scholarly journals COMPARISON OF MAMMOGRAPHY AND ULTRASOUND COMBINED VERSUS ULTRASOUND ALONE IN EARLY EVALUATION OF SYMPTOMATIC BREAST CANCERS IN PAKISTAN

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Razia Bano ◽  
Huma M Khan ◽  
Ayesha Ehsan ◽  
Awais Amjad Malik ◽  
Shahper Aqeel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Failure Rate ◽  
Clinical Findings ◽  
Initial Evaluation ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Breast Clinic ◽  
Early Evaluation ◽  
Symptomatic Breast

Purpose: The purpose of this study was to detect diagnostic accuracy of mammography and ultrasound combined versus ultrasound alone in early evaluation of symptomatic breast lesions.Materials and Methods: All new patients who presented to the breast clinic with symptomatic breast lesions, during the year 2012, were included in the study. A total of 695 patients were registered. Their clinical findings, mammogram, ultrasound and histopathology were reviewed.Results: Mammogram and ultrasound combined detected 693 (99.71%) lesions in total. Mammogram failed to detect lesions in 1.43% of patients, whereas the failure rate of ultrasound was 0.43%. The incidence of microcalcifications on mammogram was 19.13%.Conclusion: Ultrasound is a useful tool in the initial evaluation of symptomatic breasts. For places such as Pakistan where mammogram is not available at every centre, ultrasound can be used as an effective alternative for the assessment of symptomatic breast lesions.Key words: Breast cancer, mammography, ultrasound

scholarly journals Mammography in Symptomatic Women Attending a Rapid Diagnosis Breast Clinic: A Prospective Study

2006 ◽  
Vol 88 (3) ◽  
pp. 306-308 ◽  
Author(s):  
MJP Biggs ◽  
D Ravichandran
Keyword(s):  
Breast Cancer ◽  
Significant Proportion ◽  
Management Plan ◽  
Clinical Findings ◽  
Rapid Diagnosis ◽  
Breast Cancers ◽  
Breast Clinic ◽  
Breast Radiologist ◽  
A Prospective Study ◽  
Symptomatic Breast

INTRODUCTION We determined whether it is safe to avoid mammograms in a group of symptomatic women with a non-suspicious history and clinical examination. PATIENTS AND METHODS Symptomatic women aged 35 years or over newly referred to a rapid-diagnosis breast clinic underwent mammography on arrival in the clinic. A breast radiologist reported on the mammograms. An experienced clinician who was unaware of the mammogram findings examined patients and decided whether a mammogram was indicated or not. If not, a management plan was formulated. Mammogram findings were then provided to the clinician and any change to the original management plan as a result of mammography was recorded. RESULTS In two-thirds (67%) of 218 patients, the clinician felt a mammogram was indicated. Half (46%) of these mammograms showed an abnormality; of these abnormal mammograms, 41% were breast cancer. Among the third (n = 71) of mammograms felt not to be indicated, 3 showed abnormalities of which 2 were breast cancer. One cancer was not suspected clinically or mammographically but was diagnosed on cyto/histopathological assessment. CONCLUSIONS A significant proportion of patients attending a symptomatic breast clinic have a non-suspicious history and normal clinical findings on examination. However, even in this group avoiding mammograms risks missing clinically occult breast cancers. It would appear sensible to offer mammograms to all symptomatic women over 35 years of age.

Incidental breast lesions detected on diagnostic CT scans: A 3-year prospective study.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 69-69
Author(s):  
A. R. Ismail
Keyword(s):  
Breast Cancer ◽  
Prospective Study ◽  
Cancer Patients ◽  
Ct Scans ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Breast Clinic ◽  
Rapid Access ◽  
One Stop

69 Background: With increasing usage of diagnostic cross sectional radiology tests, patients are presenting to rapid access one-stop breast clinic with incidental breast lesions. Methods: A prospective study over a 3-year period, collecting details of all patients shown to have breast abnormalities detected by computed tomography (CT) scans done for various reasons. These patients were assessed by clinical breast examination coupled with mammography, ultrasonography and tissue biopsy if indicated. Results: An increasing trend has been seen in the total number of thoracic CT scans with 1,939 scans in 2005 and 5,215 scans in 2010 (169% increase). 26 patients were included in this study with CT scans showing incidental breast lesions in the last three years. They were all women with age range of 50-92 (median 82.5) years. The clinical indications of CT scans included evaluation of the abnormal chest radiograph (8, 31%), preoperative evaluation of non-breast malignancy (3, 11%), infectious diseases (3, 11%), weight loss (7, 27%) and miscellaneous (5, 20%). These 13 breast cancer patients constitute 1.36% of 956 breast cancers diagnosed over this three-year period. 8 out of 13 breast cancer patients in this group (62%) had metastases at the time of diagnosis. Conclusions: A significant number of breast lesions incidentally found on CT scans are shown to be breast cancers (50%). These patients need rapid access to one-stop breast clinic for full evaluation. [Table: see text]

scholarly journals The incidence and outcome of incidental breast lesions detected by computed tomography

2010 ◽  
Vol 92 (2) ◽  
pp. 124-126 ◽  
Author(s):  
A Hussain ◽  
A Gordon-Dixon ◽  
H Almusawy ◽  
P Sinha ◽  
A Desai
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Breast Lesion ◽  
Chest Ct ◽  
Ct Scans ◽  
Breast Lesions ◽  
Breast Cancers ◽  
The Mean ◽  
The Uk ◽  
Symptomatic Breast

INTRODUCTION In the UK, the majority of breast cancers are diagnosed through symptomatic breast clinics and the breast screening programmes. With increased use of computed tomography (CT) to assess various pathologies, breast lesions are picked up incidentally. The aim of this study was to investigate the incidence and outcomes of breast lesions detected incidentally on CT scans. PATIENTS AND METHODS A retrospective study was conducted to assess the incidence and outcome of incidentally found breast lesions, which were detected on chest CT scans that were conducted for other pathologies during the period from February 2007 to October 2008. RESULTS A total of 432 chest CT scans were performed over 18 months. Thirty-three (7.63%) patients were found to have an incidental breast lesion. The mean age was 73 years (range, 50–86 years). Of these, 17 (52%) were benign, eight (24%) were primary breast cancer and the remaining eight (24%) had no definite pathology. The detection rate of breast cancer was 1.85%. CONCLUSIONS CT is emerging as an important contributor to the detection of occult breast lesions. Radiological awareness of incidental breast lesions is important so that appropriate referral to a specialised breast unit is made.

scholarly journals Ultrasonography alone for diagnosis of breast cancer in women under 40

2014 ◽  
Vol 96 (3) ◽  
pp. 202-206 ◽  
Author(s):  
DC Appleton ◽  
L Hackney ◽  
S Narayanan
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Lobular Carcinoma ◽  
Clinical Findings ◽  
Breast Cancers ◽  
Breast Clinic

Introduction Recent guidelines suggest that ultrasonography should be used as the primary imaging modality in women under 40 years of age with mammography being offered if further imaging is required. The aim of this study was to assess the adequacy of ultrasonography and the utility of mammography in this patient group by reviewing the role these imaging techniques had in the diagnosis of breast cancer in our unit. Methods All breast cancers diagnosed in patients 39 years or younger from June 2009 to June 2011 were reviewed. This was a retrospective review of presentation, clinical findings, imaging modality (ultrasonography, mammography, magnetic resonance imaging [MRI]) and histology. Mammography was the primary imaging modality until May 2011 in women between 35 and 39 years of age. Both invasive and intraductal carcinoma were included in the study but lobular carcinoma in situ was excluded. Results A total of 2,495 patients were referred to the symptomatic breast clinic in this age group during the study period. Thirty women were identified with either invasive cancer (n=27) or ductal carcinoma in situ (n=3). Twenty-eight patients underwent mammography, graded as uncertain, suspicious or malignant in the majority. Malignancy was missed in one patient. All 30 patients underwent ultrasonography, reported as uncertain, suspicious or malignant, an indication for diagnostic core biopsy. Ultrasonography alone did not miss any cancers but did fail to detect multifocal disease in one patient. Conclusions In this study group, ultrasonography was reliable as the primary imaging modality for women under 40, identifying all cancers in this cohort. Mammography and/or MRI remain essential adjuncts to accurately determine multifocality and/or the extent of disease.

scholarly journals Duct Excision is Still Necessary to Rule out Breast Cancer in Patients Presenting with Spontaneous Bloodstained Nipple Discharge

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
R. E. Foulkes ◽  
G. Heard ◽  
T. Boyce ◽  
R. Skyrme ◽  
P. A. Holland ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Malignant Disease ◽  
Nonoperative Management ◽  
Nipple Discharge ◽  
Breast Clinic ◽  
Exact Test ◽  
Malignant Lesions ◽  
Duct Excision ◽  
Symptomatic Breast ◽  
Rule Out

Introduction. Spontaneous nipple discharge is the third most common reason for presentation to a symptomatic breast clinic. Benign and malignant causes of spontaneous nipple discharge continue to be difficult to distinguish. We analyse our experience of duct excisions for spontaneous nipple discharge to try to identify features that raise suspicion of breast cancer and to identify features indicative of benign disease that would be suitable for nonoperative management.Methods. Details of one hundred and ninety-four patients who underwent duct excision for spontaneous nipple discharge between 1995 and 2005 were analysed.Results. Malignant disease was identified in 11 (5.7%) patients, 4 invasive and 7 insitu, which was 10.2% of those presenting with bloodstained discharge. All patients with malignant disease had bloodstained discharge. Discharge due to malignant disease was more likely to be bloodstained than that due to benign causes (Fisher's exact test, 2-tailedPvalue = 0.00134).Conclusion. Our findings do not support a policy of conservative management of spontaneous bloodstained nipple discharge. Cases of demonstrable spontaneous bloodstained nipple discharge should undergo duct excision to prevent malignant lesions being missed.

Subtle signs of breast cancer as an important pitfall in mammographic interpretation. Establishing an accurate diagnosis in an equivocal case

2021 ◽  
pp. 1-6
Author(s):  
Nikolaos S. Salemis ◽  
Eleni Mourtzoukou ◽  
Michail Angelopoulos
Keyword(s):  
Breast Cancer ◽  
Imaging Modality ◽  
Benign Lesion ◽  
Imaging Features ◽  
Breast Cancers ◽  
Breast Clinic ◽  
Delay In Diagnosis ◽  
Delay Of Treatment ◽  
Equivocal Case ◽  
Related Mortality

Mammogram is the standard imaging modality for the early detection of breast cancer, and it has been shown to reduce disease-related mortality by up to 30%. Mammogram, however, has its limitations. It is reported that 10–30% of breast cancers may be missed on a mammogram. Delay in the diagnosis and treatment may adversely affect the prognosis of patients with breast cancer. We present a case of multifocal invasive early breast carcinoma, which was misinterpreted twice as intramammary lymph nodes, thus resulting in a delay in diagnosis for eighteen months. The tumors were detected incidentally after the patient presented to our Breast clinic for symptoms related to a concomitant benign lesion involving the same breast. We describe the tumors’ imaging features and discuss the possible reasons that likely led to repeated misinterpretation. Awareness of possible causes for missed breast cancer is necessary to avoid delay of treatment initiation that may adversely affect prognosis.

scholarly journals Commentary on: Incidental Breast Cancers Identified in a One-Stop Symptomatic Breast Clinic

2011 ◽  
Vol 14 (2) ◽  
pp. 165
Author(s):  
Jeong Eon Lee ◽  
Jung-Hyun Yang ◽  
Seok Jin Nam
Keyword(s):  
Breast Cancers ◽  
Breast Clinic ◽  
One Stop ◽  
Symptomatic Breast

Approach to the Patient with a Breast Mass

2019 ◽  
Author(s):  
George Plitas ◽  
Monica Morrow ◽  
Brandon R Bruns
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Breast Mass ◽  
Breast Lesions ◽  
Breast Clinic ◽  
Breast Masses ◽  
Diagnosis And Management ◽  
Benign Breast Lesions

A breast mass is the most common presenting symptom among patients in a breast clinic. The presence of a breast mass can cause a great deal of anxiety in women, as well as their physicians. The differential diagnosis of a palpable breast abnormality is broad, although the majority of breast masses are benign. The responsibility of the physician who is evaluating a breast mass is to exclude the presence of malignancy. Once cancer is ruled out, the physician should then attempt to provide an accurate diagnosis, appropriate treatment, and reassurance to the patient. This chapter discusses the assessment of normal breast physiology, identification of a breast mass, evaluation of the various classifications of breast mass (e.g., dominant mass with clinically benign features and dominant mass with suspicious features), differential diagnosis and management of common benign breast masses (e.g., cysts, fibroadenomas, phyllodes tumors, hamartomas, fat necrosis), and the risk of breast cancer associated with benign breast lesions. The chapter also discusses the diagnosis and management of a breast mass in male patients. Tables outline breast lesions that may present as a palpable abnormality, factors used for the assessment of breast cancer risk, physical characteristics of benign and malignant breast masses, the accuracy of fine-needle aspiration, and benign breast lesions by category. Figures illustrate diagnostic procedures, the anatomy of the human breast, visual inspection of the breasts, physical examination of the breasts, breast palpation technique, the evaluation and management of a new breast mass, and the identification of cysts. This review contains 10 figures, 14 tables, and 64 references. Keywords: breast mass, lobuloalveolar development, subareolar nodularity, parenchyma (glandular elements), stromal tissue, ovarian graafian follicles

scholarly journals The Emerging Role of ESR1 Mutations in Luminal Breast Cancer as a Prognostic and Predictive Biomarker of Response to Endocrine Therapy

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1894 ◽  
Author(s):  
Irene De Santo ◽  
Amelia McCartney ◽  
Ilenia Migliaccio ◽  
Angelo Di Leo ◽  
Luca Malorni
Keyword(s):  
Breast Cancer ◽  
Endocrine Resistance ◽  
Metastatic Breast ◽  
Predictive Biomarker ◽  
Clinical Findings ◽  
Luminal Breast Cancer ◽  
Breast Cancers ◽  
Er Positive ◽  
Esr1 Mutations

Mutations in the hotspot ligand-binding domain of the estrogen receptor (ER) gene ESR1 have recently been recognized as mechanisms of endocrine resistance in endocrine receptor-positive metastatic breast cancer (MBC). Accumulating data suggest these mutations develop under the selective pressure of endocrine treatments, and are infrequent in untreated ER-positive breast cancers. In vitro studies show that these mutations confer ligand-independent activity, resistance to estrogen deprivation, and relative resistance to tamoxifen and fulvestrant. Post-hoc retrospective and prospective analyses of ESR1 mutations in patients with MBC have consistently found that these mutations are markers of poor prognosis and predict resistance to aromatase inhibitors (AIs). These results warrant further investigation and prospective validation in dedicated studies. Moreover, studies are ongoing to clarify the activity of novel drugs in the context of metastatic endocrine resistant luminal breast cancer harboring ESR1 mutations. In this review, we summarize the pre-clinical and clinical findings defining the characteristics of ESR1 mutant breast cancer, and highlight the potential clinical developments in this field.

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