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Sample records for benign breast lesions

  1. Optical discrimination between malignant and benign breast lesions

    NASA Astrophysics Data System (ADS)

    Quarto, Giovanna; Pifferi, Antonio; Cubeddu, Rinaldo; Ieva, Francesca; Paganoni, Anna Maria; Abbate, Francesca; Cassano, Enrico; Taroni, Paola

    2015-07-01

    Time domain multi-wavelength (635 to 1060 nm) optical mammography was performed on 82 subjects with breast lesions (45 malignant and 38 benign lesions). A perturbative approach based on the high-order calculation of the pathlength of photons inside the lesion was applied to estimate differences between lesion and average healthy tissue of the same breast in terms of: i) absorption properties, and ii) concentration of the major tissue constituents (oxy- and deoxy-hemoglobin, water, lipid and collagen). The absorption difference Δμa between lesion and healthy tissue is significantly different for malignant vs. benign lesions at all wavelengths. Logistic regression fitted to the absorption data identifies 975 nm as the key wavelength to discriminate malignant from benign lesions. When the difference in tissue composition between lesion and healthy tissue is considered, malignant lesions are characterized by significantly higher collagen content than benign lesions. Also the best model for the discrimination of malignant lesions obtained applying regression logistic to tissue composition is based only on collagen. Including demographic information into the model improves its specificity.

  2. Benign breast lesions in Bayelsa State, Niger Delta Nigeria: a 5 year multicentre histopathological audit

    PubMed Central

    Uwaezuoke, Stanley Chibuzo; Udoye, Ezenwa Patrick

    2014-01-01

    Introduction There has been no previous study to classify benign breast lesions in details based on histopathologically confirmed diagnosis in Bayelsa State, Nigeria. This study therefore aims to review all cases of benign breast lesions seen in all the three centres in Bayelsa State with histopathology services over a five year period for a comprehensive baseline data in our community for management, research and education. Methods This is a multicentre retrospective descriptive study based on histopathological diagnosed benign breast lesions from January 2009 to December 2013. Archival results and slides on benign breast lesions were retrieved and analysed using simple statistical methods. Results A total of 228 benign breast lesions (68.3%) were seen among 334 histopathologically diagnosed breast diseases. The male to female ratio was 19.7:1. Peak age incidence was the third decade (43%) with a mean age of 29.1years. Fibroadenoma was the most common benign breast disease (BBD) accounting for 45.6% of all the cases followed by fibrocystic change (23.1%). The mean ages of fibroadenoma and fibrocystic change were 23.1years and 31.1years respectively. Inflammatory breast lesions constituted 8.3%. We recorded only 2 cases (0.9%) of atypical ductal hyperplasia (ADH) with no case of atypical lobular hyperplasia (ALH) within the study period. Gynaecomastia (4%) was the main male breast lesion in the study. Conclusion Benign breast diseases are the most common breast lesions in Bayelsa State. Fibroadenoma is the most common lesion followed by fibrocystic change. The incidence of atypical hyperplasia recorded was rather low in the state. PMID:25995790

  3. Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

    PubMed Central

    Bozkurt Bostan, Tuğba; Koç, Gonca; Sezgin, Gülten; Altay, Canan; Fazıl Gelal, M.; Oyar, Orhan

    2016-01-01

    Background: Magnetic resonance imaging (MRI) has become a diagnostic and problem solving method for the breast examinations in addition to conventional breast examination methods. Diffusion-weighted imaging (DWI) adds valuable information to conventional MRI. Aims: Our aim was to show the impact of apparent diffusion coefficient (ADC) values acquired with DWI to differentiate benign and malignant breast lesions. Study Design: Diagnostic accuracy study. Methods: Forty-six women with 58 breast masses (35 malignant, 23 benign) were examined on a 1.5 T clinical MRI scanner. The morphologic characteristics of the lesions on conventional MRI sequences and contrast uptake pattern were assessed. ADC values of both lesions and normal breast parenchyma were measured. The ADC values obtained were statistically compared with the histopathologic results using Paired Samples t-Test. Results: Multiple lesions were detected in 12 (26%) of the patients, while only one lesion was detected in 34 (74%). Overall, 35 lesions out of 58 were histopathologically proven to be malignant. In the dynamic contrast-enhanced series, 5 of the malignant lesions were type 1, while 8 benign lesions revealed either type 2 or 3 time signal intensity curves (85% sensitivity, 56% spesifity). Mean ADC values were significantly different in malignant vs. benign lesions. (1.04±0.29×10−3 cm2/sec vs. 1.61±0.50×10−3 cm2/sec for the malignant and benign lesions, respectively, p=0.03). A cut-off value of 1.30×10−3 mm2/sec for ADC detected with receiver operating characteristic analysis yielded 89.1% sensitivity and 100% specificity for the differentiation between benign and malignant lesions. Conclusion: ADC values improve the diagnostic accuracy of solid breast lesions when evaluated with the conventional MRI sequences. Therefore, DWI should be incorporated to routine breast MRI protocol. PMID:27308073

  4. Discrimination between benign and malignant lesions of the breast using ultrasound disparity mapping

    NASA Astrophysics Data System (ADS)

    Steinberg, Bernard D.; Carlson, Donald L.; Birnbaum, Julia A.

    2001-05-01

    A technique called disparity mapping (DM) processes pairs of ultrasound B-scan images collected while a sonographer varies the probe pressure slightly on the breast surface. Dm measures the apparent displacement of the tissue about each image point and subsequently constructs a correlation map which represents the similarity between the speckle patterns around each point. The continuity of the lesion perimeter in the correlation image is used to separate benign from malignant lesions, with high continuity corresponding well with benign lesions and highly segmented perimeters correlating with malignancies. Twenty five solid masses were evaluated, and the results were compared with histology from core or surgical biopsy, or with cytology from fine needle aspiration. The results analyzed all lesions correctly (15 cancers and 10 benign lesions). There were no false positives or false negatives. The results suggest that DM may be a useful tool in digitally diagnosing breast lesions and consequently in reducing the number of unnecessary biopsies.

  5. Therapeutic application of ultrasound-guided 8-gauge Mammotome system in presumed benign breast lesions.

    PubMed

    Luo, Hao-jun; Chen, Xin; Tu, Gang; Wang, Jing; Wu, Cheng-yi; Yang, Guang-lun

    2011-01-01

    The stereotactic or ultrasound-guided vacuum-assisted breast biopsy (Mammotome, MMT) system is a minimally invasive surgical technique. Increasingly, it is used to remove benign breast lesions as management. To evaluate the therapeutic value of 8-gauge ultrasound-guided MMT system (UMS) in presumed benign breast lesions, a retrospective analysis was performed on a series of 2,167 consecutive 8-gauge UMS procedures. The parameters used in this analysis included lesion size, location, breast imaging reporting and data system for ultrasound category, histopathologic diagnosis, and others. A total of 1,119 women whose mean ages were 36.6 years (range: 12-71, SD: 9.6) underwent 2,167 consecutive 8-gauge UMS procedures. Among the patients, 298 cases (26.63%) did not have palpable mass, 430 (38.43%) had multiple lesions, and 237 (21.18%) had bilateral ones. The average size of excised lesions was 15.8 mm (range: 5-55, SD: 6.7) in the largest dimension, including 294 lesions < 10 mm (13.57%); 1,359 lesions, 10-19 mm (62.71%); 420 lesions, 20-29 mm (19.38%), and 94 lesions ≥ 30 mm (4.34%). Predominant lesions (81.59%) were solid on ultrasound image and nearly half (48.59%) of them were localized in the upper outer quadrant. Histopathologic diagnosis revealed that the overwhelming majority of specimens (96.61%) were benign, most of which manifested as fibroadenoma and fibrocystic changes, while high-risk lesions were revealed in 31 (2.29%) cases and malignancies in 15 (1.11%). Average time for procedure was 8.6 minutes (range: 3.5-38, SD: 5.4) and mean number of cores removed in the procedure was 9.3 (range: 2-42, SD: 3.7). Complete excision was achieved predominantly (99.82%). Complications (59, 5.27%) in which hematoma (41, 3.66%) was the majority were acceptable. In conclusion, the 8-gauge UMS procedure is a safe and potent therapeutic management with satisfactory cosmetic outcome for benign and high-risk breast lesions, especially for bilateral, multiple, and

  6. Discrimination between cancers and benign breast lesions by ultrasound disparity mapping

    NASA Astrophysics Data System (ADS)

    Steinberg, Bernard D.; Carlson, Donald L.; Zuckerman, Julia A.; Gardner, Judd

    2000-04-01

    Described are quantitative results of an ultrasound imaging method for discrimination between breast cancers and benign lesions. The procedure, called disparity mapping, may provide better medicine at lower cost. 27 in vivo samples were obtained from the Radiology Dept., Hospital of the University of Pennsylvania, of which 12 were cancers or were suspicious of being cancers and 15 were benign. Zero errors resulted from the procedure described herein. Undue optimism is unwarranted because of the small sample size, particularly of the cancers, and because the test was not blind. Because DM appears to react to elastic surface characteristics of lesions it also has the potential to disclose sites of active growth on cancerous lesions. This information, prior to surgery, would be valuable to the surgeon in planning the procedure.

  7. Ultrasonographic features and clinical implications of benign palpable breast lesions in young women

    PubMed Central

    Comstock, Christopher

    2015-01-01

    Purpose: The purpose of this study was to describe the breast ultrasonography (US) features and to investigate whether performing a core biopsy is warranted in young women having palpable solid breast masses. Methods: A total of 76 solid palpable masses in 68 consecutive women (≤25 years old) underwent tissue diagnosis by percutaneous core biopsy. Two radiologists, who were blinded to the clinical history and histopathology, independently evaluated the US features according to Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The frequency of benign and malignant descriptor terms that were used to characterize the lesions were compared to the final pathology. Results: All 76 palpable solid masses yielded benign pathology. On the US, the shape of the mass was described by radiologists 1 and 2 as oval or round (63.2% and 71.1%), margin as circumscribed (68.4% and 77.6%) and orientation as parallel (85.5% and 90.8%); the frequency of using all three benign descriptors was 61.8% and 68.5%, respectively. Suspicious descriptors were used less frequently by radiologists 1 and 2 including irregular shape (9.2% and 13.1%), non-circumscribed margin (31.6% and 22.4%) and non-parallel orientation (14.5% and 9.2%); the frequency of using all three suspicious descriptors was 9.2% and 11.8%, respectively. Conclusion: Despite the variable US features, breast malignancy seems extremely low in 25 years or younger women for palpable breast lesions. Using the BI-RADS lexicon, US accurately predicted benignity in about two thirds of our patients, supporting US surveillance as a safe alternative to invasive tissue sampling in this setting. PMID:25475650

  8. Optical imaging as an adjunct to sonograph in differentiating benign from malignant breast lesions

    NASA Astrophysics Data System (ADS)

    Zhu, Quing; Conant, Emily F.; Chance, Britton

    2000-04-01

    The role of near infrared (NIR) diffusive light imaging as an adjunct to ultrasound in differentiating benign from malignant lesions was evaluated in 27 mammography patients with infiltrating ductal carcinomas, apocrine metaplasia, fibroadenomas, radial scar and ductal hyperplasia, cysts, and normal tissues. Conventional ultrasound/mammography images were graded based on BI-RADS assessment categories. The spatial NIR measurements were made at wavelengths of 750 and 830 nm. Functional images, such as relative changes of deoxyhemoglobin (deoxyHb) and total blood concentration, were estimated from the dual wavelength measurements. Maximum relative deoxyHb and blood concentration changes were measured, and spatial correlation of masses in relative deoxyHb and blood concentration images for each breast were calculated. For the five biopsy proven benign lesions, ultrasound/mammography diagnoses were suspicious for malignancy (four cases) and highly suspicious for malignancy (one case). Four lesions showed less than 1.0 V maximum deoxyHb and less than 1.5 V maximum blood concentration levels on average and spatial image correlation showed no correlated masses in both deoxyHb and blood concentration images. For the four biopsy proven malignant lesions, ultrasound/mammography diagnoses were highly suspicious for malignancy. Maximum deoxyHb and blood concentration changes were greater than 2.9 V on average except one lesion which showed smaller deoxyHb signal (maximum 0.85 V) but the deoxyHb mass and blood concentration mass were highly correlated.

  9. Intravoxel Incoherent Motion Diffusion-Weighted MRI at 3.0 T Differentiates Malignant Breast Lesions From Benign Lesions and Breast Parenchyma

    PubMed Central

    Bokacheva, Louisa; Kaplan, Jennifer B.; Giri, Dilip D.; Patil, Sujata; Gnanasigamani, Merlin; Nyman, C. Gregory; Deasy, Joseph O.; Morris, Elizabeth A.; Thakur, Sunitha B.

    2016-01-01

    Purpose To study the differentiation of malignant breast lesions from benign lesions and fibroglandular tissue (FGT) using apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters. Materials and Methods This retrospective study included 26 malignant and 14 benign breast lesions in 35 patients who underwent diffusion-weighted MRI at 3.0T and nine b-values (0–1000 s/mm2). ADC and IVIM parameters (perfusion fraction fp, pseudodiffusion coefficient Dp, and true diffusion coefficient Dd) were determined in lesions and FGT. For comparison, IVIM was also measured in 16 high-risk normal patients. A predictive model was constructed using linear discriminant analysis. Lesion discrimination based on ADC and IVIM parameters was assessed using receiver operating characteristic (ROC) and area under the ROC curve (AUC). Results In FGT of normal subjects, fp was 1.1 ± 1.1%. In malignant lesions, fp (6.4 ± 3.1%) was significantly higher than in benign lesions (3.1 ± 3.3%, P = 0.0025) or FGT (1.5 ± 1.2%, P < 0.001), and Dd ((1.29 ± 0.28) × 10−3 mm2/s) was lower than in benign lesions ((1.56 ± 0.28) × 10−3 mm2/s, P = 0.011) or FGT ((1.86 ± 0.34) × 10−3 mm2/s, P < 0.001). A combination of Dd and fp provided higher AUC for discrimination between malignant and benign lesions (0.84) or FGT (0.97) than ADC (0.72 and 0.86, respectively). Conclusion The IVIM parameters provide accurate identification of malignant lesions. PMID:24273096

  10. Multinucleate Giant Cells in FNAC of Benign Breast Lesions: Its Significance

    PubMed Central

    R, Kalyani; Murthy V, Srinivasa

    2014-01-01

    Background: Multinucleate giant cells are described in breast aspirates. However, due to its rarity very few cases have been described cytologically. Hence recognition and correct interpretation of their presence is difficult, yet crucial for accurate diagnosis. Materials and Methods: The prospective study of FNAC (fine needle aspirate cytology) of breast lumps was conducted for a period of six months. Direct smears were prepared from the material aspirated. In case of fluid aspirates, centrifuge done and cell sediment was used for making smears. Smears were alcohol fixed and stained with PAP/H&E or air dried smears were stained with Leishman stain. Further smears were subjected to immunocytochemistry using vimentin and CD34 markers to know the origin of multinucleate giant cells. Results: We have reported 11 cases of breast lesions, which showed multinucleate giant cells on FNAC. Out of the 11 cases, Cytologically six cases showed granuloma debris with relative proportion of epithelioid histiocytes, lymphocytes, neutrophils and multinucleate giant cells. Two cases were diagnosed as acute suppurative granulomatous mastitis. Two cases of fibroadenoma and one case of fat necrosis showed multinucleate giant cells. Immunocytochemistry showed vimentin positivity in both stromal and histiocytic type of multinucleate giant cells and in isolated histiocytes. CD34 was focally positive in histiocytic type of giant cells. Conclusion: An effort is made to distinguish between the stromal and histiocytic type giant cells in non-neoplastic breast lesions. Further molecular studies have to be done to know the exact histogenesis and role of these multinucleate giant cells in benign lesions. PMID:25653953

  11. Exploring type II microcalcifications in benign and premalignant breast lesions by shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS)

    NASA Astrophysics Data System (ADS)

    Liang, Lijia; Zheng, Chao; Zhang, Haipeng; Xu, Shuping; Zhang, Zhe; Hu, Chengxu; Bi, Lirong; Fan, Zhimin; Han, Bing; Xu, Weiqing

    2014-11-01

    The characteristics of type II microcalcifications in fibroadenoma (FB), atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS) breast tissues has been analyzed by the fingerprint features of Raman spectroscopy. Fresh breast tissues were first handled to frozen sections and then they were measured by normal Raman spectroscopy. Due to inherently low sensitivity of Raman scattering, Au@SiO2 shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) technique was utilized. A total number of 71 Raman spectra and 70 SHINERS spectra were obtained from the microcalcifications in benign and premalignant breast tissues. Principal component analysis (PCA) was used to distinguish the type II microcalcifications between these tissues. This is the first time to detect type II microcalcifications in premalignant (ADH and DCIS) breast tissue frozen sections, and also the first time SHINERS has been utilized for breast cancer detection. Conclusions demonstrated in this paper confirm that SHINERS has great potentials to be applied to the identification of breast lesions as an auxiliary method to mammography in the early diagnosis of breast cancer.

  12. High-intensity focused ultrasound in breast pathology: non-invasive treatment of benign and malignant lesions.

    PubMed

    Cavallo Marincola, Beatrice; Pediconi, Federica; Anzidei, Michele; Miglio, Elena; Di Mare, Luisa; Telesca, Marianna; Mancini, Massimiliano; D'Amati, Giulia; Monti, Massimo; Catalano, Carlo; Napoli, Alessandro

    2015-03-01

    Breast neoplasms are one of the leading causes of morbidity and mortality in women. Even if surgery is the treatment of choice, other forms of less invasive radical treatment are desirable. High-intensity focused ultrasound is already established as a valid non-invasive technique that ensures tumor ablation in various organs. The use of ultrasound or magnetic resonance guidance allows having some advantages such as the capability to treat tumors in moving organs or the possibility to have a real-time monitoring of the temperature increase. The aim of this paper is to report the use of high-intensity focused ultrasound technique with ultrasound and magnetic resonance guidance for the ablation of breast tumors, including both benign and malignant lesions. PMID:25418428

  13. Comparison of trace elements in the scalp hair of malignant and benign breast lesions versus healthy women.

    PubMed

    Pasha, Qaisara; Malik, Salman A; Shaheen, Nazia; Shah, Munir H

    2010-05-01

    Trace elements including Al, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, Sb, Sr, and Zn were analyzed in the scalp hair samples of women with malignant breast lesions, women with benign breast lesions, and healthy donors using atomic absorption spectrophotometric method. In the scalp hair of malignant-tumor patients, the highest average concentration was shown by Ca (1,187 microg/g), followed by Na (655 microg/g), Mg (478 microg/g), Zn (391 microg/g), Sr (152 microg/g), Fe (114 microg/g), and K (89.8), while in the case of benign-tumor patients, the average estimated element levels were 1,522, 1,093, 572, 457, 217, 80.4, and 74.7 microg/g, respectively. Most of the elements exhibited non-normal distribution evidenced by large spread, standard error, and skewness values. Mean concentrations of Ca (634 microg/g), Zn (206 microg/g), Mg (162 microg/g), Fe (129 microg/g), and Na (82.1 microg/g) were noteworthy in the scalp hair of healthy women. Average levels of Na, Sr, K, Cd, Co, Pb, Mg, Ca, Zn, Ni, Sb, and Mn were revealed to be significantly higher in the hair of malignant and benign patients compared to the healthy women; however, Fe, Cu, Al, and Cr were not significantly different in the scalp hair of the three groups. The quartile distributions of Ca, Cd, Co, Cr, K, Mg, Mn, Na, Ni, Pb, Sb, and Sr revealed maximum spread in the scalp hair of malignant and benign groups; nevertheless, Al, Cu, Fe, and Zn exhibited almost comparable quartile levels in the three groups. Strong correlation coefficients were found between Fe and Cd, Al and Na, Mn and Sr, Co and Cr, Cd and Cr, Pb and K, Pb and Mn, Cu and Na, and Al and Fe in the scalp hair of malignant-tumor patients, while Fe and K, Cd and Co, Na and Co, and Cr and Pb showed strong correlations in the scalp hair of benign-tumor patients, both of which were significantly different compared with the healthy subjects. Multivariate cluster analysis also revealed divergent clustering of the elements in the scalp hair of

  14. High-resolution diffusion-weighted imaging for the separation of benign from malignant BI-RADS 4/5 lesions found on breast MRI at 3 Tesla

    PubMed Central

    Wisner, Dorota J.; Rogers, Nathan; Deshpande, Vibhas S.; Newitt, David N.; Laub, Gerhard A.; Porter, David A.; Kornak, John; Joe, Bonnie N.; Hylton, Nola M.

    2013-01-01

    Purpose To determine whether readout-segmented echo-planar diffusion imaging (RESOLVE) improves separation of malignant versus benign lesions compared to standard single-shot echo-planar imaging (ss-EPI) on BI-RADS 4/5 lesions detected on breast MRI. Materials and Methods Consecutive 3T breast MRI studies with BI-RADS 4/5 designation and subsequent biopsy or benign mastectomy were retrospectively identified. Freehand ROI’s were drawn on lesions and also on normal background fibroglandular tissue for comparison. Lesion-to-background contrast was evaluated by normalizing signal intensity of the lesion ROI by the normal background tissue ROI at b=800. Statistical analysis used the Mann-Whitney/Wilcoxon rank-sum test for unpaired and Wilcoxon signed-rank for paired comparisons. Results Of 38 lesions in 32 patients,10 were malignant. Lesion-to-background contrast was higher on RESOLVE than ss-EPI (1.80±0.71 vs. 1.62±0.63, p=0.03). Mean ADC was the same or lower on RESOLVE than ss-EPI, and this effect was largest in malignant lesions (RESOLVE 0.90±0.13; ss-EPI 1.00±0.13; median difference −0.10 (95%CI: −0.17,−0.02) ×10−3mm2/sec; p=0.014). By either diffusion method, there was a statistically significant difference between benign and malignant mean ADC (p<0.001). Conclusion Increased lesion-to-background contrast and improved separation of benign from malignant lesions by RESOLVE compared to standard diffusion, suggest that RESOLVE may show promise as an adjunct to clinical breast MRI. PMID:24214467

  15. Breast-feeding and benign breast disease.

    PubMed

    Bernardi, S; Londero, A P; Bertozzi, S; Driul, L; Marchesoni, D; Petri, R

    2012-01-01

    Benign breast disease (BBD) is very common among women in their fertile age, but its correlation with breast reproductive function remains unclear. Our study aimed to investigate the relation between BBD and breast-feeding. We collected data on 105 women with BBD and 98 controls, focusing on their reproductive history and breast-feeding. We analysed data by R (version 2.12.1) considering p < 0.05 as significant. The results showed that fibroadenoma represented the most frequent BBD (55%), followed by fibrocystic changes (19%), intraductal papilloma (6%) and inflammatory breast disorders (5%). The mean age was 31.5 years (± 6.1), BMI 21.2 kg/m² (± 3.4) and age at menarche 13.0 years (± 1.5). Duration of breast-feeding was not significantly different between controls and BBD types (p = NS). Selecting women with fibroadenoma breast-feeding duration directly correlated with the number of benign lesions (p < 0.05), which remains significant also by multivariate analysis. It was concluded that there seemed to be no difference in breast-feeding among BBDs types, but lactation may influence the number of fibroadenomas. Moreover, prospective studies would better define the correlation between lactation and BBDs. PMID:22185539

  16. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. PMID:26614702

  17. Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis

    PubMed Central

    Lin, Yu-Pang; Hsu, Hsian-He; Ko, Kai-Hsiung; Chu, Chi-Ming; Chou, Yu-Ching; Chang, Wei-Chou; Chang, Tsun-Hou

    2016-01-01

    To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units) to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs). A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU) analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU) to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI) to measure the HU within the most suspicious part of the lesion. PMID:27128524

  18. Multimodality imaging and state-of-art GPU technology in discriminating benign from malignant breast lesions on real time decision support system

    NASA Astrophysics Data System (ADS)

    Kostopoulos, S.; Sidiropoulos, K.; Glotsos, D.; Dimitropoulos, N.; Kalatzis, I.; Asvestas, P.; Cavouras, D.

    2014-03-01

    The aim of this study was to design a pattern recognition system for assisting the diagnosis of breast lesions, using image information from Ultrasound (US) and Digital Mammography (DM) imaging modalities. State-of-art computer technology was employed based on commercial Graphics Processing Unit (GPU) cards and parallel programming. An experienced radiologist outlined breast lesions on both US and DM images from 59 patients employing a custom designed computer software application. Textural features were extracted from each lesion and were used to design the pattern recognition system. Several classifiers were tested for highest performance in discriminating benign from malignant lesions. Classifiers were also combined into ensemble schemes for further improvement of the system's classification accuracy. Following the pattern recognition system optimization, the final system was designed employing the Probabilistic Neural Network classifier (PNN) on the GPU card (GeForce 580GTX) using CUDA programming framework and C++ programming language. The use of such state-of-art technology renders the system capable of redesigning itself on site once additional verified US and DM data are collected. Mixture of US and DM features optimized performance with over 90% accuracy in correctly classifying the lesions.

  19. A morphometric approach in breast cytology--geometrical descriptors in the differentiation between benign and malignant lesions.

    PubMed

    Mihalache, Daniela; Giuşcă, Simona Eliza; Balan, Raluca; Amălinei, Cornelia; Grigoraş, Adriana; Căruntu, Irina Draga

    2014-01-01

    This study focuses on the analysis of geometric descriptors that can be applied in breast cytology, and their correlation with the qualitative features, with the aim to underline the differences between the benign and malignant cell profile. The morphometric investigation was performed on smears obtained by fine needle aspiration, 10 cases (group 1) diagnosed as benign and 10 cases (group 2) as malignant. For group 2, the malignancy was histopathologically confirmed on the surgical resection specimen. The sequence of automated operation, previously reported by us, permitted the extraction of the following geometrical descriptors: cytoplasmic area, nuclear area, nucleo-cytoplasmic ratio, equivalent diameter and form factor. We analyzed the differences between the benign and malignant morphometric features, and the correlation between the malignant morphometric features and cytological, respectively histological grading. Statistically significant difference in cytoplasmic areas, nuclear areas, value of nucleo-cytoplasmic ratio and equivalent diameter was noted between group I and II. For the form factor, we did not register statistically significant differences. For group 2, the correlation between the morphometric features and cytological grading revealed that the nuclear area is the most valuable descriptor, due to the significant differences between the three successive grades of cytological severity, followed by the cytoplasmic area and equivalent diameter, their numerical values presenting significant differences between cytological grade 1 and 3, and 2 and 3, respectively. The statistical analysis between the morphometric features and histological grading showed that nuclear area and equivalent diameter are the most viable indicators, due to the significant differences present between the three successive grades of pathologic severity, followed by cytoplasmic area (significant differences only for grade 2 versus 3) and for nucleo-cytoplasmic ratio (significant

  20. Assessment of Functional Differences in Malignant and Benign Breast Lesions and Improvement of Diagnostic Accuracy by Using US-guided Diffuse Optical Tomography in Conjunction with Conventional US.

    PubMed

    Zhu, Quing; Ricci, Andrew; Hegde, Poornima; Kane, Mark; Cronin, Edward; Merkulov, Alex; Xu, Yan; Tavakoli, Behnoosh; Tannenbaum, Susan

    2016-08-01

    Purpose To investigate ultrasonography (US)-guided diffuse optical tomography to distinguish the functional differences of hemoglobin concentrations in a wide range of malignant and benign breast lesions and to improve breast cancer diagnosis in conjunction with conventional US. Materials and Methods The study protocol was approved by the institutional review boards and was HIPAA compliant. Written informed consent was obtained from all patients. Patients (288 women; mean age, 50 years; range, 17-94 years) who underwent US-guided biopsy were imaged with a handheld US and optical probe. The US-imaged lesion was used to guide reconstruction of light absorption maps at four wavelengths, and total hemoglobin (tHb), oxygenated hemoglobin (oxyHb), and deoxygenated hemoglobin (deoxyHb) were computed from the absorption maps. A threshold (80 μmol/L) was chosen on the basis of this study population. Two radiologists retrospectively evaluated US images on the basis of the US Breast Imaging Reporting and Data System lexicon, and a lesion was considered malignant when a score of 4C or 5 was given or a lesion had tHb greater than 80 μmol/L. A two-sample t test was used to calculate significance between groups, and Spearman ρ was computed between hemoglobin parameters and tumor pathologic grades. Results Three tumors were Tis, 37 were T1, 19 were T2-T4 carcinomas, and 233 were benign lesions. The mean maximum tHb, oxyHb, and deoxyHb of Tis-T1 and T2-T4 groups were 89.3 μmol/L ± 20.2 (standard deviation), 65.0 μmol/L ± 20.8, and 33.5 μmol/L ± 11.3, respectively, and 84.7 μmol/L ± 32.8, 57.1 μmol/L ± 19.8, and 34.7 μmol/L ± 18.9, respectively. The corresponding values of benign lesions were 54.1 μmol/L ± 23.5, 38.0 μmol/L ± 17.4, and 25.2 μmol/L ± 13.8, respectively. The mean maximum tHb, oxyHb, and deoxyHb were significantly higher in the malignant groups than the benign group (P <.001, <.001, and .041, respectively). For malignant lesions, the mean maximum t

  1. Malignancy and the benign lymphoepithelial lesion.

    PubMed

    Batsakis, J G; Bernacki, E G; Rice, D H; Stebler, M E

    1975-02-01

    The benign lymphoepithelial lesion of salivary glands is now considered the histological hallmark of a variety of clinical and pathological disorders affecting salivary tissues. Malignancy arising in the lesion is uncommon, but may take origin in either the epithelial or lymphoreticular components. Lymphomas and pseudolymphomas associated with salivary gland lymphoepithelial lesions have been predominately extra-salivary and strongly correlated with Sjögren's syndrome. Epithelial malignancy has not been associated with autoimmunity and with few exceptions has been of the anaplastic type. This report presents two patients with intra-salivary lymphomas arising in a benign lymphoepithelial lesion of salivary glands and a patient with anaplastic carcinoma arising in the epithelial islands of the lesion. The fourth patient manifested pseudolymphomatous lymphoreticular hyperplasia in lung and submandibular gland and illustrates the possible multiple organ involvement that may occur in patients with benign lymphoepithelial lesion, even without clinical evidence of concommitant autoimmune disorders. PMID:1172885

  2. Significance of nuclear morphometry in benign and malignant breast aspirates

    PubMed Central

    Narasimha, Aparna; Vasavi, B; Kumar, Harendra ML

    2013-01-01

    Background: Breast carcinoma is one of the most common cancers occurring in the female population world-wide. Normal cells gradually transform to form the cancer cells through several stages. Nuclear changes occurring during these transformational steps need to be assessed objectively. Hence nuclear morphometry can be used as a diagnostic tool. Aim: To compare the nuclear morphometric parameters of benign and malignant breast aspirates. Study Design: Cytology was used to categorize aspirates from the breast lumps in to malignant (30 cases), and benign (30 cases). Nuclear parameters were calculated using the Image J 1.44C morphometric software. Several nuclear size parameters were analyzed. Results: The nuclear area, perimeter, diameter, compactness, and concave points were found to be statistically significant (P < 0.05) parameters in differentiating benign, and malignant aspirates. Conclusion: Nuclear morphometry was thus, a useful objective tool in the differentiating benign, and malignant breast lesions. PMID:23776836

  3. [Surgery of benign vocal fold lesions].

    PubMed

    Olthoff, A

    2016-09-01

    Surgical treatment of benign vocal fold lesions can be indicated for clinical or functional reasons. The principles of phonosurgery have to be maintained in either case. The appropriate phonosurgical technique depends on the type of vocal fold lesion. Depending on the findings, phonosurgery aims to maintain or improve voice quality. The evaluation of clinical and functional results includes indirect laryngoscopy, videostroboscopy, and voice analysis. PMID:27552826

  4. Benign idiopathic partial epilepsy and brain lesion.

    PubMed

    Stephani, U; Doose, H

    1999-03-01

    A 14-year-old girl had severe head trauma from a dog bite at the age of 9 days. This resulted in extensive brain damage, tetraplegia, mental retardation, and epilepsy. The seizures were of rolandic type, and the EEG showed multifocal sharp waves. The course was benign. The initial diagnosis of a pure symptomatic epilepsy was revised after demonstrating typical benign focal sharp waves in the EEG of the healthy sister. Thus a phenocopy of a benign partial epilepsy by the brain lesion could be excluded with sufficient certainty. This observation allows the conclusion that the genetic disposition underlying the sharp-wave trait characteristic of benign partial epilepsies can be involved also in the pathogenesis of seemingly pure symptomatic epilepsies. EEG studies on siblings of such patients are needed to exclude possible phenocopies. PMID:10080522

  5. Benign breast disease and consumption of beverages containing methylxanthines.

    PubMed

    La Vecchia, C; Franceschi, S; Parazzini, F; Regallo, M; Decarli, A; Gallus, G; Di Pietro, S; Tognoni, G

    1985-05-01

    The relationship between methylxanthine (Mx) consumption and benign breast disease was evaluated in a case-control study of 288 women with histologically confirmed benign breast lumps (203 dysplastic lesions and 85 benign tumors) and 2 groups of control women--285 patients in the hospital for acute conditions apparently unrelated to the consumption of Mx-containing beverages and 291 outpatients. The relative risk estimates of dysplastic breast lesions (fibrocystic disease), with allowance for all identified potential distorting factors, for women who drank 1-2 or 3 or more cups of coffee per day were 4.1 and 6.4, respectively, when the hospital controls were the comparison group and 2.0 and 3.7, respectively, when the outpatient controls were the comparison group. The relationship was even stronger when the total consumption of Mx-containing beverages (coffee plus tea) was considered and increased with increasing duration of use. The association was not explained by any of the major risk factors for fibrocystic breast diseases or by differences in general characteristics or other lifestyle habits between cases and controls. Mx consumption was not related to the risk of benign breast tumors (fibroadenomas). These findings support the hypothesis that Mx consumption is related to the risk of dysplastic lesions of the breast. PMID:3858587

  6. Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions.

    PubMed

    Zgajnar, J; Hocevar, M; Frkovic-Grazio, S; Hertl, K; Schweiger, E; Besic, N

    2004-01-01

    Standard localization techniques of the nonpalpable breast lesions (guide wire, carbon, skin marking) have several disadvantages. Radioguided occult lesion localization (ROLL) was recently proposed as a better alternative resulting in wider surgical margins and lower average specimen weight. The aim of our study was to compare ROLL to our previously published series of the standard guidewire localization, performed at the Institute of Oncology Ljubljana. ROLL was performed in 110 nonpalpable breast lesions. Human serum albumin macroaggregats, marked with 1.8-5.5 MBq 99mTc was injected in the nonpalpable lesion. During surgery the radioactive breast tissue was excised using hand held gamma probe. Nonpalpable breast lesions were excised in all 110 patients. The definitive histology revealed 32 invasive carcinomas, 19 DCIS, 5 LCIS in and 54 benign breast lesions. Mean specimen weight was 40 g which is less in comparison to 53 g of the guidewire series (p=0.002). Surgical margins were clear in 36/51 (70%) invasive breast cancer or DCIS patients and close or involved in 15/51 (30%) patients. Compared to the guidewire series, where 41/92 (44%) margins were clear and 51/92 (56%) were close or involved, the difference was statistically significant (p=0.005). ROLL proved to be superior to guidewire localization in our series, allowing excision of the nonpalpable breast lesion with wider surgical margins despite lower average specimen weight. PMID:15640944

  7. Skin conditions: benign nodular skin lesions.

    PubMed

    Nguyen, Tam; Zuniga, Ramiro

    2013-04-01

    Benign subcutaneous lesions are a common reason that patients visit family physicians. Lipomas are the most common of these lesions; they most often occur on the trunk and proximal extremities. Recent data show that as many as half of the fat cells in lipomas are atypical. Ultrasound is used increasingly to confirm lipoma diagnosis, but deep lesions should be evaluated with magnetic resonance imaging study or computed tomography scan to exclude involvement of underlying structures and/or liposarcoma. Small lesions can sometimes be managed with serial injections of midpotency steroids. Larger lesions (larger than 5 cm), those compressing other structures, or those suspicious for malignancy should be excised using standard surgical excision or, when possible, the newer minimal-scar segmental extraction technique. Ganglion cysts are another common lesion, the presence of which often is confirmed with ultrasound if the diagnosis is not clinically apparent. Management includes splinting, aspiration, and/or injection of steroids, with or without hyaluronidase. Epidermal inclusion cysts, also called sebaceous cysts, typically are asymptomatic unless they become infected. Ultrasound can aid in diagnosis. The only definitive management is surgical excision with complete removal of the cyst wall or capsule, using minimal-scar segmental extraction or conventional surgical removal. PMID:23600336

  8. Diode Laser Excision of Oral Benign Lesions

    PubMed Central

    Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi

    2015-01-01

    Introduction: Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Methods: Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Results: Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. Conclusion: We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis. PMID:26464781

  9. Benign Breast Problems and Conditions

    MedlinePlus

    ... find a lump in my breast? • What is mammography? • What happens if a suspicious lump or area ... exam, more tests may be recommended. What is mammography? Mammography can be used as a screening test ...

  10. Unusual Benign Tumors of the Breast

    PubMed Central

    Adrada, Beatriz E; Krishnamurthy, Savitri; Carkaci, Selin; Posleman-Monetto, Flavia E; Ewere, Adesuwa; Whitman, Gary J

    2015-01-01

    The purpose of this article is to describe the imaging characteristics of a variety of benign breast tumors that may be encountered in daily practice, in order to formulate an appropriate differential diagnosis and to establish concordance between the imaging and the pathologic findings, and to assist the clinician with appropriate management. PMID:26085959

  11. Characterization of Breast Lesions: Comparison of Digital Breast Tomosynthesis and Ultrasonography

    PubMed Central

    Kim, Sun Ah; Cho, Nariya; Yi, Ann; Moon, Woo Kyung

    2015-01-01

    Objective To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. Materials and Methods A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. Results Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. Conclusion Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM. PMID:25741187

  12. Image cytometry of duct cells from benign and malignant breast disease

    SciTech Connect

    Mayall, B.H.; Gadenne, C.; King, E.B.; Chew, K.L.; Duarte, L.A.; Petrakis, N.L.

    1987-01-22

    We used image cytometry to classify benign and malignant breast lesions, to identify parameters that classify premalignant lesions, and to assess these parameters for a biological association that may be linked with malignancy. Results suggest that quantitative image analysis is able to discriminate ''normal'' from ''abnormal'' breast lesions. Thus image cytometry may provide an objective approach for early detection of malignant changes in the breast. The parameters selected by stepwise discriminant and regression analyses as being most useful for discriminating among breast lesions relate to nuclear size, shape and DNA content. These parameters are robust and easily measured and are similar to those used by others for discriminating benign from malignant lesions. Significantly, no parameter based on nuclear chromatin distribution ranked as highly in this study, unlike our experience with studies of other premalignant lesions. 9 refs., 1 fig., 3 tabs.

  13. Infrared microspectroscopic imaging of benign breast tumor tissue sections

    NASA Astrophysics Data System (ADS)

    Fabian, H.; Lasch, P.; Boese, M.; Haensch, W.

    2003-12-01

    We have applied infrared microspectroscopic imaging for the examination of benign breast tumor tissue sections. The IR spectra of the sections were obtained by classical point microscopy with a movable stage and via a microscope equipped with a focal plane array detector. The infrared microscopic data were analysed using functional group mapping techniques and cluster analysis. The output values of the two procedures were reassembled into infrared images of the tissues, and were compared with standard staining images of the corresponding tissue region. The comparative examination of identical tissue sections by the two IR approaches enabled us to assess potential problems associated with tissue microheterogeneity. It was found that in case of fibroadenoma, a benign lesion located in breast ducts, point microscopy with a spot size of ˜30 μm is a useful practical approach which minimizes the possibility of 'contamination' of the spectra because of spectral averaging of all tissue components present in the corresponding microareas. A comparison of the spectra of the benign breast tumor with those of a malignant ductal carcinoma in situ revealed that IR microspectroscopy has the potential to differentiate between these two breast tumor types.

  14. Diffuse Infiltrative Lesion of the Breast: Clinical and Radiologic Features

    PubMed Central

    An, Yeong Yi; Cha, Eun Suk; Kim, Hyeon Sook; Kang, Bong Joo; Park, Chang Suk; Jung, Na Young; Whang, In Yong; Yoon, Soo Kyung

    2011-01-01

    The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infiltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm. PMID:21228947

  15. Inverted papillomas and benign nonneoplastic lesions of the nasal cavity

    PubMed Central

    Casiano, Roy R.

    2012-01-01

    Background: Benign lesions of the nasal cavity represent a diverse group of pathologies. Furthermore, each of these disorders may present differently in any given patient as pain and discomfort, epistaxis, headaches, vision changes, or nasal obstruction. Although these nasal masses are benign, many of them have a significant capacity for local tissue destruction and symptomatology secondary to this destruction. Advances in office-based endoscopic nasendoscopy have equipped the otolaryngologist with a safe, inexpensive, and rapid means of directly visualizing lesions within the nasal cavity and the initiation of appropriate treatment. Methods: The purpose of this study is to review the diagnosis, management, and controversies of many of the most common benign lesions of the nasal cavity encountered by the primary care physician or otolaryngologist. Results: This includes discussion of inverted papilloma (IP), juvenile angiofibroma, squamous papilloma, pyogenic granuloma, hereditary hemorrhagic telangiectasia, schwannoma, benign fibro-osseous lesions, and other benign lesions of the nasal cavity, with particular emphasis on IP and juvenile angiofibroma. Conclusion: A diverse array of benign lesions occur within the nasal cavity and paranasal cavities. Despite their inability to metastasize, many of these lesions have significant capability for local tissue destruction and recurrence. PMID:22487294

  16. [Benign proliferative breast disease with and without atypia].

    PubMed

    Coutant, C; Canlorbe, G; Bendifallah, S; Beltjens, F

    2015-12-01

    In the last few years, diagnostics of high-risk breast lesions (atypical ductal hyperplasia [ADH], flat epithelial atypia [FEA], lobular neoplasia: atypical lobular hyperplasia [ALH], lobular carcinoma in situ [LCIS], radial scar [RS], usual ductal hyperplasia [UDH], adenosis, sclerosing adenosis [SA], papillary breast lesions, mucocele-like lesion [MLL]) have increased with the growing number of breast percutaneous biopsies. The management of these lesions is highly conditioned by the enlarged risk of breast cancer combined with either an increased probability of finding cancer after surgery, either a possible malignant transformation (in situ or invasive cancer), or an increased probability of developing cancer on the long range. An overview of the literature reports grade C recommendations concerning the management and follow-up of these lesions: in case of ADH, FEA, ALH, LCIS, RS, MLL with atypia, diagnosed on percutaneous biopsies: surgical excision is recommended; in case of a diagnostic based on vacuum-assisted core biopsy with complete disappearance of radiological signal for FEA or RS without atypia: surgical abstention is a valid alternative approved by multidisciplinary meeting. In case of ALH (incidental finding) associated with benign lesion responsible of radiological signal: abstention may be proposed; in case of UDH, adenosis, MLL without atypia, diagnosed on percutaneous biopsies: the concordance of radiology and histopathology findings must be ensured. No data is available to recommend surgery; in case of non-in sano resection for ADH, FEA, ALH, LCIS (except pleomorphic type), RS, MLL: surgery does not seem to be necessary; in case of previous ADH, ALH, LCIS: a specific follow-up is recommended in accordance with HAS's recommendations. In case of FEA and RS or MLL combined with atypia, little data are yet available to differ the management from others lesions with atypia; in case of UDH, usual sclerosing adenosis, RS without atypia, fibro cystic

  17. Hyperechoic breast lesions: anatomopathological correlation and differential sonographic diagnosis*

    PubMed Central

    Medeiros, Marcelo Menezes; Graziano, Luciana; de Souza, Juliana Alves; Guatelli, Camila Souza; Poli, Miriam Rosalina B.; Yoshitake, Rafael

    2016-01-01

    Hyperechoic lesions are not a frequent finding at breasts ultrasonography, and most of times are associated with benign pathologies that do not require further evaluation. However, some neoplasms such as invasive breast carcinomas and metastases may present with hyperechogenicity. Thus, the knowledge about differential diagnoses and identification of signs of lesion aggressiveness are of great relevance to avoid unnecessary procedures or underdiagnosis, and to support the correct clinical/surgical approach. On the basis of such concepts, the present essay describes and illustrates the main features of hyperechoic lesions at breast ultrasonography in different cases, with anatomopathological correlation. PMID:26929460

  18. Role of metallothioneins in benign and malignant thyroid lesions

    PubMed Central

    2012-01-01

    Recent findings in the past two decades have brought many insights into the biology of thyroid benign and malignant lesions, in particular the papillary and follicular thyroid cancers. Although, much progress have been made, thyroid cancers still pose diagnostic problems regarding differentiation of follicular lesions in relation to their aggressiveness and the treatment of advanced and undifferentiated thyroid cancers. Metallothioneins (MTs) were shown to induce cancer cells proliferation, mediate resistance to apoptosis, certain chemotherapeutics and radiotherapy. Therefore, MTs may be of utility in diagnosis and management of patients with benign and malignant lesions of the thyroid. PMID:23273222

  19. Management of breast magnetic resonance imaging-detected lesions.

    PubMed

    Seely, Jean M

    2012-08-01

    Breast magnetic resonance imaging (MRI) has become an essential component of breast imaging. Whether it is used as a problem-solving tool or a screening test or for staging patients with breast cancer, it detects many lesions in the breast. The challenge for the radiologist is to distinguish significant from insignificant lesions and to direct their management. A brief summary of the terminology according to the American College of Radiologists lexicon will be provided. This review article will cover the differential diagnosis of enhancing lesions, including masses and nonmass enhancement, from benign and malignant causes. Some of the specific morphologic and kinetic features that help to differentiate benign from malignant lesions will be illustrated, and positive predictive values of these features will be reviewed. The various methods of investigating enhancing lesions of the breast will be discussed, including second-look ultrasound, ultrasound-guided biopsy, stereotactic biopsy, and MRI-guided biopsy. A practical approach to the management of MRI-detected lesions will include timing of follow-up, when to biopsy and when to ignore enhancing lesions in the breast. PMID:21798693

  20. Four cases of echogenic breast lesions: a case series and review

    PubMed Central

    Goh, Lin Wah; Wong, Su Lin Jill; Tan, Puay Hoon

    2016-01-01

    Echogenic breast lesions are generally thought to be benign. We herein report four cases of echogenic breast lesions that were seen at our centre over 38 months. One patient had a prior history of wide excision and radiotherapy for breast cancer and was imaged as part of routine cancer surveillance, while the other three were recalled for further assessment following an abnormal screening mammogram. All four patients were assessed on ultrasonography, which demonstrated an echogenic lesion in each patient. All four lesions underwent ultrasonography-guided core biopsy, followed by excision biopsy. The indications for biopsy were interval increase in the size of lesion or indeterminate features demonstrated in the lesion. Three lesions were benign, while the lesion from the patient who had received previous radiotherapy was angiosarcoma. Not all echogenic lesions are benign and lesions with suspicious features on ultrasonography should undergo biopsy. PMID:26891743

  1. Simulation of spiculated breast lesions

    NASA Astrophysics Data System (ADS)

    Elangovan, Premkumar; Alrehily, Faisal; Pinto, R. Ferrari; Rashidnasab, Alaleh; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are a promising new approach increasingly used for the evaluation and comparison of breast imaging modalities. A key component in such an assessment paradigm is the use of simulated pathology, in particular, simulation of lesions. Breast mass lesions can be generally classified into two categories based on their appearance; nonspiculated masses and spiculated masses. In our previous work, we have successfully simulated non-spiculated masses using a fractal growth process known as diffusion limited aggregation. In this new work, we have extended the DLA model to simulate spiculated lesions by using features extracted from patient DBT images containing spiculated lesions. The features extracted included spicule length, width, curvature and distribution. This information was used to simulate realistic looking spicules which were attached to the surface of a DLA mass to produce a spiculated mass. A batch of simulated spiculated masses was inserted into normal patient images and presented to an experienced radiologist for review. The study yielded promising results with the radiologist rating 60% of simulated lesions in 2D and 50% of simulated lesions in DBT as realistic.

  2. Reflectance spectroscopy of pigmented cutaneous benign and malignant lesions

    NASA Astrophysics Data System (ADS)

    Borisova, E.; Jeliazkova, Al.; Pavlova, E.; Troyanova, P.; Kundurdjiev, T.; Pavlova, P.; Avramov, L.

    2014-10-01

    For the DRS measurements of skin benign, dysplastic and malignant lesions in vivo we applied halogen lamp (LS-1, OceanOptics Inc, Dunedin, Fl, USA) as a continuous light source in the region of 400-900 nm, optical probe (6+1 fibers) for the delivery of illumination and diffuse reflected light from the skin investigated and microspectrometer USB4000 (OceanOptics Inc., Dunedin, Fl, USA) for a storage and display of the spectra detected. As a diffuse reflectance standard Spectralon® plate was used to calibrate the spectrometer. The reflectance spectra obtained from normal skin in identical anatomic sites of different patients have similar spectral shape features, slightly differ by the reflectance intensity at different wavelengths, depending on the particular patient' skin phototype. One could find diagnostically important spectral features, related to specific intensity changes for a given wavelength due to specific pigments appearance, slope changes by value and sign for the reflectance spectra curves in a specific spectral range, disappearance or manifestation of minima, related to hemoglobin absorption at 410-420 nm, 543, 575 nm. Based on the observed peculiarities multispectral analysis of the reflectance spectra of the different lesions was used and diagnostically specific features are found. Discrimination using the DRS data obtained between benign compound and dermal nevi (45 cases), dysplastic nevi (17 cases) and pigmented malignant melanoma (41 cases) lesions is achieved with a diagnostic accuracy of 96 % for the benign nevi vs. MM, and 90 % for the dysplastic nevi vs. MM.

  3. Magnetic resonance guided localization and biopsy of suspicious breast lesions.

    PubMed

    Fischer, U; Kopka, L; Grabbe, E

    1998-02-01

    Contrast-enhanced magnetic resonance imaging (MRI) is being used increasingly as a complementary diagnostic modality in breast imaging of preselected patients. The exclusion of multicentricity before surgery and the differentiation between a scar and a carcinoma are well-accepted indications of this method. Problems result when suspicious lesions found with MRI cannot be visualized with mammography or ultrasonography. In these cases, MRI-based guidance systems are needed to guide needle biopsy or allow localization of the lesion before surgery. At our institution, 167 MR-guided interventions (35 percutaneous biopsies and 132 preoperative localizations) have been performed with the use of different types of add-on devices during the past 3 years. Percutaneous biopsy (31 fine needle aspiration and four core biopsies) revealed 24 benign and 8 malignant lesions, 3 biopsies were insufficient. Histologic examination after MR-guided wire localization showed benign findings in 68 lesions (52%) and malignancy in 64 lesions (48%). Technical aspects, experiences, advantages, and disadvantages of our system as well as those of other devices are reported and discussed. MR-compatible equipment for interventions of the breast is demonstrated. In conclusion, we perform MR-guided interventions of the breast routinely in indicated cases at a rate of approximately 3-5% for all patients undergoing diagnostic contrast-enhanced MRI of the breast. PMID:9617901

  4. Second-look ultrasonography for MRI-detected suspicious breast lesions in patients with breast cancer

    PubMed Central

    2015-01-01

    Purpose: The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer. Methods: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed. Results: Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology. Conclusion: We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions. PMID:25623054

  5. Breast ultrasound imaging phantom to mimic malign lesion characteristics

    NASA Astrophysics Data System (ADS)

    de Carvalho, I. M.; Basto, R. L. Q.; Infantosi, A. F. C.; von Krüger, M. A.; Pereira, W. C. A.

    2010-01-01

    Ultrasound (US) phantoms are used to simulate the main acoustic properties of human soft tissues and are usually applied in guided biopsy training and equipment calibration. In this work it is presented an ultrasound phantom that mimics breast lesions with irregular edge, which is a typical feature related to malignancy. The phantom matrix was made of a mixture of water, agar, glycerine and graphite and PVC powders and the lesions were of silicon and polyacrylamide. The mimicking properties were US attenuation, propagation speed and density. The images obtained were visually compatible to malignant and benign lesions and are meant to be used as references for evaluation of segmentation algorithms for image processing.

  6. Improving diagnosis of atraumatic splenic lesions, part II: benign neoplasms/nonneoplastic mass-like lesions.

    PubMed

    Ricci, Zina J; Mazzariol, Fernanda S; Flusberg, Milana; Chernyak, Victoria; Oh, Sarah K; Kaul, Bindu; Stein, Marjorie W; Rozenblit, Alla M

    2016-01-01

    Focal atraumatic splenic lesions often pose a diagnostic challenge on cross-sectional imaging. They can be categorized based on etiology as nonneoplastic, benign neoplastic (discussed in Part II), and malignant neoplastic lesions or on prevalence as common, uncommon, and rare lesions. Familiarity with pertinent clinical parameters, etiology, pathology, prevalence and ancillary features such as splenomegaly, concomitant hepatic involvement, and extrasplenic findings, in addition to knowledge of imaging spectra of the lesions, can improve diagnostic confidence. Consideration of these factors together can arm the radiologist with the necessary tools to render a more confident diagnosis and, thus, better aid management. PMID:27317213

  7. Axial Shear Strain Imaging for Differentiating Benign and Malignant Breast Masses

    PubMed Central

    Xu, Haiyan; Rao, Min; Varghese, Tomy; Sommer, Amy; Baker, Sara; Hall, Timothy J; Sisney, Gale A; Burnside, Elizabeth S

    2010-01-01

    Axial strain imaging has been utilized for the characterization of breast masses for over a decade; however, another important feature namely the shear strain distribution around breast masses has only recently been used. In this paper, we examine the feasibility of utilizing in-vivo axial-shear strain imaging for differentiating benign from malignant breast masses. Radiofrequency data was acquired using a VFX 13-5 linear array transducer on 41 patients using a Siemens SONOLINE Antares real-time clinical scanner at the University of Wisconsin Breast Cancer Center. Free-hand palpation using deformations of up to 10% was utilized to generate axial strain and axial-shear strain images using a two-dimensional cross-correlation algorithm from the radiofrequency data loops. Axial-shear strain areas normalized to the lesion size, applied strain and lesion strain contrast was utilized as a feature for differentiating benign from malignant masses. The normalized axial-shear strain area feature estimated on 8 patients with malignant tumors and 33 patients with fibroadenomas was utilized to demonstrate its potential for lesion differentiation. Biopsy results were considered the diagnostic standard for comparison. Our results indicate that the normalized axial-shear strain area is significantly larger for malignant tumors when compared to benign masses such as fibroadenomas. Axial-shear strain pixel values greater than a specified threshold, including only those with correlation coefficient values greater than 0.75, were overlaid on the corresponding B-mode image to aid in diagnosis. A scatter plot of the normalized area feature demonstrates the feasibility of developing a linear classifier to differentiate benign from malignant masses. The area under the receiver operator characteristic curve utilizing the normalized axial-shear strain area feature was 0.996, demonstrating the potential of this feature to noninvasively differentiate between benign and malignant breast masses

  8. Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT

    PubMed Central

    Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

    2016-01-01

    Abstract Interpretation of 18F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

  9. Spectrum of the Breast Lesions With Increased 18F-FDG Uptake on PET/CT.

    PubMed

    Dong, Aisheng; Wang, Yang; Lu, Jianping; Zuo, Changjing

    2016-07-01

    Interpretation of F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging. PMID:26975010

  10. The Role of the Obstetrician-Gynecologist in the Management of Breast Lesions

    PubMed Central

    Weekes, Leroy R.

