is important to be aware of the normal post-operative appearance. This chapter, appearing in the section on intervention and surgical change, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for reduction mammoplasty. Topics discussed include clinical indications, surgical technique, and benign post-operative changes, including scars, oil cysts, fat necrosis, and calcifications.

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Diagnostic value of various vascular features of breast cancer by age

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211258 ◽

2021 ◽

pp. 1-9

Author(s):

Jia Lin ◽

Wenqiang Lin ◽

Liang Xu ◽

Teng Lin

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Critical Role ◽

Added Value ◽

Breast Lesions ◽

Diagnostic Efficiency ◽

Complex Flow ◽

Diagnostic Efficacy ◽

Breast Masses ◽

Malignant Breast

BACKGROUND: Tumor angiogenesis plays a critical role in the growth and metastasis of breast cancer and evaluating the added value of vascular features to Breast Imaging Reporting and Data System (BI-RADS) in differentiating malignant nodules from benign ones is essential. Micro-flow Imaging (MFI) is a promising noninvasive diagnostic method for the microvessels in breast tumors, but its precise value is still uncertain. OBJECTIVES: Understanding whether malignant tumor vascular characteristics by MFI are associated with breast cancer and whether the diagnostic efficiency varies by age. MATERIALS AND METHODS: We used B-mode Ultrasound and MFI to detect the characteristics of 153 solid breast lesions. Two investigators reviewed the vessels images by MFI and assessed the vascular features, respectively. Evaluating diagnostic efficacy of different vascular features combined with BI-RADS in different age groups. RESULTS: The mean size of lesions is 19.4 (range 18–78) mm. There were 94 breast masses in benign, while 59 breast masses in malignant by pathology. III Adler classification, penetrating vessels, and complex flow pattern showed a positive association with a high risk of malignant breast lesions (p < 0.05). BI-RADS combined with vessel characteristics show better improvement of diagnostic performance of breast lesions in the elderly group than in the young group. CONCLUSIONS: Vascular features by MFI contribute to malignant breast masses’ diagnosis, and the association might be modified by age.

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