APPLICATION OF ELASTOGRAPHY FOR DIAGNOSIS BREAST TUMORS

2018 ◽  
Vol 8 (6) ◽  
pp. 8-14
Author(s):  
Huong Tran Thi Song ◽  
Yen Vo Thi Kim ◽  
Quan Nguyen Phuoc Bao
Keyword(s):  
Breast Cancer ◽  
Malignant Tumors ◽  
Normal Breast ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Soft Or ◽  
The Past ◽  
2D Ultrasound ◽  
Malignant Lesions ◽  
A New Technique

Breast tumor is common in women. Benign tumors account for 80%, malignant tumors account for 20%. Breast cancer is the most common and deadly cancer among women, including Vietnam. Elastography, evaluates the stiffness of the tissue, helps to distinguish soft or hard tumors, which can help distinguish benign or malignant. Benign lesions tend to be softer than malignant lesions. There are two types of elastography: SE (Strain Elastography) and Shear Ware Elastography (SWE). In examining breast lesions, the maligne tumor tends to be stronger and the higher the velocity. Studies have shown that the SWE features should be combined with 2D ultrasound to complement the BIRADS classification. Elastography is a new technique that has emerged in the past few years, promising good diagnostic prospects, more and more research and application of elastography in diagnostics breast lesions. Breast elastogarphy, survey of hardness of breast cancer showed 4 times higher than that of benign tumor and 7 folds of normal breast tissue.

ARFI ELASTOGRAPHY IN THE DIAGNOSIS OF FOCAL BREAST LESIONS

2017 ◽  
pp. 23-29
Author(s):  
Thi Kim Yen Vo ◽  
Phuoc Bao Quan Nguyen ◽  
Thanh Thao Nguyen
Keyword(s):  
Malignant Tumors ◽  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Focal Lesions ◽  
Arfi Elastography ◽  
2D Ultrasound

Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions. Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone. Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884). Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones. Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging

scholarly journals Immunohistochemical Expression of p63 in Benign and Malignant Breast Lesions

2021 ◽  
Author(s):  
Abhishek Saini ◽  
Swaran Kaur Saluja ◽  
MK Garg ◽  
Deepti Agarwal ◽  
Amrita Kulhria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Myoepithelial Cells ◽  
Normal Breast ◽  
High Morbidity ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Medical College ◽  
Malignant Breast ◽  
Malignant Lesions

Introduction: Breast carcinoma demands attention as it causes high morbidity and mortality. It is important to recognise benign lesions to distinguish them from in situ and invasive breast cancer and to assess a patient’s risk of developing breast cancer, so that the most appropriate treatment modality for each case can be established. The p63 has been characterised as a reliable marker of myoepithelial cells of lactiferous duct. It is exclusively expressed in myoepithelial cells of normal breast tissue. Hence, p63 can be of great help in the differential diagnosis involving benign lesions. Also, p63 may aid in distinguishing benign from malignant lesions. Aim: To study the Immunohistochemistry (IHC) expression of p63 in benign and malignant breast lesions. Materials and Methods: The prospective study was conducted on 76 breast specimens for a period of one year, from 1st December 2018 to 30th November 2019 in the Department of Pathology, Bhagat Phool Singh, Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India. IHC assessment for p63 nuclear protein was performed. The intensity of p63 expression was evaluated as continuous positive, discontinuous positive and negative. The extent was scored on the basis of percentage of positive cells and assigned a score of negative (0%), 1 (<25%), 2 (26-90%) and 3 (91-100%). Results: Out of 76 cases, 38 cases were diagnosed as benign and 38 cases as malignant. IHC staining with p63 showed nuclear positivity in all benign lesions. Among malignant lesions, four were positive and 34 were negative. Conclusion: According to the above results, p63 is a very useful IHC marker in diagnosing difficult cases, cases of carcinoma in situ, borderline cases and cases with inconclusive histomorphological diagnosis.

scholarly journals Accuracy of mammography and sonomammography and its correlation with histopathology in the detection of breast cancer

2021 ◽  
Vol 8 (2) ◽  
pp. 624
Author(s):  
Soundarya Yamakanamardi ◽  
Bharati V. Hiremath
Keyword(s):  
Breast Cancer ◽  
Malignant Tumors ◽  
Young Patients ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Breast Lump ◽  
Palpable Breast ◽  
Detect Breast Cancer