    1983-01-01

    This paper is based on the author's frequent experience in the diagnosis of breast masses in his everyday practice as an obstetriciangynecologist. It appears that gynecologists, by the very nature of their practices, are in an excellent position to head the case-finding expedition for breast lesions. Furthermore, the obstetrician-gynecologist can use acquired surgical skills to great advantage in the management of benign lesions and assist surgical associates in the management of the malignant lesions. PMID:6631987

  11. A Case of Benign Metastasizing Leiomyoma with Multiple Metastasis to the Soft Tissue, Skeletal Muscle, Lung and Breast

    PubMed Central

    Jo, Ji Hoon; Lee, Jin Hwa; Kim, Dae Cheol; Kim, Sung Hyun; Kwon, Hyuk Chan; Kim, Jae Seok

    2006-01-01

    Benign metastasizing leiomyoma (BML) is composed of well-differentiated smooth muscle cells and dense connective tissue. BML affects middle-aged women who have had previous hysterectomies due to a histologically benign-appearing uterine leiomyoma. We report here on a case of BML from the uterine leiomyoma in a 39-year-old woman that involved the soft tissues, skeletal muscles, lungs and breasts. She underwent a hysterectomy for the uterine leiomyoma, double oophorectomy for hormonal ablation and lung wedge resection to confirm the diagnosis. The microscopic findings of the breast and lung tumor were similar to those of the benign uterine leiomyoma. Therefore, we consider that these lesions were breast and pulmonary metastases of the uterine leiomyoma. We report here on a rare case of benign metastasizing uterine leiomyoma that involved the soft tissue, skeletal muscles, lungs and breasts, and we include a review of the relevant literature. PMID:17017672

  12. p53 alteration in morphologically normal/benign breast tissue in patients with triple-negative high-grade breast carcinomas: breast p53 signature?

    PubMed

    Wang, Xi; Stolla, Moritz; Ring, Brian Z; Yang, Qi; Laughlin, Todd S; Rothberg, Paul G; Skinner, Kristin; Hicks, David G

    2016-09-01

    p53 alterations have been identified in approximately 23% of breast carcinomas, particularly in hormone receptor-negative high-grade carcinomas. It is considered to be an early event in breast carcinogenesis. Nevertheless, the putative precursor lesion of high-grade breast carcinoma remains elusive. Breast excision specimens from 93 triple-negative high-grade invasive ductal carcinomas, 48 estrogen receptor (ER)-positive/progesterone receptor-positive/Her2-negative non-high-grade invasive ductal carcinomas, and 50 mammoplasty breasts were selected. At least 2 tissue blocks with tumor and adjacent benign tissue were sectioned and subjected to immunohistochemistry staining for p53. TP53 gene sequencing was performed on select tumors. Further immunohistochemistry staining for ER and Ki-67 was performed on consecutive sections of tissue with p53-positive normal/benign cells. Of the 93 high-grade carcinomas, 51 (55%) were positive for p53 alteration, whereas only 3 (6.25%) of the 48 non-high-grade carcinomas were p53 altered. Focal p53 positivity in adjacent normal/benign breast tissue was identified in 19 cases, and 18 of them also had p53 alteration in their carcinomas. Only 1 case had focal p53 staining in normal/benign tissue, but the tumor was negative for p53 alteration. No p53 staining positivity was identified in the mammoplasty specimens. The p53-stained normal/benign cells were ER negative and did not show an increase in the Ki-67 labeling index. These findings indicate that the p53 staining positivity in normal/benign breast tissue is not a random event. It could be considered as the "p53 signature" in breast and serve as an indicator for future potential risk of p53-positive high-grade breast carcinoma. PMID:27246177

  13. Breast lesions in generalized neurofibromatosis: breast cancer and cystosarcoma phylloides.

    PubMed

    el-Zawahry, M D; Farid, M; Abd el-Latif, A; Horeia, H; el-Gindy, M; Twakal, G

    1989-01-01

    This report describes three cases from one surgical unit of the Mansoura Teaching Hospital of Cairo, Egypt, with generalized neurofibromatosis and associated breast lesions. Two patients had carcinoma of the breast and the third had cystosarcoma phylloides. PMID:2560398

  14. Clinical Outcome of Magnetic Resonance Imaging-Detected Additional Lesions in Breast Cancer Patients

    PubMed Central

    Ha, Gi-Won; Yi, Mi Suk; Lee, Byoung Kil; Jung, Sung Hoo

    2011-01-01

    Purpose The aim of this study was to investigate the clinical outcome of additional breast lesions identified with breast magnetic resonance imaging (MRI) in breast cancer patients. Methods A total of 153 patients who underwent breast MRI between July 2006 and March 2008 were retrospectively reviewed. Thirty-three patients (21.6&) were recommended for second-look ultrasound (US) for further characterization of additional lesions detected on breast MRI and these patients constituted our study population. Results Assessment for lesions detected on breast MRI consisted of the following: 25 benign lesions (73.5&), two indeterminate (5.9%), and seven malignant (20.6%) in 33 patients. Second-look US identified 12 additional lesions in 34 lesions (35.3%) and these lesions were confirmed by histological examination. Of the 12 lesions found in the 11 patients, six (50.0%) including one contralateral breast cancer were malignant. The surgical plan was altered in 18.2% (six of 33) of the patients. The use of breast MRI justified a change in treatment for four patients (66.7%) and caused two patients (33.3&) to undergo unwarranted additional surgical procedures. Conclusion Breast MRI identified additional multifocal or contralateral cancer which was not detected initially on conventional imaging in breast cancer patients. Breast MRI has become an indispensable modality in conjunction with conventional modalities for preoperative evaluation of patients with operable breast cancer. PMID:22031803

  15. Computerized analysis of sonograms for the detection of breast lesions

    NASA Astrophysics Data System (ADS)

    Drukker, Karen; Giger, Maryellen L.; Horsch, Karla; Vyborny, Carl J.

    2002-05-01

    With a renewed interest in using non-ionizing radiation for the screening of high risk women, there is a clear role for a computerized detection aid in ultrasound. Thus, we are developing a computerized detection method for the localization of lesions on breast ultrasound images. The computerized detection scheme utilizes two methods. Firstly, a radial gradient index analysis is used to distinguish potential lesions from normal parenchyma. Secondly, an image skewness analysis is performed to identify posterior acoustic shadowing. We analyzed 400 cases (757 images) consisting of complex cysts, solid benign lesions, and malignant lesions. The detection method yielded an overall sensitivity of 95% by image, and 99% by case at a false-positive rate of 0.94 per image. In 51% of all images, only the lesion itself was detected, while in 5% of the images only the shadowing was identified. For malignant lesions these numbers were 37% and 9%, respectively. In summary, we have developed a computer detection method for lesions on ultrasound images of the breast, which may ultimately aid in breast cancer screening.

  16. Diagnostic evaluation of papillary lesions of the breast on core biopsy.

    PubMed

    Pathmanathan, Nirmala; Albertini, Ann-Flore; Provan, Pamela J; Milliken, Jane S; Salisbury, Elizabeth L; Bilous, A Michael; Byth, Karen; Balleine, Rosemary L

    2010-07-01

    The management of asymptomatic intraductal papillary lesions of the breast diagnosed on core biopsy poses a challenge for patients and clinicians, as the distinction between common benign lesions and atypical or malignant varieties may be difficult without formal excision. The aim of this study was to determine whether a combination of histopathologic and biomarker features could be used to accurately identify benign papillary lesions on core biopsy. An inclusive group of 127 excised papillary lesions was characterized by detailed histopathologic review and immunohistochemical staining for the basal markers cytokeratin 5/6 (CK5/6) and P63 and the proliferation marker Ki67. Comparison of benign, atypical, and malignant lesions revealed that the combination of broad, sclerotic fibrovascular cores, and epithelial CK5/6 staining was most commonly seen in benign papillomas. Ki67 staining revealed striking intralesional heterogeneity, but there was no difference between the high scores of benign, atypical, or malignant lesions (P=0.173). In a non-overlapping set of 42 cases, a binary classifier specifying benign lesions on the basis of thick fibrovascular cores and epithelial CK5/6 staining on core biopsy gave an overall misclassification rate of 4/42 (10%) when compared with the final excision diagnosis. Misclassified cases included 2/27 lesions ultimately diagnosed as benign and 2/2 atypical papillomas. All malignant lesions (n=13) were correctly assigned. The combined assessment of fibrovascular core thickness and CK5/6 staining on core biopsy distinguished benign from malignant papillary lesions, but did not separate benign from atypical cases. This approach may form a useful addition to the clinicopathologic evaluation of papillary lesions of the breast. PMID:20473278

  17. Textural kinetics: a novel dynamic contrast-enhanced (DCE)-MRI feature for breast lesion classification.

    PubMed

    Agner, Shannon C; Soman, Salil; Libfeld, Edward; McDonald, Margie; Thomas, Kathleen; Englander, Sarah; Rosen, Mark A; Chin, Deanna; Nosher, John; Madabhushi, Anant

    2011-06-01

    Dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) of the breast has emerged as an adjunct imaging tool to conventional X-ray mammography due to its high detection sensitivity. Despite the increasing use of breast DCE-MRI, specificity in distinguishing malignant from benign breast lesions is low, and interobserver variability in lesion classification is high. The novel contribution of this paper is in the definition of a new DCE-MRI descriptor that we call textural kinetics, which attempts to capture spatiotemporal changes in breast lesion texture in order to distinguish malignant from benign lesions. We qualitatively and quantitatively demonstrated on 41 breast DCE-MRI studies that textural kinetic features outperform signal intensity kinetics and lesion morphology features in distinguishing benign from malignant lesions. A probabilistic boosting tree (PBT) classifier in conjunction with textural kinetic descriptors yielded an accuracy of 90%, sensitivity of 95%, specificity of 82%, and an area under the curve (AUC) of 0.92. Graph embedding, used for qualitative visualization of a low-dimensional representation of the data, showed the best separation between benign and malignant lesions when using textural kinetic features. The PBT classifier results and trends were also corroborated via a support vector machine classifier which showed that textural kinetic features outperformed the morphological, static texture, and signal intensity kinetics descriptors. When textural kinetic attributes were combined with morphologic descriptors, the resulting PBT classifier yielded 89% accuracy, 99% sensitivity, 76% specificity, and an AUC of 0.91. PMID:20508965

  18. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).

    PubMed

    Rageth, Christoph J; O'Flynn, Elizabeth Am; Comstock, Christopher; Kurtz, Claudia; Kubik, Rahel; Madjar, Helmut; Lepori, Domenico; Kampmann, Gert; Mundinger, Alexander; Baege, Astrid; Decker, Thomas; Hosch, Stefanie; Tausch, Christoph; Delaloye, Jean-François; Morris, Elisabeth; Varga, Zsuzsanna

    2016-09-01

    The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision. PMID:27522516

  19. A Comparative Study of Immunohistochemical Myoepithelial Cell Markers in Cutaneous Benign Cystic Apocrine Lesions.

    PubMed

    Wood, Andrew; Houghton, Sinatra L; Biswas, Asok

    2016-07-01

    The use of immunohistochemical markers for myoepithelial cells (MEC) is a useful tool in the distinction of benign from malignant epithelial neoplasms. Although their use in breast tumors is well recognized, little is known concerning its application in comparable cutaneous lesions. Using benign cutaneous cystic apocrine lesions as a study model, the aim of this study was to compare 5 immunohistochemical markers [calponin, p63, smooth muscle actin (SMA), cytokeratin 14, and CD10] in their effectiveness to highlight MEC. Cases of apocrine hidrocystoma and cystadenoma (n = 44) were reviewed with a particular emphasis on proliferative features and apocrine change. The MEC staining pattern and the intensity and distribution scores in proliferative (n = 29) and nonproliferative (n = 15) lesions were assessed, and the differences between the 2 groups were statistically analyzed using Fisher exact test. Calponin and SMA stained MEC in the most consistent manner. Being a nuclear stain, p63 was easy to interpret but typically showed discontinuous staining. Cytokeratin 14 not only effectively highlighted MEC but also stained some luminal epithelial cells in an unpredictable manner. Because of prominent background dermal fibroblast staining, CD10 was often difficult to interpret. Only SMA and p63 showed a statistically significant difference in MEC staining intensity scores between the proliferative and nonproliferative groups. Our results show that immunohistological staining for MEC in benign cystic apocrine lesions of the skin is variable. The authors recommend that a panel of markers that includes calponin and p63 be used and highlight the need for awareness of specific caveats associated with individual markers. PMID:26630681

  20. Biomonitoring of organochlorines in women with benign and malignant breast disease

    SciTech Connect

    Siddiqui, M.K.J. . E-mail: mkjs@rediffmail.com; Anand, M.; Mehrotra, P.K.; Sarangi, R.; Mathur, N.

    2005-06-01

    Established risk factors for breast cancer explain breast cancer risk only partially. Organochlorines are considered to be a possible cause for hormone-dependent cancers. A hospital-based case-control study, the first from India, was conducted among 50 women undergoing surgery for breast disease to examine the association between organochlorine exposure and breast cancer risk. Blood, tumor, and surrounding adipose tissue of the breast were collected from the subjects with benign (control) and malignant breast (study) lesions and analyzed to determine organochlorine insecticides using a gas-liquid chromatograph equipped with an electron capture detector. The {alpha}, {beta}, {gamma}, and {delta} isomers of hexachlorocyclohexane (HCH), p,p'-dichlorodiphenyltrichloroethane (DDT), o,p'-DDT, p,p-dichlorodiphenyldichloroethylene, and p,p'-dichlorodiphenyldichloroethane were frequently detected in three specimens. Total HCH and total DDT levels were higher in the blood of the study group (25 cases) than in those of the controls (25 cases) with only {gamma}-HCH being significantly different (P0.05). However, both total HCH and total DDT were higher in the tumor tissues of the controls than in those of the study group; {gamma}-HCH was significantly different (P0.05). The level of total HCH ({alpha}-HCH was significantly different, P0.05) was higher in the breast adipose tissue of the study group, whereas total DDT was higher in the breast adipose tissue of the control group. The distribution of known confounders of breast cancer including age, body mass index, age at menarche and menopause, duration of breast feeding, and family history related to breast disease did not differ significantly between benign and malignant groups. This pilot study with limited statistical power does not support a positive association between exposure to organochlorines and risk of breast cancer but paves the way for a larger Indian study with greater statistical power encompassing different

  1. Utility of opposed-phase magnetic resonance imaging in differentiating sarcoma from benign bone lesions

    PubMed Central

    Kenneally, Barry E.; Gutowski, Christina J.; Reynolds, Alan W.; Morrison, William B.; Abraham, John A.

    2015-01-01

    Purpose To investigate the utility of opposed-phase magnetic resonance imaging (OP MRI) in differentiating malignant from benign bone lesions. Materials and methods MRI scans of musculoskeletal lesions including opposed-phase imaging sequences were reviewed by both an experienced musculoskeletal attending radiologist, and a second year radiology resident. The change in signal from IP to OP images was measured. The reviewers' evaluation of the lesions based on T1 and T2-weighted images was compared to their evaluation with inclusion of the OP sequences. Results Twenty-seven lesions in bone were analyzed: 4 malignant primary bone lesions, 3 malignant soft tissue lesions to bone, 3 metastases from visceral malignancies, and 17 benign bone lesions. Benign lesions of bone dropped in signal on OP imaging by an average of 37.1%. Five of the benign lesions decreased in signal by less than 20%, and two increased. Malignant bone lesions dropped in signal by an average of 0.69% with one of the ten lesions showing a greater than 20% drop. When OP sequences were included, concern for malignancy decreased in benign lesions and increased in malignant lesions, for both the resident and attending. Compared with standard MRI, inclusion of these sequences increased the overall confidence in diagnosis for both reviewers. Conclusion Opposed-phase imaging is helpful in differentiating benign from malignant lesions in bone. Confidence in diagnosis rose for both the attending and the resident as result of the inclusion of OP sequences. PMID:26730359

  2. Prospective evaluation of skin surface electropotentials in Japanese patients with suspicious breast lesions.

    PubMed

    Fukuda, M; Shimizu, K; Okamoto, N; Arimura, T; Ohta, T; Yamaguchi, S; Faupel, M L

    1996-10-01

    The biofield breast examination (BBE) is a new, noninvasive and cost-effective method for diagnosing breast lesions currently undergoing multicenter evaluation in the USA and Europe. The test analyzes subtle differences in electrical potential caused by dysregulated epithelial proliferation. This report summarizes a prospective evaluation of BBE in a population of 101 patients with suspicious breast lesions scheduled either for open surgical biopsy or fine needle aspiration biopsy. Of the 101 patients included in the study, 49 were found to have a breast malignancy and 52 were found to have a benign breast lesion. BBE correctly identified 44 of 49 biopsy-proven cancers (sensitivity=90%) and correctly indicated no cancer in 31 of 52 biopsy-proven benign cases (specificity=60%). Sensitivity increased to 95% for cancers less than 2.5 cm in size. These results indicate that BBE may be an effective adjunctive test to help to resolve abnormalities discovered by physical examination or other screening methods. PMID:8957069

  3. The Diagnostic Value of Superb Microvascular Imaging (SMI) in Detecting Blood Flow Signals of Breast Lesions

    PubMed Central

    Ma, Yan; Li, Gang; Li, Jing; Ren, Wei-dong

    2015-01-01

    Abstract The correlation between color Doppler flow imaging (CDFI) and Superb Microvascular Imaging (SMI) for detecting blood flow in breast lesions was investigated, as was the diagnostic value of SMI in differentiating benign from malignant breast lesions. These lesions were evaluated using both CDFI and SMI according to Adler's method. Pathologic examination showed 57 malignant lesions and 66 benign lesions. The number of blood vessels in a single mass was detected by 2 techniques (SMI and CDFI), and the difference between the 2 values (SMI-CDFI) was calculated. The optimal threshold for the diagnosis of malignant neoplasms and the diagnostic performances of SMI, CDFI, and SMI-CDFI were calculated. For the total lesions and malignant lesions alone, the difference between SMI and CDFI for detecting blood flow was significant (P < 0.01), but the difference was not significant for benign lesions (P = 0.15). The area under the receiver operating characteristic curve was 0.73 (95% confidence interval [CI]: 0.64–0.82) for CDFI; 0.81 (95% CI: 0.74–0.89) for SMI; and 0.89 (95% CI: 0.82–0.95) for SMI-CDFI. Furthermore, the modality of “SMI-CDFI” showed the best diagnostic performance. SMI provides further microvessel information in breast lesions. The diagnostic modality of “SMI-CDFI” can improve the diagnostic performance of ultrasound in the differentiation between benign and malignant masses. PMID:26356718

  4. Facts for Life: Benign Breast Changes

    MedlinePlus

    ... this series: • Biopsy • Screening and Early Detection • Imaging Methods Used to Find Breast Cancer • Mammography • When You Discover a Lump or Change Susan G. Komen ® is not a health care provider and does not give medical advice. The information provided in this material is not meant to be used for self- ...

  5. Breast ultrasound lesions classification: a performance evaluation between manual delineation and computer segmentation

    NASA Astrophysics Data System (ADS)

    Yap, Moi Hoon; Yap, Chuin Hong

    2016-03-01

    Breast cancer is a threat to women worldwide. Manual delineation on breast ultrasound lesions is time-consuming and operator dependent. Computer segmentation of ultrasound breast lesions can be a challenging task due to the ill-defined lesions boundaries and issues related to the speckle noise in ultrasound images. The main contribution of this paper is to compare the performance of the computer classifier on the manual delineation and computer segmentation in malignant and benign lesions classification. This paper we implement computer segmentation using multifractal approach on a database consists of 120 images (50 malignant lesions and 70 benign lesions). The computer segmentation result is compared with the manual delineation using Jaccard Similarity Index (JSI). The result shows that the average JSI of 0.5010 (+/-0.2088) for malignant lesions and the average JSI of 0.6787 (+/-0.1290) for benign lesions. These results indicate lower agreement in malignant lesions due to the irregular shape while the higher agreement in benign lesions with regular shape. Further, we extract the shape descriptors for the lesions. By using logistic regression with 10 fold cross validation, the classification rates of manual delineation and computer segmentation are computed. The computer segmentation produced results with sensitivity 0.780 and specificity 0.871. However, the manual delineation produced sensitivity of 0.520 and specificity of 0.800. The results show that there are no clear differences between the delineation in MD and CS in benign lesions but the computer segmentation on malignant lesions shows better accuracy for computer classifier.

  6. Spatial and temporal age-related spectral alterations in benign human breast tissue

    NASA Astrophysics Data System (ADS)

    Theophilou, Georgios; Fogarty, Simon W.; Trevisan, Júlio; Strong, Rebecca J.; Heys, Kelly A.; Patel, Imran I.; Stringfellow, Helen F.; Martin-Hirsch, Pierre L.; Martin, Francis L.

    2016-02-01

    Epidemiological evidence suggests that cancers attributable to exogenous carcinogenic agents may appear decades after initiating exposures. Environmental factors including lifestyle and/or diet have been implicated in the aetiology of breast cancer. Breast tissue undergoes continuous molecular and morphological changes from the time of thelarche to menopause and thereafter. These alterations are both cyclical and longitudinal, and can be influenced by several environmental factors including exposure to oestrogens. Research into the latent period leading to breast carcinogenesis has been mostly limited to when hyperplastic lesions are present. Investigations to identify a biomarker of commitment to disease in normal breast tissue are hindered by the molecular and histological diversity of disease-free breast tissue. Benign tissue from reduction mammoplasties provides an opportunity to study biochemical differences between women of similar ages as well as alterations with advancing age. Herein, synchrotron radiation-based Fourier-transform infrared (SR-FTIR) microspectroscopy was used to examine the terminal ductal lobular epithelium (TDLU) and, intra- and inter-lobular epithelium to identify spatial and temporal changes within these areas. Principal component analysis (PCA) followed by linear discriminant analysis of mid-infrared spectra revealed unambiguous inter-individual as well as age-related differences in each histological compartment interrogated. Moreover, exploratory PCA of luminal and myoepithelial cells within the TDLU indicated the presence of specific cells, potentially stem cells. Understanding alterations within benign tissue may assist in the identification of alterations in latent pre-clinical stages of breast cancer.

  7. Frequent phosphatidylinositol-3-kinase mutations in proliferative breast lesions.

    PubMed

    Ang, Daphne C; Warrick, Andrea L; Shilling, Amy; Beadling, Carol; Corless, Christopher L; Troxell, Megan L

    2014-05-01

    The phosphatidylinositol-3-kinase pathway is one of the most commonly altered molecular pathways in invasive breast carcinoma, with phosphatidylinositol-3-kinase catalytic subunit (PIK3CA) mutations in 25% of invasive carcinomas. Ductal carcinoma in situ (DCIS), benign papillomas, and small numbers of columnar cell lesions harbor an analogous spectrum of PIK3CA and AKT1 mutations, yet there is little data on usual ductal hyperplasia and atypical ductal and lobular neoplasias. We screened 192 formalin-fixed paraffin-embedded breast lesions from 75 patients for point mutations using a multiplexed panel encompassing 643 point mutations across 53 genes, including 58 PIK3CA substitutions. PIK3CA point mutations were identified in 31/62 (50%) proliferative lesions (usual ductal hyperplasia and columnar cell change), 10/14 (71%) atypical hyperplasias (atypical ductal hyperplasia and flat epithelial atypia), 7/16 (44%) lobular neoplasias (atypical lobular hyperplasia and lobular carcinoma in situ), 10/21 (48%) DCIS, and 13/37 (35%) invasive carcinomas. In genotyping multiple lesions of different stage from the same patient/specimen, we found considerable heterogeneity; most notably, in 12 specimens the proliferative lesion was PIK3CA mutant but the concurrent carcinoma was wild type. In 11 additional specimens, proliferative epithelium and cancer contained different point mutations. The frequently discordant genotypes of usual ductal hyperplasia/columnar cell change and concurrent carcinoma support a role for PIK3CA-activating point mutations in breast epithelial proliferation, perhaps more so than transformation. Further, these data suggest that proliferative breast lesions are heterogeneous and may represent non-obligate precursors of invasive carcinoma. PMID:24186142

  8. Retinoids, carotenoids, and tocopherols in breast adipose tissue and serum of benign breast disease and breast cancer patients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Various retinoic acid (RA) isomers (all-trans, 13-cis, 11-cis, and 9-cis) as well as retinol, carotenoids, and tocopherol concentrations were determined in both serum and breast adipose tissue of 22 benign breast disease patients and 52 breast cancer patients categorized into 4 stages by malignancy....

  9. Bimodal Multiparameter-Based Approach for Benign-Malignant Classification of Breast Tumors.

    PubMed

    Ara, Sharmin R; Alam, Farzana; Rahman, Md Hadiur; Akhter, Shabnam; Awwal, Rayhana; Hasan, Kamrul

    2015-07-01

    Proposed here is a breast tumor classification technique using conventional ultrasound B-mode imaging and a new elasticity imaging-based bimodal multiparameter index. A set of conventional ultrasound (US) and ultrasound elastography (UE) parameters are studied, and among those, the effective ones whose independent as well as combined performance is found satisfactory are selected. To improve the combined US performance, two new US parameters are proposed: edge diffusivity, which assesses edge blurriness to differentiate malignant from benign lesions, and the shape asymmetry factor, which quantifies tumor shape irregularity by comparing the tumor boundary with an ellipse fitted to the lesion. Then a new bimodal multiparameter characterization index is defined to discriminate 201 pathologically confirmed breast tumors of which 56 are malignant lesions, 79 are fibroadenomas, 42 are cysts and 24 are inflammatory lesions. The weights of the multiparameter bimodal index are optimally computed using a genetic algorithm (GA). To evaluate the performance variation of the index on different data sets, the tumors are categorized into three classes: malignant lesion versus fibroadenoma, malignant lesion versus fibroadenoma and cyst and malignant lesion versus fibroadenoma, cyst and inflammation. The test results reveal that the proposed bimodal index achieves satisfactory quality metrics (e.g., 94.64%-98.21% sensitivity, 97.24%-100.00% specificity and 96.52%-99.44% accuracy) for classification of the aforementioned three classes of breast tumors. Its performance is also observed to be better in totality of the quality metrics sensitivity, specificity, accuracy, positive predictive value and negative predictive value as compared with that of a conventional bimodal index as well as unimodal multiparameter indices based on US or UE. It is suggested that the proposed simple bimodal linear classifier may assist radiologists in better diagnosis of breast tumors and help reduce the

  10. Robotic lung segmentectomy for malignant and benign lesions

    PubMed Central

    Toker, Alper; Ayalp, Kemal; Uyumaz, Elena; Kaba, Erkan; Demirhan, Özkan

    2014-01-01

    Objective Surgical use of robots has evolved over the last 10 years. However, the academic experience with robotic lung segmentectomy remains limited. We aimed to analyze our lung segmentectomy experience with robot-assisted thoracoscopic surgery. Methods Prospectively recorded clinical data of 21 patients who underwent robotic lung anatomic segmentectomy with robot-assisted thoracoscopic surgery were retrospectively reviewed. All cases were done using the da Vinci System. A three incision portal technique with a 3 cm utility incision in the posterior 10th to 11th intercostal space was performed. Individual dissection, ligation and division of the hilar structures were performed. Systematic mediastinal lymph node dissection or sampling was performed in 15 patients either with primary or secondary metastatic cancers. Results Fifteen patients (75%) were operated on for malignant lung diseases. Conversion to open surgery was not necessary. Postoperative complications occurred in four patients. Mean console robotic operating time was 84±26 (range, 40-150) minutes. Mean duration of chest tube drainage and mean postoperative hospital stay were 3±2.1 (range, 1-10) and 4±1.4 (range, 2-7) days respectively. The mean number of mediastinal stations and number of dissected lymph nodes were 4.2 and 14.3 (range, 2-21) from mediastinal and 8.1 (range, 2-19) nodes from hilar and interlobar stations respectively. Conclusions Robot-assisted thoracoscopic segmentectomy for malignant and benign lesions appears to be practical, safe, and associated with few complications and short postoperative hospitalization. Lymph node removal also appears oncologically acceptable for early lung cancer patients. Benefits in terms of postoperative pain, respiratory function, and quality of life needs a comparative, prospective series particularly with video-assisted thoracoscopic surgery. PMID:25093090

  11. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  12. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  13. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  14. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  15. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  16. Benign liver lesions: grey-scale and contrast-enhanced ultrasound appearances

    PubMed Central

    Obaro, A E

    2015-01-01

    Ultrasound is often the first point of detection of liver lesions, with up to 75% of liver lesions detected at ultrasound having benign histology. In 2012, NICE issued recommendations that ultrasound contrast be used for the evaluation of incidentally discovered liver lesions. This has been demonstrated to provide a rapid and cost-effective evaluation for incidental liver lesions, in many cases precluding the need for further CT or MRI scans. The aim of this review is to demonstrate the ultrasound features of benign liver lesions, and to demonstrate their further characterisation with contrast ultrasound.

  17. SSAT/AHPBA Joint Symposium on Evaluation and Treatment of Benign Liver Lesions

    PubMed Central

    Chun, Yun Shin; House, Michael G.; Kaur, Harmeet; Loyer, Evelyne M.; Paradis, Valérie; Vauthey, Jean-Nicolas

    2013-01-01

    Background Benign liver lesions are common incidental radiologic findings. Methods Experts convened in 2011 at a Society for Surgery of the Alimentary Tract/ Americas Hepato-Pancreato-Biliary Association joint symposium to discuss the evaluation and treatment of benign liver lesions. Results Most benign liver lesions can be accurately diagnosed with high-quality imaging, including ultrasonography, multiphase computed tomography, and magnetic resonance imaging, particularly with hepatocyte-specific contrast agents. Percutaneous biopsy is reserved for lesions that cannot be characterized radiographically, and its accuracy is improved with immunophenotypic markers. Hepatic cysts are the most commonly diagnosed benign liver lesions; these must be distinguished from malignant cystic lesions, which are rare. Among the solid benign liver lesions, hemangiomas and focal nodular hyperplasia seldom require treatment. In contrast, hepatocellular adenomas are associated with a risk for complications. A new classification system for hepatocellular adenomas based on genetic and phenotypic features can help guide patient care. In patients who are symptomatic or at risk for complications, multidisciplinary evaluation and treatment based on clinicopathologic, radiographic, and molecular analysis is needed. Conclusions Most benign liver lesions can be accurately diagnosed radiographically and do not require treatment. Treatment is necessary for patients with symptoms or at risk for complications. PMID:23377783

  18. Diagnostic imaging strategy for MDCT- or MRI-detected breast lesions: use of targeted sonography

    PubMed Central

    2012-01-01

    Background Leading-edge technology such as magnetic resonance imaging (MRI) or computed tomography (CT) often reveals mammographically and ultrasonographically occult lesions. MRI is a well-documented, effective tool to evaluate these lesions; however, the detection rate of targeted sonography varies for MRI detected lesions, and its significance is not well established in diagnostic strategy of MRI detected lesions. We assessed the utility of targeted sonography for multidetector-row CT (MDCT)- or MRI-detected lesions in practice. Methods We retrospectively reviewed 695 patients with newly diagnosed breast cancer who were candidates for breast conserving surgery and underwent MDCT or MRI in our hospital between January 2004 and March 2011. Targeted sonography was performed in all MDCT- or MRI-detected lesions followed by imaging-guided biopsy. Patient background, histopathology features and the sizes of the lesions were compared among benign, malignant and follow-up groups. Results Of the 695 patients, 61 lesions in 56 patients were detected by MDCT or MRI. The MDCT- or MRI-detected lesions were identified by targeted sonography in 58 out of 61 lesions (95.1%). Patients with pathological diagnoses were significantly older and more likely to be postmenopausal than the follow-up patients. Pathological diagnosis proved to be benign in 20 cases and malignant in 25. The remaining 16 lesions have been followed up. Lesion size and shape were not significantly different among the benign, malignant and follow-up groups. Conclusions Approximately 95% of MDCT- or MRI-detected lesions were identified by targeted sonography, and nearly half of these lesions were pathologically proven malignancies in this study. Targeted sonography is a useful modality for MDCT- or MRI-detected breast lesions. PMID:22691539

  19. Caffeine consumption and benign breast disease: a case-control comparison.

    PubMed

    Marshall, J; Graham, S; Swanson, M

    1982-06-01

    In this case-control comparison of 323 women with benign breast disease and 1,458 controls, no differences were noted in the coffee and tea consumption patterns of the cases and controls. These findings do not support the recent suggestion of Minton, et al, that methylxanthine ingestion is causally related to benign breast disease or breast cancer. PMID:7072882

  20. Role of Breast Ultrasound for the Detection and Differentiation of Breast Lesions

    PubMed Central

    Madjar, Helmut

    2010-01-01

    Summary Diagnosis of breast cancer has been widely improved since the development of high-resolution ultrasound equipment. In the past, ultrasound was only considered useful for the diagnosis of cysts. Meanwhile, it improves the differential diagnosis of benign and malignant lesions, local preoperative staging and guided interventional diagnosis. In dense breasts, mammography has limited sensitivity. Furthermore, women with dense parenchyma have a highly increased risk of breast cancer development. Ultrasound is useful to examine dense breast tissue. Recent studies have shown that the detection of small cancers with high-resolution ultrasound is increased by 3–4 cancers per 1,000 women without clinical or mammographic abnormalities. Furthermore, stage distribution is similar between mammographically and sonographically detected carcinomas. Ultrasound is routinely used for curative diagnosis, to overcome the limitations of mammography. However, within the mammographic screening in Germany, breast density is not considered as important. Ultrasound is only used if a suspicious lesion is detected by mammography. Interestingly, 2 years ago, a screening project started in Austria in which ultrasound is always added in cases of dense breasts. Preliminary data show that the detection of additional carcinomas is increased in the same order as shown in previous studies. Therefore, an improved cancer detection and differentiation can be expected with high-resolution ultrasound. PMID:20847824

  1. Advanced MRI Techniques in the Evaluation of Complex Cystic Breast Lesions

    PubMed Central

    Popli, Manju Bala; Gupta, Pranav; Arse, Devraj; Kumar, Pawan; Kaur, Prabhjot

    2016-01-01

    OBJECTIVE The purpose of this research work was to evaluate complex cystic breast lesions by advanced MRI techniques and correlating imaging with histologic findings. METHODS AND MATERIALS In a cross-sectional design from September 2013 to August 2015, 50 patients having sonographically detected complex cystic lesions of the breast were included in the study. Morphological characteristics were assessed. Dynamic contrast-enhanced MRI along with diffusion-weighted imaging and MR spectroscopy were used to further classify lesions into benign and malignant categories. All the findings were correlated with histopathology. RESULTS Of the 50 complex cystic lesions, 32 proved to be benign and 18 were malignant on histopathology. MRI features of heterogeneous enhancement on CE-MRI (13/18), Type III kinetic curve (13/18), reduced apparent diffusion coefficient (18/18), and tall choline peak (17/18) were strong predictors of malignancy. Thirteen of the 18 lesions showed a combination of Type III curve, reduced apparent diffusion coefficient value, and tall choline peak. CONCLUSIONS Advanced MRI techniques like dynamic imaging, diffusion-weighted sequences, and MR spectroscopy provide a high level of diagnostic confidence in the characterization of complex cystic breast lesion, thus allowing early diagnosis and significantly reducing patient morbidity and mortality. From our study, lesions showing heterogeneous contrast enhancement, Type III kinetic curve, diffusion restriction, and tall choline peak were significantly associated with malignant complex cystic lesions of the breast. PMID:27330299

  2. Computerized lesion detection on breast ultrasound.

    PubMed

    Drukker, Karen; Giger, Maryellen L; Horsch, Karla; Kupinski, Matthew A; Vyborny, Carl J; Mendelson, Ellen B

    2002-07-01

    We investigated the use of a radial gradient index (RGI) filtering technique to automatically detect lesions on breast ultrasound. After initial RGI filtering, a sensitivity of 87% at 0.76 false-positive detections per image was obtained on a database of 400 patients (757 images). Next, lesion candidates were segmented from the background by maximizing an average radial gradient (ARD) index for regions grown from the detected points. At an overlap of 0.4 with a radiologist lesion outline, 75% of the lesions were correctly detected. Subsequently, round robin analysis was used to assess the quality of the classification of lesion candidates into actual lesions and false-positives by a Bayesian neural network. The round robin analysis yielded an Az value of 0.84, and an overall performance by case of 94% sensitivity at 0.48 false-positives per image. Use of computerized analysis of breast sonograms may ultimately facilitate the use of sonography in breast cancer screening programs. PMID:12148724

  3. Malignant hyperechoic breast lesions at ultrasound: A pictorial essay.

    PubMed

    Tiang, Stephen; Metcalf, Cecily; Dissanayake, Deepthi; Wylie, Elizabeth

    2016-08-01

    Malignant breast lesions are typically hypoechoic at sonography. However, a small subgroup of hyperechoic malignant breast lesions is encountered in clinical practice. We present a pictorial essay of a number of different hyperechoic breast malignancies with mammographic, sonographic and histopathologic correlation. Suspicious sonographic features in a hyperechoic lesion include inhomogeneity in echogenic pattern, an irregular margin, posterior acoustic shadowing and internal vascularity. A hyperechoic lesion at ultrasound does not discount the need to undertake histological assessment of a mammographically suspicious lesion. PMID:27216965

  4. ROC analysis of lesion descriptors in breast ultrasound images

    NASA Astrophysics Data System (ADS)

    Andre, Michael P.; Galperin, Michael; Phan, Peter; Chiu, Peter

    2003-05-01

    Breast biopsy serves as the key diagnostic tool in the evaluation of breast masses for malignancy, yet the procedure affects patients physically and emotionally and may obscure results of future mammograms. Studies show that high quality ultrasound can distinguish a benign from malignant lesions with accuracy, however, it has proven difficult to teach and clinical results are highly variable. The purpose of this study is to develop a means to optimize an automated Computer Aided Imaging System (CAIS) to assess Level of Suspicion (LOS) of a breast mass. We examine the contribution of 15 object features to lesion classification by calculating the Wilcoxon area under the ROC curve, AW, for all combinations in a set of 146 masses with known findings. For each interval A, the frequency of appearance of each feature and its combinations with others was computed as a means to find an "optimum" feature vector. The original set of 15 was reduced to 6 (area, perimeter, diameter ferret Y, relief, homogeneity, average energy) with an improvement from Aw=0.82-/+0.04 for the original 15 to Aw=0.93-/+0.02 for the subset of 6, p=0.03. For comparison, two sub-specialty mammography radiologists also scored the images for LOS resulting in Az of 0.90 and 0.87. The CAIS performed significantly higher, p=0.02.

  5. Ultrasound RF time series for classification of breast lesions.

    PubMed

    Uniyal, Nishant; Eskandari, Hani; Abolmaesumi, Purang; Sojoudi, Samira; Gordon, Paula; Warren, Linda; Rohling, Robert N; Salcudean, Septimiu E; Moradi, Mehdi

    2015-02-01

    This work reports the use of ultrasound radio frequency (RF) time series analysis as a method for ultrasound-based classification of malignant breast lesions. The RF time series method is versatile and requires only a few seconds of raw ultrasound data with no need for additional instrumentation. Using the RF time series features, and a machine learning framework, we have generated malignancy maps, from the estimated cancer likelihood, for decision support in biopsy recommendation. These maps depict the likelihood of malignancy for regions of size 1 mm(2) within the suspicious lesions. We report an area under receiver operating characteristics curve of 0.86 (95% confidence interval [CI]: 0.84%-0.90%) using support vector machines and 0.81 (95% CI: 0.78-0.85) using Random Forests classification algorithms, on 22 subjects with leave-one-subject-out cross-validation. Changing the classification method yielded consistent results which indicates the robustness of this tissue typing method. The findings of this report suggest that ultrasound RF time series, along with the developed machine learning framework, can help in differentiating malignant from benign breast lesions, subsequently reducing the number of unnecessary biopsies after mammography screening. PMID:25350925

  6. Benign and low-grade fibroepithelial neoplasms of the breast have low recurrence rate after positive surgical margins.

    PubMed

    Cowan, Morgan L; Argani, Pedram; Cimino-Mathews, Ashley

    2016-03-01

    Breast phyllodes tumors are uncommon fibroepithelial neoplasms with a range of histologic features. Surgical excision is the primary management, but the need for excision to negative margins in benign and borderline phyllodes tumors is unclear. Here, we review the surgical management patterns and outcomes of 90 patients with benign and low-grade fibroepithelial lesions of the breast treated at our institution, including 19 borderline phyllodes tumors, 52 benign phyllodes tumors, and 19 representative neoplasms with overlapping features of fibroadenoma and benign phyllodes tumors, which were classified as 'fibroadenomas with phyllodal features'. In total, 52 (58%) had positive surgical margins on first excision, and of these 17 (33%) underwent re-excision to achieve negative margins. Residual tumor was identified in three (18%) re-excisions. Patients with fibroadenoma with phyllodal features were more likely to have a positive surgical margin than with benign phyllodes tumors or borderline phyllodes tumors (89 vs 49%, P=0.0015), and were less likely to undergo re-excision for positive margins (12 vs 43%, P=0.031). In total, there were three recurrences (3%), with one per fibroadenoma with phyllodal features, benign phyllodes tumor, and borderline phyllodes tumor. There was no statistically significant difference in recurrence rates between patients with positive or negative margins, or between patients with positive margin with or without re-excision. The extent of the positive margin did not predict recurrence. In conclusion, the recurrence rate of benign and low-grade fibroepithelial lesions is low and not associated with the original margin status. Patients with fibroadenomas with phyllodal features, benign phyllodes tumors, or selected borderline phyllodes tumors and positive margins on initial excision may be managed conservatively, with close follow-up and timely re-excision of any potential recurrence. PMID:26743469

  7. Targeted Ultrasound for MR-Detected Lesions in Breast Cancer Patients

    PubMed Central

    Shin, Jung Hee; Choe, Yeon Hyeon; Ko, Kyungran; Choi, Nami

    2007-01-01

    Objective To investigate the usefulness of targeted ultrasound (US) in the identification of additional suspicious lesions found by magnetic resonance (MR) imaging in breast cancer patients and the changes in treatment based on the identification of the lesions by the use of targeted US. Materials and Methods One-hundred forty nine patients who underwent breast MR imaging for a preoperative evaluation of breast cancer between January 2002 and July 2004 were included in the study. We searched all cases for any additional lesions that were found initially by MR imaging and investigated the performance of targeted US in identifying the lesions. We also investigated their pathological outcomes and changes in treatment as a result of lesion identification. Results Of the 149 patients with breast cancer, additional suspicious lesions were detected with MR imaging in 62 patients (42%). Of the 69 additional lesions found in those 62 patients, 26 (38%) were confirmed as cancers by histology. Thirty-eight lesions in 31 patients were examined with targeted US and were histologically revealed as cancers in 18 (47%), high risk lesions in two (5%), benign lesions in 15 (39%), and unidentified lesions in three (8%). The cancer rate was statistically higher in lesions with a US correlate than in lesions without a US correlate (p = 0.028). Of 31 patients, the surgical plan was altered in 27 (87%). The use of targeted US justified a change in treatment for 22 patients (81%) and misled five patients (19%) into having an unnecessary surgical excision. Conclusion Targeted US can play a useful role in the evaluation of additional suspicious lesions detected by MR imaging in breast cancer patients, but is limited in lesions without a US correlate. PMID:18071277

  8. Diagnostic Value of Hook Wire Localization Technique for Non-Palpable Breast Lesions

    PubMed Central

    Demiral, Gokhan; Senol, Metin; Bayraktar, Baris; Ozturk, Hasan; Celik, Yahya; Boluk, Salih

    2016-01-01

    Background The aim of this study was to investigate the validity of hook wire localization biopsy for non-palpable breast lesions which were detected by ultrasonography (USG) or mammography (MMG). Methods In this retrospective study, USG or MMG-guided hook wire localization technique was performed on 83 patients who had non-palpable breast lesions. Then histopathological examination was performed on surgically removed specimens. All patients’ mammograms or ultrasonograms were categorized using Breast Imaging-Reporting and Data System (BI-RADS) classification. Results Radiologically, 27 (32.53%) patients were classified as BI-RADS 3, 49 (59.04%) BI-RADS 4, one (1.2%) BIRADS 5 and six (7.23%) BI-RADS 0. Histopathological results were benign in 68 (81.9%) and malignant in 15 (18.1%) patients. Twenty-seven patients were classified as BI-RADS 3 and definitive diagnoses for all were benign. Besides, 49 patients were classified as BI-RADS 4 and histopathologically 14 of them were reported as malignant, and 35 as benign. Sensitivity of MMG was 93% and specificity was 55%. For USG, the sensitivity was 100% and the specificity was 73%. Conclusion In early diagnosis of breast cancer, the validity of the imaging-guided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successfull results of hook wire localization technique. PMID:27081425

  9. Impact of preventive therapy on the risk of breast cancer among women with benign breast disease.

    PubMed

    Cuzick, Jack; Sestak, Ivana; Thorat, Mangesh A

    2015-11-01

    There are three main ways in which women can be identified as being at high risk of breast cancer i) family history of breast and/or ovarian cancer, which includes genetic factors ii) mammographically identified high breast density, and iii) certain types of benign breast disease. The last category is the least common, but in some ways the easiest one for which treatment can be offered, because these women have already entered into the treatment system. The highest risk is seen in women with lobular carcinoma in situ (LCIS), but this is very rare. More common is atypical hyperplasia (AH), which carries a 4-5-fold risk of breast cancer as compared to general population. Even more common is hyperplasia of the usual type and carries a roughly two-fold increased risk. Women with aspirated cysts are also at increased risk of subsequent breast cancer. Tamoxifen has been shown to be particularly effective in preventing subsequent breast cancer in women with AH, with a more than 70% reduction in the P1 trial and a 60% reduction in IBIS-I. The aromatase inhibitors (AIs) also are highly effective for AH and LCIS. There are no published data on the effectiveness of tamoxifen or the AIs for breast cancer prevention in women with hyperplasia of the usual type, or for women with aspirated cysts. Improving diagnostic consistency, breast cancer risk prediction and education of physicians and patients regarding therapeutic prevention in women with benign breast disease may strengthen breast cancer prevention efforts. PMID:26255741

  10. Quantitative Analysis of Vascular Heterogeneity in Breast Lesions Using Contrast-Enhanced 3-D Harmonic and Subharmonic Ultrasound Imaging

    PubMed Central

    Sridharan, Anush; Eisenbrey, John R.; Machado, Priscilla; Ojeda-Fournier, Haydee; Wilkes, Annina; Sevrukov, Alexander; Mattrey, Robert F.; Wallace, Kirk; Chalek, Carl L.; Thomenius, Kai E.; Forsberg, Flemming

    2015-01-01

    Ability to visualize breast lesion vascularity and quantify the vascular heterogeneity using contrast-enhanced 3-D harmonic (HI) and subharmonic (SHI) ultrasound imaging was investigated in a clinical population. Patients (n = 134) identified with breast lesions on mammography were scanned using power Doppler imaging, contrast-enhanced 3-D HI, and 3-D SHI on a modified Logiq 9 scanner (GE Healthcare). A region of interest corresponding to ultrasound contrast agent flow was identified in 4D View (GE Medical Systems) and mapped to raw slice data to generate a map of time-intensity curves for the lesion volume. Time points corresponding to baseline, peak intensity, and washout of ultrasound contrast agent were identified and used to generate and compare vascular heterogeneity plots for malignant and benign lesions. Vascularity was observed with power Doppler imaging in 84 lesions (63 benign and 21 malignant). The 3-D HI showed flow in 8 lesions (5 benign and 3 malignant), whereas 3-D SHI visualized flow in 68 lesions (49 benign and 19 malignant). Analysis of vascular heterogeneity in the 3-D SHI volumes found benign lesions having a significant difference in vascularity between central and peripheral sections (1.71 ± 0.96 vs. 1.13 ± 0.79 dB, p < 0.001, respectively), whereas malignant lesions showed no difference (1.66 ± 1.39 vs. 1.24 ± 1.14 dB, p = 0.24), indicative of more vascular coverage. These preliminary results suggest quantitative evaluation of vascular heterogeneity in breast lesions using contrast-enhanced 3-D SHI is feasible and able to detect variations in vascularity between central and peripheral sections for benign and malignant lesions. PMID:25935933

  11. Imaging features of benign and malignant ampullary and periampullary lesions.

    PubMed

    Nikolaidis, Paul; Hammond, Nancy A; Day, Kevin; Yaghmai, Vahid; Wood, Cecil G; Mosbach, David S; Harmath, Carla B; Taffel, Myles T; Horowitz, Jeanne M; Berggruen, Senta M; Miller, Frank H

    2014-01-01

    The ampulla of Vater is an important anatomic landmark where the common bile duct and main pancreatic duct converge in the major duodenal papilla. Imaging evaluation of the ampulla and periampullary region poses a unique diagnostic challenge to radiologists because of the region's complex and variable anatomy and the variety of lesions that can occur. Lesions intrinsic to the ampulla and involved segment of the biliary tree can be neoplastic, inflammatory, or congenital. Neoplastic lesions include ampullary adenocarcinomas and adenomas, which often are difficult to differentiate, as well as pancreatic or duodenal adenocarcinomas, pancreatic neuroendocrine tumors, and cholangiocarcinomas. Ultrasonography (US), computed tomography, magnetic resonance (MR) imaging, and MR cholangiopancreatography are commonly used to evaluate this region. Endoscopic retrograde cholangiopancreatography or endoscopic US examination may be necessary for more definitive evaluation. Periampullary conditions in the duodenum that may secondarily involve the ampulla include neoplasms, duodenitis, duodenal diverticula, and Brunner's gland hyperplasia or hamartomas. Because these lesions can exhibit a wide overlap of imaging features and subtle or nonspecific imaging findings, diagnosis is made on the basis of patient age, clinical history, and imaging and laboratory findings. Given the complexity of imaging evaluation of the ampulla and periampullary region, it is essential for radiologists to understand the variety of lesions that can occur and recognize their imaging characteristics. PMID:24819785

  12. Radiotherapy for a benign cause of cauda equina compression in a known case of breast carcinoma

    PubMed Central

    Bhalla, Neeraj; Husband, David J; Pillay, Robin; Thorp, Nicki

    2013-01-01

    A woman underwent breast conservation surgery and axillary clearance for T1N1M0 breast carcinoma, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. At 3-year follow-up she presented with lumbar back pain and developed bilateral lower limb weakness. MRI spine demonstrated an expansile lesion at L1 causing cauda equina compression. The mass, unusually, was centred on the spinous process; metastases typically involve pedicles. The patient underwent surgical decompression with complete resolution of neurological signs. Histology revealed Masson tumour (intravascular papillary endothelial hyperplasia), a benign vascular lesion. Pain recurrence 9 months later prompted imaging demonstrating recurrent mass. Preoperative embolisation and re-excision was undertaken for recurrent Masson tumour. Recurrence of these lesions is rare and it was felt residual disease was likely. Radiotherapy has been used in isolated cases; therefore, she was treated with adjuvant radiotherapy, the first reported case of radiation in management of extracranial Masson tumour, and remains well 3 years later. PMID:23784763

  13. Radiologists' Performance for Detecting Lesions and the Interobserver Variability of Automated Whole Breast Ultrasound

    PubMed Central

    Kim, Sung Hun; Choi, Byung Gil; Choi, Jae Jung; Lee, Ji Hye; Song, Byung Joo; Choe, Byung Joo; Park, Sarah; Kim, Hyunbin

    2013-01-01

    Objective To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. Materials and Methods AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. Results The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. Conclusion AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement. PMID:23482698

  14. Mucocele-like lesions of the breast: a clinical outcome and histologic analysis of 102 cases.

    PubMed

    Meares, Annie L; Frank, Ryan D; Degnim, Amy C; Vierkant, Robert A; Frost, Marlene H; Hartmann, Lynn C; Winham, Stacey J; Visscher, Daniel W

    2016-03-01

    Mucocele-like lesions (MLLs) of the breast are characterized by cystic architecture with stromal mucin and frequent atypia, but it is unknown whether they convey long-term breast cancer risk. We evaluated 102 MLLs that were derived from a single-institution benign breast disease cohort of 13412 women who underwent biopsy from 1967 to 2001. MLLs were histologically characterized by type of lining epithelium, architecture of the lesion, associated atypical hyperplasia (AH), and incidence of breast cancer (14.8-year median follow-up). A relatively large proportion of MLLs (42%) were diagnosed in women older than 55 years. AH was significantly more frequent in MLL patient compared to the cohort overall (27% versus 5%; P < .001). Breast cancer has developed in 13 patients with MLL. This frequency is only slightly higher than population expected rates overall (standardized incidence ratio, 2.28; 95% confidence interval, 1.21-3.91) and not significantly different from women in the cohort with (nonatypical) proliferative breast lesions. Younger women (<45) with MLL had a nonsignificant increase in risk of cancer compared to the general population (standardized incidence ratio, 5.16; 95% confidence interval, 1.41-13.23). We conclude that MLL is an uncommon breast lesion that is often associated with coexisting AH. However, in women older than 45 years, MLLs do not convey additional risk of breast cancer beyond that associated with the presence of proliferative disease. PMID:26826407

  15. Using three-class BANN classifier in the automated analysis of breast cancer lesions in DCE-MRI

    NASA Astrophysics Data System (ADS)

    Bhooshan, Neha; Giger, Maryellen; Edwards, Darrin; Drukker, Karen; Jansen, Sanaz; Li, Hui; Lan, Li; Newstead, Gillian

    2009-02-01

    The purpose of this study is to investigate three-class Bayesian artificial neural networks (BANN) in dynamic contrastenhanced MRI (DCE-MRI) CAD in distinguishing different types of breast lesions including ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), and benign. The database contains 72 DCIS lesions, 124 IDC lesions, and 131 benign breast lesions (no cysts). Breast MR images were obtained with a clinical DCE-MRI scanning protocol. In 3D, we automatically segmented each lesion and calculated its characteristic kinetic curve using the fuzzy c-means method. Morphological and kinetic features were automatically extracted, and stepwise linear discriminant analysis was utilized for feature selection in four subcategories: DCIS vs. IDC, DCIS vs. benign, IDC vs. benign, and malignant (DCIS + IDC) vs. benign. Classification was automatically performed with the selected features for each subcategory using round-robin-by-lesion two-class BANN and three-class BANN. The performances of the classifiers were assessed with two-class ROC analysis. We failed to show any statistically significant differences between the two-class BANN and three-class BANN for all four classification tasks, demonstrating that the three-class BANN performed similarly to the two-class BANN. A three-class BANN is expected to be more desirable in the clinical arena for both diagnosis and patient management.

  16. Selected benign cutaneous lesions that may simulate melanoma histologically.

    PubMed

    Wick, Mark R

    2016-07-01

    As cutaneous melanomas manifest a wide spectrum of clinical and pathologic presentations, several other lesions enter into their differential diagnosis. This article considers those entities, including melanocytic hyperplasia, cellular nodules in congenital nevi, atypical lentiginous melanocytic proliferations, "special site" nevi, epithelioid histiocytoma, neurothekeoma, cellular schwannoma, and proliferating scars. PMID:27221234

  17. Integrated imaging of hepatic tumors in childhood. Part II. Benign lesions (congenital, reparative, and inflammatory)

    SciTech Connect

    Miller, J.H.; Greenspan, B.S.

    1985-01-01

    The authors have encountered benign liver masses as frequently as malignant lesions in children with hepatomegaly. Lesions studied included abscesses, cavernous hemangioma/hemangioendothelioma, adenoma of glycogen storage disease, choledochal cysts, focal nodular hyperplasia, cystic hepatoblastoma, and hamartoma. An intergrated imaging protocol involving ultrasound, computed tomography, and scintigraphy proved to be more helpful than any one modality in establishing the benign or malignant nature of a hepatic neoplasm and the type of tumor, which is of particular importance when surgical exploration and/or biopsy is contraindicated.

  18. 27.12 MHz Radiofrequency Ablation for Benign Cutaneous Lesions

    PubMed Central

    Kim, Dong Hyun; Hyun, Dong Ju; Piquette, Raymonde; Beaumont, Clément; Germain, Lucie; Larouche, Danielle

    2016-01-01

    As surgical and/or ablative modalities, radiofrequency (RF) has been known to produce good clinical outcomes in dermatology. Recently, 27.12 MHz RF has been introduced and has several advantages over conventional 4 or 6 MHz in terms of the precise ablation and lesser pain perception. We aimed to evaluate the clinical efficacy and safety of 27.12 MHz RF for the treatment of benign cutaneous lesions. Twenty female patient subjects were enrolled. Digital photography and a USB microscope camera were used to monitor the clinical results before one session of treatment with 27.12 MHz RF and after 1 and 3 weeks. Treated lesions included telangiectasias, cherry and spider angiomas, skin tags, seborrheic keratoses, lentigo, milium, dilated pore, acne, piercing hole, and one case of neurofibroma. For vascular lesions, clinical results were excellent for 33.3%, good for 44.4%, moderate for 11.1%, and poor for 11.1%. For nonvascular lesions (epidermal lesions and other benign cutaneous lesions), clinical results were excellent for 48.3%, good for 45.2%, moderate for 3.2%, and poor for 3.2%. No serious adverse events were observed. Mild adverse events reported were slight erythema, scale, and crust. The 27.12 MHz RF treatment of benign vascular and nonvascular lesions appears safe and effective after 3 weeks of follow-up. PMID:27127789

  19. Mammographic quantitative image analysis and biologic image composition for breast lesion characterization and classification

    SciTech Connect

    Drukker, Karen Giger, Maryellen L.; Li, Hui; Duewer, Fred; Malkov, Serghei; Joe, Bonnie; Kerlikowske, Karla; Shepherd, John A.; Flowers, Chris I.; Drukteinis, Jennifer S.

    2014-03-15

    Purpose: To investigate whether biologic image composition of mammographic lesions can improve upon existing mammographic quantitative image analysis (QIA) in estimating the probability of malignancy. Methods: The study population consisted of 45 breast lesions imaged with dual-energy mammography prior to breast biopsy with final diagnosis resulting in 10 invasive ductal carcinomas, 5 ductal carcinomain situ, 11 fibroadenomas, and 19 other benign diagnoses. Analysis was threefold: (1) The raw low-energy mammographic images were analyzed with an established in-house QIA method, “QIA alone,” (2) the three-compartment breast (3CB) composition measure—derived from the dual-energy mammography—of water, lipid, and protein thickness were assessed, “3CB alone”, and (3) information from QIA and 3CB was combined, “QIA + 3CB.” Analysis was initiated from radiologist-indicated lesion centers and was otherwise fully automated. Steps of the QIA and 3CB methods were lesion segmentation, characterization, and subsequent classification for malignancy in leave-one-case-out cross-validation. Performance assessment included box plots, Bland–Altman plots, and Receiver Operating Characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) for distinguishing between benign and malignant lesions (invasive and DCIS) was 0.81 (standard error 0.07) for the “QIA alone” method, 0.72 (0.07) for “3CB alone” method, and 0.86 (0.04) for “QIA+3CB” combined. The difference in AUC was 0.043 between “QIA + 3CB” and “QIA alone” but failed to reach statistical significance (95% confidence interval [–0.17 to + 0.26]). Conclusions: In this pilot study analyzing the new 3CB imaging modality, knowledge of the composition of breast lesions and their periphery appeared additive in combination with existing mammographic QIA methods for the distinction between different benign and malignant lesion types.

  20. Laser-induced fluorescence spectroscopy of benign and malignant cutaneous lesions

    NASA Astrophysics Data System (ADS)

    Borisova, Ekaterina G.; Troyanova, P. P.; Stoyanova, V. P.; Avramov, Lachezar A.

    2005-04-01

    The goals of this work were investigation of pigmented skin lesions by the method of laser-induced fluorescence spectroscopy. Fluorescence spectra were obtained from malignant and benign skin lesions after excitation with nitrogen laser at 337 nm, namely: benign nevi, dysplastic nevi, malignant melanoma (MM), keratopapilloma, base-cell papilloma and base-cell carcinoma, as well as from healthy skin areas near to the lesion that were used posteriori to reveal changes between healthy and lesion skin spectra. Initially lesions were classified by ABCD-dermatscopic method. All suspicious lesions were excised and were investigated histologically. Spectrum of healthy skin consists of one main maximum at 470-500 nm spectral region and secondary maxima at in the regions round 400 and 440 nm. In the cases of nevi and melanoma significant decrease of fluorescence intensity, which correlated with the type of pigment lesion was observed. This reduction of the signal is related to the accumulation of melanin in the lesions that re-absorb strongly the fluorescence from native skin fluorophores in whole visible spectral region. In cases of papilloma and base-cell carcinoma an intensity decrease was also observed, related to accumulation of pigments in these cutaneous lesions. An relative increase of the fluorescence peak at 440 nm were registered in the case of base-cell carcinoma, and appearance of green fluorescence, related to increase of keratin content in benign papilloma lesions were detected. The results, obtained in this investigation of the different pigment lesions could be used for better comprehension of the skin optical properties. The fluorescence spectroscopy of the human skin are very prominent for early diagnosis and differentiation of cutaneous diseases and gives a wide range of possibilities related to real-time determination of existing pathological condition.

  1. Quantifying heterogeneity of lesion uptake in dynamic contrast enhanced MRI for breast cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Karahaliou, A.; Vassiou, K.; Skiadopoulos, S.; Kanavou, T.; Yiakoumelos, A.; Costaridou, L.

    2009-07-01

    The current study investigates whether texture features extracted from lesion kinetics feature maps can be used for breast cancer diagnosis. Fifty five women with 57 breast lesions (27 benign, 30 malignant) were subjected to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on 1.5T system. A linear-slope model was fitted pixel-wise to a representative lesion slice time series and fitted parameters were used to create three kinetic maps (wash out, time to peak enhancement and peak enhancement). 28 grey level co-occurrence matrices features were extracted from each lesion kinetic map. The ability of texture features per map in discriminating malignant from benign lesions was investigated using a Probabilistic Neural Network classifier. Additional classification was performed by combining classification outputs of most discriminating feature subsets from the three maps, via majority voting. The combined scheme outperformed classification based on individual maps achieving area under Receiver Operating Characteristics curve 0.960±0.029. Results suggest that heterogeneity of breast lesion kinetics, as quantified by texture analysis, may contribute to computer assisted tissue characterization in DCE-MRI.

  2. Differentiation of malignant and benign lung lesions with diffusion-weighted MR imaging

    PubMed Central

    Gümüştaş, Sevtap; Inan, Nagihan; Akansel, Gür; Çiftçi, Ercüment; Demirci, Ali; Özkara, Sevgiye Kaçar

    2012-01-01

    Background The aim of the study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the differential diagnosis of lung lesions. Patients and methods. Sixty-seven patients with lung lesions (48 malignant, 19 benign) were included in this prospective study. Signal intensities (SIs) were measured in diffusion-weighted MR images that were obtained with b=0, 500 and 1000 s/mm2 values. Apparent diffusion coefficient (ADC) maps were calculated by using images with b=0 and 1000 s/mm2 values. The statistical significance was determined using the Student-t test. Results The SIs of malignant lesions were significantly higher than those of benign lesions (p<0.004 for b=0 s/mm2 and p<0.000 for the other b values). Using b=500 s/mm2, SI≥391 indicated a malignant lesion with a sensitivity of 95%, specificity of 73% and positive predictive value of 87%. Using b=1000 s/mm2, SI≥277 indicated a malignant lesion with a sensitivity of 93%, specificity of 69% and positive predictive value of 85%. There was no significant difference between malignant and benign lesions regarding ADC values (p=0.675). There was no significant difference in SIs or ADC values between small cell carcinoma and non-small cell carcinoma. When comparing undifferentiated with well- partially differentiated cancers, SIs were higher with all b values, but the difference was statistically significant only with b=1000 s/mm2 (p<0.04). Conclusions Diffusion-weighteted MR trace image SI is useful for the differentiation of malignant versus benign lung lesions. PMID:23077446

  3. Visualization of suspicious lesions in breast MRI based on intelligent neural systems

    NASA Astrophysics Data System (ADS)

    Twellmann, Thorsten; Lange, Oliver; Nattkemper, Tim Wilhelm; Meyer-Bäse, Anke

    2006-05-01

    Intelligent medical systems based on supervised and unsupervised artificial neural networks are applied to the automatic visualization and classification of suspicious lesions in breast MRI. These systems represent an important component of future sophisticated computer-aided diagnosis systems and enable the extraction of spatial and temporal features of dynamic MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogenity of the cancerous tissue, these techniques reveal the malignant, benign and normal kinetic signals and and provide a regional subclassification of pathological breast tissue. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging.

  4. Dose- and time-response for breast cancer risk after radiation therapy for benign breast disease.

    PubMed Central

    Mattsson, A.; Rudén, B. I.; Palmgren, J.; Rutqvist, L. E.

    1995-01-01

    Exposure of the breast to ionising radiation increases the risk of breast cancer, especially among young women. However, some issues remain controversial, for instance the shape of the dose-response curve and the expression of time-related excess. The main purpose of this report was to examine the dose-response curves for radiation-induced breast cancer formulated according to radiobiological target theories. Another purpose was to analyse the time-related excess of breast cancer risk after exposure when dose and age at first exposure were held constant. Breast cancer incidence was analysed in a cohort of 3090 women diagnosed with benign breast disease during 1925-61 (median age 37 years). Of these, 1216 were treated with radiation therapy. The dose range was 0-50 Gy (mean 5.8 Gy). The incidence rate as function of dose was analysed using a linear-quadratic Poisson regression model. Cell-killing effects and other modifying effects were incorporated through additional log-linear terms. Additive and multiplicative models were compared in estimating the time-related excess. The analysis, which was based on 278 breast cancer cases, showed a linear dose-response relationship at low to medium dose levels with a cell-killing effect of 5% Gy-1 (95% confidence interval 2-9%). For a given absorbed dose and age at first exposure the time-related excess was proportional to the background rates with a suggestion that the excess remains throughout life. PMID:7547222

  5. Male Breast: Clinical and Imaging Evaluations of Benign and Malignant Entities with Histologic Correlation.

    PubMed

    Chau, Alec; Jafarian, Neda; Rosa, Marilin

    2016-08-01

    Breast cancer is an uncommon disease in men. As a result, the diagnosis may not initially be considered. Understanding the common benign and malignant entities affecting the male breast is critical for timely and accurate diagnosis in the primary care setting. Most patients present with a palpable breast mass or pain. The usual etiology is gynecomastia, the most common breast condition in males, but breast cancer must always be excluded through careful imaging evaluation when physical examination findings are suspicious or inconclusive. Imaging of the male breast generally relies on mammography and ultrasound, with mammography employed as the initial imaging modality of choice and ultrasound when a mass is detected or suspected. Here we describe the normal male breast anatomy and present an evaluation algorithm for the male patient with breast signs or symptoms. The most common benign and malignant entities are described. PMID:26844632

  6. Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies

    PubMed Central

    Khan, Sarah N.; Sepahdari, Ali R.

    2012-01-01

    A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated. PMID:23961022

  7. Bone Scintigraphy and Panoramic Radiography in Deciding the Extent of Bone Resection in Benign Jaw Lesions

    PubMed Central

    Jamdade, Anshuman; John, Ani

    2013-01-01

    Objective: To find out the value of correlating radiographic and scintigraphic imaging for defining the extent and nature of benign jaw lesions (BJL). Material and Methods: Twenty patients with histologically proven benign lesions of the jaws were investigated pre-operatively by panoramic radiography (PR) and bone scintigraphy (BS). To test the efficacy of combination of these two imaging modalities, their results were compared with intra-operative and histopathological findings. Result: Most of the benign lesions presented radiographically as well-defined bone destructions with fine sclerotic rims. Such lesions were found to be silent on scintigraphs and the extent of radionuclide uptake was same as radiographically visible extent of bone involvement. However, aggressive lesions showed ill-defined bone destructions without sclerotic rims on radiographs and their scintigraphic uptake correctly exceeded the radiographic extent of the bone involvement. Conclusion: The efficacy of combination of both complementary imagings is rewarding in defining the extent of the BJL, especially when radiographic margins are not so well defined. So, that surgical excisions will be complete and the possibility recurrences is reduced. PMID:24298527

  8. Noninvasive Evaluation of Nuclear Morphometry in Breast Lesions Using Multispectral Diffuse Optical Tomography

    PubMed Central

    Hajihashemi, Mohammad Reza; Grobmyer, Stephen R.; Al-Quran, Samer Z.; Jiang, Huabei

    2012-01-01

    Breast cancer is the most prevalent cancer and the main cause of cancer-related death in women worldwide. There are limitations associated with the existing clinical tools for breast cancer detection and alternative modalities for early detection and classification of breast cancer are urgently needed. Here we describe an optical imaging technique, called multispectral diffuse optical tomography (DOT), and demonstrate its ability of non-invasively evaluating nuclear morphometry for differentiating benign from malignant lesions. Photon densities along the surface of the breast were measured to allow for the extraction of three statistical parameters including the size, elongation and density of nuclei inside the breast tissue. The results from 14 patients (4 malignant and 10 benign lesions) show that there exist significant contrasts between the diseased and surrounding normal nuclei and that the recovered nuclear morphological parameters agree well the pathological findings. We found that the nuclei of cancer cells were less-spherical compared with those of surrounding normal cells, while the nuclear density or volume fraction provided the highest contrast among the three statistical parameters recovered. This pilot study demonstrates the potential of multispectral DOT as a cellular imaging method for accurate determination of breast cancer. PMID:23029196

  9. Detection of breast lesions by holographic interferometry

    NASA Astrophysics Data System (ADS)

    Hong, HyunDae; Sheffer, Daniel B.; Loughry, C. William

    1999-07-01

    The holographic interferometry (HI) technique commonly used for nondestructive testing of laminate materials was applied to create fringe contour distortion near the site of indwelling breast lesions. For this medical imaging application, the HI technique was successful in demonstrating abnormal mechanical properties of living tissue. Adequate density and contrast of fringes, crucial factors necessary for analysis of surface deformation of an object, can be made only with an appropriate stressing method. We have applied vibration and mild pressure to the surface of female breasts for the purpose of detecting localized densities and mass alterations of the tissue, which may be indicative of an abnormality of that tissue. Even though each stressing method had both positive and negative aspects, pneumatic pressure was adopted for the present study because it was more suitable for a noninvasive and noncontact breast examination. We also developed a computer based holographic imaging system to precisely control the stressing phase for the pressure and laser triggering so the resultant holograms had manageable fringe density and repeatability.

  10. [Management of benign melanocytic lesions as a melanoma prevention. Systematic review].

    PubMed

    Linertová, Renata; Valcárcel-Nazco, Cristina; Lacalle-Remigio, Juan Ramón

    2016-08-19

    There is a growing concern and awareness of skin cancer. As a result, possibly unnecessary surgeries of melanocytic lesions are carried out as a prophylactic measure. We performed a systematic review of the medical literature to identify primary studies on the effectiveness and cost-effectiveness of surgery treatment of benign melanocytic lesions for melanoma prevention. We included 19 primary studies on surgical treatment of acquired melanocytic lesions and one economic evaluation. Indicators, such as number needed to treat and the malignancy ratio, depend on several factors such as specialty and experience of the physician, pressure from the patient or patient characteristics. Early diagnosis of melanoma is critical in preventing skin cancer. However, primary studies show through several indicators that there are factors that increase the proportion of lesions treated unnecessarily. Effectiveness can be improved by careful use of techniques to identify suspicious lesions and educational programs for physicians, especially in primary care. PMID:27026061

  11. Follow-up design of unexpected enhancing lesions on preoperative MRI of breast cancer patients

    PubMed Central

    Cheung, Joo-Yeon; Moon, Jin Hee

    2015-01-01

    PURPOSE We aimed to analyze the characteristics and long-term follow-up results of unexpected enhancing lesions on preoperative magnetic resonance imaging (MRI) of breast cancer patients. METHODS From August 2007 through February 2010, second-look ultrasound (SLUS) was recommended for 84 of 312 breast cancer patients having unexpected enhancing lesions on MRI. SLUS was performed for 85 unexpected enhancing lesions in 72 patients. We performed a retrospective review to determine the size, lesion type, enhancement kinetic curve, and location in relation to the index cancer. We obtained the pathologic outcome of the detected lesions and in case of a negative finding on SLUS, we performed follow-up examinations for at least two years. RESULTS Of 85 unexpected lesions, 72 (85%) were detected on SLUS. In total, 41 lesions (56.9%) were confirmed as malignant and 31 lesions (43.6%) as benign. Cancer rate was statistically higher in lesions having type III enhancement pattern, located at the same quadrant as the index cancer. However, no significant association was observed between the cancer rate and the lesion size and type. None of the 13 negative cases on SLUS developed cancer on follow-up. CONCLUSION In case of unexpected enhancing lesions on preoperative MRI of breast cancer patients, SLUS can be useful to find out the matched lesion. Lesions with type III enhancement pattern or those located at the same quadrant as the index cancer should be considered as a separate cancer. In the absence of any suspicious findings on SLUS, patient may be followed up with confidence. PMID:25430525

  12. Hydroxyapatite crystals as a bone graft substitute in benign lytic lesions of bone

    PubMed Central

    Gupta, Anil Kumar; Kumar, Praganesh; Keshav, Kumar; Singh, Anant

    2015-01-01

    Background: Bone grafts are required to fill a cavity created after curettage of benign lytic lesions of the bone. To avoid the problems associated at donor site with autologous bone graft, we require allograft or bone graft substitutes. We evaluated the healing of lytic lesions after hydroxyapatite (HA) grafting by serial radiographs. Materials and Methods: Forty cases of benign lytic lesions of bone were managed by simple curettage and grafting using HA blocks. Commercially available HA of bovine origin (Surgiwear Ltd., Shahjahanpur, India) was used for this purpose. Mean duration of followup was 34.8 months (range 12–84 months). Mean patient age was 19.05 years (range 3–55 years). Radiological staging of graft incorporation was done as per criteria of Irwin et al. 2001. Results: In our series, two cases were in stage I. A total of 11 cases were in stage II and 27 were in stage III. Graft incorporation was radiologically complete by 15 months. Clinical recovery was observed before radiological healing. The average time taken to return to preoperative function was 3 months. Recurrence was observed in giant cell tumor (n = 3) and chondromyxoid fibroma (n = 1). There was no incidence of graft rejection, collapse, growth plate disturbances or antigenic response. Conclusions: We conclude that calcium HA is biologically acceptable bone graft substitute in the management of benign lytic lesions of bone. PMID:26806973

  13. Benign and Malignant Proliferative Fibro-osseous and Osseous Lesions of the Oral Cavity of Dogs.

    PubMed

    Soltero-Rivera, M; Engiles, J B; Reiter, A M; Reetz, J; Lewis, J R; Sánchez, M D

    2015-09-01

    Ossifying fibroma (OF) and fibrous dysplasia (FD) are benign, intraosseous, proliferative fibro-osseous lesions (PFOLs) characterized by replacement of normal bone by a fibrous matrix with various degrees of mineralization and ossification. Osteomas are benign tumors composed of mature, well-differentiated bone. Clinical, imaging, and histologic features of 15 initially diagnosed benign PFOLs and osteomas of the canine oral cavity were evaluated. Final diagnoses after reevaluation were as follows: OF (3 cases), FD (4 cases), low-grade osteosarcoma (LG-OSA) (3 cases), and osteoma (5 cases). Histology alone often did not result in a definitive diagnosis for PFOL. OF appeared as a well-circumscribed, radiopaque mass with some degree of bone lysis on imaging. Most lesions of FD showed soft tissue opacity with bone lysis and ill-defined margins. Low-grade OSA appeared as a lytic lesion with a mixed opacity and ill-defined margins. Osteomas were characterized by a mineralized, expansile, well-circumscribed lesion. Although histologic features of PFOLs were typically bland, the lesions diagnosed as LG-OSA had some features of malignancy (eg, bone invasion or a higher mitotic index). Treatment varied widely. Of the 10 dogs with benign PFOL or osteoma with known outcome (10/12), 9 showed either complete response (6/10) or stable disease (3/10) after treatment. Of the 2 dogs with LG-OSA with known outcome, 1 showed complete response after curative intent surgery, but 1 patient had recurrence after partial maxillectomy. Definitive diagnosis of mandibular/maxillary PFOL is challenging via histopathologic examination alone, and accurate diagnosis is best achieved through assimilation of clinical, imaging, and histopathologic features. PMID:25957357

  14. Mammotome biopsy under ultrasound control in the diagnostics and treatment of nodular breast lesions - own experience.

    PubMed

    Kibil, Wojciech; Hodorowicz-Zaniewska, Diana; Kulig, Jan

    2012-05-01

    Mammotome biopsy is an effective, minimally invasive, novel technique used in the verification of breast lesions.The aim of the study was to assess the value of ultrasound-guided vacuum-assisted core needle biopsy (mammotome biopsy) in the diagnostics and treatment of nodular breast lesions, considering own data.Material and methods. Analysis comprised 1183 mammotome biopsies under ultrasound control performed in 1177 female patients during the period between 2000 and 2010, at the Regional Clinic for Early Diagnostics and Treatment of Breast Lesions, I Chair and Department of General Surgery, Jagiellonian University, Collegium Medicum.Results. The average patient age amounted to 41.7 years. The size of the investigated lesions ranged between 4 and 65 mm (mean - 12 mm). The histopathological examination result was as follows: fibrocystic lesions (n=285), adenofibroma (n=477), adenosis sclerosans (n=188), hyperplasia without atypy (n=58), phyllode tumor (n=2), papilloma (n=14), hamartoma (n=1), atypical hyperplasia (n=25), in situ ductal carcinoma (n=4), in situ lobular carcinoma (n=5), infiltrating ductal carcinoma (n=114), infiltrating lobular carcinoma (n=4), non-diagnostic result (n=6). The histopathological diagnosis was obtained in 99.5% of cases. Patients diagnosed with atypical hyperplasia or cancer were qualified for surgery, according to accepted standards. The presence of a hematoma was the most common complication after the biopsy, observed in 16.5% of patients.Conclusions. The obtained results confirmed the high value of ultrasound-guided biopsies in the diagnostics of nodular breast lesions. The method is safe, minimally invasive, with few complications, providing a good cosmetic effect. In case of benign lesions with a diameter of less than 15 mm the mammotome biopsy enables to completely excise the lesions, being an alternative to open surgical biopsies. The mammotome biopsy should become the method of choice considering the diagnostics of nodular

  15. Mesenchymal tumors and tumor-like lesions of the breast: a contemporary approach review.

    PubMed

    Stolnicu, Simona; Moldovan, Cosmin; Podoleanu, Cristian; Georgescu, Rares

    2015-01-01

    The classification of the breast tumors has been revised and recently published in 2012 in the WHO blue book. Contrary to the epithelial tumors in the breast, mesenchymal tumors are rare and the classification for benign and malignant tumors is based on the same criteria in both categories, since no other specific diagnostic criteria, which would have an impact on prognosis, exist to date. The present review deals with minor changes mirroring the recent developments in the benign mesenchymal tumors (new additions are nodular fasciitis and atypical vascular lesions, while the haemangiopericytoma is removed) focusing especially on criteria to diagnose sarcomas, which represent a wide spectrum including very difficult lesions. The majority of sarcomas of the breast arise as a component of a malignant phyllodes tumor, while the pure forms are very rare. When a pure primary sarcoma of the breast is diagnosed, pathologists are encouraged to categorize the lesion according to the type of differentiation and to provide to the clinicians all the important prognostic parameters for the best treatment choice. PMID:25533916

  16. Touch Imprint Cytology and Stereotactically-Guided Core Needle Biopsy of Suspicious Breast Lesions: 15-Year Follow-up

    PubMed Central

    Schulz-Wendtland, R.; Fasching, P. A.; Bani, M. R.; Lux, M. P.; Jud, S.; Rauh, C.; Bayer, C.; Wachter, D. L.; Hartmann, A.; Beckmann, M. W.; Uder, M.; Loehberg, C. R.

    2016-01-01

    Introduction: Stereotactically-guided core needle biopsies (CNB) of breast tumours allow histological examination of the tumour without surgery. Touch imprint cytology (TIC) of CNB promises to be useful in providing same-day diagnosis for counselling purposes and for planning future surgery. Having addressed the issue of accuracy of immediate microscopic evaluation of TIC, we wanted to re-examine the usefulness of this procedure in light of the present health care climate of cost containment by incorporating the surgical 15-year follow-up data and outcome. Patients and Methods: From January until December 1996 we performed TIC in core needle biopsies of 173 breast tumours in 169 patients, consisting of 122 malignant and 51 benign tumours. Histology of core needle biopsies was proven by surgical histology in all malignant and in 5 benign tumours. Surgical breast biopsy was not performed in 46 patients with 46 benign lesions, as the histological result from the core needle biopsy and the result of the TIC were in agreement with the suspected diagnosis from the complementary breast diagnostics. A 15-year follow-up of these patients followed in 2013 and follow-up data was collected from 40 women. Results: In the 15-year follow-up of the 40 benign lesions primarily confirmed using CNB and TIC, a diagnostic sensitivity, specificity, positive and negative predictive value and accuracy of 100 % was found. Conclusion: TIC and stereotactically guided CNB showed excellent long-term follow-up in patients with benign breast lesions. The use of TIC to complement CNB can therefore provide immediate cytological diagnosis of breast lesions. PMID:26855442

  17. Cranialization of the Frontal Sinus for Secondary Mucocele Prevention following Open Surgery for Benign Frontal Lesions

    PubMed Central

    Horowitz, Gilad; Amit, Moran; Ben-Ari, Oded; Gil, Ziv; Abergel, Abraham; Margalit, Nevo; Cavel, Oren; Wasserzug, Oshri; Fliss, Dan M.

    2013-01-01

    Objective To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. Study Design Retrospective case series. Setting Tertiary academic medical center. Patients Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. Interventions Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59%) or frontal cranialization (n = 28, 41%). Main Outcome Measures The prevalence of post-surgical complications and secondary mucocele formation were compiled. Results Pathologies included osteoma (n = 34, 49%), mucocele (n = 27, 39%), fibrous dysplasia (n = 6, 9%), and encephalocele (n = 2, 3%). Complications included skin infections (n = 6), postoperative cutaneous fistula (n = 1), telecanthus (n = 4), diplopia (n = 3), nasal deformity (n = 2) and epiphora (n = 1). None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001). Conclusion Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions. PMID:24376760

  18. Benign mucinous metaplasia of the penis. A lesion resembling extramammary Paget's disease.

    PubMed

    Val-Bernal, J F; Hernández-Nieto, E

    2000-02-01

    Benign mucinous metaplasia in the surface epithelium of the genital area is rare and has only been reported once in the vulva. A unique case of benign mucinous metaplasia of the prepuce in a 65-year-old man is reported here. The lesion measured 0.6 cm, was located in the mucous surface of the foreskin, and showed acid mucin containing cells. We regard benign mucinous metaplasia as a reactive rather than a neoplastic process. The main lesions to be considered in the differential diagnosis are mucinous syringometaplasia, extramammary Paget's disease, cutaneous squamous cell carcinoma in situ with mucinous metaplasia, superficial spreading malignant melanoma, and epidermotropic metastasis. The confinement of mucin-containing cells to the epidermis, the absence of nuclear atypia, the basal orientation of the nuclei, the predominant location of the cells in the upper layers of the epithelium, and the fact that the mucinous cells are replacing the squamous epithelium rather that infiltrating it, all assist in recognizing mucinous metaplasia of the penis as a specific and benign entity. PMID:10678702

  19. The Microbiome of Aseptically Collected Human Breast Tissue in Benign and Malignant Disease

    PubMed Central

    Hieken, Tina J.; Chen, Jun; Hoskin, Tanya L.; Walther-Antonio, Marina; Johnson, Stephen; Ramaker, Sheri; Xiao, Jian; Radisky, Derek C.; Knutson, Keith L.; Kalari, Krishna R.; Yao, Janet Z.; Baddour, Larry M.; Chia, Nicholas; Degnim, Amy C.

    2016-01-01

    Globally breast cancer is the leading cause of cancer death among women. The breast consists of epithelium, stroma and a mucosal immune system that make up a complex microenvironment. Growing awareness of the role of microbes in the microenvironment recently has led to a series of findings important for human health. The microbiome has been implicated in cancer development and progression at a variety of body sites including stomach, colon, liver, lung, and skin. In this study, we assessed breast tissue microbial signatures in intraoperatively obtained samples using 16S rDNA hypervariable tag sequencing. Our results indicate a distinct breast tissue microbiome that is different from the microbiota of breast skin tissue, breast skin swabs, and buccal swabs. Furthermore, we identify distinct microbial communities in breast tissues from women with cancer as compared to women with benign breast disease. Malignancy correlated with enrichment in taxa of lower abundance including the genera Fusobacterium, Atopobium, Gluconacetobacter, Hydrogenophaga and Lactobacillus. This work confirms the existence of a distinct breast microbiome and differences between the breast tissue microbiome in benign and malignant disease. These data provide a foundation for future investigation on the role of the breast microbiome in breast carcinogenesis and breast cancer prevention. PMID:27485780

  20. The Microbiome of Aseptically Collected Human Breast Tissue in Benign and Malignant Disease.

    PubMed

    Hieken, Tina J; Chen, Jun; Hoskin, Tanya L; Walther-Antonio, Marina; Johnson, Stephen; Ramaker, Sheri; Xiao, Jian; Radisky, Derek C; Knutson, Keith L; Kalari, Krishna R; Yao, Janet Z; Baddour, Larry M; Chia, Nicholas; Degnim, Amy C

    2016-01-01

    Globally breast cancer is the leading cause of cancer death among women. The breast consists of epithelium, stroma and a mucosal immune system that make up a complex microenvironment. Growing awareness of the role of microbes in the microenvironment recently has led to a series of findings important for human health. The microbiome has been implicated in cancer development and progression at a variety of body sites including stomach, colon, liver, lung, and skin. In this study, we assessed breast tissue microbial signatures in intraoperatively obtained samples using 16S rDNA hypervariable tag sequencing. Our results indicate a distinct breast tissue microbiome that is different from the microbiota of breast skin tissue, breast skin swabs, and buccal swabs. Furthermore, we identify distinct microbial communities in breast tissues from women with cancer as compared to women with benign breast disease. Malignancy correlated with enrichment in taxa of lower abundance including the genera Fusobacterium, Atopobium, Gluconacetobacter, Hydrogenophaga and Lactobacillus. This work confirms the existence of a distinct breast microbiome and differences between the breast tissue microbiome in benign and malignant disease. These data provide a foundation for future investigation on the role of the breast microbiome in breast carcinogenesis and breast cancer prevention. PMID:27485780

  1. Nd:YAG laser treatment for benign lesions of vocal cord through fiber endoscope

    NASA Astrophysics Data System (ADS)

    Pin, Wei-Zheng

    1993-03-01

    This paper describes 120 cases with benign lesions of the vocal cord, such as the polyp and the nodule, treated by laser irradiation and application of Nd:YAG laser and optical fiber carried out through fiber laryngoscope under surface anaesthesia. One-hundred-eleven of the cases were cured, 9 improved, and 0 failed. This method is superior to other methods and has the following features: accuracy, rapidity, non-bleeding, painlessness, easy operation, rare complication, and good effect.

  2. Prehistological evaluation of benign and malignant pigmented skin lesions with optical computed tomography

    NASA Astrophysics Data System (ADS)

    Kokolakis, Athanasios; Zacharakis, Giannis; Krasagakis, Konstantin; Lasithiotakis, Konstantinos; Favicchio, Rosy; Spiliopoulos, George; Giannikaki, Elpida; Ripoll, Jorge; Tosca, Androniki

    2012-06-01

    Discrimination of benign and malignant melanocytic lesions is a major issue in clinical dermatology. Assessment of the thickness of melanoma is critical for prognosis and treatment selection. We aimed to evaluate a novel optical computed tomography (optical-CT) system as a tool for three-dimensional (3-D) imaging of melanocytic lesions and its ability to discriminate benign from malignant melanocytic lesions while simultaneously determining the thickness of invasive melanoma. Seventeen melanocytic lesions, one hemangioma, and normal skin were assessed immediately after their excision by optical-CT and subsequently underwent histopathological examination. Tomographic reconstructions were performed with a back-propagation algorithm calculating a 3-D map of the total attenuation coefficient (AC). There was a statistically significant difference between melanomas, dysplastic nevi, and non-dysplastic nevi, as indicated by Kruskal-Wallis test. Median AC values were higher for melanomas compared with dysplastic and non-dysplastic nevi. No statistically significant difference was observed when thickness values obtained by optical-CT were compared with histological thickness using a Wilcoxon sighed rank test. Our results suggest that optical-CT can be important for the immediate prehistological evaluation of biopsies, assisting the physician for a rapid assessment of malignancy and of the thickness of a melanocytic lesion.

  3. BENIGN BONE TUMORS AND TUMOR-LIKE BONE LESIONS: TREATMENT UPDATE AND NEW TRENDS

    PubMed Central

    Nogueira Drumond, José Marcos

    2015-01-01

    The treatment of benign bone tumors (BBT) and tumor-like bone lesions (TBL) has observed the introduction of new drugs, such as intravenous bisphosphonates, which have ossified bone lesions caused by fibrous dysplasia. Aneurismal bone cyst has been treated with sclerosing agents by percutaneous injection, yielding good results. Adjuvants allow joint salvage, maintenance of movements and function, with low rates of recurrence. Among them, the most used ones are bone cement (PMMA), phenol, nitrogen-based cryotherapy, hydrogen peroxide, ethanol and radiotherapy. New methods of treatment include thermal ablation with radiofrequency and laser, mainly utilized for treating osteoid osteoma. Arthroscopy allows resection of benign intra-joint lesions and assists the surgery of subchondral tumors. A great advance is the utilization of synthetic bone substitutes, which are a mixture of osteoinductive growth factors and osteoconductive ceramics, and have presented comparable results to autogenous bone grafts. There is a recent trend for closed treatments, with percutaneous injection of demineralized bone matrix (DBM) and calcium sulfate. Autogenous cancellous bone graft remains as the gold standard. Vascularized fibula graft, on the other hand, incorporates faster in the treatment of large destructive lesions. Also, allogenic cortical support allows structural augmentation for aggressive tumors. Freeze-dried allografts are used to fill contained defects and as expanders of autografts. Joint endoprosthesis may be used in large destructive lesions of the distal femur, hip and shoulder. PMID:27004184

  4. Curettage of benign bone tumors and tumor like lesions: A retrospective analysis

    PubMed Central

    Kundu, Zile Singh; Gupta, Vinay; Sangwan, Sukhbir Singh; Rana, Parveen

    2013-01-01

    Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females) with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm) cm and the mean volume of the lesions was 34.89 cm3 (range 0.94-194.52 cm3). The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm3 were found to have higher incidence of complications. Conclusion: This study demonstrates the natural

  5. New Fully Automated Method for Segmentation of Breast Lesions on Ultrasound Based on Texture Analysis.

    PubMed

    Gómez-Flores, Wilfrido; Ruiz-Ortega, Bedert Abel

    2016-07-01

    The study described here explored a fully automatic segmentation approach based on texture analysis for breast lesions on ultrasound images. The proposed method involves two main stages: (i) In lesion region detection, the original gray-scale image is transformed into a texture domain based on log-Gabor filters. Local texture patterns are then extracted from overlapping lattices that are further classified by a linear discriminant analysis classifier to distinguish between the "normal tissue" and "breast lesion" classes. Next, an incremental method based on the average radial derivative function reveals the region with the highest probability of being a lesion. (ii) In lesion delineation, using the detected region and the pre-processed ultrasound image, an iterative thresholding procedure based on the average radial derivative function is performed to determine the final lesion contour. The experiments are carried out on a data set of 544 breast ultrasound images (including cysts, benign solid masses and malignant lesions) acquired with three distinct ultrasound machines. In terms of the area under the receiver operating characteristic curve, the one-way analysis of variance test (α=0.05) indicates that the proposed approach significantly outperforms two published fully automatic methods (p<0.001), for which the areas under the curve are 0.91, 0.82 and 0.63, respectively. Hence, these results suggest that the log-Gabor domain improves the discrimination power of texture features to accurately segment breast lesions. In addition, the proposed approach can potentially be used for automated computer diagnosis purposes to assist physicians in detection and classification of breast masses. PMID:27095150

  6. Breast Lesions Evaluated by Color-Coded Acoustic Radiation Force Impulse (ARFI) Imaging.

    PubMed

    Zhou, JianQiao; Yang, ZhiFang; Zhan, WeiWei; Zhang, JingWen; Hu, Na; Dong, YiJie; Wang, YingYing

    2016-07-01

    The goal of our study was to investigate the value of color-coded Virtual Touch tissue imaging (VTI) using acoustic radiation force impulse (ARFI) technology in the characterization of breast lesions and to compare it with conventional ultrasound (US). Conventional US and color-coded VTI were performed in 196 solid breast lesions in 196 consecutive women (age range 17-91 y; mean 48.17 ± 14.46 y). A four-point scale VTI score was assigned for each lesion according to the color pattern both in the lesion and in the surrounding breast tissue. The mean VTI score was significantly higher for malignant lesions (3.80 ± 0.66, range 1-4) than for benign ones (2.02 ± 1.20, range 1-4) (p < 0.001), and the optimal cut-off value was between score 3 and score 4. The area under the receiver operating characteristic (ROC) curve for combined conventional US and VTI (0.945) was significantly higher than that for conventional US (0.902) and for VTI (0.871) (p = 0.0021 and p < 0.001, respectively). It was concluded that color-coded VTI with the proposed four-point scale score system combined with conventional US might have the potential to aid in the characterization of benign and malignant breast lesions. PMID:27131841

  7. Analysis of elemental concentration censored distributions in breast malignant and breast benign neoplasm tissues

    NASA Astrophysics Data System (ADS)

    Kubala-Kukuś, A.; Banaś, D.; Braziewicz, J.; Góźdź, S.; Majewska, U.; Pajek, M.

    2007-07-01

    The total reflection X-ray fluorescence method was applied to study the trace element concentrations in human breast malignant and breast benign neoplasm tissues taken from the women who were patients of Holycross Cancer Centre in Kielce (Poland). These investigations were mainly focused on the development of new possibilities of cancer diagnosis and therapy monitoring. This systematic comparative study was based on relatively large (˜ 100) population studied, namely 26 samples of breast malignant and 68 samples of breast benign neoplasm tissues. The concentrations, being in the range from a few ppb to 0.1%, were determined for thirteen elements (from P to Pb). The results were carefully analysed to investigate the concentration distribution of trace elements in the studied samples. The measurements of concentration of trace elements by total reflection X-ray fluorescence were limited, however, by the detection limit of the method. It was observed that for more than 50% of elements determined, the concentrations were not measured in all samples. These incomplete measurements were treated within the statistical concept called left-random censoring and for the estimation of the mean value and median of censored concentration distributions, the Kaplan-Meier estimator was used. For comparison of concentrations in two populations, the log-rank test was applied, which allows to compare the censored total reflection X-ray fluorescence data. Found statistically significant differences are discussed in more details. It is noted that described data analysis procedures should be the standard tool to analyze the censored concentrations of trace elements analysed by X-ray fluorescence methods.

  8. Breast lesions of uncertain malignant nature and limited metastatic potential: Proposals to improve their recognition and clinical management

    PubMed Central

    Rakha, Emad A.; Badve, Sunil; Eusebi, Vincenzo; Reis-Filho, Jorge S.; Fox, Stephen B.; Dabbs, David J.; Decker, Thomas; Hodi, Zsolt; Ichihara, Shu; Lee, Andrew HS.; Palacios, José; Richardson, Andrea L.; Vincent-Salomon, Anne; Schmitt, Fernando C.; Tan, Puay-Hoon; Tse, Gary M.; Ellis, Ian O.

    2016-01-01

    Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are traditionally classified into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey-zone between benign and malignant as their behaviour cannot be predicted reliably. Defined pathological categorisation of such lesions is challenging and for some entities is recognised to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over-treatment or under-treatment. The rarity of these lesions makes acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification, behaviour and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions remain of uncertain malignant nature such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of 1) breast lesions of uncertain malignant nature and 2) breast lesions of limited metastatic potential, are proposed with details of which histological entities could be included in each category, and their management implications are discussed. PMID:26348644

  9. Breast lesions of uncertain malignant nature and limited metastatic potential: proposals to improve their recognition and clinical management.

    PubMed

    Rakha, Emad A; Badve, Sunil; Eusebi, Vincenzo; Reis-Filho, Jorge S; Fox, Stephen B; Dabbs, David J; Decker, Thomas; Hodi, Zsolt; Ichihara, Shu; Lee, Andrew H S; Palacios, José; Richardson, Andrea L; Vincent-Salomon, Anne; Schmitt, Fernando C; Tan, Puay-Hoon; Tse, Gary M; Ellis, Ian O

    2016-01-01

    Breast lesions comprise a family of heterogeneous entities with variable patterns of presentation, morphology and clinical behaviour. The majority of breast lesions are classified traditionally into benign and malignant conditions and their behaviour can, in the vast majority of cases, be predicted with a reasonable degree of accuracy. However, there remain lesions which show borderline features and lie in a grey zone between benign and malignant, as their behaviour cannot be predicted reliably. Defined pathological categorization of such lesions is challenging, and for some entities is recognized to be subjective and include a range of diagnoses, and forms of terminology, which may trigger over- or undertreatment. The rarity of these lesions makes the acquisition of clinical evidence problematic and limits the development of a sufficient evidence base to support informed decision-making by clinicians and patients. Emerging molecular evidence is providing a greater understanding of the biology of these lesions, but this may or may not be reflected in their clinical behaviour. Herein we discuss some breast lesions that are associated with uncertainty regarding classification and behaviour, and hence management. These include biologically invasive malignant lesions associated with uncertain metastatic potential, such as low-grade adenosquamous carcinoma, low-grade fibromatosis-like spindle cell carcinoma and encapsulated papillary carcinoma. Other lesions of uncertain malignant nature remain, such as mammary cylindroma, atypical microglandular adenosis, mammary pleomorphic adenoma and infiltrating epitheliosis. The concept of categories of (1) breast lesions of uncertain malignant nature and (2) breast lesions of limited metastatic potential are proposed with details of which histological entities could be included in each category, and their management implications are discussed. PMID:26348644

  10. Predictive model for contrast-enhanced ultrasound of the breast: Is it feasible in malignant risk assessment of breast imaging reporting and data system 4 lesions?

    PubMed Central

    Luo, Jun; Chen, Ji-Dong; Chen, Qing; Yue, Lin-Xian; Zhou, Guo; Lan, Cheng; Li, Yi; Wu, Chi-Hua; Lu, Jing-Qiao

    2016-01-01

    AIM: To build and evaluate predictive models for contrast-enhanced ultrasound (CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system (BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve (ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant (P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BI-RADS classification. PMID:27358688

  11. Apparent absence of a benign precursor lesion: Implications for the pathogenesis of malignant melanoma

    SciTech Connect

    Ross, P.M. )

    1989-09-01

    This review relates concepts derived from the study of chemically induced skin cancer in animal models to the pathogenesis of malignant melanoma in humans. Most chemically induced experimental cancers in animals, including melanomas in rodents, arise within a benign precursor lesion. The initiation-promotion-progression sequence is a central concept in animal models for carcinogenesis. Many human melanomas appear to arise from epidermal melanocytes, with no associated precursor lesion. This article considers why there is no apparent precursor in many human melanomas and the consequences of this absence. Melanocyte physiology and factors that govern escape from defenses such as DNA repair, local tissue environment, and immunity presumably influence melanocyte conversion to melanoma. These factors may determine the absence of a precursor lesion in primary melanomas. In addition, it is possible that some human melanomas arise by cellular mechanisms different from those causing cancer in rodent models. Both molecular and prospective clinical studies will be required to explain this apparent paradox in the pathogenesis of melanoma. A similar approach may help to explain the origin of basal cell carcinoma and perhaps other human cancers that appear to arise directly from normal cells. From a clinical point of view, the absence of an identifiable, benign precursor lesion requires even greater emphasis on melanoma prevention. Research on mechanisms of ultraviolet carcinogenesis indicates that appropriate postexposure treatments may be useful in preventing long-term consequences of sunburn, including melanoma. 69 references.

  12. Potential of Diffusion-Weighted Imaging in the Characterization of Malignant, Benign, and Healthy Breast Tissues and Molecular Subtypes of Breast Cancer

    PubMed Central

    Sharma, Uma; Sah, Rani G.; Agarwal, Khushbu; Parshad, Rajinder; Seenu, Vurthaluru; Mathur, Sandeep R.; Hari, Smriti; Jagannathan, Naranamangalam R.

    2016-01-01

    The role of apparent diffusion coefficient (ADC) in the diagnosis of breast cancer and its association with molecular biomarkers was investigated in 259 patients with breast cancer, 67 with benign pathology, and 54 healthy volunteers using diffusion-weighted imaging (DWI) at 1.5 T. In 59 breast cancer patients, dynamic contrast-enhanced MRI (DCEMRI) was also acquired. Mean ADC of malignant lesions was significantly lower (1.02 ± 0.17 × 10−3 mm2/s) compared to benign (1.57 ± 0.26 × 10−3 mm2/s) and healthy (1.78 ± 0.13 × 10−3 mm2/s) breast tissues. A cutoff ADC value of 1.23 × 10−3 mm2/s (sensitivity 92.5%; specificity 91.1%; area under the curve 0.96) to differentiate malignant from benign diseases was arrived by receiver operating curve analysis. In 10/59 breast cancer patients, indeterminate DCE curve was seen, while their ADC value was indicative of malignancy, implying the potential of the addition of DWI in increasing the specificity of DCEMRI data. Further, the association of ADC with tumor volume, stage, hormonal receptors [estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor (HER2)], and menopausal status was investigated. A significant difference was seen in tumor volume between breast cancer patients of stages IIA and IIIA, IIB and IIIA, and IIB and III (B + C), respectively (P < 0.05). Patients with early breast cancer (n = 52) had significantly lower ADC and tumor volume than those with locally advanced breast cancer (n = 207). No association was found in ADC and tumor volume with the menopausal status. Breast cancers with ER−, PR−, and triple-negative (TN) status showed a significantly larger tumor volume compared to ER+, PR+, and non-triple-negative (nTN) cancers, respectively. Also, TN tumors showed a significantly higher ADC compared to ER+, PR+, and nTN cancers. Patients with ER− and TN cancers were younger than those with ER+ and nTN cancers

  13. Potential of Diffusion-Weighted Imaging in the Characterization of Malignant, Benign, and Healthy Breast Tissues and Molecular Subtypes of Breast Cancer.

    PubMed

    Sharma, Uma; Sah, Rani G; Agarwal, Khushbu; Parshad, Rajinder; Seenu, Vurthaluru; Mathur, Sandeep R; Hari, Smriti; Jagannathan, Naranamangalam R

    2016-01-01

    The role of apparent diffusion coefficient (ADC) in the diagnosis of breast cancer and its association with molecular biomarkers was investigated in 259 patients with breast cancer, 67 with benign pathology, and 54 healthy volunteers using diffusion-weighted imaging (DWI) at 1.5 T. In 59 breast cancer patients, dynamic contrast-enhanced MRI (DCEMRI) was also acquired. Mean ADC of malignant lesions was significantly lower (1.02 ± 0.17 × 10(-3) mm(2)/s) compared to benign (1.57 ± 0.26 × 10(-3) mm(2)/s) and healthy (1.78 ± 0.13 × 10(-3) mm(2)/s) breast tissues. A cutoff ADC value of 1.23 × 10(-3) mm(2)/s (sensitivity 92.5%; specificity 91.1%; area under the curve 0.96) to differentiate malignant from benign diseases was arrived by receiver operating curve analysis. In 10/59 breast cancer patients, indeterminate DCE curve was seen, while their ADC value was indicative of malignancy, implying the potential of the addition of DWI in increasing the specificity of DCEMRI data. Further, the association of ADC with tumor volume, stage, hormonal receptors [estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor (HER2)], and menopausal status was investigated. A significant difference was seen in tumor volume between breast cancer patients of stages IIA and IIIA, IIB and IIIA, and IIB and III (B + C), respectively (P < 0.05). Patients with early breast cancer (n = 52) had significantly lower ADC and tumor volume than those with locally advanced breast cancer (n = 207). No association was found in ADC and tumor volume with the menopausal status. Breast cancers with ER-, PR-, and triple-negative (TN) status showed a significantly larger tumor volume compared to ER+, PR+, and non-triple-negative (nTN) cancers, respectively. Also, TN tumors showed a significantly higher ADC compared to ER+, PR+, and nTN cancers. Patients with ER- and TN cancers were younger than those with ER+ and n

  14. Integration of DCE-MRI and DW-MRI Quantitative Parameters for Breast Lesion Classification

    PubMed Central

    Fusco, Roberta; Sansone, Mario; Filice, Salvatore; Granata, Vincenza; Catalano, Orlando; Amato, Daniela Maria; Di Bonito, Maurizio; D'Aiuto, Massimiliano; Capasso, Immacolata; Rinaldo, Massimo; Petrillo, Antonella

    2015-01-01

    Objective. The purpose of our study was to evaluate the diagnostic value of an imaging protocol combining dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in patients with suspicious breast lesions. Materials and Methods. A total of 31 breast lesions (15 malignant and 16 benign proved by histological examination) in 26 female patients were included in this study. For both DCE-MRI and DW-MRI model free and model based parameters were computed pixel by pixel on manually segmented ROIs. Statistical procedures included conventional linear analysis and more advanced techniques for classification of lesions in benign and malignant. Results. Our findings indicated no strong correlation between DCE-MRI and DW-MRI parameters. Results of classification analysis show that combining of DCE parameters or DW-MRI parameter, in comparison of single feature, does not yield a dramatic improvement of sensitivity and specificity of the two techniques alone. The best performance was obtained considering a full combination of all features. Moreover, the classification results combining all features are dominated by DCE-MRI features alone. Conclusion. The combination of DWI and DCE-MRI does not show a potential to dramatically increase the sensitivity and specificity of breast MRI. DCE-MRI alone gave the same performance as in combination with DW-MRI. PMID:26339597

  15. Focal Lesions in Fatty Liver: If Quantitative Analysis Facilitates the Differentiation of Atypical Benign from Malignant Lesions

    PubMed Central

    Shan, Quan-Yuan; Chen, Li-Da; Zhou, Lu-Yao; Wang, Zhu; Liu, Guang-Jian; Huang, Yang; Li, Wei; Liu, Jin-ya; Xie, Xiao-yan; Lu, Ming-de; Liu, Jie; Wang, Wei

    2016-01-01

    To evaluate the diagnostic performance of quantitative analysis as an adjunctive diagnostic tool to contrast-enhanced ultrasound (US) for the differentiation of atypical benign focal liver lesions (FLLs) from malignancies in fatty liver. Twenty-seven benign FLLs and fifty-six malignant FLLs that appeared hyper-enhanced during the arterial phase with washout in the portal or late phase in fatty liver were analyzed. Chi-square tests and logistic regression were applied to identify the specific features. Three sets of criteria were assigned: 1) all FLLs subjected to routine contrast-enhanced US; 2) all FLLs subjected to quantification analysis and contrast-enhanced US; and 3) parts of FLLs that could not be diagnosed using contrast-enhanced US (n = 66, 75.9%) but instead were diagnosed using parametric features. The sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (AUC) of the three sets of criteria were analyzed. The AUCs of the criterion set 2 were significantly higher than those of criterion set 1 (0.904 versus 0.792, P = 0.008). Criterion set 3 showed a relatively high sensitivity (90.2%) with a relatively high AUC (0.845). The quantification analysis offers improved diagnostic performance for the differential identification of atypical benign FLLs from malignancies in fatty liver. PMID:26725923

  16. Nd:YAG laser photocoagulation of benign oral vascular lesions: a case series.

    PubMed

    Medeiros, Rui; Silva, Igor Henrique; Carvalho, Alessandra Tavares; Leão, Jair Carneiro; Gueiros, Luiz Alcino

    2015-11-01

    Vascular anomalies of the head and neck are common lesions usually associated with functional and/or aesthetic limitations. The aim of the present paper was to report a case series of oral vascular malformations treated with Nd:YAG laser photocoagulation, highlighting the clinical evolution and post-surgical complications. Fifteen patients diagnosed with oral vascular malformations were treated with Nd:YAG laser followed by three sessions of biostimulation. None of the patients presented post-surgical pain, but 6 of 15 patients (40%) experienced minimal post-surgical complications. All cases presented complete resolution of the lesions after laser treatment. More importantly, 12 out of 15 (80%) resolved after a single session. Low morbidity, minimal patient discomfort, and satisfactory aesthetic results point Nd:YAG laser photocoagulation as a promising option for the management of benign oral vascular lesions. PMID:25962368

  17. Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound.

    PubMed

    Liu, Haixia; Tan, Tao; van Zelst, Jan; Mann, Ritse; Karssemeijer, Nico; Platel, Bram

    2014-07-01

    We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing different lesion properties; however, it does not include texture features. In this work, we expand the system by including texture features based on local binary patterns, gray level co-occurrence matrices, and Gabor filters computed from each lesion to be diagnosed. To deal with the resulting large number of features, we proposed a combination of feature-oriented classifiers combining each group of texture features into a single likelihood, resulting in three additional features used for the final classification. The classification was performed using support vector machine classifiers, and the evaluation was done with 10-fold cross validation on a dataset containing 424 lesions (239 benign and 185 malignant lesions). We compared the classification performance of the CAD system with and without texture features. The area under the receiver operating characteristic curve increased from 0.90 to 0.91 after adding texture features ([Formula: see text]). PMID:26158036

  18. Incorporating texture features in a computer-aided breast lesion diagnosis system for automated three-dimensional breast ultrasound

    PubMed Central

    Liu, Haixia; Tan, Tao; van Zelst, Jan; Mann, Ritse; Karssemeijer, Nico; Platel, Bram

    2014-01-01

    Abstract. We investigated the benefits of incorporating texture features into an existing computer-aided diagnosis (CAD) system for classifying benign and malignant lesions in automated three-dimensional breast ultrasound images. The existing system takes into account 11 different features, describing different lesion properties; however, it does not include texture features. In this work, we expand the system by including texture features based on local binary patterns, gray level co-occurrence matrices, and Gabor filters computed from each lesion to be diagnosed. To deal with the resulting large number of features, we proposed a combination of feature-oriented classifiers combining each group of texture features into a single likelihood, resulting in three additional features used for the final classification. The classification was performed using support vector machine classifiers, and the evaluation was done with 10-fold cross validation on a dataset containing 424 lesions (239 benign and 185 malignant lesions). We compared the classification performance of the CAD system with and without texture features. The area under the receiver operating characteristic curve increased from 0.90 to 0.91 after adding texture features (p<0.001). PMID:26158036

  19. In situ validation of VEGFR-2 and α v ß 3 integrin as targets for breast lesion characterization.

    PubMed

    Ehling, Josef; Misiewicz, Matthias; von Stillfried, Saskia; Möckel, Diana; Bzyl, Jessica; Pochon, Sibylle; Lederle, Wiltrud; Knuechel, Ruth; Lammers, Twan; Palmowski, Moritz; Kiessling, Fabian

    2016-04-01

    Vascular endothelial growth factor receptor 2 (VEGFR-2) and α v ß 3 integrin are the most frequently addressed targets in molecular imaging of tumor angiogenesis. In preclinical studies, molecular imaging of angiogenesis has shown potential to detect and differentiate benign and malignant lesions of the breast. Thus, in this retrospective clinical study employing patient tissues, the diagnostic value of VEGFR-2, α v ß 3 integrin and vascular area fraction for the diagnosis and differentiation of breast neoplasia was evaluated. To this end, tissue sections of breast cancer (n = 40), pre-invasive ductal carcinoma in situ (DCIS; n = 8), fibroadenoma (n = 40), radial scar (n = 6) and normal breast tissue (n = 40) were used to quantify (1) endothelial VEGFR-2, (2) endothelial α v ß 3 integrin and (3) total α v ß 3 integrin expression, as well as (4) the vascular area fraction. Sensitivity and specificity to differentiate benign from malignant lesions were calculated for each marker by receiver operating characteristics (ROC) analyses. Whereas vessel density, as commonly used, did not significantly differ between benign and malignant lesions (AUROC: 0.54), VEGFR-2 and α v ß 3 integrin levels were gradually up-regulated in carcinoma versus fibroadenoma versus healthy tissue. The highest diagnostic accuracy for differentiating carcinoma from fibroadenoma was found for total α v ß 3 integrin expression (AUROC: 0.76), followed by VEGFR-2 (AUROC: 0.71) and endothelial α v ß 3 integrin expression (AUROC: 0.68). In conclusion, total α v ß 3 integrin expression is the best discriminator between breast cancer, fibroadenoma and normal breast tissue. With respect to vascular targeting and molecular imaging of angiogenesis, endothelial VEGFR-2 appeared to be slightly superior to endothelial α v ß 3 for differentiating benign from cancerous lesions. PMID:26902100

  20. Management issues in breast lesions diagnosed by fine-needle aspiration and percutaneous core breast biopsy.

    PubMed

    Levine, Pascale; Simsir, Aylin; Cangiarella, Joan

    2006-06-01

    The use offine-needle aspiration biopsy or percutaneous core needle biopsy to diagnose breast lesions has increased during the past few decades. Although the benefits of these procedures are well known, controversies remain about the management of certain categories of breast lesions detected by these methods. This article discusses the management issues in categories of breast lesions, including papillary lesions, atypical lobular hyperplasia and lobular carcinoma in situ, and mucinous lesions diagnosed by the preoperative techniques of aspiration or core biopsy. PMID:16830962

  1. Ductal carcinoma in situ in a benign phyllodes tumor of breast: A rare presentation.

    PubMed

    Ghosh, Prithwijit; Saha, Kaushik

    2014-07-01

    Phyllodes tumor (PT) is an uncommon tumor of female breast. The tumor clinically, radiologically, cytologically as well as histologically can mimic fibroadenoma which is a common tumor of fibroepithelial group. Ductal carcinoma in situ (DCIS) in the epithelial component of PT is very rare. We report a rare case of intermediate grade DCIS arising in a benign PT in a 42-year-old lady. The patient presented with a small nodule in right breast along with serosanguineous discharge from nipple. Ultrasonography and cytology failed to distinguish between fibroadenoma and PT. Histopathological examination following wide local excision displayed the biphasic tumor comprising of benign looking cellular stroma and epithelial lining. It also demonstrated the foci of intermediate grade DCIS without any invasive component. Considering the clinicoradiological profile along with histopathological features, the diagnosis of DCIS in a benign PT of breast was made. PMID:25097439

  2. Effect of Breast Compression on Lesion Characteristic Visibility with Diffraction-Enhanced Imaging

    SciTech Connect

    Faulconer, L.; Parham, C; Connor, D; Kuzmiak, C; Koomen, M; Lee, Y; Cho, K; Rafoth, J; Livasy, C; et al.

    2010-01-01

    Conventional mammography can not distinguish between transmitted, scattered, or refracted x-rays, thus requiring breast compression to decrease tissue depth and separate overlapping structures. Diffraction-enhanced imaging (DEI) uses monochromatic x-rays and perfect crystal diffraction to generate images with contrast based on absorption, refraction, or scatter. Because DEI possesses inherently superior contrast mechanisms, the current study assesses the effect of breast compression on lesion characteristic visibility with DEI imaging of breast specimens. Eleven breast tissue specimens, containing a total of 21 regions of interest, were imaged by DEI uncompressed, half-compressed, or fully compressed. A fully compressed DEI image was displayed on a soft-copy mammography review workstation, next to a DEI image acquired with reduced compression, maintaining all other imaging parameters. Five breast imaging radiologists scored image quality metrics considering known lesion pathology, ranking their findings on a 7-point Likert scale. When fully compressed DEI images were compared to those acquired with approximately a 25% difference in tissue thickness, there was no difference in scoring of lesion feature visibility. For fully compressed DEI images compared to those acquired with approximately a 50% difference in tissue thickness, across the five readers, there was a difference in scoring of lesion feature visibility. The scores for this difference in tissue thickness were significantly different at one rocking curve position and for benign lesion characterizations. These results should be verified in a larger study because when evaluating the radiologist scores overall, we detected a significant difference between the scores reported by the five radiologists. Reducing the need for breast compression might increase patient comfort during mammography. Our results suggest that DEI may allow a reduction in compression without substantially compromising clinical image

  3. Accuracy of clinical diagnosis of benign eyelid lesions: Is a dedicated nurse-led service safe and effective?

    PubMed

    Mohite, Abhijit A; Johnson, Andria; Rathore, Deepa S; Bhandari, Kamal; Crossman, Richard; Mehta, Purnima; Ahluwalia, Harpreet S

    2016-08-01

    This article compares an independent nurse-led benign lesion service with a doctor-led one, and assesses the impact of clinician seniority on diagnostic accuracy rates. Retrospective review of benign lesions referred to a teaching hospital and managed in either a doctor- or nurse-led lid service. All lesions were diagnosed clinically, excised and then sent for histological diagnosis. Lesions were categorized into subtypes. Pre-excision clinical diagnoses were compared with histological diagnoses. Sensitivity, specificity and missed malignancy rates were calculated for each subtype. Accuracy was compared between different grades of doctors and a specialist nurse. 264 and 332 lesions were managed in a doctor-led and nurse-led service, respectively. Rates of accurate sub-typing were 79.6% and 80.4% in the doctor- and nurse-led services, respectively (p > 0.05). Clinician seniority had no bearing. Missed malignancies or pre-malignancies accounted for 1.1% and 1.5% of lesions in the doctor and nurse-led services, respectively (p > 0.05). Overall, the remaining misdiagnoses were benign lesions of another subtype (13.6%) or non-specific histological findings (5.0%) and 98.6% of lesions were confirmed as benign on histology. Overall sensitivity and specificity values were: benign epithelial proliferations 95.6% and 92.2%, epidermal inclusion cysts 92.2% and 88.0%, xanthelasma 97.5% and 100.0%, cysts of Moll 66.7% and 96.6%, naevi 39.4% and 99.8% and molluscum 20.0% and 99.8%, respectively. A dedicated nurse-led service is as effective in managing a range of clinically benign lid lesions as a doctor-led one, and clinician seniority has little impact on the diagnostic accuracy of these lesions. PMID:27322204

  4. Dedicated Three-dimensional Breast Computed Tomography: Lesion Characteristic Perception by Radiologists

    PubMed Central

    Kuzmiak, Cherie Marie; Cole, Elodia B; Zeng, Donglin; Tuttle, Laura A; Steed, Doreen; Pisano, Etta D

    2016-01-01

    Objectives: To assess radiologist confidence in the characterization of suspicious breast lesions with a dedicated three-dimensional breast computed tomography (DBCT) system in comparison to diagnostic two-dimensional digital mammography (dxDM). Materials and Methods: Twenty women were recruited who were to undergo a breast biopsy for a Breast Imaging-Reporting and Data System (BI-RADS) 4 or 5 lesion evaluated with dxDM in this Institutional Review Board-approved study. The enrolled subjects underwent imaging of the breast(s) of concern using DBCT. Seven radiologists reviewed the cases. Each reader compared DBCT to the dxDM and was asked to specify the lesion type and BI-RADS score for each lesion and modality. They also compared lesion characteristics: Shape for masses or morphology for calcifications; and margins for masses or distribution for calcifications between the modalities using confidence scores (0–100). Results: Twenty-four biopsied lesions were included in this study: 17 (70.8%) masses and 7 (29.2%) calcifications. Eight (33.3%) lesions were malignant, and 16 (66.7%) were benign. Across all lesions, there was no significant difference in the margin/distribution (Δ = −0.99, P = 0.84) and shape/morphology (Δ = −0.10, P = 0.98) visualization confidence scores of DBCT in relation to dxDM. However, analysis by lesion type showed a statistically significant increase in reader shape (Δ =11.34, P = 0.013) and margin (Δ =9.93, P = 0.023) visualization confidence with DBCT versus dxDM for masses and significant decrease in reader morphology (Δ = −29.95, P = 0.001) and distribution (Δ = −28.62, P = 0.002) visualization confidence for calcifications. Conclusion: Reader confidence in the characterization of suspicious masses is significantly improved with DBCT, but reduced for calcifications. Further study is needed to determine whether this technology can be used for breast cancer screening. PMID:27195180

  5. Confocal imaging of benign and malignant proliferative skin lesions in vivo

    NASA Astrophysics Data System (ADS)

    Gonzalez, Salvador; Rajadhyaksha, Milind M.; Anderson, R. Rox

    1999-06-01

    Near-infrared confocal reflectance microscopy (CM) provides non- invasive real-time images of thin en-face tissue sections with high resolution and contrast. Imaging of cells, nuclei, other organelles, microvessels, and hair follicles has been possible at resolution comparable to standard histology, to a maximum depth of 250-300 μm in human skin in vivo. We have characterized psoriasis as a prototype of benign proliferative skin conditions, and non-pigmented skin malignancies in vivo based on their unstained, native histologic features using CM. Our data shows that reflectance CM may potentially diagnose and morphometrically evaluate proliferative skin lesions in vivo.

  6. Accurate Characterization of Benign and Cancerous Breast Tissues: Aspecific Patient Studies using Piezoresistive Microcantilevers

    PubMed Central

    PANDYA, HARDIK J.; ROY, RAJARSHI; CHEN, WENJIN; CHEKMAREVA, MARINA A.; FORAN, DAVID J.; DESAI, JAYDEV P.

    2014-01-01

    Breast cancer is the largest detected cancer amongst women in the US. In this work, our team reports on the development of piezoresistive microcantilevers (PMCs) to investigate their potential use in the accurate detection and characterization of benign and diseased breast tissues by performing indentations on the micro-scale tissue specimens. The PMCs used in these experiments have been fabricated using laboratory-made silicon-on-insulator (SOI) substrate, which significantly reduces the fabrication costs. The PMCs are 260 μm long, 35 μm wide and 2 μm thick with resistivity of order 1.316 X 10−3 Ω-cm obtained by using boron diffusion technique. For indenting the tissue, we utilized 8 μm thick cylindrical SU-8 tip. The PMC was calibrated against a known AFM probe. Breast tissue cores from seven different specimens were indented using PMC to identify benign and cancerous tissue cores. Furthermore, field emission scanning electron microscopy (FE-SEM) of benign and cancerous specimens showed marked differences in the tissue morphology, which further validates our observed experimental data with the PMCs. While these patient aspecific feasibility studies clearly demonstrate the ability to discriminate between benign and cancerous breast tissues, further investigation is necessary to perform automated mechano-phenotyping (classification) of breast cancer: from onset to disease progression. PMID:25128621

  7. Differentiation of Benign and Malignant Breast Tumors by In-Vivo Three-Dimensional Parallel-Plate Diffuse Optical Tomography

    PubMed Central

    Choe, Regine; Konecky, Soren D.; Corlu, Alper; Lee, Kijoon; Durduran, Turgut; Busch, David R.; Pathak, Saurav; Czerniecki, Brian J.; Tchou, Julia; Fraker, Douglas L.; DeMichele, Angela; Chance, Britton; Arridge, Simon R.; Schweiger, Martin; Culver, Joseph P.; Schnall, Mitchell D.; Putt, Mary E.; Rosen, Mark A.; Yodh, Arjun G.

    2009-01-01

    We have developed a novel parallel-plate diffuse optical tomography (DOT) system for three-dimensional in vivo imaging of human breast tumor based on large optical data sets. Images of oxy-, deoxy-, total-hemoglobin concentration, blood oxygen saturation, and tissue scattering were reconstructed. Tumor margins were derived using the optical data with guidance from radiology reports and Magnetic Resonance Imaging. Tumor-to-normal ratios of these endogenous physiological parameters and an optical index were computed for 51 biopsy-proven lesions from 47 subjects. Malignant cancers (N=41) showed statistically significant higher total hemoglobin, oxy-hemoglobin concentration, and scattering compared to normal tissue. Furthermore, malignant lesions exhibited a two-fold average increase in optical index. The influence of core biopsy on DOT results was also explored; the difference between the malignant group measured before core biopsy and the group measured more than one week after core biopsy was not significant. Benign tumors (N=10) did not exhibit statistical significance in the tumor-to-normal ratios of any parameter. Optical index and tumor-to-normal ratios of total hemoglobin, oxy-hemoglobin concentration, and scattering exhibited high area under the receiver operating characteristic curve values from 0.90 to 0.99, suggesting good discriminatory power. The data demonstrate that benign and malignant lesions can be distinguished by quantitative three-dimensional DOT. PMID:19405750

  8. Differentiation of benign and malignant breast tumors by in-vivo three-dimensional parallel-plate diffuse optical tomography

    NASA Astrophysics Data System (ADS)

    Choe, Regine; Konecky, Soren D.; Corlu, Alper; Lee, Kijoon; Durduran, Turgut; Busch, David R.; Pathak, Saurav; Czerniecki, Brian J.; Tchou, Julia; Fraker, Douglas L.; Demichele, Angela; Chance, Britton; Arridge, Simon R.; Schweiger, Martin; Culver, Joseph P.; Schnall, Mitchell D.; Putt, Mary E.; Rosen, Mark A.; Yodh, Arjun G.

    2009-03-01

    We have developed a novel parallel-plate diffuse optical tomography (DOT) system for three-dimensional in vivo imaging of human breast tumor based on large optical data sets. Images of oxy-, deoxy-, and total hemoglobin concentration as well as blood oxygen saturation and tissue scattering were reconstructed. Tumor margins were derived using the optical data with guidance from radiology reports and magnetic resonance imaging. Tumor-to-normal ratios of these endogenous physiological parameters and an optical index were computed for 51 biopsy-proven lesions from 47 subjects. Malignant cancers (N=41) showed statistically significant higher total hemoglobin, oxy-hemoglobin concentration, and scattering compared to normal tissue. Furthermore, malignant lesions exhibited a twofold average increase in optical index. The influence of core biopsy on DOT results was also explored; the difference between the malignant group measured before core biopsy and the group measured more than 1 week after core biopsy was not significant. Benign tumors (N=10) did not exhibit statistical significance in the tumor-to-normal ratios of any parameter. Optical index and tumor-to-normal ratios of total hemoglobin, oxy-hemoglobin concentration, and scattering exhibited high area under the receiver operating characteristic curve values from 0.90 to 0.99, suggesting good discriminatory power. The data demonstrate that benign and malignant lesions can be distinguished by quantitative three-dimensional DOT.

  9. Characterization of lesions in dense breasts: Does tomosynthesis help?

    PubMed Central

    Rangarajan, Krithika; Hari, Smriti; Thulkar, Sanjay; Sharma, Sanjay; Srivastava, Anurag; Parshad, Rajinder

    2016-01-01

    Context: Mammography in dense breasts is challenging due to lesion obscuration by tissue overlap. Does tomosynthesis offers a solution? Aims: To study the impact of digital breast tomosynthesis (DBT) in characterizing lesions in breasts of different mammographic densities. Settings and Design: Prospective blinded study comparing mammography in two views with Mammography + Tomosynthesis. Methods and Material: Tomosynthesis was performed in 199 patients who were assigned Breast imaging reporting and data system (BIRADS) categories 0, 3, 4, or 5 on two-dimensional (2D) mammogram. Mammograms were first categorized into one of 4 mammographic breast densities in accordance with the American College of Radiology (ACR). Three radiologists independently analyzed these images and assigned a BIRADS category first based on 2D mammogram alone, and then assigned a fresh BIRADS category after taking mammography and tomosynthesis into consideration. A composite gold-standard was used in the study (histopathology, ultrasound, follow-up mammogram, magnetic resonance imaging). Each lesion was categorized into 3 groups—superior categorization with DBT, no change in BIRADS, or inferior BIRADS category based on comparison with the gold-standard. The percentage of lesions in each group was calculated for different breast densities. Results: There were 260 lesions (ages 28–85). Overall, superior categorization was seen in 21.2% of our readings on addition of DBT to mammography. DBT was most useful in ACR Densities 3 and 4 breasts where it led to more appropriate categorization in 27 and 42% of lesions, respectively. DBT also increased diagnostic confidence in 54.5 and 63.6% of lesions in ACR Densities 3 and 4, respectively. Conclusions: In a diagnostic setting, the utility of tomosynthesis increases with increasing breast density. This helps in identifying the sub category of patients where DBT can actually change management.

  10. Benign soft-tissue lesions of the fingers: radiopathological correlation and clinical considerations.

    PubMed

    Oca Pernas, Roque; Prada González, Raquel; Santos Armentia, Eloísa; Hormaza Aguirre, Nerea; Tardáguila de la Fuente, Gonzalo; Trinidad López, Carmen; Delgado Sánchez-Gracián, Carlos

    2015-04-01

    Soft-tissue lesions of the fingers are commonly found in daily clinical practice. A wide range of tumors and pseudotumors have been described in this location, and the majority of them are benign. Ganglion cysts are the most common entity, and the localized type of tenosynovial giant cell tumors are the most frequent solid condition. Both may be easily recognized owing to their typical clinical and radiological characteristics. However, categorization of the spectrum of soft-tissue lesions of the fingers remains limited, despite imaging development, and many patients undergo surgery before radiological or histological diagnosis. Clinical history, radiographic features, and ultrasound and magnetic resonance patterns may help in obtaining the correct diagnosis or reducing the list of differential diagnoses. Radiologists should be familiar with imaging findings so that they can determine the size, extension, and affected neighboring anatomical structures, and provide information that allows adequate presurgical counseling. PMID:25367671

  11. Measurement of breast-tissue x-ray attenuation by spectral mammography: solid lesions.

    PubMed

    Fredenberg, Erik; Kilburn-Toppin, Fleur; Willsher, Paula; Moa, Elin; Danielsson, Mats; Dance, David R; Young, Kenneth C; Wallis, Matthew G

    2016-04-01

    Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. For instance, techniques to distinguish between cysts and solid tumours at mammography screening would be highly desirable to reduce recalls, but the development requires knowledge of the x-ray attenuation for cysts and tumours. We have previously measured the attenuation of cyst fluid using photon-counting spectral mammography. Data on x-ray attenuation for solid breast lesions are available in the literature, but cover a relatively wide range, likely caused by natural spread between samples, random measurement errors, and different experimental conditions. In this study, we have adapted a previously developed spectral method to measure the linear attenuation of solid breast lesions. A total of 56 malignant and 5 benign lesions were included in the study. The samples were placed in a holder that allowed for thickness measurement. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, which can be used to derive the x-ray attenuation as a function of energy. The spread in equivalent material thicknesses was relatively large between samples, which is likely to be caused mainly by natural variation and only to a minor extent by random measurement errors and sample inhomogeneity. No significant difference in attenuation was found between benign and malignant solid lesions. The separation between cyst-fluid and tumour attenuation was, however, significant, which suggests it may be possible to distinguish cystic from solid breast lesions, and the results lay the groundwork for a clinical trial. In addition, the study adds a relatively large sample set to the published data and may contribute to a reduction in the overall uncertainty in the literature. PMID:26961507

  12. Measurement of breast-tissue x-ray attenuation by spectral mammography: solid lesions

    NASA Astrophysics Data System (ADS)

    Fredenberg, Erik; Kilburn-Toppin, Fleur; Willsher, Paula; Moa, Elin; Danielsson, Mats; Dance, David R.; Young, Kenneth C.; Wallis, Matthew G.

    2016-04-01

    Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. For instance, techniques to distinguish between cysts and solid tumours at mammography screening would be highly desirable to reduce recalls, but the development requires knowledge of the x-ray attenuation for cysts and tumours. We have previously measured the attenuation of cyst fluid using photon-counting spectral mammography. Data on x-ray attenuation for solid breast lesions are available in the literature, but cover a relatively wide range, likely caused by natural spread between samples, random measurement errors, and different experimental conditions. In this study, we have adapted a previously developed spectral method to measure the linear attenuation of solid breast lesions. A total of 56 malignant and 5 benign lesions were included in the study. The samples were placed in a holder that allowed for thickness measurement. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, which can be used to derive the x-ray attenuation as a function of energy. The spread in equivalent material thicknesses was relatively large between samples, which is likely to be caused mainly by natural variation and only to a minor extent by random measurement errors and sample inhomogeneity. No significant difference in attenuation was found between benign and malignant solid lesions. The separation between cyst-fluid and tumour attenuation was, however, significant, which suggests it may be possible to distinguish cystic from solid breast lesions, and the results lay the groundwork for a clinical trial. In addition, the study adds a relatively large sample set to the published data and may contribute to a reduction in the overall uncertainty in the literature.

  13. Model-Free Visualization of Suspicious Lesions in Breast MRI Based on Supervised and Unsupervised Learning.

    PubMed

    Twellmann, Thorsten; Meyer-Baese, Anke; Lange, Oliver; Foo, Simon; Nattkemper, Tim W

    2008-03-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important tool in breast cancer diagnosis, but evaluation of multitemporal 3D image data holds new challenges for human observers. To aid the image analysis process, we apply supervised and unsupervised pattern recognition techniques for computing enhanced visualizations of suspicious lesions in breast MRI data. These techniques represent an important component of future sophisticated computer-aided diagnosis (CAD) systems and support the visual exploration of spatial and temporal features of DCE-MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogeneity of cancerous tissue, these techniques reveal signals with malignant, benign and normal kinetics. They also provide a regional subclassification of pathological breast tissue, which is the basis for pseudo-color presentations of the image data. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging. PMID:19255616

  14. [Intracytoplasmic lumina of benign and malignant breast diseases--a light and electron microscopic study].

    PubMed

    Gu, C M

    1990-07-01

    Intracytoplasmic lumina (ICLs) of 70 cases with breast carcinoma and 29 cases with benign breast diseases were observed by light and electron microscopy. ICLs were morphologically divided into two types. Type A was characterized by the presence of secretory materials stained with eosin in the lumen and Type B by the cytoplasmic vacuoles under light microscope. Electron microscopic observation on Type A ICLs showed numerous filiform microvilli projecting towards the lumen and various amounts of secretory materials in the lumen. Type B of ICLs only had scanty and short microvilli and rarely secretory materials in the lumen. The results indicated that: 1. The frequency of ICLs in breast cancer was significantly higher than that in benign breast disease (P less than 0.01). 2. The frequency of ICLs in breast cancer showed strong negative correlation with its histological grades but not with its histological types. 3. ICLs had similar frequency under both light and electron microscopes. As a relatively specific structure in breast carcinoma cells, ICLs may be helpful in the diagnosis of breast carcinoma and establishment of the breast origin for metastatic carcinoma. PMID:2176965

  15. POLYBROMINATED BIPHENYL EXPOSURE AND BENIGN BREAST DISEASE IN A COHORT OF US WOMEN. (R825300)

    EPA Science Inventory

    PURPOSE: We examined the relation between serum polybrominated biphenyl (PBB) levels and the risk of benign breast disease in a cohort of Michigan women unintentionally exposed to PBBs in 1973 and interviewed in 1997.

    METHODS: We used extend...

  16. Validity of breast-specific gamma imaging for Breast Imaging Reporting and Data System 4 lesions on mammography and/or ultrasound

    PubMed Central

    Cho, Min Jeng; Yu, Yeong Beom; Park, Kyoung Sik; Chung, Hyun Woo; So, Young; Choi, Nami; Kim, Mi Young

    2016-01-01

    Purpose The purpose of this study was to assess the breast-specific gamma imaging (BSGI) in Breast Imaging Reporting and Data System (BI-RADS) 4 lesions on mammography and/or ultrasound. Methods We performed a retrospective review of 162 patients who underwent BSGI in BI-RADS 4 lesions on mammography and/or ultrasound. Results Of the 162 breast lesions, 66 were malignant tumors and 96 were benign tumors. Sensitivity and specificity of BSGI were 90.9% and 78.1%, and positive predictive value and negative predictive value were 74.1% and 92.6%. The sensitivity or specificity of mammography and ultrasound were 74.2% and 56.3% and 87.9% and 19.8%, respectively. The sensitivity and specificity of BSGI for breast lesions ≤1 cm were 88.0% and 86.8%, while the values of beast lesions >1 cm were 92.7% and 61.5%. The sensitivity or specificity of BSGI and mammography for patients with dense breasts were 92.0% and 81.3% and 72.0% and 50.0%, respectively. 26 patients showed neither a nodule nor microcalcification on ultrasound, but showed suspicious calcification on mammography. The sensitivity and specificity of BSGI with microcalcification only lesion were 75.0% and 94.4%. Conclusion This study demonstrated that BSGI had shown high sensitivity and specificity, as well as positive and negative predictive values in BI-RADS 4 lesions on ultrasound and/or mammography. BSGI showed excellent results in dense breasts, in lesions that are less than 1 cm in size and lesions with suspicious microcalcification only. PMID:27073789

  17. [Clinical practice guidelines: Benign breast tumor--Aims, methods and organization].

    PubMed

    Lavoué, V; Fritel, X; Chopier, J; Roedlich, M-N; Chamming's, F; Mathelin, C; Bendifallah, S; Boisserie-Lacroix, M; Canlorbe, G; Chabbert-Buffet, N; Coutant, C; Guilhen, N; Fauvet, R; Laas, E; Legendre, G; Thomassin Naggara, I; Ngô, C; Ouldamer, L; Seror, J; Touboul, C; Daraï, E

    2015-12-01

    Conversely to breast cancer, few data and guidelines are available to explore and manage benign breast disorders. Therefore, the Collège national des gynécologues et obstétriciens français (CNGOF - French College of Gynaecologists and Obstetricians) decided to establish clinical practice guidelines for benign breast tumour (BBT). CNGOF appointed a committee with responsibility for selecting experts, compiling questions and summarizing the recommendations. The summary of valid scientific data for each question analyzed by the experts included a level of evidence, based on the quality of the data available and defined accordingly rating scheme developed by the Haute Autorité de santé (French National Authority for Health). PMID:26527015

  18. Differentiation of benign and malignant focal liver lesions: value of virtual touch tissue quantification of acoustic radiation force impulse elastography.

    PubMed

    Guo, Le-Hang; Wang, Shu-Jun; Xu, Hui-Xiong; Sun, Li-Ping; Zhang, Yi-Feng; Xu, Jun-Mei; Wu, Jian; Fu, Hui-Jun; Xu, Xiao-Hong

    2015-03-01

    The purpose of this study was to investigate the value of virtual tissue quantification (VTQ) of acoustic radiation force impulse elastography for the differential diagnosis of benign and malignant focal liver lesions (FLLs). Thus, a total of 134 FLLs in 134 patients were included. VTQ measurement was performed for each lesion in which the shear wave velocity (SWV) was measured. The difference in SWV and SWV ratio of FLL to surrounding liver between malignant and benign FLLs was evaluated, and the cutoff value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. A total of 134 lesions including 55 (41.0%) malignant FLLs and 79 (59.0%) benign ones were analyzed. The SWV of malignant and benign FLLs was 2.95 ± 1.00 m/s and 1.69 ± 0.89 m/s, respectively. Significant difference in SWV was presented between malignant and benign FLLs (p < 0.001). The SWV ratio of each FLL to the surrounding liver parenchyma was 1.83 ± 1.32 for malignant and 1.26 ± 0.78 for benign FLLs (p < 0.001). The area under the ROC curve in distinguishing malignant from benign lesions was 0.824 for SWV and 0.660 for SWV ratio. The cutoff value for differential diagnosis was 2.13 m/s for SWV and 1.37 for SWV ratio. The associated sensitivity and specificity were 83.3 and 77.9% for SWV and 59.6 and 77.3% for SWV ratio, respectively. In conclusion, VTQ provides quantitative stiffness information of FLLs and is helpful in the differential diagnosis between malignant and benign FLLs, particularly for the patients who are not candidates for contrast-enhanced imaging such as CT, MRI or contrast-enhanced ultrasound. PMID:25691297

  19. [Benign phylloides tumor of the breast. Considerations on a clinical case].

    PubMed

    Biondi, Antonio; Di Giuntao, Michela; Motta, Salvatore; Privitera, Giuseppe; Fichera, Debora Simona; Ciuni, Roberto; Basile, Francesco

    2009-01-01

    Phyllodes tumors are unusual biphasic fibroepithelial neoplasms of the breast, accounting for < 1% of all breast tumors and raising issues of diagnosis and therapeutic choice. They can grow quickly and when the maximum diameter is greater than 10 cm. We talk about giant phyllodes tumors. Ultrasound, Mammography and FNA are not effective. A potentially useful diagnostic modality is MRI. Core tissue biopsy or incisional biopsy represent the preferred means of pre-operative diagnosis. Conservative treatment can be effective also in giant tumors depending upon the size of the tumor and the breast if a complete excision with an adequate margin of normal breast tissue can be achieved, so avoiding local recurrence often accompanied by worse histopathology. The Authors report the case of a giant benign phyllode tumor of the breast treated with conservative surgery, quadrantectomy and oncoplasty. No local recurrence at 4 years follow-up. PMID:20476682

  20. Raman spectroscopic analysis of atypical proliferative lesions of the breast

    NASA Astrophysics Data System (ADS)

    Subramanian, K.; Kendall, C.; Stone, N.; Brown, J. C.; McCarthy, K.; Bristol, J.; Chan, Y. H.

    2006-02-01

    Atypical lesions of the breast have potential to turn malignant. The diagnosis of these lesions has increased considerably with screening mammography. A good understanding of their progression to invasive cancer is yet to be proved. Using Raman spectroscopy to study their chemical finger printing at different stages of proliferation a clear picture of whether a progression exists between lesions could be made. At present there is no clear recognition of the biochemical changes that distinguish between the different proliferative lesions of the breast. Our aim is to understand these changes through Raman mapping studies. Raman spectroscopy is a highly sensitive and specific technique for demonstration of biochemical changes in different atypical proliferative lesions of the breast. The technique could be used to classify the different grades and analyse progression of pathology in the proliferative lesions of the breast. Breast pathologists carefully marked 50 ducts and classified the different pathology on H and E sections from biopsy samples. Raman spectra were measured, using a Renishaw Raman Spectrometer, on a 20-micron thick consecutive frozen section. Principal component analysis was undertaken using Matlab. Pseudocolor maps of the principal components scores have been generated. The peaks of the corresponding loads were identified enabling visualisation of the biochemical changes associated with proliferative lesions. Proliferative lesions of the duct were grouped according to the existing standard pathological classification and formed four major groups-HUT, ADH, DCIS and IDC. Spectra of biochemical constituents were fitted to mean spectra from selected regions, taken from maps of each pathology, to identify the relative concentration of the constituents. The study gave an insight into chemical make up of the ducts in each pathology group and showed similar results to earlier studies in progression but no clear-cut demarcation or continuum of the

  1. Intraoperative handheld probe for 3D imaging of pediatric benign vocal fold lesions using optical coherence tomography (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Benboujja, Fouzi; Garcia, Jordan; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

    2016-02-01

    Excessive and repetitive force applied on vocal fold tissue can induce benign vocal fold lesions. Children affected suffer from chronic hoarseness. In this instance, the vibratory ability of the folds, a complex layered microanatomy, becomes impaired. Histological findings have shown that lesions produce a remodeling of sup-epithelial vocal fold layers. However, our understanding of lesion features and development is still limited. Indeed, conventional imaging techniques do not allow a non-invasive assessment of sub-epithelial integrity of the vocal fold. Furthermore, it remains challenging to differentiate these sub-epithelial lesions (such as bilateral nodules, polyps and cysts) from a clinical perspective, as their outer surfaces are relatively similar. As treatment strategy differs for each lesion type, it is critical to efficiently differentiate sub-epithelial alterations involved in benign lesions. In this study, we developed an optical coherence tomography (OCT) based handheld probe suitable for pediatric laryngological imaging. The probe allows for rapid three-dimensional imaging of vocal fold lesions. The system is adapted to allow for high-resolution intra-operative imaging. We imaged 20 patients undergoing direct laryngoscopy during which we looked at different benign pediatric pathologies such as bilateral nodules, cysts and laryngeal papillomatosis and compared them to healthy tissue. We qualitatively and quantitatively characterized laryngeal pathologies and demonstrated the added advantage of using 3D OCT imaging for lesion discrimination and margin assessment. OCT evaluation of the integrity of the vocal cord could yield to a better pediatric management of laryngeal diseases.

  2. Subcutaneous Fungal Cyst Masquerading as Benign Lesions – A Series of Eight Cases

    PubMed Central

    Varghese, Renu G’Boy; Phansalkar, Manjiri; Ramdas, Anita; K, Authy; G, Thangiah

    2015-01-01

    Background Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions. Materials and Methods A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details. Results Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae. Conclusion Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology. PMID:26557537

  3. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?

    PubMed Central

    Stanzani, Daniela; Chala, Luciano F.; de Barros, Nestor; Cerri, Giovanni G.; Chammas, Maria Cristina

    2014-01-01

    OBJECTIVES: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification. METHODS: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results. RESULTS: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)≥0.73 before contrast injection, and an RI≥0.75 after contrast injection were significantly predictive of malignancy (p<0.001). CONCLUSION: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers. PMID:24519198

  4. Angiosarcoma of the Scalp: Metastatic Pulmonary Cystic Lesions Initially Misinterpreted as Benign Findings on 18F-FDG PET/CT

    PubMed Central

    Andersen, Kim Francis; Albrecht-Beste, Elisabeth; Berthelsen, Anne Kiil; Loft, Annika

    2015-01-01

    Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported five-year survival is <30%. The mainstay of treatment is surgical resection and adjuvant radiation therapy, but failure rates following local therapy are high. Cutaneous angiosarcoma of the scalp has a predilection for pulmonary metastases with a variety of morphologic patterns on imaging. Metastatic disease in terms of pulmonary thin-walled, cystic lesions, may not be hypermetabolic on 18F-FDG PET and, as such, could be misinterpreted as benign findings. We present a case demonstrating the diagnostic uncertainty and delay in an elderly male with angiosarcoma of the scalp presenting with metastatic lung lesions following failure of local therapy. PMID:26838798

  5. A new background distribution-based active contour model for three-dimensional lesion segmentation in breast DCE-MRI

    SciTech Connect

    Liu, Hui; Liu, Yiping; Qiu, Tianshuang; Zhao, Zuowei; Zhang, Lina

    2014-08-15

    Purpose: To develop and evaluate a computerized semiautomatic segmentation method for accurate extraction of three-dimensional lesions from dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) of the breast. Methods: The authors propose a new background distribution-based active contour model using level set (BDACMLS) to segment lesions in breast DCE-MRIs. The method starts with manual selection of a region of interest (ROI) that contains the entire lesion in a single slice where the lesion is enhanced. Then the lesion volume from the volume data of interest, which is captured automatically, is separated. The core idea of BDACMLS is a new signed pressure function which is based solely on the intensity distribution combined with pathophysiological basis. To compare the algorithm results, two experienced radiologists delineated all lesions jointly to obtain the ground truth. In addition, results generated by other different methods based on level set (LS) are also compared with the authors’ method. Finally, the performance of the proposed method is evaluated by several region-based metrics such as the overlap ratio. Results: Forty-two studies with 46 lesions that contain 29 benign and 17 malignant lesions are evaluated. The dataset includes various typical pathologies of the breast such as invasive ductal carcinoma, ductal carcinomain situ, scar carcinoma, phyllodes tumor, breast cysts, fibroadenoma, etc. The overlap ratio for BDACMLS with respect to manual segmentation is 79.55% ± 12.60% (mean ± s.d.). Conclusions: A new active contour model method has been developed and shown to successfully segment breast DCE-MRI three-dimensional lesions. The results from this model correspond more closely to manual segmentation, solve the weak-edge-passed problem, and improve the robustness in segmenting different lesions.

  6. Grey zone lesions of breast: Potential areas of error in cytology.

    PubMed

    Mitra, Suvradeep; Dey, Pranab

    2015-01-01

    Fine-needle aspiration cytology (FNAC) of the breast is a rapid, cost-effective, and sensitive procedure to diagnose breast lesions, and was widely employed to diagnose breast lesions in the past. However, in recent times, core needle biopsy of the breast is gaining popularity and acceptability, although FNAC still looms large. There are some intrinsic disadvantages to FNAC, of which the most important is probably difficulty in classification of a significant percentage of breast lesions. Such lesions are usually denoted by the rubric "grey zone lesions of the breast." This article attempts to review these grey zone lesions and highlight the difficulties in diagnosing them. PMID:26729973

  7. Grey zone lesions of breast: Potential areas of error in cytology

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2015-01-01

    Fine-needle aspiration cytology (FNAC) of the breast is a rapid, cost-effective, and sensitive procedure to diagnose breast lesions, and was widely employed to diagnose breast lesions in the past. However, in recent times, core needle biopsy of the breast is gaining popularity and acceptability, although FNAC still looms large. There are some intrinsic disadvantages to FNAC, of which the most important is probably difficulty in classification of a significant percentage of breast lesions. Such lesions are usually denoted by the rubric “grey zone lesions of the breast.” This article attempts to review these grey zone lesions and highlight the difficulties in diagnosing them. PMID:26729973

  8. Radiofrequency Transoral Microsurgical Procedures in Benign and Malignant Laryngeal and Hypopharyngeal Lesions (Institutional Experiences)

    PubMed Central

    Gerlinger, Imre; Lujber, László; Burián, András; Móricz, Péter

    2015-01-01

    Besides cold-steel and laser instruments, the use of radiofrequency (RF) devices in transoral microsurgery is getting increasing popularity mainly due to its minimal thermal effect on the collateral soft tissue. Authors summarize their surgical technique, results, and experience gained with RF applied during laryngeal interventions at the Department of Otorhinolaryngology, Head and Neck Surgery at Medical School, University of Pécs. Transoral microsurgery using radiofrequency was carried out in 23 cases in total between 1 January 2011 and 1 March 2013. Fourteen histopathologically different benign lesions and 9 malignant planocellular carcinomas of the larynx were removed using different Micro-Larynx RF Probes powered by Surgitron Dual 4.0 MHz Frequency RF (Ellman International, Oceanside, NY, USA) device. No major bleeding event occurred during or after the procedures and neither laryngeal oedema nor significant postoperative pain was recorded. Authors also reviewed the international literature in this topic while detailing some of their most interesting cases. PMID:25789337

  9. Radiofrequency transoral microsurgical procedures in benign and malignant laryngeal and hypopharyngeal lesions (institutional experiences).

    PubMed

    Somogyvári, Krisztina; Gerlinger, Imre; Lujber, László; Burián, András; Móricz, Péter

    2015-01-01

    Besides cold-steel and laser instruments, the use of radiofrequency (RF) devices in transoral microsurgery is getting increasing popularity mainly due to its minimal thermal effect on the collateral soft tissue. Authors summarize their surgical technique, results, and experience gained with RF applied during laryngeal interventions at the Department of Otorhinolaryngology, Head and Neck Surgery at Medical School, University of Pécs. Transoral microsurgery using radiofrequency was carried out in 23 cases in total between 1 January 2011 and 1 March 2013. Fourteen histopathologically different benign lesions and 9 malignant planocellular carcinomas of the larynx were removed using different Micro-Larynx RF Probes powered by Surgitron Dual 4.0 MHz Frequency RF (Ellman International, Oceanside, NY, USA) device. No major bleeding event occurred during or after the procedures and neither laryngeal oedema nor significant postoperative pain was recorded. Authors also reviewed the international literature in this topic while detailing some of their most interesting cases. PMID:25789337

  10. Benign Orofacial Lesions in Libyan Population: A 17 Years Retrospective Study

    PubMed Central

    Hatem, Marwa; Abdulmajid, Ziad S.; Taher, Elsanousi M.; El Kabir, Mohamed A.; Benrajab, Mohamed A.; Kwafi, Rafik

    2015-01-01

    Objectives: To analyze the frequency and type of benign orofacial lesions submitted for diagnosis at Tripoli Medical Centre over 17 years period (1997-2013). Materials and Methods: Entries for specimens from patients were retrieved and compiled into 9 diagnostic categories and 82 diagnoses. Results: During the 17 years period, a total of 975 specimens were evaluated, it comprised a male-female ratio of 0.76:1. The mean age of biopsied patients was 36.3±18.32 years. The diagnostic category with the highest number of specimens was skin and mucosal pathology (22.87%); and the most frequent diagnosis was pyogenic granuloma (14.05%). Conclusion: Pyogenic granuloma, lichen planus, radicular cyst and fibroepithelial polyp were found to be the most predominant diagnoses. Frequencies of most benign orofacial diseases were comparable to similar studies in the literature and to those reported from the eastern region of Libya. Further surveys are needed to define the epidemiology of orofacial diseases in Libyan population. PMID:26962370

  11. DNA repair gene variants associated with benign breast disease in high cancer risk women.

    PubMed

    Jorgensen, Timothy J; Helzlsouer, Kathy J; Clipp, Sandra C; Bolton, Judy Hoffman; Crum, Rosa M; Visvanathan, Kala

    2009-01-01

    Benign breast disease (BBD) is a risk factor for breast cancer and may have a heritable component. Deficient DNA repair has been implicated in breast cancer etiology and may exert its effect before BBD, a known precursor. The association between allelic variants in DNA repair genes and BBD was examined in a cohort of women in Washington County, Maryland. BBD was defined by two criteria: (a) a physician diagnosis of BBD or fibrocystic disease and/or (b) a benign breast biopsy. 3,212 women without BBD at baseline were genotyped for 12 candidate single nucleotide polymorphisms in seven DNA repair genes. Of these women, 482 subsequently reported a diagnosis of BBD. The Cox model was used to calculate hazard ratios (HR). Variant alleles of XRCC1 Arg(194)Trp (rs1799782) and ERCC4 Arg(415)Gln (rs1800067) were significantly associated with BBD [HR, 1.36; 95% confidence interval (95% CI), 1.06-1.74 and HR, 1.39; 95% CI, 1.09-1.76, respectively]. Similar estimates were also observed for each of the BBD criterion used. The BBD association for ERCC4 was even stronger among women with a family history of breast cancer (HR, 2.68; 95% CI, 1.52-4.66; P(interaction) = 0.02). This study suggests that variant alleles in DNA repair genes may modify BBD risk, a potential intermediate marker of breast cancer risk, particularly among high-risk subgroups. PMID:19124519

  12. Case Reports on the Differentiation of Malignant and Benign Intratracheal Lesions by 18F-FDG PET/CT.

    PubMed

    Chun, Kyung-Ah

    2015-11-01

    Malignant tracheal tumors (primary and secondary) are rare and benign tumors of the tracheobronchial tree are also rare. Few reports have been issued on the F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) findings of tracheal tumors or benign nontumorous tracheal lesions, which have been mainly studied by computed tomography (CT). The author reports 2 cases of intratracheal lesions with quite different F-FDG PET/CT findings. The first case was of a 73-year-old woman with colon cancer treated by hemicolectomy and subsequent adjuvant chemotherapy. Follow-up F-FDG PET/CT after 6 years revealed a hypermetabolic fungating mass (SUVmax: 5.8) in the distal trachea and biopsy confirmed intratracheal metastasis. The second case involved a 61-year-old man with tongue cancer who underwent mouth floor mass excision and right supraomohyoid neck dissection with submental flap reconstruction. Tracheal lesion was incidentally found during a F-FDG PET/CT follow-up study conducted 1 year later. A benign intratracheal condition with low FDG uptake (SUVmax: 1.2) and the lesion was not visualized by neck CT 4 months later. F-FDG PET/CT uptake was helpful in differentiating benign and malignant intratracheal lesions. PMID:26554767

  13. Case Reports on the Differentiation of Malignant and Benign Intratracheal Lesions by 18F-FDG PET/CT

    PubMed Central

    Chun, Kyung-Ah

    2015-01-01

    Abstract Malignant tracheal tumors (primary and secondary) are rare and benign tumors of the tracheobronchial tree are also rare. Few reports have been issued on the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) findings of tracheal tumors or benign nontumorous tracheal lesions, which have been mainly studied by computed tomography (CT). The author reports 2 cases of intratracheal lesions with quite different 18F-FDG PET/CT findings. The first case was of a 73-year-old woman with colon cancer treated by hemicolectomy and subsequent adjuvant chemotherapy. Follow-up 18F-FDG PET/CT after 6 years revealed a hypermetabolic fungating mass (SUVmax: 5.8) in the distal trachea and biopsy confirmed intratracheal metastasis. The second case involved a 61-year-old man with tongue cancer who underwent mouth floor mass excision and right supraomohyoid neck dissection with submental flap reconstruction. Tracheal lesion was incidentally found during a 18F-FDG PET/CT follow-up study conducted 1 year later. A benign intratracheal condition with low FDG uptake (SUVmax: 1.2) and the lesion was not visualized by neck CT 4 months later. 18F-FDG PET/CT uptake was helpful in differentiating benign and malignant intratracheal lesions. PMID:26554767

  14. Mammotome(®) biopsy system for the resection of breast lesions: Clinical experience in two high-volume teaching hospitals.

    PubMed

    Jiang, Yangping; Lan, Huanrong; Ye, Qian; Jin, Ketao; Zhu, Min; Hu, Xiaoyan; Teng, Lisong; Cao, Feilin; Lin, Xianfang

    2013-09-01

    Ultrasound-guided vacuum-assisted breast biopsy (VABB) is regarded as a feasible, effective, minimally invasive and safe method for the removal of benign breast lesions, without the occurrence of serious complications. The aim of this study was to evaluate the feasibility, efficacy and safety of ultrasound-guided VABB using the Mammotome(®) biopsy system in the treatment of breast lesions. The clinical outcomes of 3,681 patients with breast lesions were evaluated following excisions by ultrasound-guided VABB in two high-volume teaching hospitals. From January 2008 to December 2012, a total of 4,867 ultrasound-guided VABB procedures were performed in the 3,681 patients, who had a mean age of 37.8 years (range, 16-73 years). The parameters examined in this analysis included lesion size, lesion location in the inner breast, Breast Imaging Reporting and Data System (BI-RADS) ultrasound category and histopathological diagnosis. Ultrasonography follow-up was performed at 3-6 month intervals in order to assess recurrence. The size of the investigated lesions ranged between 6 and 62 mm and a histopathological diagnosis was made in 100% of cases. The results indicated that the majority of specimens (98.89%) were benign. On average, the ultrasound-guided VABB was performed in 10.3 min (range, 7.5-43 min) and the mean number of cores removed in the procedure was 8.1 (range, 3-32). A complete excision was achieved in the majority of cases (99.7%). The presence of a hematoma was the most common complication following the biopsy, and was observed in 27.5% of patients. The mean follow-up period was 25.5 months (range, 1-60 months), during which the rate of recurrence was 4.4%. The results indicated that ultrasound-guided VABB using the Mammotome biopsy system is an effective and safe procedure that is able to rapidly remove the majority of benign breast lesions using a small incision and without the occurrence of scarring or complications. PMID:24137261

  15. Mammotome® biopsy system for the resection of breast lesions: Clinical experience in two high-volume teaching hospitals

    PubMed Central

    JIANG, YANGPING; LAN, HUANRONG; YE, QIAN; JIN, KETAO; ZHU, MIN; HU, XIAOYAN; TENG, LISONG; CAO, FEILIN; LIN, XIANFANG

    2013-01-01

    Ultrasound-guided vacuum-assisted breast biopsy (VABB) is regarded as a feasible, effective, minimally invasive and safe method for the removal of benign breast lesions, without the occurrence of serious complications. The aim of this study was to evaluate the feasibility, efficacy and safety of ultrasound-guided VABB using the Mammotome® biopsy system in the treatment of breast lesions. The clinical outcomes of 3,681 patients with breast lesions were evaluated following excisions by ultrasound-guided VABB in two high-volume teaching hospitals. From January 2008 to December 2012, a total of 4,867 ultrasound-guided VABB procedures were performed in the 3,681 patients, who had a mean age of 37.8 years (range, 16–73 years). The parameters examined in this analysis included lesion size, lesion location in the inner breast, Breast Imaging Reporting and Data System (BI-RADS) ultrasound category and histopathological diagnosis. Ultrasonography follow-up was performed at 3–6 month intervals in order to assess recurrence. The size of the investigated lesions ranged between 6 and 62 mm and a histopathological diagnosis was made in 100% of cases. The results indicated that the majority of specimens (98.89%) were benign. On average, the ultrasound-guided VABB was performed in 10.3 min (range, 7.5–43 min) and the mean number of cores removed in the procedure was 8.1 (range, 3–32). A complete excision was achieved in the majority of cases (99.7%). The presence of a hematoma was the most common complication following the biopsy, and was observed in 27.5% of patients. The mean follow-up period was 25.5 months (range, 1–60 months), during which the rate of recurrence was 4.4%. The results indicated that ultrasound-guided VABB using the Mammotome biopsy system is an effective and safe procedure that is able to rapidly remove the majority of benign breast lesions using a small incision and without the occurrence of scarring or complications. PMID:24137261

  16. [The treatment of nonpalpable breast lesions. Our experience].

    PubMed

    Latteri, M; Cipolla, C; Amato, C; Cassano, T; Salanitro, L; Graceffa, G; Di Lisi, G; Bottino, A; Grillo, A; Farro, G

    1991-04-01

    Thanks to the diffusion of the clinico-mammographic screening, in the last ten years a considerable increase of breast carcinomas diagnosed in a subclinical stage has been registered. The authors report the preliminary results of their experience in nonpalpable lesions of the breast and confirm the validity of conservative surgery for their treatment. Nonpalpable breast carcinomas must be considered as an early stage of palpable T1 tumors, for which validity of conservative surgery is largely demonstrated. Moreover, results are not compromised by possible multicentricity and/or positivity of axillary lymph nodes. PMID:1911072

  17. Breast-lesion Segmentation Combining B-Mode and Elastography Ultrasound.

    PubMed

    Pons, Gerard; Martí, Joan; Martí, Robert; Ganau, Sergi; Noble, J Alison

    2016-05-01

    Breast ultrasound (BUS) imaging has become a crucial modality, especially for providing a complementary view when other modalities (i.e., mammography) are not conclusive in the task of assessing lesions. The specificity in cancer detection using BUS imaging is low. These false-positive findings often lead to an increase of unnecessary biopsies. In addition, increasing sensitivity is also challenging given that the presence of artifacts in the B-mode ultrasound (US) images can interfere with lesion detection. To deal with these problems and improve diagnosis accuracy, ultrasound elastography was introduced. This paper validates a novel lesion segmentation framework that takes intensity (B-mode) and strain information into account using a Markov Random Field (MRF) and a Maximum a Posteriori (MAP) approach, by applying it to clinical data. A total of 33 images from two different hospitals are used, composed of 14 cancerous and 19 benign lesions. Results show that combining both the B-mode and strain data in a unique framework improves segmentation results for cancerous lesions (Dice Similarity Coefficient of 0.49 using B-mode, while including strain data reaches 0.70), which are difficult images where the lesions appear with blurred and not well-defined boundaries. PMID:26062760

  18. Novel Use for DOG1 in Discriminating Breast Invasive Carcinoma from Noninvasive Breast Lesions

    PubMed Central

    Cheng, Henghui; Qu, Zhiling; Zhou, Sheng; Ruan, Qiurong

    2016-01-01

    Aims. DOG1 has proven to be a useful marker of gastrointestinal stromal tumors (GISTs). Recently, DOG1 expression has also been reported in some non-GIST malignant tumors, but the details related to DOG1 expression in breast tissue remain unclear. The aim of this study was to detect the expression of DOG1 in the human breast and to evaluate the feasibility of using DOG1 to discriminate between invasive breast carcinoma and noninvasive breast lesions. Methods and Results. A total of 210 cases, including both invasive and noninvasive breast lesions, were collected to assess DOG1 expression immunohistochemically. DOG1 expression was consistently positive in breast myoepithelial cells (MECs), which was similar to the results obtained for three other MEC markers: calponin, smooth muscle myosin heavy chain (SMMHC), and P63 (P > 0.05 in all). Importantly, DOG1 was useful in discriminating invasive breast carcinoma from noninvasive breast lesions (P < 0.05). Conclusions. DOG1 is a useful marker of breast MECs, and adding DOG1 to the MEC identification panel will provide more sophisticated information when diagnosing uncertain cases in the breast. PMID:27041791

  19. Association of BDNF and BMPR1A with clinicopathologic parameters in benign and malignant gallbladder lesions

    PubMed Central

    2013-01-01

    Background Neurotrophic factors such as brain derived neurotrophic factor (BDNF) are synthesized in a variety of neural and non-neuronal cell types and regulate survival, proliferation and apoptosis. In addition, bone morphogenetic proteins (BMPs) inhibit the proliferation of pulmonary large carcinoma cells bone morphogenetic protein receptor, type IA (BMPR1A). Little is known about the expression of BDNF or BMPR1A in malignant gall bladder lesions. This study was to evaluate BDNF and BMPR1A expression and evaluate the clinicopathological significance in benign and malignant lesions of the gallbladder. Methods The BDNF and BMPR1A expression of gallbladder adenocarcinoma, peritumoral tissues, adenoma, polyp and chronic cholecystitis were Immunohistochemically determined. Results BDNF expression was significantly higher in gallbladder adenocarcinoma than in peritumoral tissues, adenoma, polyps and chronic cholecystitis samples. However, BMPR1A expression was significantly lower in gallbladder adenocarcinoma than in peritumoral tissues, adenomas, polyps and chronic cholecystitis tissues. The specimens with increased expression of BDNF in the benign lesions exhibited moderate- or severe-dysplasia of gallbladder epithelium. BDNF expression was significantly lower in well-differentiated adenocarcinomas with maximum tumor diameter <2 cm, no metastasis to lymph nodes, and no invasion of regional tissues compared to poorly-differentiated adenocarcinomas with maximal tumor diameter >2 cm, metastasis of lymph node, and invasiveness of regional tissues in gallbladder adenocarcinoma. BMPR1A expression were significantly higher in the well-differentiated adenocarcinoma with maximal tumor diameter <2 cm, no metastasis of lymph node, and no invasion of regional tissues compared to poorly-differentiated adenocarcinomas with maximal tumor diameter >2 cm, metastasis of lymph node, and invasiveness of regional tissues in gallbladder. Univariate Kaplan-Meier analysis indicated

  20. Effect of the chest wall on breast lesion reconstruction

    NASA Astrophysics Data System (ADS)

    Ardeshirpour, Yasaman; Huang, Minming; Zhu, Quing

    2009-07-01

    The chest wall underneath the breast tissue affects near-infrared (NIR) diffusive waves measured with reflection geometry. With the assistance of a co-registered ultrasound, the depth and the tilting angle of the chest wall can be determined and are used to model the breast as a two-layer medium. Finite element method (FEM) is suitable for modeling complex boundary conditions and is adapted to model the breast tissue and chest wall. Four parameters of bulk absorption and reduced scattering coefficients of these two layers are estimated and used for imaging reconstruction. Using a two-layer model, we have systematically investigated the effect of the chest wall on breast lesion reconstruction. Results have shown that chest-wall depth, titling angle, and difference between optical properties of two layers of lesion and reference sites affect the lesion reconstruction differently. Our analysis will be valuable and informative to researchers who are using reflectance geometry for breast imaging. The analysis can also provide guidelines for imaging operators to minimize image artifacts and to produce the best reconstruction results.

  1. Role of Multiparameter Analysis of AgNORs in FNA Smears of Thyroid Swellings in Differentiating Benign and Malignant Lesions

    PubMed Central

    Hossain, Mohammad Ismail; Hassan, Md Quamrul; Bhattacharjee, Pradip; Ahamad, M. Shahab Uddin; Rahman, Zillur

    2012-01-01

    Background. The aim of this study is to assess the role of multiparameter analysis of silver (Ag)-stained nucleolar organizer regions (AgNORs) technique on aspiration smears of thyroid swellings to distinguish between benign and malignant lesions. Materials and Methods. Aspiration smears from 166 cases of thyroid swellings were examined. Diagnosis was confirmed by histology in 61 cases. AgNOR staining was done on FNA smears according to silver-staining protocol proposed by the International Committee for AgNOR quantification. Multiparameter analysis of AgNORs such as mAgNOR, pAgNOR, and AgNOR size grade was done on 50–100 cells under oil immersion lens. Results. AgNOR parameter of benign and malignant thyroid lesions was compared and was found to be statistically significant. Out of 157 satisfactory AgNOR stained cases, 148 (94.3%) were benign lesions and 9 (5.7%) cases were malignant lesions. In AgNOR analysis, sensitivity was found to be 83.33%, specificity 100%, PPV 100%, NPV 98.21%, and accuracy was 98.36%. Conclusions. AgNOR analysis in the FNA smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid swellings. PMID:22792510

  2. Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

    PubMed

    Field, Scott S

    2016-02-01

    Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. PMID:26185119

  3. Towards an Automated MEMS-based Characterization of Benign and Cancerous Breast Tissue using Bioimpedance Measurements

    PubMed Central

    Pandya, Hardik J.; Kim, Hyun Tae; Roy, Rajarshi; Chen, Wenjin; Cong, Lei; Zhong, Hua; Foran, David J.; Desai, Jaydev P.

    2014-01-01

    Micro-Electro-Mechanical-Systems (MEMS) are desirable for use within medical diagnostics because of their capacity to manipulate and analyze biological materials at the microscale. Biosensors can be incorporated into portable lab-on-a-chip devices to quickly and reliably perform diagnostics procedure on laboratory and clinical samples. In this paper, electrical impedance-based measurements were used to distinguish between benign and cancerous breast tissues using microchips in a real-time and label-free manner. Two different microchips having inter-digited electrodes (10 µm width with 10 µm spacing and 10 µm width with 30 µm spacing) were used for measuring the impedance of breast tissues. The system employs Agilent E4980A precision impedance analyzer. The impedance magnitude and phase were collected over a frequency range of 100 Hz to 2 MHz. The benign group and cancer group showed clearly distinguishable impedance properties. At 200 kHz, the difference in impedance of benign and cancerous breast tissue was significantly higher (3110 Ω) in the case of microchips having 10 µm spacing compared to microchip having 30 µm spacing (568 Ω). PMID:25013305

  4. Echogenicity of benign adrenal focal lesions on imaging with new ultrasound techniques – report with pictorial presentation

    PubMed Central

    Kasperlik-Załuska, Anna A.; Migda, Bartosz; Otto, Maciej; Dobruch-Sobczak, Katarzyna; Jakubowski, Wiesław S.

    2015-01-01

    Aim The aim of the research was to assess the echogenicity of benign adrenal focal lesions using new ultrasound techniques. Material and method 34 benign adrenal masses in 29 patients were analyzed retrospectively. The examinations were conducted using Aplio XG (Toshiba, Japan) ultrasound scanner with a convex probe 1–6 MHz in the B-mode presentation with the combined use of new ultrasound techniques: harmonic imaging and spatial compound sonography. The size of the adrenal tumors, their echogenicity and homogeneity were analyzed. Statistical analysis was conducted using the STATISTICA 10 software. Results The following adrenal masses were assessed: 12 adenomas, 10 nodular hyperplasias of adrenal cortex, 7 myelolipomas, 3 pheochromocytomas, a hemangioma with hemorrhage and a cyst. The mean diameter of nodular hyperplasia of adrenal cortex was not statistically different from that of adenomas (p = 0.075). The possibility of differentiating between nodular hyperplasia and adenoma using the parameter of hypoechogenicity or homogeneity of the lesion was demonstrated with the sensitivity and specificity of 100% and 41.7%, respectively. The larger the benign adrenal tumor was, the more frequently did it turn out to have a mixed and inhomogenous echogenicity (p < 0.05; ROC areas under the curve: 0.832 and 0.805, respectively). Conclusions A variety of echogenicity patterns of benign adrenal focal lesions was demonstrated. The image of an adrenal tumor correlates with its size. The ultrasound examination, apart from its indisputable usefulness in detecting and monitoring adrenal tumors, may also allow for the differentiation between benign lesions. However, for lesions found incidentally an algorithm for the assessment of adrenal incidentalomas is applicable, which includes computed tomography and magnetic resonance imaging. PMID:26807294

  5. CDKN2A (p14(ARF)/p16(INK4a)) and ATM promoter methylation in patients with impalpable breast lesions.

    PubMed

    Delmonico, Lucas; Moreira, Aline dos Santos; Franco, Marco Felipe; Esteves, Eliane Barbosa; Scherrer, Luciano; Gallo, Claúdia Vitória de Moura; do Nascimento, Cristina Moreira; Ornellas, Maria Helena Faria; de Azevedo, Carolina Maria; Alves, Gilda

    2015-10-01

    Early detection of breast cancer increases the chances of cure, but the reliable identification of impalpable lesions is still a challenge. In spite of the advances in breast cancer detection, the molecular basis of impalpable lesions and the corresponding circulating biomarkers are not well understood. Impalpable lesions, classified by radiologists according to the Breast Imaging Reporting and Data System in the categories 3 and 4, can be either benign or malignant (slow growing or aggressive). In this article, we report the DNA methylation pattern in CDKN2A (p14(ARF)/p16(INK4a)) and in ATM gene promoters from 62 impalpable lesions, 39 peripheral blood samples, and 39 saliva samples, assessed by methylation-specific polymerase chain reaction method. ATM showed the greatest percentage of methylation in DNA from lesions (benign and malignant), blood (even with p16(INK4a)), and saliva, followed by p16(INK4a) and p14(ARF). Among the malignant cases, ATM promoter was the most hypermethylated in lesion DNA and in blood and saliva DNAs, and p14(ARF), the least. The highest percentage of p16(INK4a) methylation was found in the blood. Finally, our data are relevant because they were obtained using impalpable breast lesions from patients who were carefully recruited in 2 public hospitals of Rio de Janeiro. PMID:26255234

  6. An approach to the diagnosis of spindle cell lesions of the breast.

    PubMed

    Rakha, Emad A; Aleskandarany, Mohammed A; Lee, Andrew H S; Ellis, Ian O

    2016-01-01

    Although most breast spindle cell lesions (BSCLs) are rare, they constitute a wide spectrum of diseases, ranging from reactive processes to aggressive malignant tumours. Despite their varied histogenesis and behaviour, some lesions show an overlap of morphological features, making accurate diagnosis a challenging task, particularly in needle core biopsies. Clinical history and immunohistochemistry can help in making a correct diagnosis in morphologically challenging cases. To make an accurate diagnosis, it is important to maintain a wide differential diagnosis and be familiar with the diverse morphological appearances of these different entities. BSCLs can generally be classified into bland-looking and malignant-looking categories. In the former, the commonest diagnosis is scarring. However, it is important to distinguish low-grade spindle cell metaplastic breast carcinoma from other benign entities, as the management is clearly different. In the malignant category, it is important to differentiate metaplastic carcinoma from other malignant primary and metastatic malignant spindle cell tumours of the breast, such as malignant phyllodes tumour, angiosarcoma, and melanoma. This review focuses on the classification and histological and molecular diagnosis of various BSCLs, with an emphasis on the diagnostic approach, including in core biopsies. PMID:26768028

  7. Quantitative evaluation of automatic methods for lesions detection in breast ultrasound images

    NASA Astrophysics Data System (ADS)

    Marcomini, Karem D.; Schiabel, Homero; Carneiro, Antonio Adilton O.

    2013-02-01

    Ultrasound (US) is a useful diagnostic tool to distinguish benign from malignant breast masses, providing more detailed evaluation in dense breasts. Due to the subjectivity in the images interpretation, computer-aid diagnosis (CAD) schemes have been developed, increasing the mammography analysis process to include ultrasound images as complementary exams. As one of most important task in the evaluation of this kind of images is the mass detection and its contours interpretation, automated segmentation techniques have been investigated in order to determine a quite suitable procedure to perform such an analysis. Thus, the main goal in this work is investigating the effect of some processing techniques used to provide information on the determination of suspicious breast lesions as well as their accurate boundaries in ultrasound images. In tests, 80 phantom and 50 clinical ultrasound images were preprocessed, and 5 segmentation techniques were tested. By using quantitative evaluation metrics the results were compared to a reference image delineated by an experienced radiologist. A self-organizing map artificial neural network has provided the most relevant results, demonstrating high accuracy and low error rate in the lesions representation, corresponding hence to the segmentation process for US images in our CAD scheme under tests.

  8. Incorporation of clinical data into a computerized method for the assessment of mammographic breast lesions

    NASA Astrophysics Data System (ADS)

    Huo, Zhimin; Giger, Maryellen L.

    2000-06-01

    We previously developed a computerized method to classify mammographic masses as benign or malignant. In this method, mammographic features that are similar to the ones used by radiologists are automatically extracted to characterize a mass lesion. These features are then merged by an artificial neural network (ANN), which yields an estimated likelihood of malignancy for each mass. The performance of the method was evaluated on an independent database consisting of 110 cases (60 benign and 50 malignant cases). The method achieved an Az of 0.91 from round-robin analysis in the task of differentiating between benign and malignant masses using the computer-extracted features only. As the most important clinical risk factor for breast cancer, age achieved a performance level (Az equals 0.79) similar to that (Az equals 0.77 and 0.80) of the computer-extracted spiculation features, which are the most important indicators for malignancy of a mass, in differentiating between the malignant and benign cases. In this study, age is included as an additional input feature to the ANN. The performance of the scheme (Az equals 0.93) is improved when age is included. However, the improvement is not found to be statistically significant. Our results indicated that age may be a strong feature in predicting malignancy of a mass. For this database, however, the inclusion of age may not have a strong impact on the determination of the likelihood for a mammographic mass lesion when the major mammographic characteristics (e.g., spiculation) of a mass are accurately extracted and analyzed along with other features using an artificial neural network.

  9. Meta analysis of efficacy and safety between Mammotome vacuum-assisted breast biopsy and open excision for benign breast tumor

    PubMed Central

    Ding, Boni; Chen, Daojin; Li, Xiaorong; Zhang, Hongyan

    2013-01-01

    Objective To compare the efficacy and safety between Mammotome vacuum-assisted breast biopsy (Mammotome VABB) and conventional open excision for benign breast tumor. Methods A computer-based online search of Medline, PubMed, Embase, Ovid, Cochrane Library, VIP, Wanfang, CNKI and Chinese Biological Medicine Database was performed, and conference references were manually searched. With the Cochrane Collaboration Guidelines, all randomized controlled trials comparing mammotome minimally invasive operation and conventional open excision were systematically reviewed. The Cochrane Collaboration’s RevMan 5.0 software was used for data analysis. Results A total of 15 studies involving 5,256 patients was included. Meta-analyses showed no significant difference in the size of tumor, postoperative hematomas, ecchymosis, ecchymoma and residual disease between Mammotome VABB and conventional open excision. Mammotome VABB was superior to open excision as to the size of incision, intraoperative blood loss, operative time, healing time, size of scar, wound infection and breast deformation. Conclusions Mammotome VABB is an ideal method for benign breast tumor. PMID:25083462

  10. Classification of breast lesions presenting as mass and non-mass lesions

    NASA Astrophysics Data System (ADS)

    Gallego-Ortiz, Cristina; Martel, Anne L.

    2014-03-01

    We aim to develop a CAD system for robust and reliable di erential diagnosis of breast lesions, in particular non-mass lesions. A necessary prerequisite for the development of a successful CAD system is the selection of the best subset of lesion descriptors. But an important methodological concern is whether the selected features are in uenced by the model employed rather than by the underlying characteristic distribution of descriptors for positive and negative cases. Another interesting question is how a particular classi er exploits the relationships between descriptors to increase the accuracy of the classi cation. In this work we set to: (1) Characterize kinetic, morphological and textural features among mass and non-mass lesions; (2) Examine feature spaces and compare selection of subset of features based on similarity of feature importance across feature rankings; (3) Compare two classi er performances namely binary Support Vector Machines (SVM) and Random Forest (RF) for the task of di erentiating between positive and negative cases when using binary classi cation for mass and non-mass lesions separately or when employing a multi-class classi cation. Breast MRI datasets consists of 243 (173 mass and 70 non-mass) lesions. Results show that RF variable importance used with RF-binary based classi cation optimized for mass and non-mass lesions separately o ers the best classi cation accuracy.

  11. Classification of benign and malignant breast masses based on shape and texture features in sonography images.

    PubMed

    Zakeri, Fahimeh Sadat; Behnam, Hamid; Ahmadinejad, Nasrin

    2012-06-01

    The purpose of this research was evaluating novel shape and texture feature' efficiency in classification of benign and malignant breast masses in sonography images. First, mass regions were extracted from the region of interest (ROI) sub-image by implementing a new hybrid segmentation approach based on level set algorithms. Then two left and right side areas of the masses are elicited. After that, six features (Eccentricity_feature, Solidity_feature, DeferenceArea_Hull_Rectangular, DeferenceArea_Mass_Rectangular, Cross-correlation-left and Cross-correlation-right) based on shape, texture and region characteristics of the masses were extracted for further classification. Finally a support vector machine (SVM) classifier was utilized to classify breast masses. The leave-one-case-out protocol was utilized on a database of eighty pathologically-proven breast sonographic images of patients (forty-seven benign cases and thirty-three malignant cases) to evaluate our method. The classification results showed an overall accuracy of 95.00%, sensitivity of 90.91%, specificity of 97.87%, positive predictive value of 96.77%, negative predictive value of 93.88%, and Matthew's correlation coefficient of 89.71%. The experimental results declare that our proposed method is actually a beneficial tool for the diagnosis of the breast cancer and can provide a second opinion for a physician's decision or can be used for the medicine training especially when coupled with other modalities. PMID:21082222

  12. Electropotential evaluation as a new technique for diagnosing breast lesions.

    PubMed

    Faupel, M; Vanel, D; Barth, V; Davies, R; Fentiman, I S; Holland, R; Lamarque, J L; Sacchini, V; Schreer, I

    1997-01-01

    A new approach, termed the Biofield test, may have the potential to augment the process of diagnosing breast cancer. This technique is based on the analysis of skin surface electrical potentials measured by an array of specially designed sensors which are placed on the breasts. Measurements are recorded noninvasively and then analyzed using pattern recognition algorithms to produce an immediate and objective assessment of breast tissue in vivo. Initial clinical trials suggests that the test can achieve a sensitivity of approximately 90% and a specificity of 40-50%, which indicates that the test might be useful for excluding cancer when it is, in fact, absent. Although research to date has focused on the differential diagnosis of suspicious breast lesions, future applications could include breast cancer screening, close surveillance and diagnosis of recurrent cancers in breasts previously treated with conservative therapy, and monitoring the effectiveness of breast cancer therapies. Improvements and new applications are expected to occur as additional research and validation in actual clinical settings is performed. PMID:9056147

  13. Laser treatment of 13 benign oral vascular lesions by three different surgical techniques

    PubMed Central

    Romeo, Umberto; Del Vecchio, Alessandro; Russo, Claudia; Gaimari, Gianfranco; Arnabat-Dominguez, Josep; España, Antoni J.

    2013-01-01

    Objectives: Benign Oral Vascular Lesions (BOVLs) are a group of vascular diseases characterized by congenital, inflammatory or neoplastic vascular dilations clinically evidenced as more or less wide masses of commonly dark bluish color. If traumatized BOVLs are characterized by a great risk of hemorrhage and their treatment usually requires great caution to prevent massive bleeding. In the last decades lasers have dramatically changed the way of treatment of BOVLs permitting the application of even peculiar techniques that gave interesting advantages in their management reducing hemorrhage risks. The aim of this study was to evaluate the capabilities and disadvantages of three laser assisted techniques in the management of BOVLs. Study design: In this study 13 BOVLs were treated by three different laser techniques: the traditional excisional biopsy (EB), and two less invasive techniques, the transmucosal thermocoagulation (TMT) and the intralesional photocoagulation (ILP). Two different laser devices were adopted in the study: a KTP laser (DEKA, Florence, Italy, 532nm) and a GaAlAs laser (Laser Innovation, Castelgandolfo, Italy, 808nm) selected since their great effectiveness on hemoglobin. Results: In each case, lasers permitted safe treatments of BOVLs without hemorrhages, both during the intervention and in the post-operative period. The minimally invasive techniques (TMT and ILP) permitted even the safe resolution of big lesions without tissue loss. Conclusions: Laser devices confirm to be the gold standard in BOVLs treatment, permitting even the introduction of minimal invasive surgery principles and reducing the risks of hemorrhage typical of these neoplasms. As usual in laser surgery, it is necessary a clear knowledge of the devices and of the laser-tissue interaction to optimize the results reducing risks and disadvantages. Key words:Oral vascular diseases, laser, photocoagulation. PMID:23385496

  14. Metachronous Occurrence of Granular Cell Tumor in Breast Skin and Scalp: Diagnostic Challenging Differentiating Benign from Malignant and a Literature Review.

    PubMed

    Akkaya, Hampar; Toru, Havva Serap; Ayva, Ebru Sebnem; Karabulut, Zulfikar; Durusoy, Cicek

    2016-01-01

    Granular cell tumor (GCT) is a Schwann cell related benign neoplasm of soft tissue. GCT is an uncommon entity that occurs in a wide variety of body sites, but it is generally presented in the skin, oral cavity, superficial soft tissue, and respiratory and digestive tracts. Most of the GCTs are benign but clinically and radiologically these may mimic malignancy. Histopathological diagnosis is gold standard for establishing the true nature of the lesion. GCT is most commonly solitary but in about 10% of cases can be multifocal, usually involving various skin and soft tissue sites versus involving various internal sites. Therefore, these can involve skin and soft tissue or submucosa and viscera. GCT is usually benign; however, local recurrence is common due to incomplete removal. Malignant cases are rarely reported in 1-2% of cases. In this study, we report clinical and histopathological findings of a 36-year-old woman with metachronous GCT in breast and scalp. The clinical features raise the question of whether these are metachronous benign GCTs or whether this is establishment of malignant behavior. The aim of this report is to present the histopathological and clinical features of GCT and the diagnostic challenge of differentiating benign from malignant GCT. PMID:26881167

  15. Kinetic Curve Type Assessment for Classification of Breast Lesions Using Dynamic Contrast-Enhanced MR Imaging

    PubMed Central

    Chen, Jun-Ming; Zhang, Geoffrey; Liao, Yen-Hsiu; Huang, Tzung-Chi

    2016-01-01

    Objective The aim of this study was to employ a kinetic model with dynamic contrast enhancement-magnetic resonance imaging to develop an approach that can efficiently distinguish malignant from benign lesions. Materials and Methods A total of 43 patients with 46 lesions who underwent breast dynamic contrast enhancement-magnetic resonance imaging were included in this retrospective study. The distribution of malignant to benign lesions was 31/15 based on histological results. This study integrated a single-compartment kinetic model and dynamic contrast enhancement-magnetic resonance imaging to generate a kinetic modeling curve for improving the accuracy of diagnosis of breast lesions. Kinetic modeling curves of all different lesions were analyzed by three experienced radiologists and classified into one of three given types. Receiver operating characteristic and Kappa statistics were used for the qualitative method. The findings of the three radiologists based on the time-signal intensity curve and the kinetic curve were compared. Results An average sensitivity of 82%, a specificity of 65%, an area under the receiver operating characteristic curve of 0.76, and a positive predictive value of 82% and negative predictive value of 63% was shown with the kinetic model (p = 0.017, 0.052, 0.068), as compared to an average sensitivity of 80%, a specificity of 55%, an area under the receiver operating characteristic of 0.69, and a positive predictive value of 79% and negative predictive value of 57% with the time-signal intensity curve method (p = 0.003, 0.004, 0.008). The diagnostic consistency of the three radiologists was shown by the κ-value, 0.857 (p<0.001) with the method based on the time-signal intensity curve and 0.826 (p<0.001) with the method of the kinetic model. Conclusions According to the statistic results based on the 46 lesions, the kinetic modeling curve method showed higher sensitivity, specificity, positive and negative predictive values as compared with

  16. Automated benign & malignant thyroid lesion characterization and classification in 3D contrast-enhanced ultrasound.

    PubMed

    Acharya, U Rajendra; S, Vinitha Sree; Molinari, Filippo; Garberoglio, Roberto; Witkowska, Agnieszka; Suri, Jasjit S

    2012-01-01

    In this work, we present a Computer Aided Diagnosis (CAD) based technique for automatic classification of benign and malignant thyroid lesions in 3D contrast-enhanced ultrasound images. The images were obtained from 20 patients. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture based features were extracted from the thyroid images. The resulting feature vectors were used to train and test three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr) using ten-fold cross validation technique. Our results show that combination of DWT and texture features in the K-NN classifier resulted in a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Thus, the preliminary results of the proposed technique show that it could be adapted as an adjunct tool that can give valuable second opinions to the doctors regarding the nature of the thyroid nodule. The technique is cost-effective, non-invasive, fast, completely automated and gives more objective and reproducible results compared to manual analysis of the ultrasound images. We however intend to establish the clinical applicability of this technique by evaluating it with more data in the future. PMID:23365926

  17. Accuracy of lesion boundary tracking in navigated breast tumor excision

    NASA Astrophysics Data System (ADS)

    Heffernan, Emily; Ungi, Tamas; Vaughan, Thomas; Pezeshki, Padina; Lasso, Andras; Gauvin, Gabrielle; Rudan, John; Engel, C. Jay; Morin, Evelyn; Fichtinger, Gabor

    2016-03-01

    PURPOSE: An electromagnetic navigation system for tumor excision in breast conserving surgery has recently been developed. Preoperatively, a hooked needle is positioned in the tumor and the tumor boundaries are defined in the needle coordinate system. The needle is tracked electromagnetically throughout the procedure to localize the tumor. However, the needle may move and the tissue may deform, leading to errors in maintaining a correct excision boundary. It is imperative to quantify these errors so the surgeon can choose an appropriate resection margin. METHODS: A commercial breast biopsy phantom with several inclusions was used. Location and shape of a lesion before and after mechanical deformation were determined using 3D ultrasound volumes. Tumor location and shape were estimated from initial contours and tracking data. The difference in estimated and actual location and shape of the lesion after deformation was quantified using the Hausdorff distance. Data collection and analysis were done using our 3D Slicer software application and PLUS toolkit. RESULTS: The deformation of the breast resulted in 3.72 mm (STD 0.67 mm) average boundary displacement for an isoelastic lesion and 3.88 mm (STD 0.43 mm) for a hyperelastic lesion. The difference between the actual and estimated tracked tumor boundary was 0.88 mm (STD 0.20 mm) for the isoelastic and 1.78 mm (STD 0.18 mm) for the hyperelastic lesion. CONCLUSION: The average lesion boundary tracking error was below 2mm, which is clinically acceptable. We suspect that stiffness of the phantom tissue affected the error measurements. Results will be validated in patient studies.

  18. Surgical Management of Benign and Borderline Phyllodes Tumors of the Breast.

    PubMed

    Moutte, Amandine; Chopin, Nicolas; Faure, Christelle; Beurrier, Frédéric; Ho Quoc, Christophe; Guinaudeau, Florence; Treilleux, Isabelle; Carrabin, Nicolas

    2016-09-01

    Phyllodes tumors (PT) are uncommon fibroepithelial breast neoplasms and there is currently no clear consensual treatment for these tumors. The aim of our study was to evaluate the surgical management and outcome of benign and borderline PT. We retrospectively assessed 76 cases of benign or borderline PT managed at the Leon Berard comprehensive cancer center in Lyon, France between July 2003 and December 2013. The mean age at diagnosis was 37.9 years and the median follow-up was 58 months. Seventy-five patients (99%), with a mean tumor size of 27 mm, underwent a breast-conserving procedure. The tumor margins were considered positive (when the tumor was present at the inked surgical section) in seven of 76 cases (9%) and negative in 65 out of 76 cases (86%). We observed the presence of small negative surgical margins <10 mm in 89% and <1 mm in 71% of the patients. Although no re-excision was performed to increase these margins, we did not see any increase in the local recurrence rate (4%) when compared to recurrence rates reported in the literature. We thus suggest that systematic revision surgery for close or positive surgical margins for benign PT should not be systematically performed. However, as recurrences occur within 2 years of initial excision, we recommend a regular clinical and imaging follow-up especially during this period for which patient's compliance is essential. PMID:27265474

  19. Step by step approach to rare breast lesions containing spindle cells.

    PubMed

    Ünal, Betül; Erdoğan, Gülgün; Karaveli, Fatma Şeyda

    2015-01-01

    Differential diagnosis of spindle cell lesions of breast is challenging for certain reasons. The most important reason is the presence of cytological atypia and mitosis in all three conditions: reactive, benign, and malignant. Patients diagnosed with benign and malignant tumor/tumor-like lesions that had spindle cell components following the histopathological examination were included in the study. The patients' medical records were accessed to obtain the clinical history, follow-up notes, and radiological findings. Following histopathological, immunohistochemical, and clinical evaluations, the patients were diagnosed as follows: pseudoangiomatous stromal hyperplasia (PASH), bilateral desmoid-type fibromatosis (FM), adenomyoepithelioma (AME), myofibroblastoma (MFB), malignant phyllodes tumor (MF), high-grade AS, post-chemotherapy osteosarcoma (OS) + Paget's disease, and metaplastic carcinoma (MC). An algorithmic approach should be used in the diagnosis; cellular structure, presence and grade of atypia, growth pattern, mitotic activity, immunohistochemical staining, and clinical and radiological features should be evaluated together. Detection of some molecular changes can be useful in differential diagnosis. PMID:26558181

  20. Quantitative expression analysis and study of the novel human kallikrein-related peptidase 14 gene (KLK14) in malignant and benign breast tissues.

    PubMed

    Papachristopoulou, Georgia; Avgeris, Margaritis; Charlaftis, Antonios; Scorilas, Andreas

    2011-01-01

    Human kallikrein-related peptidase 14 gene (KLK14) is regulated by androgens and progestins. This gene is expressed in the central nervous system and endocrine tissues such as the breast, prostate and ovary. The differential KLK14 mRNA expression levels are related to several human neoplasias, among them breast cancer. The aim of this study was to analyse the KLK14 expression in breast tissues and to investigate its differential diagnostic and prognostic value in the mammary carcinomas. For this purpose, we isolated total RNA from 70 malignant and 33 benign specimens. After testing RNA quality, we synthesised cDNA by reverse transcription and applied a highly sensitive quantitative real-time PCR (qRT-PCR) method for KLK14 mRNA quantification using the SYBR Green® chemistry. HPRT1 was used as a reference gene and the BT20 breast cancer cell line as a calibrator. Relative quantification analysis was performed using the comparative CT method 2-ΔΔCT. KLK14 expression was detected in both types of breast tumours. However, a statistically significant increase of the KLK14 mRNA level was observed in the malignant, compared to the benign tumour samples (p<0.001), highlighting its value in discriminating these breast lesions. Elevated KLK14 expression profiles were associated with higher tumour grade (p=0.043) and size (p=0.007) in cancerous samples. Furthermore, KLK14 mRNA expression showed negative correlation in a statistically significant manner with estrogen receptor status (p=0.024). In accordance with logistic regression models (p=0.012) and receiver-operating-characteristics analysis (p<0.001), KLK14 gene expression could be evaluated as a putative independent diagnostic biomarker in breast tumour biopsies. PMID:21057706

  1. An infrared image based methodology for breast lesions screening

    NASA Astrophysics Data System (ADS)

    Morais, K. C. C.; Vargas, J. V. C.; Reisemberger, G. G.; Freitas, F. N. P.; Oliari, S. H.; Brioschi, M. L.; Louveira, M. H.; Spautz, C.; Dias, F. G.; Gasperin, P.; Budel, V. M.; Cordeiro, R. A. G.; Schittini, A. P. P.; Neto, C. D.

    2016-05-01

    The objective of this paper is to evaluate the potential of utilizing a structured methodology for breast lesions screening, based on infrared imaging temperature measurements of a healthy control group to establish expected normality ranges, and of breast cancer patients, previously diagnosed through biopsies of the affected regions. An analysis of the systematic error of the infrared camera skin temperature measurements was conducted in several different regions of the body, by direct comparison to high precision thermistor temperature measurements, showing that infrared camera temperatures are consistently around 2 °C above the thermistor temperatures. Therefore, a method of conjugated gradients is proposed to eliminate the infrared camera direct temperature measurement imprecision, by calculating the temperature difference between two points to cancel out the error. The method takes into account the human body approximate bilateral symmetry, and compares measured dimensionless temperature difference values (Δ θ bar) between two symmetric regions of the patient's breast, that takes into account the breast region, the surrounding ambient and the individual core temperatures, and doing so, the results interpretation for different individuals become simple and non subjective. The range of normal whole breast average dimensionless temperature differences for 101 healthy individuals was determined, and admitting that the breasts temperatures exhibit a unimodal normal distribution, the healthy normal range for each region was considered to be the dimensionless temperature difference plus/minus twice the standard deviation of the measurements, Δ θ bar ‾ + 2σ Δ θ bar ‾ , in order to represent 95% of the population. Forty-seven patients with previously diagnosed breast cancer through biopsies were examined with the method, which was capable of detecting breast abnormalities in 45 cases (96%). Therefore, the conjugated gradients method was considered effective

  2. Impact of lesion segmentation metrics on computer-aided diagnosis/detection in breast computed tomography

    PubMed Central

    Kuo, Hsien-Chi; Giger, Maryellen L.; Reiser, Ingrid; Drukker, Karen; Boone, John M.; Lindfors, Karen K.; Yang, Kai; Edwards, Alexandra

    2014-01-01

    Abstract. Evaluation of segmentation algorithms usually involves comparisons of segmentations to gold-standard delineations without regard to the ultimate medical decision-making task. We compare two segmentation evaluations methods—a Dice similarity coefficient (DSC) evaluation and a diagnostic classification task–based evaluation method using lesions from breast computed tomography. In our investigation, we use results from two previously developed lesion-segmentation algorithms [a global active contour model (GAC) and a global with local aspects active contour model]. Although similar DSC values were obtained (0.80 versus 0.77), we show that the global + local active contour (GLAC) model, as compared with the GAC model, is able to yield significantly improved classification performance in terms of area under the receivers operating characteristic (ROC) curve in the task of distinguishing malignant from benign lesions. [Area under the ROC curve (AUC)=0.78 compared to 0.63, p≪0.001]. This is mainly because the GLAC model yields better detailed information required in the calculation of morphological features. Based on our findings, we conclude that the DSC metric alone is not sufficient for evaluating segmentation lesions in computer-aided diagnosis tasks. PMID:26158052

  3. Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

    PubMed Central

    Yilmaz, M H; Kilic, F; Icten, G E; Aydogan, F; Ozben, V; Halac, M; Olgun, D C; Gazioglu, E; Celik, V; Uras, C; Altug, Z A

    2012-01-01

    Objective The purpose of this study was to present an alternative technique for the pre-operative localisation of solely MRI-detected suspicious breast lesions using a computer-assisted MRI-guided radio-guided occult lesion localisation (ROLL) technique. Methods Between January 2009 and June 2010, 25 females with a total of 25 suspicious breast lesions that could be detected only by MRI, and for whom breast surgery was planned, underwent the computer-assisted MRI-guided ROLL technique. A seven-channel biopsy breast array coil and computerised diagnostic workstation were used for the localisation procedure. Three-phase dynamic contrast-enhanced axial images were taken. After investigating the localisation co-ordinates with the help of intervention software on a workstation, an 18 G coaxial cannula was placed in the exact position determined. Following verification of the cannula position by additional axial scans, 99mTc-labelled macroalbumin aggregate and MRI contrast material were injected. Post-procedure MRI scans were used to confirm the correct localisation. Results All the procedures were technically successful. The mean lesion size was 10.8 mm (range: 4–25 mm). The mean total magnet and the mean localisation times were 28.6 min (range: 18–46 min) and 13.1 min (range: 8–20 min), respectively. Grid and pillar methods were used for localisation in 24 procedures and 1 procedure, respectively. On histopathological examination, 6 malignant, 10 high-risk and 9 benign lesions were identified. All patients tolerated the procedure well. There were no major complications. Conclusion This is the first report documenting the application of MRI-guided ROLL. Based on our preliminary results, this technique is very efficient and seems to be a good alternative to wire localisation. PMID:22010030

  4. Epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood

    SciTech Connect

    Oviedo, M.A.; Chmiel, J.S.; Curb, J.D.; Kautz, J.A.; Haenszel, W.; Scanlon, E.F.

    1983-07-01

    To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, 996 eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied. The Mantel-Haenszel method of analysis, controlling for age and race, was used to estimate the approximate relative risk of carcinoma of the breast in the irradiated group compared with that for the nonirradiated group. The type of radiation history included radiotherapy for mastitis or enlarged thymus (nine patients), irradiation of the head and neck (69 patients), diagnostic fluoroscopies (ten patients) and miscellaneous irradiation (52 patients) for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein. Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent.

  5. Dual modality surgical guidance of non-palpable breast lesions

    NASA Astrophysics Data System (ADS)

    Judy, Patricia Goodale

    Although breast conserving therapy has some advantages over the traditional mastectomy procedure, the biggest disadvantage is the chance of local re-occurrence in which a second surgery is often required. Adequate surgical removal of breast tumors requires accurate tumor localization in order to ensure a balance between optimal cosmetic results and minimization of the risk for local re-occurrence. These challenges have motivated the search for alternative, more accurate methods for intraoperative localization of non-palpable breast lesions. The overall goal of this project was to develop an innovative technique for radioguided localization of non-palpable breast lesions that is more accurate, easier for the breast surgeon, and more comfortable for the patient than the current practice of wire localization. The technique uses a dual modality breast imaging system to place a marker composed of radiolabeled albumin (99mTc-MAA or 111ln-MAA) into the lesion. Preliminary studies were made to evaluate the localization accuracy of the system, which showed that the dual modality breast scanner is capable of accurate 3-dimensional localization using either X-ray or gamma ray imaging. A 3-axis needle positioning system was built and integrated into the dual modality breast scanner and its accuracy tested. A pilot clinical trial to evaluate the dual-modality surgical guidance technique was designed and preliminary clinical data collected. Detailed results were presented on the first three subjects; although a total of seven subjects have been recruited to the study to date. So far, it has been demonstrated that the radioguided surgery technique can be performed with approximately 10 times less radiomarker activity than is currently being used by other researchers employing 99mTc-MAA as a radiomarker, while maintaining comparable localization accuracy. Although the DMSG technique has not been tested in a large cohort of subjects, the preliminary data on the first few are

  6. Surface-enhanced Raman spectroscopy of saliva proteins for the noninvasive differentiation of benign and malignant breast tumors

    PubMed Central

    Feng, Shangyuan; Huang, Shaohua; Lin, Duo; Chen, Guannan; Xu, Yuanji; Li, Yongzeng; Huang, Zufang; Pan, Jianji; Chen, Rong; Zeng, Haishan

    2015-01-01

    The capability of saliva protein analysis, based on membrane protein purification and surface-enhanced Raman spectroscopy (SERS), for detecting benign and malignant breast tumors is presented in this paper. A total of 97 SERS spectra from purified saliva proteins were acquired from samples obtained from three groups: 33 healthy subjects; 33 patients with benign breast tumors; and 31 patients with malignant breast tumors. Subtle but discernible changes in the mean SERS spectra of the three groups were observed. Tentative assignments of the saliva protein SERS spectra demonstrated that benign and malignant breast tumors led to several specific biomolecular changes of the saliva proteins. Multiclass partial least squares–discriminant analysis was utilized to analyze and classify the saliva protein SERS spectra from healthy subjects, benign breast tumor patients, and malignant breast tumor patients, yielding diagnostic sensitivities of 75.75%, 72.73%, and 74.19%, as well as specificities of 93.75%, 81.25%, and 86.36%, respectively. The results from this exploratory work demonstrate that saliva protein SERS analysis combined with partial least squares–discriminant analysis diagnostic algorithms has great potential for the noninvasive and label-free detection of breast cancer. PMID:25609959

  7. Identification of lesion subtypes in biopsies of ductal carcinoma in situ of the breast using biomarker ratio imaging microscopy.

    PubMed

    Clark, Andrea J; Petty, Howard R

    2016-01-01

    Although epidemiological studies propose aggressive and non-aggressive forms of ductal carcinoma in situ (DCIS), they cannot be identified with conventional histopathology. We now report a retrospective study of human biopsy samples using biomarker ratio imaging microscopy (BRIM). Using BRIM, micrographs of biomarkers whose expression correlates with breast cancer aggressiveness are divided by micrographs of biomarkers whose expression negatively correlates with aggressiveness to create computed micrographs reflecting aggressiveness. The biomarker pairs CD44/CD24, N-cadherin/E-cadherin, and CD74/CD59 stratified DCIS samples. BRIM identified subpopulations of DCIS lesions with ratiometric properties resembling either benign fibroadenoma or invasive carcinoma samples. Our work confirms the existence of distinct subpopulations of DCIS lesions, which will likely have utility in breast cancer research and clinical practice. PMID:27247112

  8. Identification of lesion subtypes in biopsies of ductal carcinoma in situ of the breast using biomarker ratio imaging microscopy

    PubMed Central

    Clark, Andrea J.; Petty, Howard R.

    2016-01-01

    Although epidemiological studies propose aggressive and non-aggressive forms of ductal carcinoma in situ (DCIS), they cannot be identified with conventional histopathology. We now report a retrospective study of human biopsy samples using biomarker ratio imaging microscopy (BRIM). Using BRIM, micrographs of biomarkers whose expression correlates with breast cancer aggressiveness are divided by micrographs of biomarkers whose expression negatively correlates with aggressiveness to create computed micrographs reflecting aggressiveness. The biomarker pairs CD44/CD24, N-cadherin/E-cadherin, and CD74/CD59 stratified DCIS samples. BRIM identified subpopulations of DCIS lesions with ratiometric properties resembling either benign fibroadenoma or invasive carcinoma samples. Our work confirms the existence of distinct subpopulations of DCIS lesions, which will likely have utility in breast cancer research and clinical practice. PMID:27247112

  9. A comprehensive evaluation of the 8-gauge vacuum-assisted Mammotome® system for ultrasound-guided diagnostic biopsy and selective excision of breast lesions

    PubMed Central

    Povoski, Stephen P; Jimenez, Rafael E

    2007-01-01

    Background Minimally invasive breast biopsy technology is now considered a standard of care for the diagnostic evaluation of suspicious breast lesions. The aim of the current study was to present a comprehensive evaluation of the 8-gauge vacuum-assisted Mammotome® system for ultrasound-guided diagnostic biopsy and selective excision of breast lesions. Methods A retrospective analysis was conducted of a series of 304 consecutive 8-gauge Mammotome® procedures that were performed under ultrasound guidance by a single surgeon from March 2004 to December 2006. Multiple variables, including patient demographics, characteristics of the breast lesion (based on ultrasound and mammography), procedural and histopathology variables, and interval follow-up variables (based on ultrasound and mammography), were evaluated. Results Among 304 procedures, 235 (77%) were performed with the presumption of complete excision of the ultrasound lesion during Mammotome® core acquisition, while 69 (23%) were performed with only partial excision of the ultrasound lesion during Mammotome® core acquisition (diagnostic tissue sampling only). 100% of all ultrasound lesions were accurately diagnosed, demonstrating no apparent false-negative results among the 256 patients that were compliant with follow-up at a median interval follow-up duration of 11 months (range 1 to 37). Likewise, 89% of all appropriately selected ultrasound lesions were completely excised, as demonstrated on interval follow-up ultrasound at a median time of 6 months (range, 3 to 16). There were no independent predictors of successful complete excision of any given appropriately selected ultrasound lesion by the ultrasound-guided 8-gauge Mammotome® biopsy technique. Conclusion The 8-gauge vacuum-assisted Mammotome® system is highly accurate for ultrasound-guided diagnostic biopsy of suspicious breast lesions and is highly successful for complete excision of appropriately selected presumed benign breast lesions. This

  10. [HYPOFRACTIONATED RADIOSURGERY FOR BENIGN BRAIN LESIONS--THE BEST OF ALL WORLDS].

    PubMed

    Cohen-Inbar, Or

    2016-05-01

    Despite advances in neurosurgical technique, postoperative morbidity continues to taint open complete removal of many benign cranial base tumors (meningioma, pituitary adenomas, schwannomas). The incidence of temporary and permanent cranial nerve deficits is reported to be as high as 44% and 56% respectively, with postoperative mortality rates as high as 9%. As a consequence, many neurosurgeons choose to perform partial resections in order to preserve neurological functions. Progression rates after partial removal of a meningioma with no radiosurgery have been reported to be as high as 70%, compared to > 90% post-radiosurgical progression free survival rates. This resulted in a change of paradigms from an attempted radical resection to a combined neurosurgical-radiosurgical approach due to the high surgical morbidity the former entails. Radiosurgery has traditionally been used to treat lesions < 3.5-4 cm (or 14-16 cm³). Radiosurgery is thought to inactivate target cells regardless of their mitotic activity or inherent radio-sensitivity. When the distance between the tumor and anterior visual pathways is < 3 mm, radiosurgery is contraindicated because of the difficulty in delivering an effective dose to the tumor while maintaining a tolerable dose to the optic apparatus. Fractionated Radiosurgery (Temporal or spatial fractionation) may help overcome these limitations associated with larger volume target and dose fall-off. It should be considered in patients with sellar, parasellar or para-acoustic tumors involving major vasculature or when there is broad contact with the optic apparatus or cranial nerves. Fractionated radiosurgery offers a substantial reduction in radiation-related toxicity and with maintaining high tumor control rates. PMID:27526562

  11. Complement System in the Pathogenesis of Benign Lymphoepithelial Lesions of the Lacrimal Gland

    PubMed Central

    Li, Jing; Ge, Xin; Wang, Xiaona; Liu, Xiao; Ma, Jianmin

    2016-01-01

    Objective We aimed to examine the potential involvement of local complement system gene expression in the pathogenesis of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. Methods We collected data from 9 consecutive pathologically confirmed patients with BLEL of the lacrimal gland and 9 cases with orbital cavernous hemangioma as a control group, and adopted whole genome microarray to screen complement system-related differential genes, followed by RT-PCR verification and in-depth enrichment analysis (Gene Ontology analysis) of the gene sets. Results The expression of 14 complement system-related genes in the pathologic tissue, including C2, C3, ITGB2, CR2, C1QB, CR1, ITGAX, CFP, C1QA, C4B|C4A, FANCA, C1QC, C3AR1 and CFHR4, were significantly upregulated while 7 other complement system-related genes, C5, CFI, CFHR1|CFH, CFH, CD55, CR1L and CFD were significantly downregulated in the lacrimal glands of BLEL patients. The microarray results were consistent with RT-PCR analysis results. Immunohistochemistry analysis of C3c and C1q complement component proteins in the resected tissue were positive in BLEL patients, while the control group had negative expression of these proteins. Gene ontology (GO) analysis revealed that activation of the genes of complement system-mediated signaling pathways were the most enriched differential gene group in BLEL patients. Conclusions Local expression of complement components is prominently abnormal in BLEL, and may well play a role in its pathogenesis. PMID:26849056

  12. Association of TCR-signaling pathway with the development of lacrimal gland benign lymphoepithelial lesions

    PubMed Central

    Ma, Jian-Min; Cui, Yi-Xin; Ge, Xin; Li, Jing; Li, Jin-Ru; Wang, Xiao-Na

    2015-01-01

    AIM To identify the association of the T cell receptor (TCR) signaling with the development of benign lymphoepithelial lesions (BLEL) of the lacrimal gland. METHODS We collected affected lacrimal gland tissues from 9 patients who underwent dacryoadenectomy in the Capital Medical University Beijing Tongren Hospital Eye Center between August 2010 and March 2013 and were confirmed to have lacrimal gland BLEL by histopathological analysis. Tumor tissues from 9 patients with orbital cavernous hemangioma were also collected and used as control. Whole genome gene expression microarray was used to compare gene expression profiles of affected lacrimal gland tissues from patients with lacrimal gland BLEL to those from of orbital cavernous hemangiomas. Differential expression of TCR pathway genes between these tissues was confirmed by polymerase chain reaction (PCR) and immunohistochemistry. RESULTS Microarray analysis showed that in lacrimal glands with BLEL, 32 signaling pathways were enriched in the upregulated genes, while 25 signaling pathways were enriched in the downregulated genes. In-depth analysis of the microarray data showed that the expression of 27 genes of the TCR signaling pathway increased significantly. To verify the differential expression of three of these genes, CD3, CD4, and interleukin (IL)-10, reverse transcription-PCR (RT-PCR) and immunohistochemistry assays were performed. RT-PCR analysis showed that CD3 and CD4 were expressed in the lacrimal glands with BLEL, but IL-10 was not expressed. Immunohistochemistry confirmed that CD3 and CD4 proteins were also present, but IL-10 protein was not. CD3, CD4, or IL-10 expression was not found in the orbital cavernous hemangiomas with either RT-PCR or immunohistochemistry. CONCLUSION TCR signaling pathway might be involved in the pathogenesis of lacrimal gland BLEL. PMID:26309862

  13. Benign nodular hepatocellular lesions caused by abnormal hepatic circulation: etiological analysis and introduction of a new concept.

    PubMed

    Kondo, F

    2001-12-01

    Problems in definitive diagnosis and etiology of various benign nodular hepatocellular lesions were evaluated. Of these lesions, focal nodular hyperplasia (FNH), nodular regenerative hyperplasia (NRH), nodular lesions associated with idiopathic portal hypertension (IPH), non-cirrhotic large regenerative nodules (LRN), hepatocellular adenoma (HA)-like hyperplastic nodules, and partial nodular transformation (PNT) have been suggested to be related to abnormal hepatic circulation. However, the following points are considered to need further clarification: (i) is the abnormal circulation caused by thrombosis, vasculitis, or congenital anomaly?; (ii) is thrombosis a cause or a result of congestion?; (iii) are impaired blood vessels primarily the portal veins or arteries?; (iv) how are these disorders related to various syndromes, immunological abnormalities and abnormal blood flow of other organs, which are reported to coexist with these lesions often?; and (v) how should non-typical cases, which differ from typical cases, be interpreted? In addition, a concept that may lead to solving these problems (anomalous portal tract syndrome; a hypothesis that congenital vascular anomaly is the origin of these benign nodular hepatocellular lesions) was introduced. PMID:11851827

  14. Spectral embedding based active contour (SEAC): application to breast lesion segmentation on DCE-MRI

    NASA Astrophysics Data System (ADS)

    Agner, Shannon C.; Xu, Jun; Rosen, Mark; Karthigeyan, Sudha; Englander, Sarah; Madabhushi, Anant

    2011-03-01

    Spectral embedding (SE), a graph-based manifold learning method, has previously been shown to be useful in high dimensional data classification. In this work, we present a novel SE based active contour (SEAC) segmentation scheme and demonstrate its applications in lesion segmentation on breast dynamic contrast enhance magnetic resonance imaging (DCE-MRI). In this work, we employ SE on DCE-MRI on a per voxel basis to embed the high dimensional time series intensity vector into a reduced dimensional space, where the reduced embedding space is characterized by the principal eigenvectors. The orthogonal eigenvector-based data representation allows for computation of strong tensor gradients in the spectrally embedded space and also yields improved region statistics that serve as optimal stopping criteria for SEAC. We demonstrate both analytically and empirically that the tensor gradients in the spectrally embedded space are stronger than the corresponding gradients in the original grayscale intensity space. On a total of 50 breast DCE-MRI studies, SEAC yielded a mean absolute difference (MAD) of 3.2+/-2.1 pixels and mean Dice similarity coefficient (DSC) of 0.74+/-0.13 compared to manual ground truth segmentation. An active contour in conjunction with fuzzy c-means (FCM+AC), a commonly used segmentation method for breast DCE-MRI, produced a corresponding MAD of 7.2+/-7.4 pixels and mean DSC of 0.58+/-0.32. In conjunction with a set of 6 quantitative morphological features automatically extracted from the SEAC derived lesion boundary, a support vector machine (SVM) classifier yielded an area under the curve (AUC) of 0.73, for discriminating between 10 benign and 30 malignant lesions; the corresponding SVM classifier with the FCM+AC derived morphological features yielded an AUC of 0.65.

  15. Adolescent Intakes of Vitamin D and Calcium and Incidence of Proliferative Benign Breast Disease

    PubMed Central

    Su, Xuefen; Colditz, Graham A.; Collins, Laura C.; Baer, Heather J.; Sampson, Laura A.; Willett, Walter C.; Berkey, Catherine S.; Schnitt, Stuart J.; Connolly, James L.; Rosner, Bernard A.; Tamimi, Rulla M.

    2013-01-01

    Vitamin D and calcium have been shown to have protective effects against breast cancer development in animal studies. Vitamin D and calcium play important anticarcinogenic roles in animal studies. Exposures between menarche and first birth may be important in breast development and future breast cancer risk. However, the relations between adolescent vitamin D and calcium intake and the risk of proliferative benign breast disease (BBD), a marker of increased breast cancer risk, have not yet been evaluated. We examined these associations in the Nurses’ Health Study II. Among the 29,480 women who completed an adolescent diet questionnaire in 1998, 682 proliferative BBD cases were identified and confirmed by centralized pathology review between 1991 and 2001. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression and adjusted for potential confounders. A suggestive inverse association was observed between adolescent total vitamin D intake and proliferative BBD. Women in the highest quintile of vitamin D intake during adolescence had a 21% lower risk (multivariate HR (95% CI): 0.79 (0.61, 1.01), p-trend = 0.07) of proliferative BBD than women in the lowest quintile. Results were essentially the same when the analysis was restricted to prospective cases (n = 142) diagnosed after return of the adolescent diet questionnaire and independent of adult vitamin D intake. Adolescent total milk intake was positively associated with proliferative BBD (≥3 servings/day vs. <1 serving/day HR (95% CI): 1.41 (0.91, 2.17), p-trend = 0.03), after additional adjustment for total vitamin D. Calcium intake during adolescence was not associated with proliferative BBD (p-trend = 0.91). Vitamin D intake during adolescence may be important in the earlier stage of breast carcinogenesis. These findings, if corroborated, may suggest new pathways and strategies for breast cancer prevention. PMID:22622809

  16. Maximum Value Measured by 2-D Shear Wave Elastography Helps in Differentiating Malignancy from Benign Focal Liver Lesions.

    PubMed

    Tian, Wen-Shuo; Lin, Man-Xia; Zhou, Lu-Yao; Pan, Fu-Shun; Huang, Guang-Liang; Wang, Wei; Lu, Ming-De; Xie, Xiao-Yan

    2016-09-01

    The goal of the work described here was to evaluate the diagnostic efficacy of 2-D shear wave elastography (2-D SWE) in differentiating malignancy from benign focal liver lesions (FLLs). The maxima, minima, means and the standard deviations of 2-D SWE measurements, expressed in kilopascals (Emax, Emin, Emean, ESD), were obtained for 221 patients with 229 FLLs. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of 2-D SWE. The Mann-Whitney U-test was used to assess inter-group differences. Emax, Emin, Emean and ESD were significantly higher in the 164 malignant lesions than in the 65 benign lesions (p < 0.001). For identification of malignant FLLs, the areas under receiver operating characteristic curves for Emax, Emin, Emean and ESD were 0.920, 0.710, 0.879 and 0.915, respectively. Emax was 96.21 ± 35.40 for 19 intrahepatic cholangiocarcinomas and 90.32 ± 54.71 for 35 liver metastatic lesions, which were significantly higher than 61.83 ± 28.87 for 103 hepatocellular carcinomas (p < 0.0001 and p = 0.0237). Emax was 38.72 ± 18.65 for 15 focal nodular hyperplasias, which was significantly higher than 20.56 ± 10.74 for 37 hemangiomas (p = 0.0009). The Emax values for adjacent liver parenchyma of hepatocellular carcinomas and intrahepatic cholangiocarcinomas were significantly higher than those for the other three lesion types (p < 0.005). In conclusion, Emax values of FLLs and adjacent liver parenchyma could help in differentiating malignant from benign FLLs. PMID:27283039

  17. Improving the Accuracy of Computer-aided Diagnosis for Breast MR Imaging by Differentiating between Mass and Nonmass Lesions.

    PubMed

    Gallego-Ortiz, Cristina; Martel, Anne L

    2016-03-01

    Purpose To determine suitable features and optimal classifier design for a computer-aided diagnosis (CAD) system to differentiate among mass and nonmass enhancements during dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast. Materials and Methods Two hundred eighty histologically proved mass lesions and 129 histologically proved nonmass lesions from MR imaging studies were retrospectively collected. The institutional research ethics board approved this study and waived informed consent. Breast Imaging Reporting and Data System classification of mass and nonmass enhancement was obtained from radiologic reports. Image data from dynamic contrast-enhanced MR imaging were extracted and analyzed by using feature selection techniques and binary, multiclass, and cascade classifiers. Performance was assessed by measuring the area under the receiver operating characteristics curve (AUC), sensitivity, and specificity. Bootstrap cross validation was used to predict the best classifier for the classification task of mass and nonmass benign and malignant breast lesions. Results A total of 176 features were extracted. Feature relevance ranking indicated unequal importance of kinetic, texture, and morphologic features for mass and nonmass lesions. The best classifier performance was a two-stage cascade classifier (mass vs nonmass followed by malignant vs benign classification) (AUC, 0.91; 95% confidence interval (CI): 0.88, 0.94) compared with one-shot classifier (ie, all benign vs malignant classification) (AUC, 0.89; 95% CI: 0.85, 0.92). The AUC was 2% higher for cascade (median percent difference obtained by using paired bootstrapped samples) and was significant (P = .0027). Our proposed two-stage cascade classifier decreases the overall misclassification rate by 12%, with 72 of 409 missed diagnoses with cascade versus 82 of 409 missed diagnoses with one-shot classifier. Conclusion Separately optimizing feature selection and training classifiers

  18. 3D lacunarity in multifractal analysis of breast tumor lesions in dynamic contrast-enhanced magnetic resonance imaging.

    PubMed

    Soares, Filipe; Janela, Filipe; Pereira, Manuela; Seabra, João; Freire, Mário M

    2013-11-01

    Dynamic contrast-enhanced magnetic resonance (DCE-MR) of the breast is especially robust for the diagnosis of cancer in high-risk women due to its high sensitivity. Its specificity may be, however, compromised since several benign masses take up contrast agent as malignant lesions do. In this paper, we propose a novel method of 3D multifractal analysis to characterize the spatial complexity (spatial arrangement of texture) of breast tumors at multiple scales. Self-similar properties are extracted from the estimation of the multifractal scaling exponent for each clinical case, using lacunarity as the multifractal measure. These properties include several descriptors of the multifractal spectra reflecting the morphology and internal spatial structure of the enhanced lesions relatively to normal tissue. The results suggest that the combined multifractal characteristics can be effective to distinguish benign and malignant findings, judged by the performance of the support vector machine classification method evaluated by receiver operating characteristics with an area under the curve of 0.96. In addition, this paper confirms the presence of multifractality in DCE-MR volumes of the breast, whereby multiple degrees of self-similarity prevail at multiple scales. The proposed feature extraction and classification method have the potential to complement the interpretation of the radiologists and supply a computer-aided diagnosis system. PMID:24057004

  19. EFFICACY OF THE ENNEKING STAGING SYSTEM IN RELATION TO TREATING BENIGN BONE TUMORS AND TUMOR-LIKE BONE LESIONS

    PubMed Central

    Nogueira Drumond, José Marcos

    2015-01-01

    Objective: To evaluate the efficacy of the Enneking staging system for determining the prognosis, planning surgical treatment and indicating adjuvant therapy for benign bone tumors (BBT) and tumor-like bone lesions (TBL). Methods: A retrospective multicenter, descriptive, nonrandomized study was carried out on a representative sample comprising a large series of 165 patients with a total of 168 benign bone tumors and tumor-like bone lesions. The patient sample was typical, and matched the literature in all respects. All the patients were classified according to the Enneking staging system, and the initial staging of each lesion was correlated with its behavior after either conservative or surgical treatment, in order to determine the efficacy of the system. The treatment options and complications were described and analyzed. Results: The results from the treatment provided 95.2% agreement with the Enneking staging system, with a 95% confidence interval of between 90.8 and 97.9%. Of the 168 tumors treated, only eight (4.8%) could not be controlled in relation to the initial treatment indicated by the Enneking staging system. Tumors classified as active were the most prevalent, comprising 73.2% of the lesions. Tumor recurrence was significantly more frequent (p < 0.001) in the aggressive stage. All the patients staged as latent evolved to cure. The study suggested that surgery with wide margins, for aggressive lesions, could provide better lesion control, with a lower recurrence rate (p > 0.001). For latent and active lesions, the study demonstrated the efficacy of both expectant treatment and excision, with or without autogenous bone graft. Conclusion: The results confirm that the Enneking staging system was very efficient in determining the prognosis, enabling surgical planning and indicating adjuvant therapy for treatment of BBT and TBL. PMID:27019838

  20. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    PubMed Central

    Nakamura, Tomoki; Matsumine, Akihiko; Asanuma, Kunihiro; Matsubara, Takao; Sudo, Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentation was 35 years and the average follow-up time was 76 months. Results: The average intraoperative blood loss was 1088 mL and intraoperative blood transfusion was required in eight patients. The average operative time was 167 minutes. All patients required one week and 12 weeks after surgery before full weight-bearing was allowed. All patients had regained full physical function without pain by the final follow-up. No patient sustained a pathological fracture of the femur following the procedure. All patients achieved partial or complete radiographic consolidation of the lesion within one year except one patient who developed a local tumor recurrence in 11 months. Post-operative superficial wound infection was observed in one patient, which resolved with intravenous antibiotics. Chronic hip pain was observed in one patient due to the irritation of tensor fascia lata muscle by the tube plate. Conclusion: We suggest that the treatment of benign bone lesion of the proximal femur using compression hip screw and synthetic bone graft is a safe and effective method. PMID:27163071

  1. Residual analysis of the water resonance signal in breast lesions imaged with high spectral and spatial resolution (HiSS) MRI: A pilot study

    SciTech Connect

    Weiss, William A. Medved, Milica; Karczmar, Gregory S.; Giger, Maryellen L.

    2014-01-15

    Purpose: High spectral and spatial resolution magnetic resonance imaging (HiSS MRI) yields information on the local environment of suspicious lesions. Previous work has demonstrated the advantages of HiSS (complete fat-suppression, improved image contrast, no required contrast agent, etc.), leading to initial investigations of water resonance lineshape for the purpose of breast lesion classification. The purpose of this study is to investigate a quantitative imaging biomarker, which characterizes non-Lorentzian components of the water resonance in HiSS MRI datasets, for computer-aided diagnosis (CADx). Methods: The inhomogeneous broadening and non-Lorentzian or “off-peak” components seen in the water resonance of proton spectra of breast HiSS images are analyzed by subtracting a Lorentzian fit from the water peak spectra and evaluating the difference spectrum or “residual.” The maxima of these residuals (referred to hereafter as “off-peak components”) tend to be larger in magnitude in malignant lesions, indicating increased broadening in malignant lesions. The authors considered only those voxels with the highest magnitude off-peak components in each lesion, with the number of selected voxels dependent on lesion size. Our voxel-based method compared the magnitudes and frequencies of off-peak components of all voxels from all lesions in a database that included 15 malignant and 8 benign lesions (yielding ∼3900 voxels) based on the lesions’ biopsy-confirmed diagnosis. Lesion classification was accomplished by comparing the average off-peak component magnitudes and frequencies in malignant and benign lesions. The area under the ROC curve (AUC) was used as a figure of merit for both the voxel-based and lesion-based methods. Results: In the voxel-based task of distinguishing voxels from malignant and benign lesions, off-peak magnitude yielded an AUC of 0.88 (95% confidence interval [0.84, 0.91]). In the lesion-based task of distinguishing malignant and

  2. Cysts within Otherwise Probably Benign Solid Breast Masses and the Risk of Malignancy.

    PubMed

    Jales, Rodrigo Menezes; Araujo, Karla Galvão; Sarian, Luis Otávio Zanata; Serra, Kátia Piton; Keppke, Helena; Francisco, Juliana; Derchain, Sophie Françoise Mauricette

    2016-04-01

    Objective The objective of this study is to assess whether the largest cyst diameter is useful for BI-RADS ultrasonography classification of predominantly solid breast masses with an oval shape, circumscribed margins, and largest axis parallel to the skin, which, except for the cystic component, would be likely classified as benign. Methods This study received approval from the local institutional review board. From March 2009 to August 2014, we prospectively biopsied 170 breast masses from 164 women. We grouped the largest cyst and mass diameters according to histopathological diagnoses. We used Student's t-test, linear regression, and the area under the receiver operating characteristic curve (AUC) for statistical assessment. Results Histopathological examination revealed 143 (84%) benign and 27 (16%) malignant masses. The mean largest mass diameter was larger among malignant (mean ± standard deviation, 34.1 ± 16.6 mm) than benign masses (24.7 ± 16.7 mm) (P < 0.008). The mean largest cyst diameter was also larger among malignant (9.9 ± 7.1 mm) than benign masses (4.6 ± 3.6 mm) (P < 0.001). Agreement between measurements of the largest mass and cyst diameters was low (R(2) = 0.26). AUC for the largest cyst diameter (0.78) was similar to the AUC for the largest mass diameter (0.69) (p = 0.2). A largest cyst diameter < 3, ≥ 3 to < 11, and ≥ 11 mm had a positive predictive value of 0, 15, and 52%, respectively. Conclusion A largest cystic component < 3 mm identified within breast masses that show favorable characteristics may be considered clinically inconsequential in ultrasonography characterization. Conversely, masses with a largest cystic component ≥ 3 mm should be classified as BI-RADS-US category 4. PMID:27093646

  3. Low-fat dietary pattern and risk of benign proliferative breast disease: a randomized, controlled dietary modification trial

    PubMed Central

    Rohan, Thomas E.; Negassa, Abdissa; Caan, Bette; Chlebowski, Rowan T.; Curb, J. David; Ginsberg, Mindy; Lane, Dorothy S.; Neuhouser, Marian L.; Shikany, James M.; Wassertheil-Smoller, Sylvia; Page, David L.

    2014-01-01

    Modifiable factors, including diet, might alter breast cancer risk. We used the WHI Dietary Modification (DM) trial to test the effect of the intervention on risk of benign proliferative breast disease, a condition associated with increased risk of and considered to be on the pathway to invasive breast cancer. The WHI DM trial was a randomized, controlled, primary prevention trial conducted in 40 US clinical centers from 1993–2005. 48,835 postmenopausal women, aged 50–79 years, without prior breast cancer, were enrolled. Participants were randomly assigned to the DM intervention group or to the comparison group. The intervention was designed to reduce total dietary fat intake to 20% of total energy intake, and to increase fruit and vegetable intake to ≥5 servings/day and intake of grain products to ≥6 servings/day, but resulted in smaller, albeit significant changes in practice. Participants had biennial mammograms and regular clinical breast exams. We identified women who reported breast biopsies free of cancer, obtained the histologic sections, and subjected them to standardized central review. During follow-up (average, 7.7 years), 570 incident cases of benign proliferative breast disease were ascertained in the intervention group and 793 in the comparison group. The hazard ratio for the association between DM and benign proliferative breast disease was 1.09 (95%CI, 0.98–1.23). Risk varied by levels of baseline total vitamin D intake but it varied little by levels of other baseline variables. These results suggest that a modest reduction in fat intake and increase in fruit, vegetable, and grain intake does not alter the risk of benign proliferative breast disease. PMID:19138971

  4. Is there an Upgrading to Malignancy at Surgery of Mucocele-Like Lesions Diagnosed on Percutaneous Breast Biopsy?

    PubMed

    Diorio, Caroline; Provencher, Louise; Morin, Josée; Desbiens, Christine; Poirier, Brigitte; Poirier, Éric; Hogue, Jean-Charles; Jacob, Simon; Côté, Gary

    2016-03-01

    Management of pure mucocele-like lesion (MLL) diagnosed on percutaneous breast biopsy (PBB) is controversial. To assess surgical upgrade rate and clinical outcome of pure MLL obtained as sole diagnosis on PBB. Patients diagnosed with a MLL as the most advanced lesion on PBB from April 1997 to December 2010 were reviewed for radiologic presentation, biopsy technique, and pathologic and clinical outcomes. Of the 21,340 image-guided PBB performed during the study period, 50 women with 51 MLL (0.24%) were identified. Mean age was 53.1 ± 7.7 years. Radiologic findings were mostly microcalcifications (n = 47, 92.2%). Stereotactic PBB was performed for 49 lesions (96.1%). Surgery was performed shortly after biopsy in 35 women, with benign final pathology in 33, and upgrade to ductal carcinoma in situ (DCIS) in two patients (2/35, 5.7%). Mean follow-up was 4.2 ± 2.5 years (3.7 ± 2.1 years for surgical patients; 5.9 ± 2.9 years for follow-up only patients); three women were lost to follow-up (3/50). Three invasive cancers (3/47, 6.4%) were diagnosed 1.2, 1.2, and 2.8 years after biopsy: two in surgical patients, and one in a follow-up only patient. No cancer occurred at the same site as the original MLL. Pure MLL lesion of the breast is a rare entity and is mostly associated with a benign outcome. We observed an upgrade to DCIS slightly superior to 5%, but no invasive cancer. It is therefore unclear if these lesions should be excised or clinically and radiologically followed up when such lesions are found at PBB. PMID:26662058

  5. Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions

    PubMed Central

    Lakiotaki, Eleftheria; Giaginis, Constantinos; Tolia, Maria; Alexandrou, Paraskevi; Delladetsima, Ioanna; Giannopoulou, Ioanna; Kyrgias, George; Patsouris, Efstratios; Theocharis, Stamatios

    2015-01-01

    The endocannabinoid system is comprised of cannabinoid receptors (CB1 and CB2), their endogenous ligands (endocannabinoids), and proteins responsible for their metabolism participate in many different functions indispensable to homeostatic regulation in several tissues, exerting also antitumorigenic effects. The present study aimed to evaluate the clinical significance of CB1 and CB2 expression in human benign and malignant thyroid lesions. CB1 and CB2 proteins' expression was assessed immunohistochemically on paraffin-embedded thyroid tissues obtained from 87 patients with benign (n = 43) and malignant (n = 44) lesions and was statistically analyzed with clinicopathological parameters, follicular cells' proliferative capacity, and risk of recurrence rate estimated according to the American Thyroid Association (ATA) staging system. Enhanced CB1 and CB2 expression was significantly more frequently observed in malignant compared to benign thyroid lesions (p = 0.0010 and p = 0.0005, resp.). Enhanced CB1 and CB2 expression was also significantly more frequently observed in papillary carcinomas compared to hyperplastic nodules (p = 0.0097 and p = 0.0110, resp.). In malignant thyroid lesions, elevated CB2 expression was significantly associated with the presence of lymph node metastases (p = 0.0301). Enhanced CB2 expression was also more frequently observed in malignant thyroid cases with presence of capsular (p = 0.1165), lymphatic (p = 0.1989), and vascular invasion (p = 0.0555), as well as in those with increased risk of recurrence rate (p = 0.1165), at a nonsignificant level though, whereas CB1 expression was not associated with any of the clinicopathological parameters examined. Our data suggest that CB receptors may be involved in malignant thyroid transformation and especially CB2 receptor could serve as useful biomarker and potential therapeutic target in thyroid neoplasia. PMID:26539529

  6. The impact of breast structure on lesion detection in breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Kiarashi, Nooshin; Nolte, Loren W.; Lo, Joseph Y.; Segars, William P.; Ghate, Sujata V.; Samei, Ehsan

    2015-03-01

    Virtual clinical trials (VCT) can be carefully designed to inform, orient, or potentially replace clinical trials. The focus of this study was to demonstrate the capability of the sophisticated tools that can be used in the design, implementation, and performance analysis of VCTs, through characterization of the effect of background tissue density and heterogeneity on the detection of irregular masses in digital breast tomosynthesis. Twenty breast phantoms from the extended cardiactorso (XCAT) family, generated based on dedicated breast computed tomography of human subjects, were used to extract a total of 2173 volumes of interest (VOI) from simulated tomosynthesis images. Five different lesions, modeled after human subject tomosynthesis images, were embedded in the breasts, for a total of 6×2173 VOIs with and without lesions. Effects of background tissue density and heterogeneity on the detection of the lesions were studied by implementing a doubly composite hypothesis signal detection theory paradigm with location known exactly, lesion known exactly, and background known statistically. The results indicated that the detection performance as measured by the area under the receiver operating characteristic curve (ROC) deteriorated as density was increased, yielding findings consistent with clinical studies. The detection performance varied substantially across the twenty breasts. Furthermore, the log-likelihood ratio under H0 and H1 seemed to be affected by background tissue density and heterogeneity differently. Considering background tissue variability can change the outcomes of a VCT and is hence of crucial importance. The XCAT breast phantoms can address this concern by offering realistic modeling of background tissue variability based on a wide range of human subjects.

  7. The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions

    PubMed Central

    Avcu, S; Koseoglu, M N; Ceylan, K; Dbulutand, M; Unal, O

    2011-01-01

    Objectives To investigate the role of diffusion-weighted MRI (DWI) in the diagnosis of urinary bladder (UB) tumours by means of measuring apparent diffusion coefficient (ADC) values. Methods A total of 83 people aged between 18 and 86 years were included in the study: 63 patients with UB pathology (46 malignant, 17 benign) constituted the case group; 20 individuals without any UB pathology constituted the control group. DWI was applied to all individuals. The ADC values were measured based on the tissue of the UB mass entities and normal UB wall in the control group. Results The mean ADC value in the UB carcinoma group was significantly lower than that in the control group: 1.0684 ± 0.26 × 10−3 mm2 s–1 and 2.010 ± 0.11 × 10−3 mm2 s–1, respectively (p<0.01). There was a significant difference among the mean ADC values of different grades of malignant tumours, corresponding to 0.9185 ± 0.20 mm2 s–1 and 1.281 ± 0.18 mm2 s–1 in high-grade and low-grade malignant UB carcinomas, respectively (p<0.01). The ADC value in the carcinoma group was significantly lower than that in the benign lesion group: 1.0684 ± 0.26 × 10−3 mm2 s–1 and 1.803 ± 0.19 × 10−3 mm2 s–1, respectively (p<0.01). All 46 malignant lesions displayed a restriction in diffusion; 4 of the 17 benign lesions displayed a mild restriction in diffusion. The sensitivity, specificity and accuracy of DWI in the diagnosis of malignant UB lesions was 100%, 76.5% and 93.65%, respectively. Conclusion DWI can be beneficial in the differentiation of benign and malignant UB lesions, as well as of high-grade and low-grade UB carcinomas, using quantitative ADC measurements. PMID:21224296

  8. Modeling realistic breast lesions using diffusion limited aggregation

    NASA Astrophysics Data System (ADS)

    Rashidnasab, Alaleh; Elangovan, Premkumar; Dance, David R.; Young, Kenneth C.; Diaz, Oliver; Wells, Kevin

    2012-03-01

    Synthesizing the appearance of malignant masses and inserting these into digital mammograms can be used as part of a wider framework for investigating the radiological detection task in X-ray mammography. However, the randomness associated with cell division within cancerous masses and the associated complex morphology challenges the realism of the modeling process. In this paper, Diffusion Limited Aggregation (DLA), a type of fractal growth process is proposed and utilized for modeling breast lesions. Masses of different sizes, shapes and densities were grown by controlling DLA growth parameters either prior to growth, or dynamically updating these during growth. A validation study was conducted by presenting 30 real and 30 simulated masses in a random order to a team of radiologists. The results from the validation study suggest that the observers found it difficult to differentiate between the real and simulated lesions.

  9. The role of diet in the development of breast cancer: a case-control study of patients with breast cancer, benign epithelial hyperplasia and fibrocystic disease of the breast.

    PubMed

    Ingram, D M; Nottage, E; Roberts, T

    1991-07-01

    A case-control study was undertaken to investigate the role of diet in women with breast cancer, and in two groups of women with benign breast disease: epithelial hyperplasia, and fibrocystic disease without hyperplasia. The study provides data which suggest that the consumption of red meat, savoury meals (pizza, pies, stew, etc.) and of starches is disadvantageous, while the consumption of chicken and fish, and of fruit, appears to be beneficial. These patterns were present for both the breast cancer patients and the patients with benign epithelial hyperplasia. One-third of breast cancer patients had changed their diet after their diagnosis, compared to only around 12% in controls and patients with benign breast disease. Overall, the women studied had changed their diet to reduce their intake of sugars, dairy products and meat, and increased their intake of poultry, fish, fruit and vegetables over the past decade; but the breast cancer group was less likely to have made this change. PMID:1854621

  10. The management of papillary breast lesions on core biopsy: the contentious issues.

    PubMed

    Rozen, Warren M; Joseph, Samuel; Murphy, Craig

    2007-06-01

    The management of papillary lesions of the breast diagnosed on core needle biopsy is highly contentious. Papillary lesions are epithelial proliferations of breast tissue and are on a continuum of mutations with atypical hyperplastic lesions and in situ carcinoma. With the current literature suggesting that excisional biopsy of papillary lesions might not be required, we discuss a unique case that suggests otherwise. We present a 21-year-old woman with multiple papillary lesions on core biopsy of a breast lesion, and a subsequent excisional biopsy revealing extensive in situ carcinoma of the breast. This finding necessitated total mastectomy. This unique case highlights that core biopsy specimens are unable to effectively exclude adjacent in situ carcinoma and suggests that papillary lesions diagnosed on core needle biopsy require excisional biopsy. PMID:17592679

  11. Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer

    PubMed Central

    Kryvenko, Oleksandr N; Jankowski, Michelle; Chitale, Dhananjay A; Tang, Deliang; Rundle, Andrew; Trudeau, Sheri; Rybicki, Benjamin A

    2013-01-01

    Benign changes ranging from atrophy and inflammation to high-grade prostatic intraepithelial neoplasia (HGPIN) are common findings on prostate core needle biopsies. Although atrophy and inflammation may be precursors of prostate cancer, only HGPIN is currently recommended to be included in surgical pathology reports. To determine whether these benign findings increase prostate cancer risk, we conducted a case–control study nested within a historical cohort of 6692 men with a benign prostate specimen collected between 1990 and 2002. The analytic sample included 574 case–control pairs comprised of cases diagnosed with prostate cancer a minimum of 1 year after cohort entry and controls matched to cases on date and age at cohort entry, race, and type of specimen. The initial benign specimen was reviewed for presence of HGPIN, atrophy (simple, lobular, and partial) and inflammation (glandular and/or stromal). HGPIN significantly increased risk for prostate cancer (odds ratio (OR) = 2.00; 95% confidence interval (CI) = 1.25–3.20). Inflammation within the stromal compartment was associated with decreased risk (OR = 0.66; CI = 0.52–0.84), and diffuse stromal inflammation of severe grade had the strongest inverse association with risk (OR = 0.21; CI = 0.07–0.62). In a model adjusted for prostate-specific antigen (PSA) level at cohort entry and inflammation, simple atrophy was associated with a 33% increased prostate cancer risk that was marginally significant (P = 0.03). Clinicians should consider patterns and extent of inflammation when managing high-risk patients with negative biopsy results. Identifying benign inflammatory processes that underlie high PSA levels would help to reduce the number of unnecessary repeated prostate biopsies. PMID:22460812

  12. The differentiation of the character of solid lesions in the breast in the compression sonoelastography. Part I: The diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid, focal lesions in the breast in relation to the pathomorphological verification

    PubMed Central

    2012-01-01

    The aim of this study was to evaluate the diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid lesions in the breast in relation to the pathomorphological verification. From January to July 2010, 375 ultrasound breast examinations were conducted. The study enrolled 80 women aged 17–83, with 99 solid, focal lesions present in breasts, which were qualified for pathomorphological verification on the basis of the ultrasound examination. All patients underwent: the interview, physical examination, ultrasound examination and sonoelastography. The ultrasound features of the lesions, their vascularization patterns in the Doppler examination as well as the adjacent tissues were determined. Next, the focal lesions were categorized according to the BIRADS-US classification. The obtained results were analyzed statistically. In the group of 80 patients, 99 focal, solid lesions in breasts were visualized, including 39 neoplastic, malignant lesions (group I) and 60 lesions of benign nature (group II). The malignant lesions were often characterized by: greater size, irregular shape (34/39), prevalence of the anteroposterior dimension over the lateral-lateral dimension (22/39), acoustic shadowing (20/39), the margins not well-circumscribed (37/39), spiculated margins (16/39) and the presence of calcifications (14/39). The benign lesions were much more often hyper- and isoechogenic (14/60). In group I the lesions more often demonstrated the features of increased vascularization (29/39) and the presence of irregularly shaped vessels (23/29). This vascularization more often originated in the adjacent tissues. In the surroundings of the malignant neoplastic lesions, the presence of edema (16/39) and skin thickening (6/39) occurred more frequently and the abnormal axillary lymph nodes were more often diagnosed. The lesions of group I were assigned to the following BIRADS categories: BIRADS-US 4 (9 lesions) and BIRADS-US 5 (30 lesions). In group

  13. Nuclear magnetic resonance for the differentiation of benign and malignant breast tissues and axillary lymph nodes.

    PubMed Central

    Fossel, E T; Brodsky, G; deLayre, J L; Wilson, R E

    1983-01-01

    We have utilized proton T1 (spin-lattice relaxation time) values of Nuclear Magnetic Resonance to study 110 tissue samples obtained from 11 mastectomy specimens. Samples of 1 cm3 from primary tumor sites, nipples, and other breast quadrants, as well as intact lymph nodes were studied and then histologically scored for the presence or absence of carcinoma and, if present, whether it was an isolated microscopic focus (micro). Of 54 samples of breast tissue, 12 contained carcinoma, 5 micro: of 45 lymph nodes, 15 contained metastatic carcinoma, 2 micro; of the 11 nipples, 2 had carcinoma, both micro. For the malignant samples (excluding micro) mean T1 value was 0.47 +/- 0.07 sec, (range 0.39-0.79 sec). For the 72 benign samples (excluding nipple) mean T1 value was 0.26 +/- 0.03 sec (range 0.14-0.36 sec). The 13 tumor-bearing nodes had a mean T1 value of 0.47 +/- 0.03 sec (range 0.40-0.63 sec); mean for the benign nodes was 0.26 +/- 0.007 sec (range 0.19-0.35 sec). The differences were highly significant in each case (p less than 0.001). For micro examples, T1 values were at malignancy threshold levels or just below, except for nipple tissues, where discrimination was poor. For the 20 other malignant samples, there was no correlation between T1 value and the per cent of sample containing malignancy. PMID:6625722

  14. Dietary patterns and benign breast diseases: a case-control study.

    PubMed

    Tiznobeyk, Zeinab; Sheikhi Mobarakeh, Zahra; Qorbani, Mostafa; Koohdani, Fariba; Sotoudeh, Gity; Khajehnasiri, Farahnaz; Khosravi, Shahla; Doostan, Farideh

    2016-07-01

    Several studies have investigated the relation between benign breast diseases (BBD) and food intake. However, dietary patterns of these patients have not been taken into consideration up to now. The aim of this study is to determine the association between dietary patterns and BBD. In this case-control study, ninety-six patients with BBD and seventy controls were selected from women attending the Iranian Center for Breast Cancer affiliated with Academic Center for Education, Culture and Research. Demographic, physical activity and semi-quantitative FFQ were completed. The main dietary patterns were extracted by factor analysis. Two major dietary patterns emerged: Healthy dietary pattern including fish, poultry, eggs, low-fat dairy products, vegetables, legumes, nuts and seeds, whole grains, oil and mayonnaise, olives, fruits; and Unhealthy dietary pattern including red meats, organ and processed meats, high-fat dairy products, refined grains, sweets and desserts, animal and solid fats. After adjustment for age, BMI and energy intake, the participants in the highest tertile of Healthy dietary pattern (OR 0·44; 95 % CI 0·20, 0·99) were less likely to have BBD compared with those in the first tertile. After adjustment for other confounding variables, this relationship still remained close to significant level. However, higher consumption of Unhealthy dietary pattern was not associated with the risk of BBD. In conclusion, Healthy dietary pattern might be inversely associated with the risk of BBD; however, this result should be interpreted with caution. Future studies are needed to confirm our findings. PMID:27198589

  15. A radiological approach to benign and malignant lesions of the mandible.

    PubMed

    Harmon, M; Arrigan, M; Toner, M; O'Keeffe, S A

    2015-04-01

    There is a wide range of pathological conditions that affect the mandible. Although some lesions demonstrate characteristic imaging features, many of the pathological processes encountered in the mandible often exhibit similar imaging appearances resulting in uncertainty for the reporting radiologist. Many mandibular lesions remain impossible to distinguish without histological analysis. Therefore, this review aims to reassure the radiologist that although imaging findings may not always lead to a specific diagnosis, they narrow the differential diagnosis and guide further work-up. In this regard, we aim to provide a clinically useful framework and approach for radiologists to use when they encounter lesions within the mandible. PMID:25559378

  16. Dietary and reproductive factors associated with benign breast disease in Mexican women.

    PubMed

    Galván-Portillo, Marcia; Torres-Sánchez, Luisa; López-Carrillo, Lizbeth

    2002-01-01

    Benign breast disease (BBD) is common in women in the reproductive age group. The results of epidemiological studies that have examined the relationship between diet and BBD are controversial and scarce. The aim of the present study was to identify and evaluate the impact of dietary and reproductive risk factors in the development of BBD in Mexican women. Between 1994 and 1996, 121 women with BBD and 121 age-matched (+/- 3 yr) clinical controls with non-breast-related diseases were identified. The study population was directly interviewed about their reproductive history, and a semiquantitative food frequency questionnaire was used to obtain dietary information. The population was originally identified as part of a hospital-based case-control study examining exposure to 1,1-bis(p-chlorophenyl)-2,2,2-trichloroethane and breast cancer. A significant reduction in the risk of BBD was observed when comparing the upper with the lower tertiles of consumption of citrus fruit [odds ratio (OR) = 0.43, 95% confidence interval (CI) = 0.21-0.88], non-citrus fruit (OR = 0.35, 95% CI = 0.16-0.76), diary products (OR = 0.36, 95% CI = 0.18-0.75), and food sources of lignans (OR = 0.48, 95% CI = 0.24-0.98). A marginally significant reduction in the risk of BBD associated with the consumption of vitamin B-12 (OR = 0.48, 95% CI = 0.23-1.02) was also observed. Our results add new information about the role of diet in the etiology of BBD. PMID:12588693

  17. The Automated Breast Volume Scanner (ABVS): initial experiences in lesion detection compared with conventional handheld B-mode ultrasound: a pilot study of 50 cases.

    PubMed

    Wojcinski, Sebastian; Farrokh, Andre; Hille, Ursula; Wiskirchen, Jakub; Gyapong, Samuel; Soliman, Amr A; Degenhardt, Friedrich; Hillemanns, Peter

    2011-01-01

    The idea of an automated whole breast ultrasound was developed three decades ago. We present our initial experiences with the latest technical advance in this technique, the automated breast volume scanner (ABVS) ACUSON S2000(™). Volume data sets were collected from 50 patients and a database containing 23 women with no detectable lesions in conventional ultrasound (BI-RADS(®)-US 1), 13 women with clearly benign lesions (BI-RADS(®)-US 2), and 14 women with known breast cancer (BI-RADS(®)-US 5) was created. An independent examiner evaluated the ABVS data on a separate workstation without any prior knowledge of the patients' histories. The diagnostic accuracy for the experimental ABVS was 66.0% (95% confidence interval [CI]: 52.9-79.1). The independent examiner detected all breast cancers in the volume data resulting in a calculated sensitivity of 100% in the described setting (95% CI: 73.2%-100%). After the ABVS examination, there were a high number of requests for second-look ultrasounds in 47% (95% CI: 30.9-63.5) of the healthy women (with either a clearly benign lesion or no breast lesions at all in conventional handheld ultrasound). Therefore, the specificity remained at 52.8% (95% CI: 35.7-69.2). When comparing the concordance of the ABVS with the gold standard (conventional handheld ultrasound), Cohen's Kappa value as an estimation of the inter-rater reliability was κ = 0.37, indicating fair agreement. In conclusion, the ABVS must still be regarded as an experimental technique for breast ultrasound, which definitely needs to undergo further evaluation studies. PMID:22114526

  18. The Automated Breast Volume Scanner (ABVS): initial experiences in lesion detection compared with conventional handheld B-mode ultrasound: a pilot study of 50 cases

    PubMed Central

    Wojcinski, Sebastian; Farrokh, Andre; Hille, Ursula; Wiskirchen, Jakub; Gyapong, Samuel; Soliman, Amr A; Degenhardt, Friedrich; Hillemanns, Peter

    2011-01-01

    The idea of an automated whole breast ultrasound was developed three decades ago. We present our initial experiences with the latest technical advance in this technique, the automated breast volume scanner (ABVS) ACUSON S2000™. Volume data sets were collected from 50 patients and a database containing 23 women with no detectable lesions in conventional ultrasound (BI-RADS®-US 1), 13 women with clearly benign lesions (BI-RADS®-US 2), and 14 women with known breast cancer (BI-RADS®-US 5) was created. An independent examiner evaluated the ABVS data on a separate workstation without any prior knowledge of the patients’ histories. The diagnostic accuracy for the experimental ABVS was 66.0% (95% confidence interval [CI]: 52.9–79.1). The independent examiner detected all breast cancers in the volume data resulting in a calculated sensitivity of 100% in the described setting (95% CI: 73.2%–100%). After the ABVS examination, there were a high number of requests for second-look ultrasounds in 47% (95% CI: 30.9–63.5) of the healthy women (with either a clearly benign lesion or no breast lesions at all in conventional handheld ultrasound). Therefore, the specificity remained at 52.8% (95% CI: 35.7–69.2). When comparing the concordance of the ABVS with the gold standard (conventional handheld ultrasound), Cohen’s Kappa value as an estimation of the inter-rater reliability was κ = 0.37, indicating fair agreement. In conclusion, the ABVS must still be regarded as an experimental technique for breast ultrasound, which definitely needs to undergo further evaluation studies. PMID:22114526

  19. The effect of low dose carbidopa/levodopa on prolactin and growth hormone concentrations in patients with breast cancer and in benign breast tumours.

    PubMed Central

    Jones, M K; Ramsay, I D; Jenner, P G

    1978-01-01

    1 Low doses of carbidopa/levodopa (12.5 mg 1-alpha-methyl-dopahydrazine, 125 mg levodopa) were administered orally to 29 patients with tumours of the breast (16 with breast cancer, 13 with benign breast disease). 2 Plasma dopa response curves were similar in all the patients studied. 3 Prolactin and growth hormone showed similar responses to carbidopa/levodopa irrespective of age or diagnosis. 4 Prolactin showed an unusual reponse in four patients which has not previously been recorded. PMID:656281

  20. Diagnostic performance and inter-observer concordance in lesion detection with the automated breast volume scanner (ABVS)

    PubMed Central

    2013-01-01

    Background Automated whole breast ultrasound scanners of the latest generation have reached a level of comfortable application and high quality volume acquisition. Nevertheless, there is a lack of data concerning this technology. We investigated the diagnostic performance and inter-observer concordance of the Automated Breast Volume Scanner (ABVS) ACUSON S2000™ and questioned its implications in breast cancer diagnostics. Methods We collected 100 volume data sets and created a database containing 52 scans with no detectable lesions in conventional ultrasound (BI-RADS®-US 1), 30 scans with benign lesions (BI-RADS®-US 2) and 18 scans with breast cancer (BI-RADS®-US 5). Two independent examiners evaluated the ABVS data on a separate workstation without any prior knowledge of the patients’ histories. Results The inter-rater reliability reached fair agreement (κ=0.36; 95% confidence interval (CI): 0.19-0.53). With respect to the true category, the conditional inter-rater validity coefficient was κ=0.18 (95% CI: 0.00-0.26) for the benign cases and κ=0.80 (95% CI: 0.61-1.00) for the malignant cases. Combining the assessments of examiner 1 and examiner 2, the diagnostic accuracy (AC), sensitivity (SE) and specificity (SP) for the experimental ABVS were AC = 79.0% (95% CI: 67.3-86.1), SE = 83.3% (95% CI: 57.7-95.6) and SP = 78.1% (% CI: 67.3-86.1), respectively. However, after the ABVS examination, there were a high number of requests for second-look ultrasounds in up to 48.8% of the healthy women due to assumed suspicious findings in the volume data. In an exploratory analysis, we estimated that an ABVS examination in addition to mammography alone could detect a relevant number of previously occult breast cancers (about 1 cancer in 300 screened and otherwise healthy women). Conclusions The ABVS is a reliable imaging method for the evaluation of the breast with high sensitivity and a fair inter-observer concordance. However, we have to overcome the problem of the

  1. Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF): benign breast tumors - short text.

    PubMed

    Lavoué, Vincent; Fritel, Xavier; Antoine, Martine; Beltjens, Françoise; Bendifallah, Sofiane; Boisserie-Lacroix, Martine; Boulanger, Loic; Canlorbe, Geoffroy; Catteau-Jonard, Sophie; Chabbert-Buffet, Nathalie; Chamming's, Foucauld; Chéreau, Elisabeth; Chopier, Jocelyne; Coutant, Charles; Demetz, Julie; Guilhen, Nicolas; Fauvet, Raffaele; Kerdraon, Olivier; Laas, Enora; Legendre, Guillaume; Mathelin, Carole; Nadeau, Cédric; Naggara, Isabelle Thomassin; Ngô, Charlotte; Ouldamer, Lobna; Rafii, Arash; Roedlich, Marie-Noelle; Seror, Jérémy; Séror, Jean-Yves; Touboul, Cyril; Uzan, Catherine; Daraï, Emile

    2016-05-01

    Screening with breast ultrasound in combination with mammography is needed to investigate a clinical breast mass (Grade B), colored single-pore breast nipple discharge (Grade C), or mastitis (Grade C). The BI-RADS system is recommended for describing and classifying abnormal breast imaging findings. For a breast abscess, a percutaneous biopsy is recommended in the case of a mass or persistent symptoms (Grade C). For mastalgia, when breast imaging is normal, no MRI or breast biopsy is recommended (Grade C). Percutaneous biopsy is recommended for a BI-RADS category 4-5 mass (Grade B). For persistent erythematous nipple or atypical eczema lesions, a nipple biopsy is recommended (Grade C). For distortion and asymmetry, a vacuum core-needle biopsy is recommended due to the risk of underestimation by simple core-needle biopsy (Grade C). For BI-RADS category 4-5 microcalcifications without any ultrasound signal, a minimum 11-G vacuum core-needle biopsy is recommended (Grade B). In the absence of microcalcifications on radiography cores additional samples are recommended (Grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial atypia, radial scar and mucocele with atypia, surgical excision is commonly recommended (Grade C). Expectant management is feasible after multidisciplinary consensus. For these lesions, when excision margins are not clear, no new excision is recommended except for LCIS characterized as pleomorphic or with necrosis (Grade C). For grade 1 phyllodes tumor, surgical resection with clear margins is recommended. For grade 2 phyllodes tumor, 10mm margins are recommended (Grade C). For papillary breast lesions without atypia, complete disappearance of the radiological signal is recommended (Grade C). For papillary breast lesions with atypia, complete surgical excision is recommended (Grade C). PMID:26967341

  2. Pleomorphic Adenoma of Base of Tongue: Is Midline Mandibulotomy Necessary for Approaching Benign Base Tongue Lesions?

    PubMed Central

    Bansal, Sandeep; Kalsotra, Gopika; Mohammed, Abdul Wadood; Bahl, Amanjit; Gupta, Ashok K.

    2012-01-01

    Objective. To report a rare presentation of pleomorphic adenoma, at base tongue, excised surgically by a transoral midline glossotomy technique without mandibulotomy. Case Report. Pleomorphic adenoma is a benign tumor of the salivary gland found rarely in the base of tongue. Surgery is the definitive treatment for this tumor, and different approaches have been mentioned in the literature. In our case we surgically excised the tumor by a transoral midline glossotomy technique without mandibulotomy where we combined the cosmetic advantage of transoral technique and the exposure advantage of a glossotomy technique. Discussion. We discuss the different approaches to oropharynx, their advantages and disadvantages. Primary transoral approach provides better cosmesis but less exposure whereas median labiomandibuloglossotomy approach provides more exposure but is cosmetically unacceptable. Conclusion. A transoral midline glossotomy approach without mandibulotomy provides wide exposure with acceptable cosmesis. PMID:22953125

  3. Lipoleiomyoma of the left broad ligament with dermoid cyst in ipsilateral ovary and synchronous multiple benign lesions of female genital tract: An unusual association.

    PubMed

    Mishra, Sweta Singh; Saha, Arpita; Mishra, Pritinanda; Jena, Saubhagya Kumar

    2016-01-01

    Lipoleiomyoma of the uterus is a rare variant of leiomyoma, and lipoleiomyoma of the broad ligament is still rarer, with only a handful of cases being reported. The present case was a perimenopausal woman who presented with a huge lower abdominal mass. Ultrasonography and computed tomography showed a heterogeneous solid mass in the left adnexa. The histopathological findings confirmed the nature of the lesions as a benign lipoleiomyoma with dermoid cyst of the left ovary and its other associated benign lesions, were the interesting features seen in this case which were not suspected clinically and radiologically. PMID:27510676

  4. 18F Sodium Fluoride PET/CT in Patients with Prostate Cancer: Quantification of Normal Tissues, Benign Degenerative Lesions, and Malignant Lesions

    PubMed Central

    Oldan, Jorge D.; Hawkins, A. Stewart; Chin, Bennett B.

    2016-01-01

    Understanding the range and variability of normal, benign degenerative, and malignant 18F sodium fluoride (18F NaF) positron emission tomography/computed tomography (PET/CT) uptake is important in influencing clinical interpretation. Further, it is essential for the development of realistic semiautomated quantification techniques and simulation models. The purpose of this study is to determine the range of these values in a clinically relevant patient population with prostate cancer. 18F NaF PET/CT scans were analyzed in patients with prostate cancer (n = 47) referred for evaluation of bone metastases. Mean and maximum standardized uptake values [SUVs (SUVmean and SUVmax)] were made in normal background regions (n = 470) including soft tissues (liver, aorta, bladder, adipose, brain, and paraspinal muscle) and osseous structures (T12 vertebral body, femoral diaphyseal cortex, femoral head medullary space, and ribs). Degenerative joint disease (DJD; n = 281) and bone metastases (n = 159) were identified and quantified by an experienced reader using all scan information including coregistered CT. For normal bone regions, the highest 18F NaF PET SUVmean occurred in T12 (6.8 ± 1.4) and it also showed the lowest coefficient of variation (cv = 21%). For normal soft tissues, paraspinal muscles showed very low SUVmean (0.70 ± 0.11) and also showed the lowest variability (cv = 16%). Average SUVmean in metastatic lesions is higher than uptake in benign degenerative lesions but values showed a wide variance and overlapping values (16.3 ± 13 vs 11.1 ± 3.8; P < 0.00001). The normal 18F NaF PET uptake values for prostate cancer patients in normal background, benign degenerative disease, and osseous metastases are comparable to those reported for a general population with a wide variety of diagnoses. These normal ranges, specifically for prostate cancer patients, will aid in clinical interpretation and also help to establish the basis of normal limits in a semiautomated data

  5. (18)F Sodium Fluoride PET/CT in Patients with Prostate Cancer: Quantification of Normal Tissues, Benign Degenerative Lesions, and Malignant Lesions.

    PubMed

    Oldan, Jorge D; Hawkins, A Stewart; Chin, Bennett B

    2016-01-01

    Understanding the range and variability of normal, benign degenerative, and malignant (18)F sodium fluoride ((18)F NaF) positron emission tomography/computed tomography (PET/CT) uptake is important in influencing clinical interpretation. Further, it is essential for the development of realistic semiautomated quantification techniques and simulation models. The purpose of this study is to determine the range of these values in a clinically relevant patient population with prostate cancer. (18)F NaF PET/CT scans were analyzed in patients with prostate cancer (n = 47) referred for evaluation of bone metastases. Mean and maximum standardized uptake values [SUVs (SUVmean and SUVmax)] were made in normal background regions (n = 470) including soft tissues (liver, aorta, bladder, adipose, brain, and paraspinal muscle) and osseous structures (T12 vertebral body, femoral diaphyseal cortex, femoral head medullary space, and ribs). Degenerative joint disease (DJD; n = 281) and bone metastases (n = 159) were identified and quantified by an experienced reader using all scan information including coregistered CT. For normal bone regions, the highest (18)F NaF PET SUVmean occurred in T12 (6.8 ± 1.4) and it also showed the lowest coefficient of variation (cv = 21%). For normal soft tissues, paraspinal muscles showed very low SUVmean (0.70 ± 0.11) and also showed the lowest variability (cv = 16%). Average SUVmean in metastatic lesions is higher than uptake in benign degenerative lesions but values showed a wide variance and overlapping values (16.3 ± 13 vs 11.1 ± 3.8; P < 0.00001). The normal (18)F NaF PET uptake values for prostate cancer patients in normal background, benign degenerative disease, and osseous metastases are comparable to those reported for a general population with a wide variety of diagnoses. These normal ranges, specifically for prostate cancer patients, will aid in clinical interpretation and also help to establish the basis of normal limits in a

  6. Histology and clinical outcome of benign and malignant vascular lesions primary to feline cervical lymph nodes.

    PubMed

    Roof-Wages, E; Spangler, T; Spangler, W L; Siedlecki, C T

    2015-03-01

    A novel form of primary feline hemangiosarcoma and additional cases of plexiform vascularization in the cervical lymph nodes are reported. Sixteen cases of feline lymphadenopathy attributed to abnormal vascular proliferation were identified and evaluated. Most of these lesions were diagnosed histologically as hemangiosarcoma. However, lesions of plexiform vascularization, with and without areas of putative malignant transformation, were also identified. Mean age of the cats was 11 years (range, 3-16 years) with most being domestic shorthair and medium hair (13). Two domestic long hair and 1 Maine Coon were identified. Excisional nodal biopsy was performed in 15 cases and incisional biopsy in 1 case. Six cats were euthanized due to their disease. Survival times ranged from ≤ 1 month to ≥ 30 months. We provide a new clinical differential for cervical lymphadenopathy in cats that is not widely recognized. Proper identification of primary nodal vascular lesions in cats will enable further characterization of clinical features and biologic behavior to determine specific therapy. PMID:24879661

  7. Expression of the G2-M checkpoint regulators cyclin B1 and cdc2 in nonmalignant and malignant human breast lesions: immunocytochemical and quantitative image analyses.

    PubMed Central

    Kawamoto, H.; Koizumi, H.; Uchikoshi, T.

    1997-01-01

    We investigated the in vivo expression of cyclin B1 and Cdc2 (key molecules for G2-M transition during the cell cycle) in nonmalignant and cancerous human breast lesions using immunohistochemistry and quantitative proliferative index (PI) analysis. Breast epithelial cells co-expressed cyclin B1 and Cdc2 in their cytoplasm in the G2 phase and in their nuclei in the M phase. Cyclin B1, but not Cdc2, immunostaining rapidly disappeared from the nuclei during the mitotic metaphase to anaphase transition. Static image analysis revealed the mean proliferative index for cyclin B1/cdc2 for each type of lesion to be as follows: normal glands (n = 20), 2.0/2.5%; benign lesions, including typical ductal hyperplasia (n = 76), 2.5/5.8%; atypical ductal hyperplasia (n = 21), 3.0/6.6%; carcinomas in situ (n = 70), 7.4/14.0%; and invasive carcinomas (n = 58), 10.0/22.9%. Proliferative index data for atypical hyperplasia were virtually identical to those for benign lesions and were significantly lower than those for breast cancer, suggesting that expression levels of cyclin B1 and Cdc2 may be used to distinguish premalignant human breast lesions from advanced disease. Furthermore, the proliferative index for cyclin B1 for comedo-type ductal carcinomas in situ agreed with that for invasive ductal carcinomas (mean, 10.1% versus 9.5%), apparently explaining the clinicopathological aggressiveness of this tumor at the molecular level. Images Figure 1 Figure 2 Figure 3 PMID:9006317

  8. Intraoperative diagnosis of benign and malignant breast tissues by fourier transform infrared spectroscopy and support vector machine classification

    PubMed Central

    Tian, Peirong; Zhang, Weitao; Zhao, Hongmei; Lei, Yutao; Cui, Long; Wang, Wei; Li, Qingbo; Zhu, Qing; Zhang, Yuanfu; Xu, Zhi

    2015-01-01

    Background: Fourier transform infrared (FTIR) spectroscopy has shown its unique advantages in distinguishing cancerous tissue from normal one. The aim of this study was to establish a quick and accurate diagnostic method of FTIR spectroscopy to differentiate malignancies from benign breast tissues intraoperatively. Materials and methods: In this study, a total of 100 breast tissue samples obtained from 100 patients were taken on surgery. All tissue samples were scanned for spectra intraoperatively before being processed for histopathological diagnosis. Standard normal variate (SNV) method was adopted to reduce scatter effects. Support vector machine (SVM) classification was used to discriminate spectra between malignant and benign breast tissues. Leave-one-out cross validation (LOOCV) was used to evaluate the discrimination. Results: According to histopathological examination, 50 cases were diagnosed as fibroadenoma and 50 cases as invasive ductal carcinoma. The results of SVM algorithm showed that the sensitivity, specificity and accuracy rate of this method are 90.0%, 98.0% and 94.0%, respectively. Conclusions: FTIR spectroscopy technique in combination with SVM classification could be an accurate, rapid and objective tool to differentiate malignant from benign tumors during operation. Our studies establish the feasibility of FTIR spectroscopy with chemometrics method to guide surgeons during the surgery as an effective supplement for pathological diagnosis on frozen section. PMID:25785083

  9. Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

    PubMed Central

    2013-01-01

    Background Magnetic resonance imaging (MRI) guided wire localization presents several challenges apart from the technical difficulties. An alternative to this conventional localization method using a wire is the radio-guided occult lesion localization (ROLL), more related to safe surgical margins and reductions in excision volume. The purpose of this study was to establish a safe and reliable magnetic resonance imaging-radioguided occult lesion localization (MRI-ROLL) technique and to report our initial experience with the localization of nonpalpable breast lesions only observed on MRI. Methods Sixteen women (mean age 53.2 years) with 17 occult breast lesions underwent radio-guided localization in a 1.5-T MR system using a grid-localizing system. All patients had a diagnostic MRI performed prior to the procedure. An intralesional injection of Technetium-99m macro-aggregated albumin followed by distilled water was performed. After the procedure, scintigraphy was obtained. Surgical resection was performed with the help of a gamma detector probe. The lesion histopathology and imaging concordance; the procedure’s positive predictive value (PPV), duration time, complications, and accuracy; and the rate of exactly excised lesions evaluated with MRI six months after the surgery were assessed. Results One lesion in one patient had to be excluded because the radioactive substance came back after the injection, requiring a wire placement. Of the remaining cases, there were four malignant lesions, nine benign lesions, and three high-risk lesions. Surgical histopathology and imaging findings were considered concordant in all benign and high-risk cases. The PPV of MRI-ROLL was greater if the indication for the initial MR examination was active breast cancer. The median procedure duration time was 26 minutes, and all included procedures were defined as accurate. The exact and complete lesion removal was confirmed in all (100%) patients who underwent six-month postoperative MRI

  10. Value of Virtual Touch Tissue Imaging Quantification for Evaluation of Ultrasound Breast Imaging-Reporting and Data System Category 4 Lesions.

    PubMed

    Li, Xiao-Long; Xu, Hui-Xiong; Bo, Xiao-Wan; Liu, Bo-Ji; Huang, Xian; Li, Dan-Dan; Guo, Le-Hang; Xu, Jun-Mei; Sun, Li-Ping; Fang, Lin; Xu, Xiao-Hong

    2016-09-01

    The purpose of the study was to evaluate the value of 2-D shear wave elastography (SWE) of virtual touch tissue imaging quantification (VTIQ) for ultrasound (US) Breast Imaging-Reporting and Data System (BI-RADS) category 4 lesions. One hundred sixteen lesions were subject to conventional US, conventional strain elastography (SE) of elasticity imaging (EI), acoustic radiation force impulse (ARFI)-induced SE of virtual touch tissue imaging (VTI) and VTIQ before biopsies. Of the 116 lesions, 69 (59.5%) were benign and 47 (40.5%) were malignant. Significant differences were found between benign and malignant lesions in EI score, VTI score and shear wave speed (SWS) on VTIQ (both p < 0.05). The cut-off values were EI score ≥4, VTI score ≥4 and SWS ≥3.49 m/s, respectively. The diagnostic performance of VTIQ in terms of area under receiver operating characteristic curve (AUROC) were the highest (i.e., AUROC = 0.907), in comparison with EI, VTI alone or a combination of both. The associated sensitivity, specificity and accuracy were 87.2%, 82.6% and 84.5%, respectively. The combination of VTI and VTIQ, however, was similar with US BI-RADS (p = 0.475) in sensitivity in that only two (4.3%) of 47 malignant lesions were misdiagnosed as benign that were BI-RADS category 4b on US. VTIQ is valuable to differentiate benign from malignant BI-RADS category 4 lesions, and the combination of VTI and VTIQ might be useful for patient selection before biopsy. PMID:27174418

  11. Ex vivo Raman spectroscopic study of breast metastatic lesions in lungs in animal models.

    PubMed

    Bhattacharjee, Tanmoy; Tawde, Sneha; Hudlikar, Rasika; Mahimkar, Manoj; Maru, Girish; Ingle, Arvind; Murali Krishna, C

    2015-08-01

    The lung is one of the most common sites of metastases, with approximately 50% of patients with extrathoracic cancer exhibiting pulmonary metastases. Correct identification of the metastatic status of a lung lesion is vital to therapeutic planning and better prognosis. However, currently available diagnostic techniques, such as conventional radiography and low dose computed tomography (LDCT), may fail to identify metastatic lesions. Alternative techniques such as Raman spectroscopy (RS) are hence being extensively explored for correct diagnosis of metastasis. The current ex vivo study aims to evaluate the ability of a fiber optic-based Raman system to distinguish breast cancer metastasis in lung from primary breast and lung tumor in animal models. In this study, spectra were acquired from normal breast, primary breast tumor, normal lung, primary lung tumor, and breast cancer metastasis in lung tissues and analyzed using principal component analysis and principal component-linear discriminant analysis. Breast cancer metastasis in lung could be classified with 71% classification efficiency. Approximately 6% breast metastasis spectra were misclassified with breast tumor, probably due to the presence of breast cancer cells in metastasized lungs. Test prediction results show 64% correct prediction of breast metastasis, while 13% breast metastasis spectra were wrongly predicted as breast tumor, suggesting the possible influence of breast cancer cells. Thus, findings of this study, the first of such explorations, demonstrate the potential of RS in classifying breast metastasis in lungs from primary lung and primary breast tumor. Prospective evaluation on a larger cohort with better multivariate analysis, combined with LDCT and recently developed real-time in vivo probes, RS can play a significant role in nonsurgical screening of lesions, which can lead to individualized therapeutic regimes and improved prognoses. PMID:26295177

  12. Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

    PubMed

    Tse, Gary M; Tan, Puay-Hoon

    2010-08-01

    Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are widely used in diagnosing breast lesions, with both achieving high sensitivity and specificity. Whether FNAC or CNB is better remains highly controversial. In this review, the advantages and disadvantages of each of these methods are discussed, especially in relation to specific problematic groups of breast lesions. In general, CNB has a slight advantage with lower inadequate and suspicious rates, allowing easier grade assessment and ancillary testings (hormome receptors, HER2) in cases of cancers. FNAC cannot reliably predict invasion in a malignant aspirate, whereas CNB, although useful in confirming invasion in carcinomas, has a much lower efficacy in predicting invasion when only in situ carcinoma is detected. The other problematic areas are papillary breast lesions and fibroepithelial lesions, notably phyllodes tumors. In papillary lesions, FNAC diagnosis is inaccurate, but with CNB, one can confidently diagnose papillary lesion, although there is still significant false positive and false negative rates, even with immunohistochemistry. For fibroepithelial lesions, using either FNAC or CNB to differentiate between a phyllodes tumor from fibroadenoma is also inaccurate. As management of breast diseases necessitates the triple approach (clinical, imaging and pathological), an awareness of the limitations of these very useful diagnostic modalities by all specialists is prudent, especially when dealing with these specific groups of breast lesions. PMID:20526738

  13. Rapid Discrimination of Malignant Breast Lesions from Normal Tissues Utilizing Raman Spectroscopy System: A Systematic Review and Meta-Analysis of In Vitro Studies

    PubMed Central

    Jia, Hongyuan; Wei, Zhigong; Xiao, Yue; Xu, Jing

    2016-01-01

    Purpose The aim of this study is to evaluate the diagnostic accuracy of Raman spectroscopy system in the detection of malignant breast lesions through a systemic review and meta-analysis of published studies. Methods We conducted a comprehensive literature search of PubMed and Embase from 2000 to June 2015. Published studies that evaluated the diagnostic performance of Raman spectroscopy in distinguishing malignant breast lesions from benign lesions and normal tissues were included in our study. The pooled sensitivity, specificity, diagnostic odds ratio, and the area under the curve of summary receiver-operating characteristic curves was derived. A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies guidelines was used to assess the quality of included studies. Results The initial search produced a total of 157 articles after removing duplicates. Nine studies (8 in vitro and 1 in vivo) were eligible in this meta-analysis. We analyzed the eight in vitro studies with 1756 lesions, the pooled sensitivity and specificity of Raman spectroscopy system for the diagnosis of malignant breast lesions were 0.92 (95% CI 0.86–0.96) and 0.97 (97% CI 0.93–0.98), respectively. Diagnostic odds ratio was 266.70 (95% CI 89.38–795.79), and the area under the curve of summary receiver-operating characteristic curves was 0.98 (95% CI 0.97–0.99). Significant heterogeneity was found between studies. There was no evidence of considerable publication bias. Conclusions Raman spectroscopy system is an optical diagnostic technology with great value for detecting malignant breast lesions. At the same time, it has advantages of being non-invasive, real-time, and easy to use. Thus it deserves to be further explored for intra-operatory breast tumor margin detection. PMID:27459193

  14. Evaluation of Ki67, p16 and CK17 Markers in Differentiating Cervical Intraepithelial Neoplasia and Benign Lesions

    PubMed Central

    Sari Aslani, Fatemeh; Safaei, Akbar; Pourjabali, Masoumeh; Momtahan, Mozhdeh

    2013-01-01

    Background: Cervical intraepithelial neoplasia (CIN) is a premalignant lesion capable of progressing to cervical cancer. Despite the existing well-defined criteria, the histomorphologic diagnosis is subject to high rates of discordance among pathologists. The aim of this study was to evaluate Ki-67 (MIB-1), CK17 and p16 INK4a (p16) markers by immunohistochemical methods in differentiating CIN from benign cervical lesions. Methods: The present study reviewed and re-classified 77 cervical biopsies, originally diagnosed as 31 non-CIN, and 46 CIN, as 54 non-CIN, and 23 CIN based on at least two similar diagnoses. Immunostaining by Ki67, p16 and CK17 markers was performed on all cases and the results were compared with pervious and consensus diagnosis. Results: The overall agreement between pervious and consensus diagnosis was 67.5% (Kappa=0.39, P<0.001). The sensitivity and specificity of Ki67 immunostaining were 95.6% and 85.1% respectively, while for p16 the corresponding values were 91.3% and 98.1%. The overall agreement, for both p16 and Ki67, with consensus diagnosis were significant (P<0.001). The sensitivity and specificity of CK17 negative staining in CIN detection were 39.1% and 40.7% respectively. Conclusion: Ki67 and p16 markers are recommended as complementary tests for differentiating between dysplastic and non-dysplastic lesions. CK17 does not discriminate between immature metaplasia with and without dysplasia. PMID:23645953

  15. Knowledge of human papillomavirus and its association with head and neck benign and malignant lesions in a group of dental patients in pakistan.

    PubMed

    Gichki, Abdul Samad; Buajeeb, Waranun; Doungudomdacha, Sombhun; Khovidhunkit, Siribang-On Pibooniyom

    2015-01-01

    Human papillomaviruses (HPVs) remain a serious world health problem due to their association with cervical and head and neck cancers. While over 100 HPV types have been identified, only a few subtypes are associated with malignancies. HPV 16 and 18 are the most prevalent oncogenic types in head and neck cancers. Although it has been proven that some subsets of benign and malignant head and neck lesions are associated with HPV, the general population have very little awareness and knowledge of their association with HPV. Therefore, the purpose of this study was to determine the knowledge of HPV and its links with head and neck benign and malignant lesions in a group of Pakistani dental patients who attended the Dental Department of the Sandeman provincial hospital in Quetta, Pakistan. One hundred and ninety-two patients were recruited and requested to answer a questionnaire. It was revealed that there was a low level of knowledge about HPV and its association with head and neck benign and malignant lesions among the participants. This result suggested that more education regarding the relationship of HPV in inducing head and neck benign and malignant lesions is required in this group of patients. PMID:25743835

  16. A Clinicopathological Study of Benign Phyllodes Tumour of Breast with Emphasis on Unusual Features

    PubMed Central

    Naik, Reena

    2016-01-01

    Introduction Benign Phyllodes Tumours (PTs) are rare fibroepithelial neoplasms that resemble fibroadenoma. But unlike fibroadenoma, benign PT can recur and both stromal & epithelial components can progress to malignancy. Contrary to earlier belief that benign PT is a stromal neoplasm and possibly arises from fibroadenoma, more recent molecular studies have suggested that both stroma and epithelium can become neoplastic. Sometimes, benign PT can occur synchronously with fibroadenoma. Here histomorphologic analysis of eleven cases of benign PT are presented including some unusual features. Materials and Methods Eleven cases of benign PT diagnosed between Dec 2014 and Jan 2016 in the Department of Pathology were studied. The demographic and clinicopathological features were analysed. Results The most common age group affected was 20-30 years (range: 13-45). Clinical features included pain, lump and bleeding from nipple. The tumour size varied from 2.5-18 cm in diameter. H&E stained sections showed secondary changes (haemorrhage, myxoid, change, cystic degeneration), epithelial hyperplasia (8), squamous & columnar metaplasia (1), benign tubular adenoma like areas (1), Ductal Carcinoma In Situ (DCIS) (1), Invasive Ductal Carcinoma (IDC) (1), Pseudoangiomatous Stromal Hyperplasia (PASH) (1), histologic infarction (2), tumour necrosis (1) and synchronous fibroadenoma (1). Unusual histologic features included atypical ductal hyperplasia, DCIS, IDC, synchronous fibroadenoma and tubular adenoma like areas arising within benign PT. Conclusion This study shows a spectrum of hyperplastic, metaplastic, dysplastic, benign, in-situ-malignancy and even invasive ductal malignancy occurring in benign PT. Therefore adequate and extensive sampling is recommended for accurate diagnosis.

  17. High Milk Consumption Does Not Affect Prostate Tumor Progression in Two Mouse Models of Benign and Neoplastic Lesions

    PubMed Central

    Boutillon, Florence; Verkarre, Virginie; Camparo, Philippe; Viltard, Mélanie; Méjean, Arnaud; Oudard, Stéphane; Souberbielle, Jean-Claude; Friedlander, Gérard; Goffin, Vincent

    2015-01-01

    Epidemiological studies that have investigated whether dairy (mainly milk) diets are associated with prostate cancer risk have led to controversial conclusions. In addition, no existing study clearly evaluated the effects of dairy/milk diets on prostate tumor progression, which is clinically highly relevant in view of the millions of men presenting with prostate pathologies worldwide, including benign prostate hyperplasia (BPH) or high-grade prostatic intraepithelial neoplasia (HGPIN). We report here a unique interventional animal study to address this issue. We used two mouse models of fully penetrant genetically-induced prostate tumorigenesis that were investigated at the stages of benign hyperplasia (probasin-Prl mice, Pb-Prl) or pre-cancerous PIN lesions (KIMAP mice). Mice were fed high milk diets (skim or whole) for 15 to 27 weeks of time depending on the kinetics of prostate tumor development in each model. Prostate tumor progression was assessed by tissue histopathology examination, epithelial proliferation, stromal inflammation and fibrosis, tumor invasiveness potency and expression of various tumor markers relevant for each model (c-Fes, Gprc6a, activated Stat5 and p63). Our results show that high milk consumption (either skim or whole) did not promote progression of existing prostate tumors when assessed at early stages of tumorigenesis (hyperplasia and neoplasia). For some parameters, and depending on milk type, milk regimen could even exhibit slight protective effects towards prostate tumor progression by decreasing the expression of tumor-related markers like Ki-67 and Gprc6a. In conclusion, our study suggests that regular milk consumption should not be considered detrimental for patients presenting with early-stage prostate tumors. PMID:25938513

  18. A computer simulation study comparing lesion detection accuracy with digital mammography, breast tomosynthesis, and cone-beam CT breast imaging

    SciTech Connect

    Gong Xing; Glick, Stephen J.; Liu, Bob; Vedula, Aruna A.; Thacker, Samta

    2006-04-15

    Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a three-dimensional (3D) object onto a 2D plane. Recently, two promising approaches for 3D volumetric breast imaging have been proposed, breast tomosynthesis (BT) and CT breast imaging (CTBI). To investigate possible improvements in lesion detection accuracy with either breast tomosynthesis or CT breast imaging as compared to digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through a CsI based flat-panel imager. Polyenergetic x-ray spectra of Mo/Mo 28 kVp for digital mammography, Mo/Rh 28 kVp for BT, and W/Ce 50 kVp for CTBI were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total average glandular dose of 4 mGy, which is approximately equivalent to that given in conventional two-view screening mammography. The same total dose was modeled for both the DM and BT simulations. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum, with the composition of 50% fibroglandular and 50% adipose tissue. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with five observers reading an ensemble of images for each case. The average area under the ROC curves (A{sub z}) was 0.76 for DM, 0.93 for BT, and 0.94 for CTBI. Results indicated that for the same dose, a 5 mm lesion embedded in a structured breast phantom was detected by the two volumetric breast imaging systems, BT and CTBI, with statistically

  19. Patterns of Benign and Malignant Lesions of the Thyroid in Two Wilayahs of Northeastern Algeria

    PubMed Central

    Guidoum, Mona; Kherfi-Kadi, Hind; Benharkat-Boughaba, Ouahiba; Djemaa-Bendjazia, Aicha; Keghouche, Sihem; Abedi-Ardekani, Behnoush; Azzouz, Amina; Kadi, Yacine; Hainaut, Pierre; Bouslama, Zihad

    2015-01-01

    The aim of this study is to compare histological patterns and to estimate the burden of thyroid cancers in the two Wilayahs (departments) of El-Taref and Guelma in northeast of Algeria (total population 0.9 million), locally reputed as having different rates of endemic thyroid diseases and cancer. A retrospective analysis of central pathology registers and clinical records of patients with thyroid diseases, covering the period 2008–2012, was conducted. A total of 145 cases of thyroid cancers with histological confirmation were registered in the two Wilayahs during the period, with a female to male ratio of 5.9 : 1. Estimates of crude incidence rates suggested that thyroid cancers were twice as frequent in the Wilayah of Guelma compared to El-Taref (p < 0.05) with a tendency to occur at a younger age in resident of the Wilayah of El-Taref. Diagnoses of thyroid adenoma were more frequent in the Wilayah of Guelma, whereas the prevalence of other thyroid lesions, including goitre, was similar in the two Wilayahs. This first descriptive study on geographic variations in thyroid cancer in Northern Africa suggests that significant differences may occur in relation with environmental and lifestyle exposures. PMID:26681943

  20. Automated analysis of non-mass-enhancing lesions in breast MRI based on morphological, kinetic, and spatio-temporal moments and joint segmentation-motion compensation technique

    NASA Astrophysics Data System (ADS)

    Hoffmann, Sebastian; Shutler, Jamie D.; Lobbes, Marc; Burgeth, Bernhard; Meyer-Bäse, Anke

    2013-12-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) represents an established method for the detection and diagnosis of breast lesions. While mass-like enhancing lesions can be easily categorized according to the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon, a majority of diagnostically challenging lesions, the so called non-mass-like enhancing lesions, remain both qualitatively as well as quantitatively difficult to analyze. Thus, the evaluation of kinetic and/or morphological characteristics of non-masses represents a challenging task for an automated analysis and is of crucial importance for advancing current computer-aided diagnosis (CAD) systems. Compared to the well-characterized mass-enhancing lesions, non-masses have no well-defined and blurred tumor borders and a kinetic behavior that is not easily generalizable and thus discriminative for malignant and benign non-masses. To overcome these difficulties and pave the way for novel CAD systems for non-masses, we will evaluate several kinetic and morphological descriptors separately and a novel technique, the Zernike velocity moments, to capture the joint spatio-temporal behavior of these lesions, and additionally consider the impact of non-rigid motion compensation on a correct diagnosis.

  1. Breast Lesions: Quantitative Diagnosis Using Ultrasound Shear Wave Elastography-A Systematic Review and Meta-Analysis.

    PubMed

    Liu, Baoxian; Zheng, Yanling; Huang, Guangliang; Lin, Manxia; Shan, Quanyuan; Lu, Ying; Tian, Wenshuo; Xie, Xiaoyan

    2016-04-01

    The aim of this meta-analysis was to estimate the diagnostic performance of shear wave elastography (SWE) in differentiating malignant from benign breast lesions. A literature search of PubMed, Web of Science and Scopus up to November 2014 was conducted. A summary receiver operating characteristic curve was constructed, and pooled weighted estimates of sensitivity and specificity were calculated using a bivariate mixed-effects regression model. Thirty-three studies, which included a total of 5838 lesions (2093 malignant, 3745 benign) from 5397 patients, were finally analyzed. Summary sensitivity and specificity were 0.886 (95% confidence interval [CI], 0.858-0.909) and 0.866 (95% CI, 0.833-0.894), respectively. The pooled diagnostic odds ratio was 50.410 (95% CI, 34.972-72.664). And the area under the receiver operating characteristic curve of SWE was 0.94 (95% CI, 0.91-0.96). No publication bias existed among these studies (p = 0.245). In the subgroup analysis, sensitivity and specificity were 0.862 (95% CI, 0.811-0.901) and 0.875 (95% CI, 0.793-0.928) among 1552 lesions from 1429 patients in the 12 studies using acoustic radiation force impulse imaging and 0.897 (95% CI, 0.863-0.923) and 0.863 (95% CI, 0.831-0.889) among another 4436 lesions from 4097 patients in the 21 studies using supersonic shear imaging. When analysis confined to 9 studies evaluated the diagnostic performance of combination SWE and conventional ultrasound, the area under the curve was 0.96 (95% CI, 0.94-0.97), yielding a sensitivity of 0.971 (95% CI, 0.941-0.986) and specificity of 0.801 (95% CI, 0.733-0.856). SWE seems to be a good quantitative method for differentiating breast lesions, with promise for integration into routine imaging protocols. PMID:26778289

  2. Selected applications of Er:YAG and CO2 lasers for treatment of benign neoplasms and tumorous lesions in the mouth

    PubMed Central

    Andrysiak, Piotr; Sidorowicz, Krzysztof; Witmanowski, Henryk; Hędzelek, Wiesław; Sokalski, Jerzy

    2015-01-01

    Introduction Benign neoplasms and hyperplastic tumorous lesions are common oral pathologies. These lesions require to be surgically removed by conventional surgery, laser, or electrosurgery. Surgical treatment aims at complete removal of pathological lesions and ensuring proper healing of the tissues to minimize the risk of lesion recurrence. Aim To present possible applications of Er:YAG and CO2 lasers in removal of benign neoplasms and tumorous lesions developing on oral mucosa as well as to specify indications and limitations of these two methods. Material and methods Temperature-induced injuries due to laser light application, possibility of post-operative histopathological evaluation of the removed tissue, efficacy of the cut and coagulation, healing process and completeness of laser surgeries give rise to our special concern. Results The main asset of the CO2 laser comparing to Er:YAG laser is an effective coagulation while thermal injury to the tissues is its limitation, especially with multiple passage of the beam and too high power applied. Er:YAG laser application does not exclude histopathological examination of the removed lesion tissue which is its advantage over CO2 laser. Conclusions Still, insufficient coagulation is a limitation ofits use in the case of richly vascularized lesions. PMID:26759541

  3. Management of a Benign Phyllodes Tumor in a 13-Year-Old Girl with Trans-position of the Nipple Areola Complex and Breast Reconstruction.

    PubMed

    Erginel, B; Celet Ozden, B; Yesil Onder, S; Yuksel, S; Gun Soysal, F; Celik, A; Salman, T

    2015-01-01

    Phyllodes tumor is a rare primary tumor of the breast. In children and adolescents, it is even rarer with only 20 cases, treatment of which vary in the literature. Herein we report the case of a 13-year-old female patient with a giant benign phyllodes tumor eroding the bottom of the breast skin and causing nipple retraction. We performed breast conservative surgery by mobilizing the areola, using skin flaps and inserting an implant. Breast malignancy, including phyllodes tumor (PT), is very rare in adolescents. PT, previously called cystosarcoma phylloides, consists of leaf-like fronds, from which the tumor gets its name (1, 2). Although PT is most often seen in the fourth decade of life, almost 20 cases have been reported in the adolescent period, most of which are benign. The histologic types are benign, borderline, and malignant, depending on the mitotic rate of the tumor (3, 4). PMID:26158262

  4. The network of antigen-antibody reactions in adult women with breast cancer or benign breast pathology or without breast pathology.

    PubMed

    Romo-González, Tania; Esquivel-Velázquez, Marcela; Ostoa-Saloma, Pedro; Lara, Carlos; Zentella, Alejandro; León-Díaz, Rosalba; Lamoyi, Edmundo; Larralde, Carlos

    2015-01-01

    The Immunoglobulin G (IgG) antibody response to different protein antigens of the mammary ductal carcinoma by adult women affected by Breast Cancer (BC) distinguishes at least 103 proteins that differ in their molecular weights (MW). The IgG producing cell clones (nodes) coexist with each other in each individual organism and share energy resources among themselves, as well as factors that control the level of expression and Specificity of their IgG antibodies. So, it can be proposed that among them there is a Network of interconnections (links) unveiled by the antigens, which specifically react with the IgG antibodies produced by the clones. This Network possibly regulates IgG antibodies' activity and effectiveness. We describe the Network of nodes and links that exists between the different antigens and their respective IgG producing cell clones against the extracted protein antigens from the cells of the T47D Cell-Line, in 50 women with BC, 50 women with Benign Breast Pathology (BBP) and 50 women without breast pathology (H). We have found that women with BBP have the highest number of Links, followed by the H group and, lastly, the women with BC, a finding which suggests that cancer interferes with the Connectivity between the IgG producing cell clones and blocks the expression of 322 links in women with BBP and 32 links in women with H. It is also plausible that the largest number of links in the women with BBP indicates the Network's state of arousal that provides protection against BC. On the other hand, there were many missing links in the BC group of women; the clone which lost more links in the BC group was the hub 24, which point to some of the antigens of T47D as potentially useful as vaccines, as the immune system of women with BBP is well aware of them. PMID:25781932

  5. The Network of Antigen-Antibody Reactions in Adult Women with Breast Cancer or Benign Breast Pathology or without Breast Pathology

    PubMed Central

    Romo-González, Tania; Esquivel-Velázquez, Marcela; Ostoa-Saloma, Pedro; Lara, Carlos; Zentella, Alejandro; León-Díaz, Rosalba; Lamoyi, Edmundo; Larralde, Carlos

    2015-01-01

    The Immunoglobulin G (IgG) antibody response to different protein antigens of the mammary ductal carcinoma by adult women affected by Breast Cancer (BC) distinguishes at least 103 proteins that differ in their molecular weights (MW). The IgG producing cell clones (nodes) coexist with each other in each individual organism and share energy resources among themselves, as well as factors that control the level of expression and Specificity of their IgG antibodies. So, it can be proposed that among them there is a Network of interconnections (links) unveiled by the antigens, which specifically react with the IgG antibodies produced by the clones. This Network possibly regulates IgG antibodies' activity and effectiveness. We describe the Network of nodes and links that exists between the different antigens and their respective IgG producing cell clones against the extracted protein antigens from the cells of the T47D Cell-Line, in 50 women with BC, 50 women with Benign Breast Pathology (BBP) and 50 women without breast pathology (H). We have found that women with BBP have the highest number of Links, followed by the H group and, lastly, the women with BC, a finding which suggests that cancer interferes with the Connectivity between the IgG producing cell clones and blocks the expression of 322 links in women with BBP and 32 links in women with H. It is also plausible that the largest number of links in the women with BBP indicates the Network’s state of arousal that provides protection against BC. On the other hand, there were many missing links in the BC group of women; the clone which lost more links in the BC group was the hub 24, which point to some of the antigens of T47D as potentially useful as vaccines, as the immune system of women with BBP is well aware of them. PMID:25781932

  6. Mapping transitions between healthy and pathological lesions in human breast tissues by diffraction enhanced imaging computed tomography (DEI-CT) and small angle x-ray scattering (SAXS)

    NASA Astrophysics Data System (ADS)

    Conceição, A. L. C.; Antoniassi, M.; Geraldelli, W.; Poletti, M. E.

    2014-02-01

    In this work we have combined the DEI-CT and SAXS technique to study the transition between healthy and pathological breast tissues, which include benign and malignant lesions. The ability of DEI-CT to enhance the contrast between soft tissues was used to localize the tumor region in the sample. Then, the tumor region and its surroundings were scanned by SAXS in order to map the changes promoted by the neoplasias at nano-level.It was clearly observed that pathological tissues present distinguishable SAXS scattering profiles from those of normal tissue. These differences are mainly related to changes in arrangement and diameter of collagen fibrils, evaluated by the higher order of reflection peaks of these fibrils. Differences related to the peak intensities and the total scattered intensity were found by comparing the healthy and pathological regions. The 2nd order of collagen reflection arises only in the healthy region neighboring the benign lesion. A broader peak at q=0.16 nm-1 seems to characterize the malignant lesions. Finally, based on this information, the transition between healthy and pathological human breast tissues was mapped which allowed to get insights into the changes promoted by tumors during growth and progression.

  7. Platelet sensitivity to prostacyclin in normal subjects, and in patients with benign and malignant tumours of the breast.

    PubMed Central

    Benedetto, C.; Zonca, M.; Tavella, A. M.; Petitti, E.; Massobrio, M.; Nigam, S.; Slater, T. F.

    1985-01-01

    Platelet sensitivity to prostacyclin (PG12) was determined in normal male and female subjects, and in patients with benign and malignant tumours of the breast. The IC50 overall mean values for PG12 on ADP-induced platelet aggregation were similar for normal men and women, being 0.97 +/- 0.05 ng ml-1 and 0.83 +/- 0.07 ng ml-1 respectively. However, there were significant differences in the IC50 values for women in the 1st (0.81 +/- 0.06 ng ml-1) vs. 2nd (1.37 +/- 0.13 ng ml-1) phase of the menstrual cycle; post-menopausal women gave similar values to normal males and to pre-menopausal women in the 1st phase of the cycle. No significant differences were found between normal subjects and patients with benign or malignant tumours of the breast when account was taken of the status of the patient in relation to the phase of the menstrual cycle and the menopause. The importance of the hormonal status in evaluating changes in platelet sensitivity in patients with breast cancer is strongly emphasised. PMID:3881119

  8. A Randomized Pilot Study of Inositol in Association with Betaine and Boswellia in the Management of Mastalgia and Benign Breast Lump in Premenopausal Women.

    PubMed

    Pasta, Vittorio; Dinicola, Simona; Giuliani, Alessandro; Harrath, Abdel Halim; Alwasel, Saleh H; Tartaglia, Francesco; Cucina, Alessandra; Bizzarri, Mariano

    2016-01-01

    Benign mammary lumps and mastalgia are the most common breast disorders; yet, there is no clear-cut consensus about the best strategy for their treatment. We hypothesized that a combination, including boswellic acid, betaine, and myoinositol, would be beneficial in breast disorders by exerting a pleiotropic effect on multiple pathways. Indeed, myoinositol has already been proven to modulate some factors involved in the genesis of breast diseases, such as fibrosis and metabolic and endocrine cues. In our study, 76 women were randomly assigned to either the experimental or the placebo arm. After six months of treatment, statistically significant differences between the two groups were recorded for pain relief (56% vs 17%) and breast density reduction (60% vs 9%). Furthermore, benign breast mass dimension showed a reduction in the experimental group (40% vs 16%). The combination of boswellic acid, betaine, and myoinositol has been demonstrated to be effective in the treatment of breast pain and radiologically and histologically confirmed benign breast mass and in the reduction of breast density, one of the pivotal risk factors for the development of breast cancer, without any side effects. PMID:27127407

  9. A Randomized Pilot Study of Inositol in Association with Betaine and Boswellia in the Management of Mastalgia and Benign Breast Lump in Premenopausal Women

    PubMed Central

    Pasta, Vittorio; Dinicola, Simona; Giuliani, Alessandro; Harrath, Abdel Halim; Alwasel, Saleh H.; Tartaglia, Francesco; Cucina, Alessandra; Bizzarri, Mariano

    2016-01-01

    Benign mammary lumps and mastalgia are the most common breast disorders; yet, there is no clear-cut consensus about the best strategy for their treatment. We hypothesized that a combination, including boswellic acid, betaine, and myoinositol, would be beneficial in breast disorders by exerting a pleiotropic effect on multiple pathways. Indeed, myoinositol has already been proven to modulate some factors involved in the genesis of breast diseases, such as fibrosis and metabolic and endocrine cues. In our study, 76 women were randomly assigned to either the experimental or the placebo arm. After six months of treatment, statistically significant differences between the two groups were recorded for pain relief (56% vs 17%) and breast density reduction (60% vs 9%). Furthermore, benign breast mass dimension showed a reduction in the experimental group (40% vs 16%). The combination of boswellic acid, betaine, and myoinositol has been demonstrated to be effective in the treatment of breast pain and radiologically and histologically confirmed benign breast mass and in the reduction of breast density, one of the pivotal risk factors for the development of breast cancer, without any side effects. PMID:27127407

  10. Three-dimensional finite element model for lesion correspondence in breast imaging

    NASA Astrophysics Data System (ADS)

    Qiu, Yan; Li, Lihua; Goldgof, Dmitry; Sarkar, Sudeep; Anton, Sorin; Clark, Robert A.

    2004-05-01

    Predicting breast tissue deformation is of great significance in several medical applications such as biopsy, diagnosis, and surgery. In breast surgery, surgeons are often concerned with a specific portion of the breast, e.g., tumor, which must be located accurately beforehand. Also clinically it is important for combining the information provided by images from several modalities or at different times, for the detection/diagnosis, treatment planning and guidance of interventions. Multi-modality imaging of the breast obtained by X-ray mammography, MRI is thought to be best achieved through some form of data fusion technique. However, images taken by these various techniques are often obtained under entirely different tissue configurations, compression, orientation or body position. In these cases some form of spatial transformation of image data from one geometry to another is required such that the tissues are represented in an equivalent configuration. We propose to use a 3D finite element model for lesion correspondence in breast imaging. The novelty of the approach lies in the following facts: (1) Finite element is the most accurate technique for modeling deformable objects such as breast. The physical soundness and mathematical rigor of finite element method ensure the accuracy and reliability of breast modeling that is essential for lesion correspondence. (2) When both MR and mammographic images are available, a subject-specific 3D breast model will be built from MRIs. If only mammography is available, a generic breast model will be used for two-view mammography reading. (3) Incremental contact simulation of breast compression allows accurate capture of breast deformation and ensures the quality of lesion correspondence. (4) Balance between efficiency and accuracy is achieved through adaptive meshing. We have done intensive research based on phantom and patient data.

  11. Automated lesion detection in dynamic contrast enhanced magnetic resonance imaging of breast

    NASA Astrophysics Data System (ADS)

    Liang, Xi; Kotagiri, Romamohanarao; Frazer, Helen; Yang, Qing

    2015-03-01

    We propose an automated method in detecting lesions to assist radiologists in interpreting dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) of breast. The aim is to highlight the suspicious regions of interest to reduce the searching time of the lesions and the possibility of radiologists overlooking small regions. In our method, we locate the suspicious regions by applying a threshold on essential features. The features are normalized to reduce the variation between patients. Support vector machine classifier is then applied to exclude normal tissues from these regions, using both kinetic and morphological features extracted in the lesions. In the evaluation of the system on 21 patients with 50 lesions, all lesions were successfully detected with 5.02 false positive regions per breast.

  12. Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China

    PubMed Central

    Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

    2015-01-01

    There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps. PMID:26343700

  13. Evaluation of Tissue Sampling Methods Used for MRI-Detected Contralateral Breast Lesions in the American College of Radiology Imaging Network 6667 Trial

    PubMed Central

    DeMartini, Wendy B.; Hanna, Lucy; Gatsonis, Constantine; Mahoney, Mary C.; Lehman, Constance D.

    2013-01-01

    OBJECTIVE The purpose of our study was to evaluate tissue sampling methods used for MRI-detected suspicious contralateral breast lesions in the American College of Radiology Imaging Network (ACRIN) 6667 trial. MATERIALS AND METHODS Breast MRI was performed at 25 institutions in 969 women who had a recent diagnosis of unilateral breast cancer and negative contralateral mammography and clinical breast examinations. Biopsy was recommended for MRI findings in 135 women, and 121 underwent sampling. Frequencies and positive biopsy rates of sampling methods used for initial diagnosis and imaging guidance techniques were calculated and compared. RESULTS Sampling yielded 30 malignant and 91 benign results. Initial sampling used needle biopsy in 88 of 121 (72.7%) and surgical biopsy in 30 of 121 (24.8%) women. Surgical biopsy was excisional biopsy in 28 of 30 (93.3%) and mastectomy in two of 30 (6.7%). The remaining three of 121 (2.5%) women underwent mastectomy, but it was not documented whether this represented initial tissue sampling. Of imaging-guided procedures, 56 of 106 (52.8%) used MRI; 49 of 106 (46.2%), ultrasound; and one of 106 (1.0%), stereotaxis. MRI-guided sampling was with needle biopsy rather than wire-localized surgical biopsy in 33 of 56 (58.9%) women, whereas ultrasound used needle biopsy in 47 of 49 (95.9%). Positive biopsy rates of sampling methods were 20.5% for needle biopsy, 46.2% for excisional biopsy, and 0% for mastectomy. CONCLUSION The majority of initial biopsies for MRI-detected contralateral breast lesions used needle biopsy rather than surgical biopsy. Contralateral surgery could have been avoided in most cases had needle biopsy been performed because most excisional biopsy and all mastectomy results were benign. MRI-guided biopsy was significantly more likely than ultrasound-guided sampling to use wire-localized surgical biopsy rather than needle biopsy. PMID:22915431

  14. Clinical Characteristics of Breast Cancers in African-American Women with Benign Breast Disease: A Comparison to the Surveillance, Epidemiology, and End Results Program

    PubMed Central

    Mitro, Susanna D.; Ali-Fehmi, Rouba; Bandyopadhyay, Sudeshna; Alosh, Baraa; Albashiti, Bassam; Radisky, Derek C.; Frost, Marlene H.; Degnim, Amy C.; Ruterbusch, Julie J.; Cote, Michele L.

    2014-01-01

    Benign breast disease (BBD) is a very common condition, diagnosed in approximately half of all American women throughout their lifecourse. White women with BBD are known to be at substantially increased risk of subsequent breast cancer; however, nothing is known about breast cancer characteristics that develop after a BBD diagnosis in African-American women. Here, we compared 109 breast cancers that developed in a population of African-American women with a history of BBD to 10,601 breast cancers that developed in a general population of African-American women whose cancers were recorded by the Metropolitan Detroit Cancer Surveillance System (MDCSS population). Demographic and clinical characteristics of the BBD population were compared to the MDCSS population, using chi-squared tests, Fisher's exact tests, t-tests, and Wilcoxon tests where appropriate. Kaplan–Meier curves and Cox regression models were used to examine survival. Women in the BBD population were diagnosed with lower grade (p = 0.02), earlier stage cancers (p = 0.003) that were more likely to be hormone receptor-positive (p = 0.03) compared to the general metropolitan Detroit African-American population. In situ cancers were more common among women in the BBD cohort (36.7%) compared to the MDCSS population (22.1%, p < 0.001). Overall, women in the BBD population were less likely to die from breast cancer after 10 years of follow-up (p = 0.05), but this association was not seen when analyses were limited to invasive breast cancers. These results suggest that breast cancers occurring after a BBD diagnosis may have more favorable clinical parameters, but the majority of cancers are still invasive, with survival rates similar to the general African-American population. PMID:25200244

  15. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy.

    PubMed

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-06-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled on the basis of the breast tissue components, and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma, and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity, and specificity of 100%, 95.6%, 62.5%, and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, fibroadenoma, or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study shows the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing nondiagnostic and false-negative biopsies. PMID:23729641

  16. Surgical treatment of breast lesions at a Day Centre: Experience of the European Institute of Oncology.

    PubMed

    Ballardini, Bettina; Cavalli, Marta; Manfredi, Giovanni Francesco; Sangalli, Claudia; Galimberti, Viviana; Intra, Mattia; Rossi, Elisabetta Maria Cristina; Seco, Javiera; Campanelli, Giampiero; Veronesi, Paolo

    2016-06-01

    Breast cancer is the commonest malignancy in women worldwide. The reduced aggressiveness of breast cancer surgery has made it possible treat patients in the day surgery setting. The European Institute of Oncology, Milan, opened its new Day Center in May 2010. From May 2010 to December 2014, 17,087 patients with breast conditions were treated by the Institute's Division of Senology, 4132 (24.2%) of these in the day surgery setting, including malignant and benign conditions; 204 (4.9%) were not discharged on the day of surgery, being converted to inpatients; five (0.1%) patients returned to hospital for persistent hematoma. Our experience of performing breast cancer surgery in the day surgery setting is in line that of the literature. It is safe, but requires a well-organized unit and multidisciplinary medical team to function smoothly, with much attention paid to patient comfort and education, so as to ensure maximum patient acceptance and satisfaction. PMID:27123957

  17. MR-guided fine needle aspiration of breast lesions: Initial experience

    SciTech Connect

    Wald, D.S.; Weinreb, J.C.; Newstead, G.; Flyer, M.; Bose, S.

    1996-01-01

    Fine needle aspiration (FNA) is a minimally invasive procedure that is used to obtain cytologic specimens of suspicious lesions in the breast. The goal of this study was to evaluate the logistics and limitations of MR-guided FNA using a prototype breast localization coil. MR-guided FNAs were attempted on 18 lesions (detected on mammography and/or palpation) in 16 patients. Patients were prone with their compressed mediolaterally between two plates in a circularly polarized RF coil. Lesion position was determined by reference to fiducial makers that corresponded to a grid of holes placed at 5 mm intervals in compression plate. FNA was performed with a 22G non-ferromagnetic needle. FNA was successful for 11 of 18 lesions (61%). Of the seven unsuccessful cases, there were four in which the lesions were too posteriorly placed to be accessed through the compression plate by the needle. Three cases were too anteriorly placed to be effectively immobilized and, although successfully localized, were insufficiently sampled by the FNA technique. MR-guided FNA is possible using a prototype breast localization device in a select group of patients. Current coil design limits its use in performing MR-guided FNA on the most anteriorly and posteriorly placed breast lesions. Unique requirements of FNA under MR guidance as compared to needle localization and biopsy have been identified. Modifications in localization hardware and cytology aspiration needles should overcome these restrictions. 15 refs., 3 figs.

  18. Expression of gelatinase B and the extracellular matrix metalloproteinase inducer EMMPRIN in benign and malignant pigment cell lesions of the skin.

    PubMed Central

    van den Oord, J. J.; Paemen, L.; Opdenakker, G.; de Wolf-Peeters, C.

    1997-01-01

    By the degradative effect on basement membrane collagen type IV, matrix metalloproteinases (MMPs) or gelatinases are important in the early invasion of malignant tumors. These enzymes may be released by the tumor cells themselves or may be derived from nearby fibroblasts that have been stimulated by the extracellular MMP inducer EMMPRIN. We studied the distribution of 92-kd gelatinase B (MMP-9) and of EMMPRIN in 33 benign and 41 malignant, paraffin-embedded pigment cell lesions using immunohistochemistry and monoclonal antibodies. In benign pigment cell lesions, EMMPRIN but not gelatinase B was expressed in cellular blue nevi whereas all other benign lesions, including common blue nevi, were negative. In malignant melanomas (MMs), both gelatinase B and EMMPRIN were variably expressed in the pure and invasive radial growth phase but not in the vertical growth phase. All lentigo maligna cases and all metastatic lesions were negative. Of MMs with thickness < 1.6 mm, 63% expressed gelatinase B and 70% expressed EMMPRIN, whereas in MMs with > 1.6 mm thickness, only 10% expressed gelatinase B and only 25% expressed EMMPRIN. We conclude that early invasion of MM is associated with de novo expression of gelatinase B and EMMPRIN by neoplastic melanocytes. Expression of EMMPRIN and MMP-9 may be partly responsible for the stromal changes observed in thin MM. Their absence in the vertical growth phase and in metastatic lesions suggests that other factors are involved in tissue degradation during later stages of tumor progression in MM. The lack of both gelatinase B and EMMPRIN in lentigo maligna may contribute to the indolent behavior of this type of pigment cell lesion. Images Figure 1 PMID:9284814

  19. Improved characterization of molecular phenotypes in breast lesions using 18F-FDG PET image homogeneity

    NASA Astrophysics Data System (ADS)

    Cao, Kunlin; Bhagalia, Roshni; Sood, Anup; Brogi, Edi; Mellinghoff, Ingo K.; Larson, Steven M.

    2015-03-01

    Positron emission tomography (PET) using uorodeoxyglucose (18F-FDG) is commonly used in the assessment of breast lesions by computing voxel-wise standardized uptake value (SUV) maps. Simple metrics derived from ensemble properties of SUVs within each identified breast lesion are routinely used for disease diagnosis. The maximum SUV within the lesion (SUVmax) is the most popular of these metrics. However these simple metrics are known to be error-prone and are susceptible to image noise. Finding reliable SUV map-based features that correlate to established molecular phenotypes of breast cancer (viz. estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) expression) will enable non-invasive disease management. This study investigated 36 SUV features based on first and second order statistics, local histograms and texture of segmented lesions to predict ER and PR expression in 51 breast cancer patients. True ER and PR expression was obtained via immunohistochemistry (IHC) of tissue samples from each lesion. A supervised learning, adaptive boosting-support vector machine (AdaBoost-SVM), framework was used to select a subset of features to classify breast lesions into distinct phenotypes. Performance of the trained multi-feature classifier was compared against the baseline single-feature SUVmax classifier using receiver operating characteristic (ROC) curves. Results show that texture features encoding local lesion homogeneity extracted from gray-level co-occurrence matrices are the strongest discriminator of lesion ER expression. In particular, classifiers including these features increased prediction accuracy from 0.75 (baseline) to 0.82 and the area under the ROC curve from 0.64 (baseline) to 0.75.

  20. Analysis of breast CT lesions using computer-aided diagnosis: an application of neural networks on extracted morphologic and texture features

    NASA Astrophysics Data System (ADS)

    Ray, Shonket; Prionas, Nicolas D.; Lindfors, Karen K.; Boone, John M.

    2012-03-01

    Dedicated cone-beam breast CT (bCT) scanners have been developed as a potential alternative imaging modality to conventional X-ray mammography in breast cancer diagnosis. As with other modalities, quantitative imaging (QI) analysis can potentially be utilized as a tool to extract useful numeric information concerning diagnosed lesions from high quality 3D tomographic data sets. In this work, preliminary QI analysis was done by designing and implementing a computer-aided diagnosis (CADx) system consisting of image preprocessing, object(s) of interest (i.e. masses, microcalcifications) segmentation, structural analysis of the segmented object(s), and finally classification into benign or malignant disease. Image sets were acquired from bCT patient scans with diagnosed lesions. Iterative watershed segmentation (IWS), a hybridization of the watershed method using observer-set markers and a gradient vector flow (GVF) approach, was used as the lesion segmentation method in 3D. Eight morphologic parameters and six texture features based on gray level co-occurrence matrix (GLCM) calculations were obtained per segmented lesion and combined into multi-dimensional feature input data vectors. Artificial neural network (ANN) classifiers were used by performing cross validation and network parameter optimization to maximize area under the curve (AUC) values of the resulting receiver-operating characteristic (ROC) curves. Within these ANNs, biopsy-proven diagnoses of malignant and benign lesions were recorded as target data while the feature vectors were saved as raw input data. With the image data separated into post-contrast (n = 55) and pre-contrast sets (n = 39), a maximum AUC of 0.70 +/- 0.02 and 0.80 +/- 0.02 were achieved, respectively, for each data set after ANN application.

  1. Advances in Optical Spectroscopy and Imaging of Breast Lesions

    SciTech Connect

    Demos, S; Vogel, A J; Gandjbakhche, A H

    2006-01-03

    A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and monitoring of treatment.

  2. For “difficult” benign colorectal lesions referred to surgical resection a second opinion by an experienced endoscopist is mandatory: A single centre experience

    PubMed Central

    Luigiano, Carmelo; Iabichino, Giuseppe; Pagano, Nico; Eusebi, Leonardo Henry; Miraglia, Stefania; Judica, Antonino; Alibrandi, Angela; Virgilio, Clara

    2015-01-01

    AIM: To assess how many patients with benign “difficult” colorectal lesions (DCRLs) referred to surgical resection, may be treated with endoscopic resection (ER) rather than surgical resection. METHODS: The prospectively collected colonoscopy database of our Endoscopic Unit was reviewed to identify all consecutive patients who, between July 2011 and August 2013, underwent an endoscopic re-evaluation before surgical resection due to the presence of DCRLs with a histological confirmation of benignancy on forceps biopsy. ER was attempted when the lesion did not have definite features of deeply invasive cancer. The “nonlifting sign” excluded ER only in naive lesions without a prior attempted resection. Lesions were classified, using the Kyoto-Paris classification for mucosal neoplasia. For sessile and non-polypoid lesions the “inject and cut” resection technique was used. Pedunculated and semi-pedunculated lesions were transected at the stalk just below the polyps head and before or after resection, metal clips or a loop were applied on the stalk to prevent bleeding. The lesions were histologically classified according to the Vienna criteria and for the pedunculated lesions the Haggitt classification was used. RESULTS: Eighty-two patients (42 females, mean age 62 years) with 82 lesions (mean size 37 mm) were included in the study. Sixty-nine (84%) lesions were endoscopically resected, while 13 underwent surgical resection since ER was deemed unsuitable. On histology, cancer was found in 21/69 lesions (14 intra-mucosal, 7 sub-mucosal) and was associated with the size (P < 0.001) and with type 0-IIa +Is (P = 0.011) and 0-IIa + IIc (P < 0.001) lesions. All patients with sub-mucosal cancer, underwent surgical resection. Complications occurred in 11/69 patients (7 bleedings, 2 transmural burn syndromes, 2 perforations), all managed endoscopically or conservatively, and were associated with presence of invasive cancer (P = 0.021). During follow-up recurrence

  3. [Clarification of breast lesions using core-cut, drill and fine needle biopsy].

    PubMed

    Junkermann, H; Anton, H W; Krapfl, E; Harcos, A; von Fournier, D

    1993-05-01

    Interest in needle biopsy methods (core cut-, drill-, and fine-needle biopsy) has recently increased considerably because of the rise in screening mammography and new developments in the therapy of breast cancer. In order to achieve adequate results using needle biopsy and to avoid complications, certain technical details must be strictly adhered to. An experienced surgeon can achieve a sensitivity of above 90% in the diagnosis of breast carcinoma with all three methods. Considering the advantages and disadvantages of these three methods of needle biopsy, we prefer--based on our own experience--high-speed core-cut biopsy for the morphological evaluation of breast lesions. PMID:8516437

  4. Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors

    PubMed Central

    Bogorad, Roman L.; Courtillot, Carine; Mestayer, Chidi; Bernichtein, Sophie; Harutyunyan, Lilya; Jomain, Jean-Baptiste; Bachelot, Anne; Kuttenn, Frédérique; Kelly, Paul A.; Goffin, Vincent; Touraine, Philippe

    2008-01-01

    There is currently no known genetic disease linked to prolactin (Prl) or its receptor (PrlR) in humans. Given the essential role of this hormonal system in breast physiology, we reasoned that genetic anomalies of Prl/PrlR genes may be related to the occurrence of breast diseases with high proliferative potential. Multiple fibroadenomas (MFA) are benign breast tumors which appear most frequently in young women, including at puberty, when Prl has well-recognized proliferative actions on the breast. In a prospective study involving 74 MFA patients and 170 control subjects, we identified four patients harboring a heterozygous single nucleotide polymorphism in exon 6 of the PrlR gene, encoding Ile146→Leu substitution in its extracellular domain. This sole substitution was sufficient to confer constitutive activity to the receptor variant (PrlRI146L), as assessed in three reconstituted cell models (Ba/F3, HEK293 and MCF-7 cells) by Prl-independent (i) PrlR tyrosine phosphorylation, (ii) activation of signal transducer and activator of transcription 5 (STAT5) signaling, (iii) transcriptional activity toward a Prl-responsive reporter gene, and (iv) cell proliferation and protection from cell death. Constitutive activity of PrlRI146L in the breast sample from a patient was supported by increased STAT5 signaling. This is a unique description of a functional mutation of the PrlR associated with a human disease. Hallmarks of constitutive activity were all reversed by a specific PrlR antagonist, which opens potential therapeutic approaches for MFA, or any other disease that could be associated with this mutation in future. PMID:18779591

  5. Characteristics, Malignancy Rate, and Follow-up of BI-RADS Category 3 Lesions Identified at Breast MR Imaging: Implications for MR Image Interpretation and Management.

    PubMed

    Chikarmane, Sona A; Birdwell, Robyn L; Poole, Patricia S; Sippo, Dorothy A; Giess, Catherine S

    2016-09-01

    Purpose To (a) evaluate the frequency of Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment in screening and diagnostic breast magnetic resonance (MR) imaging, (b) review findings considered indicative of BI-RADS category 3, and (c) determine outcomes of BI-RADS category 3 lesions, including upgrades, downgrades, and malignancy rates. Materials and Methods This retrospective study was approved by the institutional review board and compliant with HIPAA. The authors retrospectively reviewed the breast MR imaging database (2009-2011) to identify breast MR images classified as showing BI-RADS category 3 lesions. There were 9216 BI-RADS assessments in 5778 examinations (3360 women). Of the 9216 assessments, 567 (6%) in 483 women (average age, 47.2 years; median age, 47.0 years) were assigned BI-RADS category 3. In women with more than one BI-RADS category 3 lesion, the first lesion reported in the impression was used for data analysis. Outcomes data were available for 435 of the 483 women (90.1%). These women comprised the study cohort. Medical records from January 1, 2009, to May 31, 2015, were reviewed to obtain demographic characteristics and outcomes. χ(2) statistics and 95% exact confidence intervals (CIs) were constructed. Results MR imaging was performed for high-risk screening in 240 of the 435 patients (55.2%) and for diagnostic purposes in 195 (44.8%). Findings included mass (n = 125, 28.7%), focus (n = 111, 25.5%), nonmass enhancement (n = 80, 18.3%), moderate or marked background parenchymal enhancement (BPE) (n = 91, 20.9%), posttreatment changes (n = 16, 3.8%), and other findings (n = 12, 2.8%). Outcomes were as follows: 339 of the 435 patients (78%) did not have evidence of malignancy at more than 24 months, 28 (6.4%) underwent mastectomy (all benign), and 68 (15.6%) had lesion upgrades, with 11 cancers (2.5%). All 11 cancers were diagnosed in women with a genetic mutation or a personal history of breast cancer. No cancer was

  6. Concentration Study of High Sensitive C - reactive Protein and some Serum Trace Elements in Patients with Benign and Malignant Breast Tumor

    PubMed Central

    Abdollahi, Alireza; Ali-Bakhshi, Abbas; Farahani, Zahra

    2015-01-01

    Background : Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide including both males and females are from breast cancer. In this study we compared few serum elements in patients with benign and malignant breast tumor to find any related prognostic and predictive value. Subjects and Methods: A case-control study was carried out in a hospital (Tehran - Iran) in 2012. Target population was divided in 2 groups; subjects with benign and malignant breast tumors. We did preoperative hematological test. Five milliliter fasting blood vein was collected, centrifuged in 3000 g for 15 minutes to obtain serum. We measured serum Calcium (Ca), Phosphorus (P), Magnesium (Mg), Zinc (Zn), and high sensitive-CRP, analyzed statistically and compared recorded elements in 2 groups by software package SPSS version 16. The level of significant was considered P < 0.05. Results: Of 87 women, 49 cases with benign breast disease (group A) and 38 cases with breast cancer (group B) entered our study. Serum concentration of Ca, mg, and P in group A were higher than group B, however these differences were not significant. We found no significant correlation between serum Zn and type of tumor in our patients. On the other hand, a significant elevation in hs-CRP in patient with breast cancer was seen (P Value=.000). Conclusion : Our results have shown similar concentration of Ca, Mg, Zn, P and completely different hs-CRP concentration in patients with benign and malignant breast disease. PMID:26865928

  7. The role of the diffusion sequence in magnetic resonance imaging for the differential diagnosis between hepatocellular carcinoma and benign liver lesions

    PubMed Central

    CARAIANI, COSMIN-NICOLAE; MARIAN, DAN; MILITARU, CLAUDIA; CALIN, ADRIANA; BADEA, RADU

    2016-01-01

    Background and aim To assess the role of diffusion weighted imaging sequence (DWI), routinely used in hepatic magnetic resonance imaging (MRI) for the differentiation of hepatocellular carcinoma (HCC) from benign liver lesions. Methods A number of 56 liver MRI examinations were retrospectively analyzed independently by two experienced radiologists, blinded to each other results. A total number of 70 Focal Liver Lesions (FLLs) assessed by liver MRI in 56 patients were included in the present study. All lesions were retrospectively analyzed by two experienced radiologists, independently from each other and who were not aware of the previous results given by using different imaging techniques. All included FLLs had a final histological diagnosis, or the final diagnosis was based on consensus reading by two experienced radiologists. The signal of the included FLLs was qualitatively appreciated on the b-800 sequences and on the apparent diffusion coefficient (ADC) map. The ADC value of each FLL was measured and the ADC ratio between the ADC value of the assessed FLL and that of the surrounding liver parenchyma was calculated. Results The mean ADC value for benign FLLs as assessed by the two independent readers was 1.75 × 10−3 and 1.72 × 10−3. The mean ADC value for HCC nodules was 0.92 × 10−3 for the first reader and 0.91 × 10−3 for the second reader respectively. The mean ADC ratio for benign FLLs was 1.81 and 1.84 for the two readers, respectively. The ADC ratio for HCC nodules was 0.91 and 0.91, respectively. The ADC value is an indicator which is less prone to interobserver variability (correlation of 0.919→1). The ADC ratio has, as the analysis of the ROC curve shows, the best predictive value for differentiation between benign FLLs and HCC nodules. Analysis of the signal intensity on the DWI b-800 image alone is of no significance in differentiating benign FLLs from HCC nodules (p>0.005). Conclusions The ADC value and the ADC ratio assessed on liver

  8. Simulated lesion, human observer performance comparison between thin-section dedicated breast CT images versus computed thick-section simulated projection images of the breast

    PubMed Central

    Chen, L; Boone, JM; Abbey, CK; Hargreaves, J; Bateni, C; Lindfors, KK; Yang, K; Nosratieh, A; Hernandez, A; Gazi, P

    2015-01-01

    Objectives The objective of this study was to compare the lesion detection performance of human observers between thin-section computed tomography images of the breast, with thick-section (>40 mm) simulated projection images of the breast. Methods Three radiologists and six physicists each executed a two alterative force choice (2AFC) study involving simulated spherical lesions placed mathematically into breast images produced on a prototype dedicated breast CT scanner. The breast image data sets from 88 patients were used to create 352 pairs of image data. Spherical lesions with diameters of 1, 2, 3, 5, and 11 mm were simulated and adaptively positioned into 3D breast CT image data sets; the native thin section (0.33 mm) images were averaged to produce images with different slice thicknesses; average section thicknesses of 0.33 mm, 0.71 mm, 1.5 mm, and 2.9 mm were representative of breast CT; the average 43 mm slice thickness served to simulate simulated projection images of the breast. Results The percent correct of the human observer’s responses were evaluated in the 2AFC experiments. Radiologists lesion detection performance was significantly (p<0.05) better in the case of thin-section images, compared to thick section images similar to mammography, for all but the 1 mm lesion diameter lesions. For example, the average of three radiologist’s performance for 3 mm diameter lesions was 92 % correct for thin section breast CT images while it was 67 % for the simulated projection images. A gradual reduction in observer performance was observed as the section thickness increased beyond about 1 mm. While a performance difference based on breast density was seen in both breast CT and the projection image results, the average radiologist performance using breast CT images in dense breasts outperformed the performance using simulated projection images in fatty breasts for all lesion diameters except 11 mm. The average radiologist performance outperformed that of the

  9. Present state of and problems with core needle biopsy for non-palpable breast lesions.

    PubMed

    Iwase, Takuji; Takahashi, Kaoru; Gomi, Naoya; Horii, Rie; Akiyama, Futoshi

    2006-01-01

    The widespread use of screening mammography has resulted in increased detection of nonpalpable breast lesions here in Japan. For the histopathologic work-up of these lesions, stereotactic core biopsy is essential as a minimally invasive diagnostic procedure. However, the number of facilities that provide this procedure cannot keep up with the increasing demand from patients. Another issue is interpreting the results of the biopsy. With a histological diagnosis using needle samples, there is always a risk of underestimation or a false-negative result. To avoid missing cancers after stereotactic biopsy, it is important to check for sampling errors and for discrepancies between the radiologic and pathologic findings. We are pushing for the rapid spread of an ideal form of stereotactic breast core biopsy (using prone-type units, digital methods, and vacuum-assisted breast biopsy devices) throughout Japan so that every patient can undergo this examination. PMID:16518060

  10. Automatic ultrasound image enhancement for 2D semi-automatic breast-lesion segmentation

    NASA Astrophysics Data System (ADS)

    Lu, Kongkuo; Hall, Christopher S.

    2014-03-01

    Breast cancer is the fastest growing cancer, accounting for 29%, of new cases in 2012, and second leading cause of cancer death among women in the United States and worldwide. Ultrasound (US) has been used as an indispensable tool for breast cancer detection/diagnosis and treatment. In computer-aided assistance, lesion segmentation is a preliminary but vital step, but the task is quite challenging in US images, due to imaging artifacts that complicate detection and measurement of the suspect lesions. The lesions usually present with poor boundary features and vary significantly in size, shape, and intensity distribution between cases. Automatic methods are highly application dependent while manual tracing methods are extremely time consuming and have a great deal of intra- and inter- observer variability. Semi-automatic approaches are designed to counterbalance the advantage and drawbacks of the automatic and manual methods. However, considerable user interaction might be necessary to ensure reasonable segmentation for a wide range of lesions. This work proposes an automatic enhancement approach to improve the boundary searching ability of the live wire method to reduce necessary user interaction while keeping the segmentation performance. Based on the results of segmentation of 50 2D breast lesions in US images, less user interaction is required to achieve desired accuracy, i.e. < 80%, when auto-enhancement is applied for live-wire segmentation.

  11. Differential diagnosis of lung lesion in breast carcinoma: a metachronous neoplasm or metastasis?

    PubMed

    Maddala, Raja Naga Mahesh; Udupa, Karthik; Thomas, Joseph; Pai, Kanthilatha

    2016-01-01

    A 34-year-old woman-a diagnosed case of pT1N1MO, stage IIa, estrogen and progesterone receptor positive (ER, PR) positive, Her2 negative carcinoma of the left breast-was managed with modified radical mastectomy and adjuvant chemotherapy. While planning for radiotherapy, she was found to have a well-defined enhancing lesion with spiculated margins in the superior segment of the right lower lobe along with a heterogeneously enhancing right hilar lymph node on CT. Histopathological evaluation of the lesion was suggestive of adenocarcinoma. The lesion was negative for ER, PR receptors, mammoglobin and gross cystic disease fluid protein. Thyroid transcription factor 1 (TTF-1) was positive, suggesting a primary lung adenocarcinoma rather than metastatic lesion from the breast. This case clearly signifies the importance of histopathological diagnosis of suspicious metastatic lesions in the setting of early breast cancer. We would also like to highlight the importance of TTF-1 in differentiating primary lung malignancy from metastasis. PMID:27170610

  12. Adolescent physical activity and inactivity: a prospective study of risk of benign breast disease in young women.

    PubMed

    Berkey, Catherine S; Tamimi, Rulla M; Willett, Walter C; Rosner, Bernard; Lindsay Frazier, A; Colditz, Graham A

    2014-08-01

    In previous investigations of adolescent activity recalled in adulthood, modest reductions in risk of benign breast disease (BBD) and premenopausal breast cancer were seen with moderate-strenuous activity during high school. We therefore investigated physical activity, walking, and recreational inactivity (watching TV-videos, playing computer-videogames) reported by adolescent girls in relation to their subsequent risk for BBD as young women. The Growing Up Today Study includes 9,039 females, 9-15 years at study initiation (1996), who completed questionnaires annually through 2001, then in 2003, 2005, 2007, 2010 and 2013. Annual surveys (1996-2001) obtained data on physical and sedentary activities during the past year. Beginning in 2005, women (≥18 years) reported whether they had ever been diagnosed with BBD confirmed by breast biopsy (n = 133 cases, to 11/01/2013). Logistic regression (adjusted for baseline adiposity and age; additional factors in multivariable-adjusted models) estimated associations between adolescent activities (moderate-vigorous, walking, METS, inactivity) and biopsy-confirmed BBD in young women. Girls who walked the most had significantly lower risk of BBD (multivariable-adjusted OR = 0.61, ≥30 vs ≤15 min/day; p = .049). We observed no evidence that inactivity (≥3 vs <2 h/day OR = 1.02, p = .92) or METS (top vs bottom tertile OR = 1.19, p = .42) were associated with BBD. Accounting for factors including family history, childhood adiposity, and other activities and inactivities, adolescent girls who walked the most were at lower risk for BBD. We found no evidence that high moderate-vigorous activity might reduce risk, nor did we observe any association with inactivity. Continued follow-up will re-evaluate these findings as more BBD cases, and ultimately breast cancer, are diagnosed. PMID:25034340

  13. Adolescent Physical Activity and Inactivity: A Prospective Study of Risk of Benign Breast Disease in Young Women

    PubMed Central

    Berkey, Catherine S.; Tamimi, Rulla M.; Willett, Walter C.; Rosner, Bernard; Frazier, A. Lindsay; Colditz, Graham A.

    2016-01-01

    Purpose In previous investigations of adolescent activity recalled in adulthood, modest reductions in risk of benign breast disease (BBD) and premenopausal breast cancer were seen with moderate-strenuous activity during high school. We therefore investigated physical activity, walking, and recreational inactivity (watching TV-videos, playing computer-videogames) reported by adolescent girls in relation to their subsequent risk for BBD as young women. Methods The Growing Up Today Study (GUTS) includes 9039 females, 9–15yrs at study initiation (1996), who completed questionnaires annually through 2001, then 2003, 2005, 2007, 2010 and 2013. Annual surveys (1996–2001) obtained data on physical and sedentary activities during the past year. Beginning in 2005, women (≥18yr) reported whether they had been diagnosed with BBD confirmed by breast biopsy (n=133 cases, to 11/01/2013). Logistic regression (adjusted for baseline adiposity and age; additional factors in multivariable-adjusted models) estimated associations between adolescent activities (moderate-vigorous, walking, METS, inactivity) and biopsy-confirmed BBD in young women. Results Girls who walked the most had significantly lower risk of BBD (multivariable-adjusted OR=0.61,p=.049, ≥30min/day vs ≤15min/day). We observed no evidence that inactivity (≥3 hrs/day vs <2hr/day OR=1.02,p=.92) or METS (top vs bottom tertile OR=1.19,p=.42) were associated with BBD. Conclusion Accounting for factors including family history, childhood adiposity, other activities and inactivities, adolescent girls who walked the most were at lower risk for BBD. We found no evidence that high moderate-vigorous activity might reduce risk, nor did we observe any association with inactivity. Continued follow-up will re-evaluate these findings as more BBD cases, and ultimately breast cancer, are diagnosed. PMID:25034340

  14. Computer-Aided Diagnosis Scheme for Distinguishing Between Benign and Malignant Masses in Breast DCE-MRI.

    PubMed

    Honda, Emi; Nakayama, Ryohei; Koyama, Hitoshi; Yamashita, Akiyoshi

    2016-06-01

    Our purpose in this study was to develop a computer-aided diagnosis (CAD) scheme for distinguishing between benign and malignant breast masses in dynamic contrast material-enhanced magnetic resonance imaging (DCE-MRI). Our database consisted 90 DCE-MRI examinations, each of which contained four sequential phase images; this database included 28 benign masses and 62 malignant masses. In our CAD scheme, we first determined 11 objective features of masses by taking into account the image features and the dynamic changes in signal intensity that experienced radiologists commonly use for describing masses in DCE-MRI. Quadratic discriminant analysis (QDA) was employed to distinguish between benign and malignant masses. As the input of the QDA, a combination of four objective features was determined among the 11 objective features according to a stepwise method. These objective features were as follows: (i) the change in signal intensity from 2 to 5 min; (ii) the change in signal intensity from 0 to 2 min; (iii) the irregularity of the shape; and (iv) the smoothness of the margin. Using this approach, the classification accuracy, sensitivity, and specificity were shown to be 85.6 % (77 of 90), 87.1 % (54 of 62), and 82.1 % (23 of 28), respectively. Furthermore, the positive and negative predictive values were 91.5 % (54 of 59) and 74.2 % (23 of 31), respectively. Our CAD scheme therefore exhibits high classification accuracy and is useful in the differential diagnosis of masses in DCE-MRI images. PMID:26691512

  15. Application of a GRNN oracle to the intelligent combination of several breast cancer benign/malignant predictive paradigms

    NASA Astrophysics Data System (ADS)

    Land, Walker H., Jr.; Masters, Timothy D.; Lo, Joseph Y.

    2000-06-01

    The General Regression Neural Network (GRNN) is well known to be an extremely effective prediction model in a wide variety of problems. It has been recently established that in many prediction problems, the results obtained by intelligently combining the outputs of several different prediction models are generally superior to the results obtained by using any one of the models. An overseer model that combines predictions from other independently trained prediction models is often called an oracle. This paper describes how the GRNN is modified to serve as a powerful oracle for combining decisions from four different breast cancer benign/malignant prediction models using mammogram data. Specifically, the GRNN oracle combines decisions from an evolutionary programming derived neural network, a probabilistic neural network, a fully- interconnected three-layer, feed-forward, error backpropagation network, and a linear discriminant analysis model. In all experiments conducted, the oracle consistently provided superior benign/malignant classification discrimination as measured by the receiver operator characteristic curve Az index values.

  16. Clinician's Guide to Imaging and Pathologic Findings in Benign Breast Disease

    PubMed Central

    Neal, Lonzetta; Tortorelli, Cindy L.; Nassar, Aziza

    2010-01-01

    The discussion of abnormal results of breast imaging and abnormal pathologic findings can be challenging for health care professionals and often is stressful for patients. Although most imaging findings and biopsy results are negative and do not infer a substantial increase in breast cancer risk, the subsequent conversation between the patient and her practitioner is more effective and informative with a thorough review of the pathologic results and an appreciation of the importance of radiologic-histologic concordance. This article provides insight into and understanding of breast imaging and biopsy techniques and of histologic findings as a means to timely and appropriate decision making and action by the patient and her health care professional. PMID:20194153

  17. Clinician's guide to imaging and pathologic findings in benign breast disease.

    PubMed

    Neal, Lonzetta; Tortorelli, Cindy L; Nassar, Aziza

    2010-03-01

    The discussion of abnormal results of breast imaging and abnormal pathologic findings can be challenging for health care professionals and often is stressful for patients. Although most imaging findings and biopsy results are negative and do not infer a substantial increase in breast cancer risk, the subsequent conversation between the patient and her practitioner is more effective and informative with a thorough review of the pathologic results and an appreciation of the importance of radiologic-histologic concordance. This article provides insight into and understanding of breast imaging and biopsy techniques and of histologic findings as a means to timely and appropriate decision making and action by the patient and her health care professional. PMID:20194153

  18. Inflammatory Breast Carcinoma Presenting with Two Different Patterns of Cutaneous Metastases: Carcinoma Telangiectaticum and Carcinoma Erysipeloides

    PubMed Central

    Yaghoobi, Reza; Talaizade, Abdolhasan; Lal, Karan; Ranjbari, Nastaran; Sohrabiaan, Nasibe

    2015-01-01

    Cutaneous metastases can have many different clinical presentations. They are seen in patients with advanced malignant disease; however, they can be the initial manifestation of undetected malignancies. Inflammatory breast carcinoma is a rare and aggressive form of breast cancer that has a nonspecific appearance mimicking many benign conditions including mastitis, breast abscesses, and/or dermatitis. The authors report the case of a 40-year-old woman with inflammatory breast carcinoma presenting with violaceous papulovesicular lesions resembling lymphangioma circumscriptum and erythematous patches resembling erysipelas. These lesions represent two different types of cutaneous metastases, both of which were the initial signs of inflammatory breast carcinoma in the patient described herein. Skin biopsy of lesions confirmed invasive breast cancer and further prompted a work up for inflammatory breast carcinoma. This case demonstrates the importance of follow-up for all breast lesions, even those considered to be of benign nature, for they can be presenting signs of metastatic breast cancer. PMID:26345728

  19. Comparative performance of multiview stereoscopic and mammographic display modalities for breast lesion detection

    SciTech Connect

    Webb, Lincoln J.; Samei, Ehsan; Lo, Joseph Y.; Baker, Jay A.; Ghate, Sujata V.; Kim, Connie; Soo, Mary Scott; Walsh, Ruth

    2011-04-15

    Purpose: Mammography is known to be one of the most difficult radiographic exams to interpret. Mammography has important limitations, including the superposition of normal tissue that can obscure a mass, chance alignment of normal tissue to mimic a true lesion and the inability to derive volumetric information. It has been shown that stereomammography can overcome these deficiencies by showing that layers of normal tissue lay at different depths. If standard stereomammography (i.e., a single stereoscopic pair consisting of two projection images) can significantly improve lesion detection, how will multiview stereoscopy (MVS), where many projection images are used, compare to mammography? The aim of this study was to assess the relative performance of MVS compared to mammography for breast mass detection. Methods: The MVS image sets consisted of the 25 raw projection images acquired over an arc of approximately 45 deg. using a Siemens prototype breast tomosynthesis system. The mammograms were acquired using a commercial Siemens FFDM system. The raw data were taken from both of these systems for 27 cases and realistic simulated mass lesions were added to duplicates of the 27 images at the same local contrast. The images with lesions (27 mammography and 27 MVS) and the images without lesions (27 mammography and 27 MVS) were then postprocessed to provide comparable and representative image appearance across the two modalities. All 108 image sets were shown to five full-time breast imaging radiologists in random order on a state-of-the-art stereoscopic display. The observers were asked to give a confidence rating for each image (0 for lesion definitely not present, 100 for lesion definitely present). The ratings were then compiled and processed using ROC and variance analysis. Results: The mean AUC for the five observers was 0.614{+-}0.055 for mammography and 0.778{+-}0.052 for multiview stereoscopy. The difference of 0.164{+-}0.065 was statistically significant with a

  20. Significance of Breast Lesion Descriptors in the ACR BI-RADS MRI Lexicon

    PubMed Central

    Agrawal, Garima; Su, Min-Ying; Nalcioglu, Orhan; Feig, Stephen A.; Chen, Jeon-Hor

    2009-01-01

    In recent years, dynamic contrast enhanced MRI (DCE-MRI) has altered the clinical management for women with breast cancer. In March 2007, the American Cancer Society (ACS) issued a new guideline recommending annual MRI screening for high-risk women. This guideline is expected to substantially increase the number of women each year who receive breast MRI. The diagnosis of breast MRI involves the description of morphological and enhancement kinetics features. To standardize the communication language, the Breast Imaging-Reporting and Data System (BI-RADS) MRI lexicon was developed by the American College of Radiology (ACR). In this article, we will review various appearances of breast lesions on MRI using the standardized terms of ACR BI-RADS MRI lexicon. The purpose is to familiarize all medical professionals with the breast MRI lexicon, since the use of this imaging modality is rapidly growing in the field of breast disease. Using this common language, a comprehensive analysis of both morphological and kinetic features used in image interpretation will help radiologists and other clinicians to communicate more clearly and consistently. This may in turn help physicians and patients to jointly select an appropriate management protocol for each patient’s clinical situation. PMID:19197974

  1. Potential of Computer-aided Diagnosis of High Spectral and Spatial (HiSS) MRI in the Classification of Breast Lesions

    PubMed Central

    Bhooshan, Neha; Giger, Maryellen; Medved, Milica; Li, Hui; Wood, Abbie; Yuan, Yading; Lan, Li; Marquez, Angelica; Karczmar, Greg; Newstead, Gillian

    2014-01-01

    Purpose: To compare the performance of CADx analysis of pre-contrast HiSS MRI to that of clinical DCE-MRI in the diagnostic classification of breast lesions. Materials and Methods: Thirty-four malignant and seven benign lesions were scanned using 2D HiSS and clinical 4D DCE-MRI protocols. Lesions were automatically segmented. Morphological features were calculated for HiSS whereas both morphological and kinetic features were calculated for DCE-MRI. After stepwise feature selection, Bayesian artificial neural networks merged selected features, and ROC analysis evaluated the performance with leave-one-lesion-out validation. Results: AUC values of 0.92 ± 0.06 and 0.90 ± 0.05 were obtained using CADx on HiSS and DCE-MRI, respectively, in the task of classifying benign and malignant lesions. While we failed to show that the higher HiSS performance was significantly better than DCE-MRI, non-inferiority testing confirmed that HiSS was not worse than DCE-MRI. Conclusion: CADx of HiSS (without contrast) performed similarly to CADx on clinical DCE-MRI; thus, computerized analysis of HiSS may provide sufficient information for diagnostic classification. The results are clinically important for patients in whom contrast agent is contra-indicated. Even in the limited acquisition mode of 2D single slice HiSS, by using quantitative image analysis to extract characteristics from the HiSS images, similar performance levels were obtained as compared to those from current clinical 4D DCE-MRI. As HiSS acquisitions become possible in 3D, CADx methods can also be applied. Since HiSS and DCE-MRI are based on different contrast mechanisms, the use of the two protocols in combination may increase diagnostic accuracy. PMID:24023011

  2. Molecular classification of non-invasive breast lesions for personalised therapy and chemoprevention.

    PubMed

    Buckley, Niamh; Boyle, David; McArt, Darragh; Irwin, Gareth; Harkin, D Paul; Lioe, Tong; McQuaid, Stephen; James, Jacqueline A; Maxwell, Perry; Hamilton, Peter; Mullan, Paul B; Salto-Tellez, Manuel

    2015-12-22

    Breast cancer screening has led to a dramatic increase in the detection of pre-invasive breast lesions. While mastectomy is almost guaranteed to treat the disease, more conservative approaches could be as effective if patients can be stratified based on risk of co-existing or recurrent invasive disease.Here we use a range of biomarkers to interrogate and classify purely non-invasive lesions (PNL) and those with co-existing invasive breast cancer (CEIN). Apart from Ductal Carcinoma In Situ (DCIS), relative homogeneity is observed. DCIS contained a greater spread of molecular subtypes. Interestingly, high expression of p-mTOR was observed in all PNL with lower expression in DCIS and invasive carcinoma while the opposite expression pattern was observed for TOP2A.Comparing PNL with CEIN, we have identified p53 and Ki67 as predictors of CEIN with a combined PPV and NPV of 90.48% and 43.3% respectively. Furthermore, HER2 expression showed the best concordance between DCIS and its invasive counterpart.We propose that these biomarkers can be used to improve the management of patients with pre-invasive breast lesions following further validation and clinical trials. p53 and Ki67 could be used to stratify patients into low and high-risk groups for co-existing disease. Knowledge of expression of more actionable targets such as HER2 or TOP2A can be used to design chemoprevention or neo-adjuvant strategies. Increased knowledge of the molecular profile of pre-invasive lesions can only serve to enhance our understanding of the disease and, in the era of personalised medicine, bring us closer to improving breast cancer care. PMID:26657114

  3. Molecular classification of non-invasive breast lesions for personalised therapy and chemoprevention

    PubMed Central

    McArt, Darragh; Irwin, Gareth; Harkin, D. Paul; Lioe, Tong; McQuaid, Stephen; James, Jacqueline A.; Maxwell, Perry; Hamilton, Peter; Mullan, Paul B.; Salto-Tellez, Manuel

    2015-01-01

    Breast cancer screening has led to a dramatic increase in the detection of pre-invasive breast lesions. While mastectomy is almost guaranteed to treat the disease, more conservative approaches could be as effective if patients can be stratified based on risk of co-existing or recurrent invasive disease. Here we use a range of biomarkers to interrogate and classify purely non-invasive lesions (PNL) and those with co-existing invasive breast cancer (CEIN). Apart from Ductal Carcinoma in situ (DCIS), relative homogeneity is observed. DCIS contained a greater spread of molecular subtypes. Interestingly, high expression of p-mTOR was observed in all PNL with lower expression in DCIS and invasive carcinoma while the opposite expression pattern was observed for TOP2A. Comparing PNL with CEIN, we have identified p53 and Ki67 as predictors of CEIN with a combined PPV and NPV of 90.48% and 43.3% respectively. Furthermore, HER2 expression showed the best concordance between DCIS and its invasive counterpart. We propose that these biomarkers can be used to improve the management of patients with pre-invasive breast lesions following further validation and clinical trials. p53 and Ki67 could be used to stratify patients into low and high-risk groups for co-existing disease. Knowledge of expression of more actionable targets such as HER2 or TOP2A can be used to design chemoprevention or neo-adjuvant strategies. Increased knowledge of the molecular profile of pre-invasive lesions can only serve to enhance our understanding of the disease and, in the era of personalised medicine, bring us closer to improving breast cancer care. PMID:26657114

  4. In-plane visibility of lesions using breast tomosynthesis and digital mammography

    SciTech Connect

    Timberg, P.; Baath, M.; Andersson, I.; Mattsson, S.; Tingberg, A.; Ruschin, M.

    2010-11-15

    Purpose: The purpose of this work was to evaluate the visibility of simulated lesions in 2D digital mammography (DM) and breast tomosynthesis (BT) images of patients. Methods: Images of the same women were acquired on both a DM system (Mammomat Novation, Siemens Healthcare, Erlangen, Germany) and a BT prototype system adapted from the same type of DM system. Using the geometrical properties of the two systems, simulated lesions were projected and added to each DM image as well as to each BT projection image prior to 3D reconstruction. The same beam quality and approximately the same total absorbed dose to the glandular tissue were used for each breast image acquisition on the two systems. A series of four-alternative forced choice human observer experiments was conducted for each of five simulated lesion diameters: 0.2, 1, 3, 8, and 25 mm. An additional experiment was conducted for the 0.2 mm lesion in BT only at twice the dose level (BT{sub 2x}). Threshold signal was defined as the lesion signal intensity required for a detectability index (d{sup '}) of 2.5. Four medical physicists participated in all experiments. One experiment, consisting of 60 cases, was conducted per test condition (i.e., lesion size and signal combination). Results: For the smallest lesions (0.2 mm), the threshold signal for DM was 21% lower than for BT at equivalent dose levels, and BT{sub 2x} was 26% lower than DM. For the lesions larger than 1 mm, the threshold signal increased linearly (in log space) with the lesion diameter for both DM and BT, with DM requiring around twice the signal as BT. The difference in the threshold signal between BT and DM at each lesion size was statistically significant, except for the 0.2 mm lesion between BT{sub 2x} and DM. Conclusions: The results of this study indicate that low-signal lesions larger than 1.0 mm may be more visible in BT compared to DM, whereas 0.2 mm lesions may be better visualized with DM compared to BT, when compared at equal dose.

  5. Radiation-associated atypical vascular lesions: vascular lesions with endothelial cell atypia presenting in the radiation port of breast cancer patients.

    PubMed

    Anzalone, C Lane; Cohen, Philip R; Tschen, Jaime A; MacFarlane, Deborah F

    2014-01-01

    Atypical vascular lesions are an uncommon adverse sequela to the radiotherapy of tumors. Many characteristics are shared between atypical vascular lesions caused by radiation port and well-differentiated radiation-induced angiosarcomas. The authors retrospectively reviewed the medical literature using PubMed, searching the terms acquired, atypical, benign, lymphangioma, lymphangioendothelioma, lymphangiomatous, lesion, papules, progressive, and vascular. Patient reports and previous reviews of the subject were critically assessed and the salient features are presented. Atypical vascular lesions associated with the radiation port present as clinically innocuous flesh-colored to erythematous papules or plaques. The condition presents within the radiation field, approximately 3 years after initial treatment. While the exact me chanism remains to be elucidated, growing evidence supports an association between radiation-associated atypical vascular lesions and radiation-induced angiosarcomas. Atypical vascular lesions within a radiation port are suggested to be in a state of morphologic continuum, which may progress into the more aggressive, malignant angiosarcoma. The authors recommend consideration for biopsy of new skin lesions within or adjacent to radiation. While it is clear that atypical vascular lesions caused by radiation are not equivalent to angiosarcoma, growing evidence supports that radiation-associated atypical vascular lesions may progress to angiosarcoma in some patients; therefore, the authors recommend excision of the lesion with margins depending on clinical judgment and the lesion encountered. PMID:25823080

  6. Contrast-enhanced ultrasound improved performance of breast imaging reporting and data system evaluation of critical breast lesions

    PubMed Central

    Luo, Jun; Chen, Ji-Dong; Chen, Qing; Yue, Lin-Xian; Zhou, Guo; Lan, Cheng; Li, Yi; Wu, Chi-Hua; Lu, Jing-Qiao

    2016-01-01

    AIM: To determine whether contrast-enhanced ultrasound (CEUS) can improve the precision of breast imaging reporting and data system (BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235 (49.36%) lesions into category 3, 20 (8.51%), 13 (5.53%) and 12 (5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74 (31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosis of malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed. CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields. PMID:27358689

  7. Combining CRF and multi-hypothesis detection for accurate lesion segmentation in breast sonograms.

    PubMed

    Hao, Zhihui; Wang, Qiang; Seong, Yeong Kyeong; Lee, Jong-Ha; Ren, Haibing; Kim, Ji-yeun

    2012-01-01

    The implementation of lesion segmentation for breast ultrasound image relies on several diagnostic rules on intensity, texture, etc. In this paper, we propose a novel algorithm to achieve a comprehensive decision upon these rules by incorporating image over-segmentation and lesion detection in a pairwise CRF model, rather than a term-by-term translation. Multiple detection hypotheses are used to propagate object-level cues to segments and a unified classifier is trained based on the concatenated features. The experimental results show that our algorithm can avoid the drawbacks of separate detection or bottom-up segmentation, and can deal with very complicated cases. PMID:23285589

  8. Imaging of the Adolescent Breast

    PubMed Central

    Jones, Katie N.

    2013-01-01

    The mainstay of breast imaging in the adolescent is ultrasonography. There is occasionally a need for additional imaging, particularly with magnetic resonance imaging (MRI). Imaging of the adolescent breast differs substantially from the adult in both the imaging modalities utilized and the relative likelihood of pathologies encountered. The majority of lesions in the adolescent are benign, but the presence of a breast lesion may cause anxiety to patients and their families due to the wide awareness of breast malignancy in the adult population. It is important to be aware of the imaging modalities available to image the adolescent breast to prevent unnecessary radiation exposure while answering the clinical question. The current recommendations for adolescent diagnostic and screening breast imaging will be reviewed. Benign breast lesions such as fibroadenomas, fibrocystic change, pseudoangiomatous stromal hyperplasia, gynecomastia, and posttraumatic or infectious lesions with their associated imaging findings and management will be outlined. Additionally, review of breast malignancies that can affect adolescents will provide the reader with features to distinguish benign from malignant processes in the adolescent based on imaging findings and clinical presentation. PMID:24872737

  9. Standardized measures of lobular involution and subsequent breast cancer risk among women with benign breast disease: a nested case-control study.

    PubMed

    Figueroa, Jonine D; Pfeiffer, Ruth M; Brinton, Louise A; Palakal, Maya M; Degnim, Amy C; Radisky, Derek; Hartmann, Lynn C; Frost, Marlene H; Stallings Mann, Melody L; Papathomas, Daphne; Gierach, Gretchen L; Hewitt, Stephen M; Duggan, Maire A; Visscher, Daniel; Sherman, Mark E

    2016-08-01

    Lesser degrees of terminal duct-lobular unit (TDLU) involution predict higher breast cancer risk; however, standardized measures to quantitate levels of TDLU involution have only recently been developed. We assessed whether three standardized measures of TDLU involution, with high intra/inter pathologist reproducibility in normal breast tissue, predict subsequent breast cancer risk among women in the Mayo benign breast disease (BBD) cohort. We performed a masked evaluation of biopsies from 99 women with BBD who subsequently developed breast cancer (cases) after a median of 16.9 years and 145 age-matched controls. We assessed three metrics inversely related to TDLU involution: TDLU count/mm(2), median TDLU span (microns, which approximates acini content), and median category of acini counts/TDLU (0-10; 11-20; 21-30; 31-50; >50). Associations with subsequent breast cancer risk for quartiles (or categories of acini counts) of each of these measures were assessed with multivariable conditional logistic regression to estimate odds ratios (ORs) and 95 % confidence intervals (CI). In multivariable models, women in the highest quartile compared to the lowest quartiles of TDLU counts and TDLU span measures were significantly associated with subsequent breast cancer diagnoses; TDLU counts quartile4 versus quartile1, OR = 2.44, 95 %CI 0.96-6.19, p-trend = 0.02; and TDLU spans, quartile4 versus quartile1, OR = 2.83, 95 %CI = 1.13-7.06, p-trend = 0.03. Significant associations with categorical measures of acini counts/TDLU were also observed: compared to women with median category of <10 acini/TDLU, women with >25 acini counts/TDLU were at significantly higher risk, OR = 3.40, 95 %CI 1.03-11.17, p-trend = 0.032. Women with TDLU spans and TDLU count measures above the median were at further increased risk, OR = 3.75 (95 %CI 1.40-10.00, p-trend = 0.008), compared with women below the median for both of these metrics. Similar results were observed for

  10. An unusual breast lesion: the ultrasonographic, mammographic, MRI and nuclear medicine findings of mammary hibernoma.

    PubMed

    Martini, N; Londero, V; Machin, P; Travaini, L L; Zuiani, C; Bazzocchi, M; Paganelli, G

    2010-01-01

    We report the case of a 42-year-old woman being treated for an ovarian cancer who was diagnosed at the age of 40. A CT-positron emission tomography (PET) scan performed as follow-up documented abnormal uptake in the right breast. Mammograms were negative for malignancy, while a focal hyperechoic lesion was observed on ultrasonography in the same breast. Thus, she was referred to our institution for breast MRI, which showed a focal area of enhancement with atypical features. Percutaneous biopsy was performed, and a mammary hibernoma was diagnosed. Radiological and pathological correlation was provided. To our knowledge, this is the only report that describes the features of this rare tumour on four different imaging modalities (mammography, ultrasonography, MRI and CT-PET). PMID:20139247

  11. An unusual breast lesion: the ultrasonographic, mammographic, MRI and nuclear medicine findings of mammary hibernoma

    PubMed Central

    Martini, N; Londero, V; Machin, P; Travaini, L L; Zuiani, C; Bazzocchi, M; Paganelli, G

    2010-01-01

    We report the case of a 42-year-old woman being treated for an ovarian cancer who was diagnosed at the age of 40. A CT–positron emission tomography (PET) scan performed as follow-up documented abnormal uptake in the right breast. Mammograms were negative for malignancy, while a focal hyperechoic lesion was observed on ultrasonography in the same breast. Thus, she was referred to our institution for breast MRI, which showed a focal area of enhancement with atypical features. Percutaneous biopsy was performed, and a mammary hibernoma was diagnosed. Radiological and pathological correlation was provided. To our knowledge, this is the only report that describes the features of this rare tumour on four different imaging modalities (mammography, ultrasonography, MRI and CT–PET). PMID:20139247

  12. A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy

    PubMed Central

    Vazales, Ryan; Constant, Dustin; Snyder, Robert J.

    2014-01-01

    A rare case report of Aggressive Digital Adenocarcinoma (ADPCa) is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC), marjolin’s ulceration/squamous cell carcinoma (MSCC) and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

  13. The absence of aldehyde dehydrogenase 1 A1-positive cells in benign mammary stroma is associated with risk factors for breast cancer

    PubMed Central

    Isfoss, Björn Logi; Holmqvist, Bo; Jernström, Helena; Alm, Per; Olsson, Håkan

    2016-01-01

    In this study, aldehyde dehydrogenase 1 (ALDH1)-expressing cells in stroma of histologically normal breast tissue from premenopausal women were investigated in situ regarding cellular morphology, cell distribution, and relation to the additional stem cell markers, CD44 (+) and CD24 (−). These results were correlated with hormonal and genetic risk factors for breast cancer. Triple immunofluorescence labeling was performed on tissues from premenopausal women with a family history of breast cancer, and breast reduction specimens from premenopausal women with no family history of breast cancer were used as a control group. The majority of ALDH1-immunoreactive cells in stroma were spindle-shaped or polygonal, and such cells that were CD44− and CD24− were absent in the breast stroma of a significantly larger number of nulliparous than parous women. A less common morphological type of ALDH1-positive cells in stroma was round or oval in shape, and such cells that were CD44+ and CD24− were absent in a significant number of women with a family history of breast cancer. The CD44+/CD24− immunophenotype is consistent with stem cells, and the round/oval morphology suggests mesenchymal cells. This study demonstrates that there are two morphologically distinct types of ALDH1-positive cells in histologically benign mammary stroma, and the absence of these cells is correlated with clinical risk factors for breast cancer in premenopausal women. PMID:27313475

  14. The absence of aldehyde dehydrogenase 1 A1-positive cells in benign mammary stroma is associated with risk factors for breast cancer.

    PubMed

    Isfoss, Björn Logi; Holmqvist, Bo; Jernström, Helena; Alm, Per; Olsson, Håkan

    2016-01-01

    In this study, aldehyde dehydrogenase 1 (ALDH1)-expressing cells in stroma of histologically normal breast tissue from premenopausal women were investigated in situ regarding cellular morphology, cell distribution, and relation to the additional stem cell markers, CD44 (+) and CD24 (-). These results were correlated with hormonal and genetic risk factors for breast cancer. Triple immunofluorescence labeling was performed on tissues from premenopausal women with a family history of breast cancer, and breast reduction specimens from premenopausal women with no family history of breast cancer were used as a control group. The majority of ALDH1-immunoreactive cells in stroma were spindle-shaped or polygonal, and such cells that were CD44(-) and CD24(-) were absent in the breast stroma of a significantly larger number of nulliparous than parous women. A less common morphological type of ALDH1-positive cells in stroma was round or oval in shape, and such cells that were CD44(+) and CD24(-) were absent in a significant number of women with a family history of breast cancer. The CD44(+)/CD24(-) immunophenotype is consistent with stem cells, and the round/oval morphology suggests mesenchymal cells. This study demonstrates that there are two morphologically distinct types of ALDH1-positive cells in histologically benign mammary stroma, and the absence of these cells is correlated with clinical risk factors for breast cancer in premenopausal women. PMID:27313475

  15. Automatic ultrasonic breast lesions detection using support vector machine based algorithm

    NASA Astrophysics Data System (ADS)

    Yeh, Chih-Kuang; Miao, Shan-Jung; Fan, Wei-Che; Chen, Yung-Sheng

    2007-03-01

    It is difficult to automatically detect tumors and extract lesion boundaries in ultrasound images due to the variance in shape, the interference from speckle noise, and the low contrast between objects and background. The enhancement of ultrasonic image becomes a significant task before performing lesion classification, which was usually done with manual delineation of the tumor boundaries in the previous works. In this study, a linear support vector machine (SVM) based algorithm is proposed for ultrasound breast image training and classification. Then a disk expansion algorithm is applied for automatically detecting lesions boundary. A set of sub-images including smooth and irregular boundaries in tumor objects and those in speckle-noised background are trained by the SVM algorithm to produce an optimal classification function. Based on this classification model, each pixel within an ultrasound image is classified into either object or background oriented pixel. This enhanced binary image can highlight the object and suppress the speckle noise; and it can be regarded as degraded paint character (DPC) image containing closure noise, which is well known in perceptual organization of psychology. An effective scheme of removing closure noise using iterative disk expansion method has been successfully demonstrated in our previous works. The boundary detection of ultrasonic breast lesions can be further equivalent to the removal of speckle noise. By applying the disk expansion method to the binary image, we can obtain a significant radius-based image where the radius for each pixel represents the corresponding disk covering the specific object information. Finally, a signal transmission process is used for searching the complete breast lesion region and thus the desired lesion boundary can be effectively and automatically determined. Our algorithm can be performed iteratively until all desired objects are detected. Simulations and clinical images were introduced to

  16. Diode Laser in Minor Oral Surgery: A Case Series of Laser Removal of Different Benign Exophytic Lesions

    PubMed Central

    Sotoode, Somaye Mazarei; Azimi, Somayyeh; Taheri, Sayed Alinaghi; Asnaashari, Mohammad; Khalighi, Hamidreza; Rahmani, Somayeh; Jafari, Soudeh; Elmi Rankohi, Zahra

    2015-01-01

    Introduction: The role of laser in conservative management of oral disease is well established. Laser procedures are common in the fields of oral surgery, implant dentistry, endodontic, and periodontic therapy. Case: This case series describes the use of diode laser for the excision of oral exophytic lesions. All the patients attended the oral medicine department of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Criteria in patient selection were accessibility to lesions, patient fear from blade surgery, aesthetics, and probability of bleeding. An informed consent was filled by every patient. All of the lesions were completely excised under local anaesthesia by diode laser with 300 μm-fibre tip, 808 nm continuous wavelength and 3-3.5 W power for 3×60 seconds (Dr Smile, Italia). During surgery, the fibre tip was in contact with lesions. No analgesics were prescribed to the patients. The patients were followed for the first, second, and forth week after treatment. Conclusion: The lesions could be excised using the diode laser. This procedure was a quick clinical technique without bleeding. PMID:26464782

  17. Detection of serous precursor lesions in resected fallopian tubes from patients with benign diseases and a relatively low risk for ovarian cancer.

    PubMed

    Nishida, Naoyo; Murakami, Fumihiro; Higaki, Koichi

    2016-06-01

    The frequency of ovarian cancers in Japan has increased; however, doubts have been raised concerning the mechanism by which high-grade serous adenocarcinomas (HGSCs) arise. Conventionally, HGSC is thought to originate from the ovarian surface epithelium or epithelial inclusion cyst. However, recent data indicate that HGSCs may in fact develop from precursor lesions in the fallopian tube, including epithelia with a p53 signature, serous tubal intraepithelial carcinomas (STICs), secretory cell outgrowths (SCOUTs), and tubal intraepithelial lesions in transition (TILT). Here, we determined the frequency of these fallopian tube precursors in surgically excised samples from 123 patients with benign pelvic diseases. We identified 12 cases with a p53 signature (9.7%), 26 with observable SCOUTs (21.1%), and 4 with TILT (3.2%), but no STIC cases. Although the lifetime risk for developing ovarian cancer is only around 1.4% for women without germ-line mutations, it is important to evaluate the presence of precursor lesions to understand HGSC pathogenesis better. Taken together, salpingectomy appears to be an option for women who are past their childbearing age and plan to undergo elective pelvic surgery. To our knowledge, this is the first study to investigate the presence of these specific precursors post-salpingectomy in low-risk patients. PMID:27250113

  18. Metastases to the breast

    SciTech Connect

    McCrea, E.S.; Johnston, C.; Haney, P.J.

    1983-10-01

    Metastases to the breast are uncommon, wtih about 250 cases reported from clinical and autopsy series. The mammographic findings in 16 new cases revealed a spectrum of changes that included solitary of multiple lesions, well demarcated or poorly marginated masses, and diffuse involvement of skin or parenchyma or both. Diffuse disease was seen more frequently in this series (4/16), at times simulating inflammatory breast cancer. Although diagnosis of a primary malignancy usually preceded detection of the breast lesion, 40% (6/16) had no history of malignancy. Prognosis remains poor; however, it was improved in the lymphoma-leukemia group due to improved immunotherapeutic and chemotherapeutic regimes. The clinical, radiologic, and pathologic features are discussed. Some of the lesions encountered can be confused with a primary breast malignancy or a benign lesion, necessitating prompt and accurate biopsy to preclude unnecessary major surgery and to improve survival in cancers amenable to current therapy.

  19. Polyarteritis Nodosa Presenting as Digital Gangrene and Breast Lesion following Exposure to Silicone Breast Implants

    PubMed Central

    Homsi, Yamen; Carlson, John Andrew; Homsi, Samer

    2015-01-01

    Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis of small and medium sized arteries. We report a case of a 49-year old woman who presented with PAN following exposure to silicone breast implants. Although the relationship between silicone implants and connective tissue diseases has been investigated in the literature, no prior reports were found documenting PAN after silicone mammoplasty. While the pathogenesis of idiopathic PAN is not known yet, responsiveness to immunosuppressive therapy may suggest an immunologic mechanism. More robust research is needed to understand the connection between silicone breast implants and autoimmunity. PMID:26844000

  20. A Prospective Study to Evaluate the Reliability of Thyroid Imaging Reporting and Data System in Differentiation between Benign and Malignant Thyroid Lesions

    PubMed Central

    Srinivas, M Naren Satya; Amogh, V N; Gautam, Munnangi Satya; Prathyusha, Ivvala Sai; Vikram, N R; Retnam, M Kamala; Balakrishna, B V; Kudva, Narendranath

    2016-01-01

    Objectives: To evaluate diagnostic reliability of the daily use of thyroid imaging reporting and data system (TIRADS) classification proposed by Kwak et al., in differentiating between a benign and a malignant thyroid lesion, to calculate inter-observer variability in the interpretation of each of the TIRADS ultrasound features and to evaluate role of TIRADS system in reducing unnecessary biopsies of benign lesions. Materials and Methods: Three hundred and sixty-five patients with clinically suspected thyroid lesions during the period from November 1, 2011, to August 31, 2015, were prospectively scanned on gray-scale and Doppler imaging by six radiologists separately. We used GE VOLUSON 730 PRO machine (GE healthcare, Milwaukee, USA) equipped with a 7.5–12 MHz high-frequency linear array transducer with color and power Doppler capability. We evaluated five sonological features: Internal composition, echogenicity, margins, presence and type of calcification, and shape of the lesion. Based on the TIRADS proposed by Kwak et al., we determined categories of the thyroid lesions. The diagnostic performance of TIRADS classification system was evaluated by comparison with the fine-needle aspiration cytology (FNAC) reports which were subsequently obtained after taking informed consent from the patients. All follicular neoplasms on FNAC were further followed up with excision biopsy and histology. The cytopathological report was used as the standard final diagnosis for comparison. The P value and odds ratio were determined to quantify how strongly the presence or absence of a particular ultrasound feature was associated with benignity or malignancy in the study population. The risk of malignancy was stratified for each TIRADS category-based on the total number of benign and malignant lesions in that category. Cervical lymph nodes were also evaluated for their size, loss of the central, echogenic hilum, presence of irregular and indistinct margin, microcalcification, and

  1. Fusion of digital breast tomosynthesis images via wavelet synthesis for improved lesion conspicuity

    NASA Astrophysics Data System (ADS)

    Hariharan, Harishwaran; Pomponiu, Victor; Zheng, Bin; Whiting, Bruce; Gur, David

    2014-03-01

    Full-field digital mammography (FFDM) is the most common screening procedure for detecting early breast cancer. However, due to complications such as overlapping breast tissue in projection images, the efficacy of FFDM reading is reduced. Recent studies have shown that digital breast tomosynthesis (DBT), in combination with FFDM, increases detection sensitivity considerably while decreasing false-positive, recall rates. There is a huge interest in creating diagnostically accurate 2-D interpretations from the DBT slices. Most of the 2-D syntheses rely on visualizing the maximum intensities (brightness) from each slice through different methods. We propose a wavelet based fusion method, where we focus on preserving holistic information from larger structures such as masses while adding high frequency information that is relevant and helpful for diagnosis. This method enables the spatial generation of a 2D image from a series of DBT images, each of which contains both smooth and coarse structures distributed in the wavelet domain. We believe that the wavelet-synthesized images, generated from their DBT image datasets, provide radiologists with improved lesion and micro-calcification conspicuity as compared with FFDM images. The potential impact of this fusion method is (1) Conception of a device-independent, data-driven modality that increases the conspicuity of lesions, thereby facilitating early detection and potentially reducing recall rates; (2) Reduction of the accompanying radiation dose to the patient.

  2. Correlative analysis of breast lesions on full-field digital mammography and magnetic resonance imaging

    NASA Astrophysics Data System (ADS)

    Yuan, Yading

    Multi-modality imaging techniques are increasingly being applied in clinical practice to improve the accuracy with which breast cancer can be diagnosed. However, interpreting images from different modalities is not trivial as different images of the same lesion may exhibit different physical lesion attributes, and currently the various image modality acquisitions are performed under different breast positioning protocols. The general objective of this research is to investigate computerized correlative feature analysis (CFA) methods for integrating information from full-field digital mammographic (FFDM) images and dynamic contrast-enhanced magnetic resonance (DCE-MR) images by taking advantage of the information from different imaging modalities, and thus improving the diagnostic ability of computer-aided diagnosis (CADx) in breast cancer workup. The main hypothesis to be tested is that by incorporating correlative feature analysis in CADx, one can achieve an accurate and efficient discrimination between corresponding and non-corresponding lesion pairs, and subsequently improve performance in the estimation of computer-estimated probabilities of malignancy. The main contributions of this research work are summarized as follows. (1) A novel active-contour model based algorithm was developed for lesion segmentation on mammograms. This new algorithm yielded a statistically improved segmentation performance as compared to previously developed methods: a region-growing method and a radial gradient index (RGI) based method. (2) A computerized feature-based, supervised-learning driven CFA method was investigated to identify corresponding lesions in different mammographic views. The performance obtained by combining multiple features was found to be statistically better than the use of a distance feature alone, and robust across different mammographic view combinations. (3) A multi-modality CADx method that automatically selects and combines discriminative information from

  3. Fine needle aspiration cytology of radiation-induced changes in nonneoplastic breast lesions. Possible pitfalls in cytodiagnosis

    SciTech Connect

    Peterse, J.L.; Thunnissen, F.B.; van Heerde, P.

    1989-03-01

    The range of radiation-induced changes in fine needle aspiration (FNA) smears of the breast is described. In 41 of more than 800 patients who underwent breast-conserving treatment, a palpable breast lesion developed, and FNA was performed. In six cases, a recurrent carcinoma was present. In the remaining cases, three patterns of nonneoplastic lesions could be discerned: epithelial atypia (14 cases), fat necrosis (10 cases) and poorly cellular smears without epithelial atypia or fat necrosis (13 cases). It is important to be familiar with the patterns of radiation-induced epithelial atypia, since such atypia may lead to a misdiagnosis of recurrent carcinoma. These atypical cells may show impressive anisocytosis and anisonucleosis; however, the nuclear/cytoplasmic ratio remains normal and an admixture of bipolar cells is present. Cell dissociation and necrotic cell debris, as often seen in breast cancer smears, were never encountered in FNA smears from radiated nonneoplastic breasts.

  4. Are Irregular Hypoechoic Breast Masses on Ultrasound Always Malignancies?: A Pictorial Essay

    PubMed Central

    Kim, Youe Ree; Kim, Hun Soo

    2015-01-01

    Irregular hypoechoic masses in the breast do not always indicate malignancies. Many benign breast diseases present with irregular hypoechoic masses that can mimic carcinoma on ultrasonography. Some of these diseases such as inflammation and trauma-related breast lesions could be suspected from a patient's symptoms and personal history. Careful ultrasonographic examination and biopsy could help to differentiate these from malignancies. PMID:26576116

  5. A finite element model for simulating acoustic streaming in cystic breast lesions with experimental validation.

    PubMed

    Nightingale, K R; Trahey, G E

    2000-01-01

    Streaming detection is an ultrasonic technique that can be used to distinguish fluid-filled lesions, or cysts, from solid lesions. With this technique, high intensity ultrasound pulses are used to induce acoustic streaming in cyst fluid, and this motion is detected using Doppler flow estimation methods. Results from a pilot clinical study were recently published in which acoustic streaming was successfully induced and detected in 14 of 15 simple breast cysts and four of 14 sonographically indeterminate breast lesions in vivo. In the study, the detected velocities were found to vary considerably among cysts and for different pulsing regimes. A finite element model of streaming detection is presented. This model is utilized to investigate methods of increasing induced acoustic streaming velocity while minimizing patient exposure to high intensity ultrasound during streaming detection. Parameters studied include intensity, frequency, acoustic beam shape, cyst-diameter, cyst fluid protein concentration, and cyst fluid viscosity. The model, which provides both transient and steady-state solutions, is shown to predict trends in streaming velocity accurately. Experimental results from studies investigating the potential for nonlinear streaming enhancement in cysts are also provided. PMID:18238532

  6. Fusion of classifiers for REIS-based detection of suspicious breast lesions

    NASA Astrophysics Data System (ADS)

    Lederman, Dror; Wang, Xingwei; Zheng, Bin; Sumkin, Jules H.; Tublin, Mitchell; Gur, David

    2011-03-01

    After developing a multi-probe resonance-frequency electrical impedance spectroscopy (REIS) system aimed at detecting women with breast abnormalities that may indicate a developing breast cancer, we have been conducting a prospective clinical study to explore the feasibility of applying this REIS system to classify younger women (< 50 years old) into two groups of "higher-than-average risk" and "average risk" of having or developing breast cancer. The system comprises one central probe placed in contact with the nipple, and six additional probes uniformly distributed along an outside circle to be placed in contact with six points on the outer breast skin surface. In this preliminary study, we selected an initial set of 174 examinations on participants that have completed REIS examinations and have clinical status verification. Among these, 66 examinations were recommended for biopsy due to findings of a highly suspicious breast lesion ("positives"), and 108 were determined as negative during imaging based procedures ("negatives"). A set of REIS-based features, extracted using a mirror-matched approach, was computed and fed into five machine learning classifiers. A genetic algorithm was used to select an optimal subset of features for each of the five classifiers. Three fusion rules, namely sum rule, weighted sum rule and weighted median rule, were used to combine the results of the classifiers. Performance evaluation was performed using a leave-one-case-out cross-validation method. The results indicated that REIS may provide a new technology to identify younger women with higher than average risk of having or developing breast cancer. Furthermore, it was shown that fusion rule, such as a weighted median fusion rule and a weighted sum fusion rule may improve performance as compared with the highest performing single classifier.

  7. [Benign breast tumors: Recommendations of Collège National des Gynécologues Obstétriciens Français (CNGOF)--Short text].

    PubMed

    Lavoué, V; Fritel, X; Antoine, M; Beltjens, F; Bendifallah, S; Boisserie-Lacroix, M; Boulanger, L; Canlorbe, G; Catteau-Jonard, S; Chabbert-Buffet, N; Chamming's, F; Chéreau, E; Chopier, J; Coutant, C; Demetz, J; Guilhen, N; Fauvet, R; Kerdraon, O; Laas, E; Legendre, G; Mathelin, C; Nadeau, C; Thomassin Naggara, I; Ngô, C; Ouldamer, L; Rafii, A; Roedlich, M-N; Seror, J; Séror, J-Y; Touboul, C; Uzan, C; Daraï, E

    2015-12-01

    Breast sonography is required with mammogram to explore clinical breast mass (grade B), colored unipore breast nipple discharge (grade C), or mastitis (grade C). Bi-RADS system is recommended to describe and classify breast-imaging abnormalities. For breast abscess, a percutaneous biopsy is recommended in case of mass or persistent symptoms (grade C). For mastodynia, when breast imaging is normal, no MRI neither breast biopsy is recommended (grade C). Percutaneous biopsy is recommended for BI-RADS 4-5 mass (grade B). For persistent erythematous breast nipple or atypical eczema lesion, a nipple biopsy is recommended (grade C). For distortion and asymmetry, a vacuum core needle biopsy is recommended because of the risk of underestimation by simple core needle biopsy (grade C). For BI-RADS 4-5 microcalcifications without ultrasound signal, a vacuum core needle biopsy of at least 11 gauges is recommended (grade B); in the absence of microcalcifications on radiograph carrots, additional samples are recommended (grade B). For atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, flat epithelial with atypia, radial scar, mucocele with atypia, surgical excision is commonly recommended (grade C). Expectant management is feasible after multidisciplinary concertation. For these lesions, when excision is not in sano, no new excision is recommended except for pleomorphic or with necrosis CLIS (grade C). For grade 1 phyllode tumour, in sano surgical resection is recommended; for grade 2 phyllode, 10-mm margins are recommended (grade C). For breast papillary without atypia, complete disappearance of the radiologic signal is recommended (grade C). For breast papillary with atypia, complete surgical excision is recommended (grade C). PMID:26541565

  8. Association between power law coefficients of the anatomical noise power spectrum and lesion detectability in breast imaging modalities

    NASA Astrophysics Data System (ADS)

    Chen, Lin; Abbey, Craig K.; Boone, John M.

    2013-03-01

    Previous research has demonstrated that a parameter extracted from a power function fit to the anatomical noise power spectrum, β, may be predictive of breast mass lesion detectability in x-ray based medical images of the breast. In this investigation, the value of β was compared with a number of other more widely used parameters, in order to determine the relationship between β and these other parameters. This study made use of breast CT data sets, acquired on two breast CT systems developed in our laboratory. A total of 185 breast data sets in 183 women were used, and only the unaffected breast was used (where no lesion was suspected). The anatomical noise power spectrum computed from two-dimensional region of interests (ROIs), was fit to a power function (NPS(f) = α f-β), and the exponent parameter (β) was determined using log/log linear regression. Breast density for each of the volume data sets was characterized in previous work. The breast CT data sets analyzed in this study were part of a previous study which evaluated the receiver operating characteristic (ROC) curve performance using simulated spherical lesions and a pre-whitened matched filter computer observer. This ROC information was used to compute the detectability index as well as the sensitivity at 95% specificity. The fractal dimension was computed from the same ROIs which were used for the assessment of β. The value of β was compared to breast density, detectability index, sensitivity, and fractal dimension, and the slope of these relationships was investigated to assess statistical significance from zero slope. A statistically significant non-zero slope was considered to be a positive association in this investigation. All comparisons between β and breast density, detectability index, sensitivity at 95% specificity, and fractal dimension demonstrated statistically significant association with p < 0.001 in all cases. The value of β was also found to be associated with patient age and

  9. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    PubMed Central

    Yamada, Masatoshi; Saito, Akira; Yamamoto, Yoichiro; Cosatto, Eric; Kurata, Atsushi; Nagao, Toshitaka; Tateishi, Ayako; Kuroda, Masahiko

    2016-01-01

    Background: Intraductal proliferative lesions (IDPLs) of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH) and low-grade ductal carcinoma in situ (LG-DCIS). In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH), ADH, LG-DCIS, intermediate-grade (IM)-DCIS, and high-grade (HG)-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA) and a support vector machine. Results: High diagnostic accuracy (81.8–99.3%) was achieved between pathologists’ diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer. PMID:26955499

  10. Cost-effective and non-invasive automated benign and malignant thyroid lesion classification in 3D contrast-enhanced ultrasound using combination of wavelets and textures: a class of ThyroScan™ algorithms.

    PubMed

    Acharya, U R; Faust, O; Sree, S V; Molinari, F; Garberoglio, R; Suri, J S

    2011-08-01

    Ultrasound has great potential to aid in the differential diagnosis of malignant and benign thyroid lesions, but interpretative pitfalls exist and the accuracy is still poor. To overcome these difficulties, we developed and analyzed a range of knowledge representation techniques, which are a class of ThyroScan™ algorithms from Global Biomedical Technologies Inc., California, USA, for automatic classification of benign and malignant thyroid lesions. The analysis is based on data obtained from twenty nodules (ten benign and ten malignant) taken from 3D contrast-enhanced ultrasound images. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture algorithms are used to extract relevant features from the thyroid images. The resulting feature vectors are fed to three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr). The performance of these classifiers is compared using Receiver Operating Characteristic (ROC) curves. Our results show that combination of DWT and texture features coupled with K-NN resulted in good performance measures with the area of under the ROC curve of 0.987, a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Finally, we have proposed a novel integrated index called Thyroid Malignancy Index (TMI), which is made up of texture features, to diagnose benign or malignant nodules using just one index. We hope that this TMI will help clinicians in a more objective detection of benign and malignant thyroid lesions. PMID:21728394

  11. Added value of semi-quantitative breast-specific gamma imaging in the work-up of suspicious breast lesions compared to mammography, ultrasound and 3-T MRI

    PubMed Central

    Seymer, A; Keinrath, P; Holzmannhofer, J; Pirich, C; Hergan, K; Meissnitzer, M W

    2015-01-01

    Objective: To prospectively analyse the diagnostic value of semi-quantitative breast-specific gamma imaging (BSGI) in the work-up of suspicious breast lesions compared with that of mammography (MG), breast ultrasound and MRI of the breast. Methods: Within a 15-month period, 67 patients with 92 breast lesions rated as Category IV or V according to the breast imaging reporting and data system detected with MG and/or ultrasound were included into the study. After the injection of 740–1110 MBq of Technetium-99m (99mTc) SestaMIBI intravenously, scintigrams were obtained in two projections comparable to MG. The BSGI was analysed visually and semi-quantitatively by calculating a relative uptake factor (X). With the exception of two patients with cardiac pacemakers, all patients underwent 3-T breast MRI. Biopsy results were obtained as the reference standard in all patients. Sensitivity, specificity, positive- and negative-predictive values, accuracy and area under the curve were calculated for each modality. Results: Among the 92 lesions, 67 (72.8%) were malignant. 60 of the 67 cancers of any size were detected by BSGI with an overall sensitivity of 90%, only exceeded by ultrasound with a sensitivity of 99%. The sensitivity of BSGI for lesions <1 cm declined significantly to 60%. Overall specificity of ultrasound was only 20%. