ROLE OF CONTRAST ENHANCED COMPUTED TOMOGRAPHY SCAN IN DIAGNOSIS OF LOCAL SPREAD, DISTANT METASTASIS AND STAGING OF BREAST CARCINOMA

2021 ◽  
pp. 63-64
Author(s):  
Sangeeta Saxena ◽  
Suresh Kumar Saini ◽  
Dharm Raj Meena ◽  
Harsh Vardhan Khokhar
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Imaging Modality ◽  
Contrast Material ◽  
Stage Iv ◽  
Clinical Staging ◽  
Histopathological Correlation ◽  
Appropriate Treatment ◽  
Correlation Result ◽  
Enhanced Computed Tomography

Background: Breast cancer is the most common cause of cancer death for women worldwide. The accurate clinical staging of patients with breast cancer is important in determining the most appropriate treatment. The present study investigated the value of staging CECT in detecting asymptomatic distant (lung, liver and bone) metastases in patients with primary breast cancer. Material And Method: 30 patients with Breast Imaging Reporting and Data System category (BI-RADS) 4, 5 and 6 lesions underwent unenhanced breast CTand contrast material enhanced CTbefore histopathological correlation. Result And Discussion: In present study, 5(16.6%) cases shows metastasis into the lungs, 3(10%) cases shows metastasis into the liver, 3(10%) cases shows metastasis into the bones, 1(3.3%)case show metastasis into multiple site(lung and liver), 18(60%) cases shows no any evidence of metastasis. By contrast, 12 of 30 patients (40%) with stage III were upstaged to stage IV and 13 patients (43.3%) of those were originally stage IIIB or IIIC. Conclusion:CECTappears as an essential imaging modality to detect presence, extent and localisation of metastasis.

Detecting accurate tumor size across imaging modalities in breast cancer

2021 ◽  
pp. 1-6
Author(s):  
Olutayo Sogunro ◽  
Constance Cashen ◽  
Sami Fakir ◽  
Julie Stausmire ◽  
Nancy Buderer
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Imaging ◽  
Imaging Modality ◽  
Breast Cancer Diagnosis ◽  
Imaging Modalities ◽  
Clinical Staging ◽  
P Value ◽  
Pathology Report ◽  
Breast Cancers

BACKGROUND: Of the most common imaging modalities for breast cancer diagnosis – mammogram (MAM), ultrasound (US), magnetic resonance imaging (MRI) – it has not been well established which of these most accurately corresponds to the histological tumor size. OBJECTIVE: To determine which imaging modality (MAM, US, MRI) is most accurate for determining the histological tumor size of breast lesions. METHODS: A retrospective study of 76 breast cancers found in 73 female patients who received MAM, US, and/or MRI was performed. 239 charts were reviewed and 73 patients met inclusion criteria. Analysis was performed using signed rank tests comparing the reported tumor size on the imaging modality to the tumor size on pathology report. RESULTS: Mammography and ultrasonography underestimated tumor size by 3.5 mm and 4 mm (p-values < 0.002), respectively. MRI tends to overestimate tumor size by 3 mm (p-value = 0.0570). Mammogram was equivalent to pathological size within 1 mm 24% of the time and within 2 mm 35% of the time. CONCLUSIONS: No one single modality is the most accurate for detecting tumor size. When interpreting the size reported on breast imaging modalities, the amount of underestimation and overestimation in tumor size should be considered for both clinical staging and surgical decision-making.

scholarly journals Oregnancy-associated breast cancer: Analysis of cases in the mastology service of hospital santa marcelina de itaquera, são paulo, from 2014 to 2019

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Grasiela Benini dos Santos Cardoso
Keyword(s):  
Breast Cancer ◽  
Gestational Age ◽  
Post Partum ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Lymph Node Biopsy ◽  
The Other ◽  
Clinical Staging ◽  
Fusiform Cell ◽  
Luminal B

Thirty-one year old, median gestational age of 28 weeks. Four of our patients were primiparous with less than 20 years of age, and two between the ages of 30 and 34, with median of secundiparous patients (50%). By analyzing the obesity and BMI (body mass index) factors, we concluded that 3 patients were mildly obese, and one presented with morbid obesity at the time of diagnosis. Our BMI mean was 29. Considering histology and immunohistochemical, eight patients were diagnosed with ductal invasive carcinoma, without other specifications; one was diagnosed with fusiform cell carcinoma, and one with mucinous carcinoma. The histological subtypes found were luminal B (4 cases) and triple negative (6 cases). These results were compatible with a French retrospective study from 2017. The pregnant woman, or in the puerperium, with breast cancer may present the same symptoms as the other patients with the disease, but diagnosis can be delayed due to the physiological changes in breast tissue in the pregnancy-puerperal period. In our study, all patients were diagnosed at advanced clinical staging (IIIA, IIIB and IV). The treatment follows the same protocols as for non-pregnant patients, considering not only the type of tumor and disease staging, but also gestational age. The most used therapy for our group was neoadjuvant chemotherapy, followed by radical modified mastectomy. This was owed to the advanced stage of the disease. The sentinel lymph node biopsy was performed in two patients. One was diagnosed in the post-partum period, and the other was diagnosed while pregnant of 34 weeks. The latter received surgical treatment after the pregnancy. Chemotherapics are relatively safe when applied after the second trimester. During the patients’ follow-up, one of them presented with progression of the disease to the brain (this patient was in stage IV, with lung metastasis); one presented with bone and hepatic metastasis; and the other one had plastron recurrence. Until the conclusion of this study, four patients died. Conclusions: Pregnancy-associated breast cancer is a condition that should be observed by health teams, since its early diagnosis enables an approach that minimizes damages for the maternal-fetal binomial. Besides, detecting this disease in its early stages is the main factor that impacts the disease-free survival.

scholarly journals Differences in the breast cancer diagnostic process across stage groups in Ontario, Canada

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Patti Groome ◽  
Marlo Whitehead ◽  
Li Jiang ◽  
Julie Gilbert ◽  
Eva Grunfeld ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Screening Program ◽  
Stage Iv ◽  
Stage I ◽  
Diagnostic Process ◽  
Cancer Diagnostic ◽  
Diagnostic Interval ◽  
The Impact ◽  
Diagnostic Intervals

ABSTRACT ObjectivesEarly diagnosis leads to better cancer survival and short diagnostic intervals reduce patient anxiety. We are studying factors that prolong the breast cancer diagnostic process in Ontario, Canada. ApproachThis is a retrospective study of all patients diagnosed 2007-2011 (n=33,752). We linked data from Cancer Care Ontario and the Institute for Clinical Evaluative Sciences including: Ontario Cancer Registry, physician claims, ambulatory, ER visits, and hospital discharges. Detection method (screening versus symptomatic) was determined using Screening Program and claims data. The diagnostic interval is the time from first relevant health care encounter to the definitive diagnosis. Elements of the diagnostic interval include: use of imaging, biopsy, and the number of encounters and providers. ResultsOverall, 30.6% were screen-diagnosed and the median diagnostic interval was 40 days (IQR 21-80). The median interval was shorter in the screened group at 32 days versus symptomatic at 45 days. The diagnostic interval was longer for stage I patients at 47 days compared to stage II (37 days), stage III (33 days) or stage IV (22 days). Stage IV patients were less likely to be diagnosed via biopsy (44% vs 61%) and the symptomatic stage IV subgroup less likely to have breast imaging (61% vs 96%). 26% of stage IV patients saw 0 or 1 providers while 8% of stage I patients saw 6 or more. 19% of stage I patients had 10 or more encounters overall versus 15% and 28% had >1 mammogram versus 14%. Effects are largely similar in screened and symptomatic groups. ConclusionShorter diagnostic intervals in stage IV are associated with a more direct diagnostic path. We will present results quantifying the number of days attributable to the diagnostic elements. Understanding the impact of elements of the diagnostic process provide targets for improvement of its length.

scholarly journals Clinical Utility of Neoadjuvant MRI in Early-Stage Breast Cancer Patients

2021 ◽  
Author(s):  
Lauren Corke ◽  
Lidiya Luzhna ◽  
Kaylie Willemsma ◽  
Caroline Illmann ◽  
Miranda Mcdermott ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Early Stage ◽  
Neoadjuvant Treatment ◽  
Disease Free Survival ◽  
Early Stage Breast Cancer ◽  
Clinical Staging ◽  
Conventional Imaging ◽  
Multifocal Disease ◽  
The Impact

Abstract Background With the increasing use of neoadjuvant treatment (NAT) for patients with early-stage breast cancer (ESBC), adequate clinical staging is essential to inform treatment. While the use of MRI with NAT has been proposed to help with accuracy of pre-treatment clinical staging, its impact in clinical practice remains controversial. Methods A prospective institutional database of patients with ESBC treated with NAT between May 2012 and December 2020 was analyzed in order to compare the management of patients who received an MRI prior to NAT to those who did not. The indications for MRI and correlation of MRI findings to conventional breast imaging were evaluated. The impact of MRI on management was compared between the MRI and non-MRI groups. Results A total of 530 patients met inclusion criteria. Of these, 186 (35.1%) had an MRI and 344 (64.9%) did not. The most frequent indication for MRI was the determination of disease extent (54.5%). Patients who had an MRI prior to neoadjuvant treatment were significantly more likely to be younger (47 years versus 57 years; p<0.001) and have multifocal disease (32.3% versus 22.1%; p<0.05). When compared to conventional imaging, MRI reported a greater extent of disease in the breast (37.6%), more nodal involvement (18.8%) and multifocal disease (15.1%). Additional diagnostic interventions were advised in 52.2% of patients. who underwent MRI. Rates of mastectomies were greater in the MRI group (80.0% versus 58.9%; p<0.05) in addition to more axillary dissections (28.0% versus 17.4%; p<0.01). Rates of locoregional recurrences were low in both groups, with similar disease-free survival outcomes at 5 years. Conclusions MRI identified significantly more disease in contrast to conventional imaging and lead to more aggressive surgical management. Prospective studies evaluating the role of neoadjuvant MRI and its impact on long term outcomes are needed.

scholarly journals Current Landscape of Breast Cancer Imaging and Potential Quantitative Imaging Markers of Response in ER-Positive Breast Cancers Treated with Neoadjuvant Therapy

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1511 ◽  
Author(s):  
Ella F. Jones ◽  
Deep K. Hathi ◽  
Rita Freimanis ◽  
Rita A. Mukhtar ◽  
A. Jo Chien ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Breast Imaging ◽  
Imaging Modality ◽  
Neoadjuvant Treatment ◽  
Specific Treatment ◽  
Response To Treatment ◽  
Breast Cancers ◽  
Treatment Approaches ◽  
Imaging Markers

In recent years, neoadjuvant treatment trials have shown that breast cancer subtypes identified on the basis of genomic and/or molecular signatures exhibit different response rates and recurrence outcomes, with the implication that subtype-specific treatment approaches are needed. Estrogen receptor-positive (ER+) breast cancers present a unique set of challenges for determining optimal neoadjuvant treatment approaches. There is increased recognition that not all ER+ breast cancers benefit from chemotherapy, and that there may be a subset of ER+ breast cancers that can be treated effectively using endocrine therapies alone. With this uncertainty, there is a need to improve the assessment and to optimize the treatment of ER+ breast cancers. While pathology-based markers offer a snapshot of tumor response to neoadjuvant therapy, non-invasive imaging of the ER disease in response to treatment would provide broader insights into tumor heterogeneity, ER biology, and the timing of surrogate endpoint measurements. In this review, we provide an overview of the current landscape of breast imaging in neoadjuvant studies and highlight the technological advances in each imaging modality. We then further examine some potential imaging markers for neoadjuvant treatment response in ER+ breast cancers.

scholarly journals ARTIFICIAL INTELLIGENCE TO INTERPRET MAMMOGRAMS- ARE WE THERE YET?

2020 ◽  
pp. 30-31
Author(s):  
Dinesh Sethi ◽  
Namrita Sachdev ◽  
Yashvant Singh
Keyword(s):  
Breast Cancer ◽  
Artificial Intelligence ◽  
Deep Learning ◽  
Breast Imaging ◽  
Imaging Modality ◽  
The World ◽  
Screening Mammograms ◽  
Detect Breast Cancer ◽  
Related Mortality

Breast cancer is one of the leading causes of cancer related mortality in women. Mammography is the most widely used imaging modality to detect breast cancer. Due to a large number of screening mammograms and a limited number of breast imaging radiologists available all over the world, the role of Artificial Intelligence in the form of Deep Learning algorithms is being explored to assist the radiologists in interpreting these mammograms.

scholarly journals Intracranial Metastasis as the Initial Presentation of a Young Woman with Luminal B Her-2 Positive Stage 4 Breast Cancer

2020 ◽  
Vol 8 (1) ◽  
pp. 43-46
Author(s):  
Santi Christiani Gultom ◽  
Amaylia Oehadian
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Residual Disease ◽  
Stage Iv ◽  
Intracranial Metastasis ◽  
Luminal B ◽  
Appropriate Treatment ◽  
Stage 4 ◽  
Her 2 ◽  
Epidermal Growth

Objective: Breast cancer is the second most common cause of brain metastasis (BM) among all of the solid cancers, with metastases occurring in 10%–16% of patients and in as many as 30% of autopsy studies. Breast cancer-related BM usually has a poor prognosis and survival rate in the absence of any treatment within 2 months. Survival after BM is related to the subtype of the primary tumor. Human epidermal growth factor-2 (HER-2)-positive patients have a significantly better prognosis compared with other subtypes. The prognosis for the majority of patients with BM remains poor, despite local and systemic therapies, with a median survival of around 10 months. Methods: This case is interesting because our patient is very young, diagnosed with BM before breast cancer was identified, bit still surviving 12 months after her BM diagnosis. A 19-year old woman presented with seizures, vomit and headaches. Results: A cranial CT-scan showed an intracranial mass. The intracranial tumor was removed, and yielded a histopathological result of metastatic adenocarcinoma. Further examination found a lump in her right breast. She was diagnosed with intracranial metastatic stage 4 luminal B Her 2(+) breast cancer. She was referred for WBRT, a mastectomy, chemotherapy with docetaxel cyclophosphamide 4 cycles, followed by 12 cycles of trastuzumab, and continued treatment with tamoxifen and goserelin. The last PET-Scan showed no residual disease. Conclusion: Breast cancer as the primary tumor should be considered in women with a metastatic brain tumor. With appropriate treatment, even stage IV luminal B breast cancer with BM can still have a long life with good quality.

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