Background: Mammography (MMG) plays a pivotal role in the early diagnosis of breast cancer (BC). However, it is sometimes difficult to use it to diagnose palpable breast lesions among young patients. Ultrasound can be used as an adjunct in differentiating cystic and solid masses. Studies evaluating the combination of MMG and sonomammography (SMG) as an adjunct to detect Breast cancer, are quite scarce in the literature. This study aimed to assess the accuracy of MMG and to comprehend the role of ultrasound as an adjunct to MMG for finding breast lesions.Methods: Women attending the outpatient department (OPD) with complaints of breast lump, or those undergoing MMG screening were included. All patients then subsequently underwent MMG, SMG and biopsy. MMG and SMG findings were then correlated with the histopathology results.Results: Irregular shape and calcifications (MMG) and hypoechoic pattern (SMG) were found to be significant features differentiating malignant from benign lesions. Calcifications in benign tumors were observed 5.05 times less frequently than in malignant tumors. MMG combined with SMG had a sensitivity of 90.4%, specificity of 82.4%, positive and negative predictive value of 95% and 67% respectively, along with an accuracy of 88.9% in differentiating benign from malignant masses.Conclusions: SMG used as an adjunct to MMG is a reliable modality, especially in detecting lesions that are not picked up on MMG, including intraductal papilloma and duct ectasia.

scholarly journals Role of quantitative analysis of T2 relaxation time in differentiating benign from malignant breast lesions

2018 ◽  
Vol 46 (5) ◽  
pp. 1928-1935 ◽  
Author(s):  
Li Liu ◽  
Bo Yin ◽  
Kawai Shek ◽  
Daoying Geng ◽  
Yiping Lu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Relaxation Time ◽  
Quantitative Analysis ◽  
Breast Lesions ◽  
T2 Relaxation Time ◽  
T2 Relaxation ◽  
Malignant Breast ◽  
Mri Diagnosis ◽  
Malignant Lesions

Objective To investigate the role of quantitative analysis of T2 relaxation time in the magnetic resonance imaging (MRI) diagnosis of breast cancer. Methods The study enrolled patients with clinical breast masses who were examined using MRI at eight different echo times. The differences in T2 relaxation time of benign and malignant breast lesions were analysed. Results A total of 67 patients (67 breast lesions: 46 malignant, 21 benign) were examined. The mean ± SD T2 relaxation time was significantly lower in the 46 malignant lesions compared with the 21 benign lesions (82.69 ± 15.37 ms versus 95.48 ± 26.51 ms, respectively). The area under the curve was 0.731. Using 79.52 ms as the cut-off between benign and malignant breast lesions, a sensitivity of 85.7% and a specificity of 58.7% were obtained. Conclusions There was a significant difference in T2 relaxation time between benign and malignant breast lesions. The specificity of using T2 relaxation time alone for the differentiation of benign from malignant lesions was not high, but it could constitute a new adjunct in the MRI diagnosis of breast cancer.

Radiomics- Quantitative Biomarker Analysis for Breast Cancer Diagnosis and Prediction: A Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Priscilla Dinkar Moyya ◽  
Mythili Asaithambi
Keyword(s):  
Breast Cancer ◽  
Molecular Subtypes ◽  
Breast Cancer Diagnosis ◽  
Benign Tumors ◽  
Genomic Information ◽  
Tumor Characterization ◽  
Breast Malignancy ◽  
The Past ◽  
Biomarker Analysis

Background: Cancer of the breast has become a global problem for women's health. Though concerns regarding early detection and accurate diagnosis were raised, an effort is required for precision medicine as well as personalized treatment. In the past years, the area of medicinal imaging has seen an unprecedented growth that leads to an advancement of radiomics, which provides countless quantitative biomarkers extracted from modern diagnostic images, including a detailed tumor characterization of breast malignancy. Discussion: In this research, we presented the methodology and implementation of radiomics, together with its future trends and challenges by the basis of published papers. Radiomics could distinguish between malignant from benign tumors, predict prognostic factors, molecular subtypes of breast carcinoma, treatment response to neoadjuvant chemotherapy (NAC), and recurrence survival. The incorporation of quantitative knowledge with clinical, histopathological and genomic information will enable physicians to afford customized care of treatment for patients with breast cancer. Conclusion: Our research was intended to help physicians and radiologists learn fundamental knowledge about radiomics and also to work collaboratively with researchers to explore evidence for further usage in clinical practice.

Diffusion-weighted imaging using ADC mapping as an imaging biomarker for breast cancer invasiveness.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 11093-11093
Author(s):  
Hubert Bickel ◽  
Wolfgang Bogner ◽  
Peter Christian Dubsky ◽  
Rupert Bartsch ◽  
Margaretha Rudas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diffusion Weighted Imaging ◽  
Malignant Tumors ◽  
Imaging Biomarker ◽  
Benign Tumors ◽  
Non Invasive ◽  
Diffusion Weighted ◽  
Cancer Invasiveness ◽  
Adc Values ◽  
Breast Cancer Invasiveness

11093 Background: Recently, functional imaging techniques such as diffusion weighted imaging (DWI) have been added to routine MR and have shown great potential for improving breast cancer diagnosis. DWI depicts cellular diffusivity on a molecular level and can be quantified using the apparent diffusion coefficient (ADC). In malignant tumors diffusivity is restricted, leading to lower ADC values than benign tumors. The aim of this study was to proof, that DWI can be used to differentiate benign from malignant tumors and to elucidate if ADC can serve as an imaging biomarker for breast cancer invasiveness. Methods: In this IRB-approved study 250 patients with 267 suspicious breast lesions (BI-RADS IV-V) were included. All patients underwent routine MR at 3T. A DWI-sequence was added to a standard imaging protocol, increasing measurement time by 2:30 min. The lesions were identified in routine MR and DWI sequences and ADC values of the lesions were calculated. Histopathology was used as the standard of reference for all lesions. Appropriate statistical tests were used to compare the ADC values of benign and malignant tumors (cut-off value 1.25×10-3mm²/s), of invasive and non-invasive disease and between different invasive tumor subtypes. Results: There were 91 benign (mean ADC 1.58×10-3mm²/s) and 176 malignant (.94×10-3mm²/s) lesions, sensitivity and specificity were 94.3% (PPV 95.4%, CI 0.91-0.98) and 91.2% (NPV 89.2%, CI 0.81-0.94). 155 lesions were invasive cancers (median ADC .90×10-3mm²/s), while 21 were non-invasive ductal carcinoma in situ (1.22×10-3mm²/s). The invasive cancers were 130 invasive ductal (median ADC .91×10-3mm²/s) and 25 invasive lobular cancers (.83×10-3mm²/s). ADC was significantly different between benign and malignant lesions (p<.001) and between invasive and non-invasive cancers (p<.001), while no significant difference could be found between the invasive cancer subtypes (p=.163). Conclusions: Diffusion-weighted imaging reliably allows differentiation of benign and malignant breast tumors. The data suggest that ADC can be used as a non-invasive imaging biomarker for breast cancer invasiveness and may be of importance to treatment planning and outcome in breast cancer patients.

scholarly journals Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions

2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Malignant Tumors ◽  
Blood Perfusion ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Time To Peak ◽  
Contrast Enhanced

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.

scholarly journals Contrast Enhanced Mammography: The added value in the assessment of Suspicious Breast Lesions

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R Abdullah ◽  
L Abdelmonem ◽  
N Nasry ◽  
M Ayoub
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Malignant Tumors ◽  
High Energy ◽  
Added Value ◽  
Breast Lesions ◽  
Predictive Values ◽  
Dense Breasts ◽  
Contrast Enhanced

Abstract Background Breast cancer in women is a major public health problem throughout the world, being the second most common cancer worldwide. Sonomammography has been always recommended as the basic breast imaging modality for early detection and diagnosis of breast cancer. Some malignant tumors have been missed, specially in dense breasts, and high false-negative rate have been reported. Contrast enhanced spectral mammography is a new modality, used to depict the tumor vascularity and neoangiogenesis; a classic sign of malignant tumors. Aim of Work The purpose of this study is to determine the added value of dual energy contrast mammography to sono-mammography in the assessment of suspicious breast lesions. Patients and Methods 36 patients were included in the study, referred from outpatient clinics in private settings and from Demerdash Hospitals. Contrast enhanced spectral mammography CESM was performed by using a digital mammography unit (Seno DS; GE, Buc, France) that had been adapted to obtain two images for each view: a low-energy image (below the k edge of iodine, 33.2 keV) and a high-energy image (above the k edge of iodine) at 45 to 49 kVp. Results: CEDM versus sonomammography shows p (0.021) value less than 0.05. Also the area under the ROC curve was higher for MX+CEDM (94.4%) than that was for sonomammography (63.8%) compared to pathology analysis with 100% sensitivity, 88.2 % specificity, 90.48 %PPV and 100 % NPV in diagnosis of suspicious lesions. Conclusion The diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma has proven to be superior to sonomammography alone. CEDM had a better diagnostic accuracy mainly due to improved positive and negative predictive values (Positive predictive value about 90.48, negative predictive value 100). The role of CEDM in detection of multifocal / multicentric carcinomas with particular interest for the assessment of the extent of disease specially in dense breasts is appreciated.

Significance of serum colony-stimulating factor-1 as a breast cancer marker

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11071-11071
Author(s):  
S. Aharinejad ◽  
A. Thomas ◽  
C. Singer ◽  
E. Kubista ◽  
P. Paulus ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Tumor Size ◽  
Malignant Disease ◽  
Operating Characteristic ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Colony Stimulating Factor ◽  
Cancer Marker ◽  
Stimulating Factor

11071 Background: A specific and sensitive biomarker that indicates the presence of breast cancer is highly desirable, yet available markers are of limited value. Colony-stimulating factor-1 (CSF-1) is involved in mammary gland development and mediates breast cancer progression. Earlier work indicated correlation of serum CSF-1 with breast cancer staging, and a recent report suggests that CSF-1 is a potential breast cancer marker, however the data reported so far await validation. Methods: In a prospective study in 799 women with no history of malignant disease undergoing surgery, serum CSF-1 levels were measured by a commercially available ELISA. In this cohort, 312 patients had breast cancer and 487 age-matched women had benign tumors. The tumor size, nodal and metastasis status, histological tumor type, hormone and human epidermal growth factor receptor 2 (HER2) and menopausal status were evaluated. Mean CSF-1 serum concentrations were compared between the patient groups by non-parametric Wilcoxon two-sample and Kruskal-Wallis test. The area under the receiver operating characteristic curve was calculated by logistic regression. Results: Mean serum CSF-1 concentrations were significantly higher in all patients with malignant tumors (502±429 pg/mL) as compared to those with benign tumors (382±344 pg/mL) (p<0.0001, Wilcoxon). Increased CSF-1 concentrations were significantly related to malignant versus non-malignant disease in logistic regression and receiver operating characteristic analysis (p<0.0001, AUC=0.6). Increased CSF-1 levels in patients with malignant tumors were associated with postmenopausal (p=0.0038) but not premenopausal (p=0.94) status (Wilcoxon). Serum CSF-1 concentrations did not correlate significantly with tumor size, nodal and metastasis status, hormone receptor and HER2 status of patients (Kruskal-Wallis). Conclusions: Our data suggest that serum CSF-1 could serve as a breast cancer marker in postmenopausal women. While its serum levels are not related to breast cancer stage at diagnosis, they might be useful for breast cancer screening in postmenopausal women. No significant financial relationships to disclose.

scholarly journals Intramammary Metastasis in a Patient with a History of Renal Cell Carcinoma: A Case Report

2018 ◽  
Vol 11 (2) ◽  
pp. 318-322
Author(s):  
Miyuki Kitahara ◽  
Yasuo Hozumi ◽  
Rio Asada ◽  
Aya Sawa ◽  
Hitoaki Saito ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Needle Biopsy ◽  
Malignant Tumors ◽  
Definitive Diagnosis ◽  
Benign Tumors ◽  
Immunohistochemical Examination ◽  
History Of

Intramammary metastasis of renal cell carcinoma (RCC) is extremely rare, accounting for only 1.5% of all intramammary metastases. Distinguishing intramammary metastases from benign tumors and breast cancer is clinically problematic. Some patients undergo excessive surgery after a misdiagnosis of breast cancer instead of a mammary tumor. We performed a core needle biopsy (CNB) of a breast mass that developed in a 71-year-old woman after surgeries for bilateral RCC and breast cancer, leading to a diagnosis of intramammary metastasis of RCC. In this case, the CNB and immunohistochemical examination were critical for reaching a definitive diagnosis. We conclude that, when examining patients with mammary tumors, establishing their history of malignant tumors may help diagnose intramammary metastasis and select the best treatment strategy.

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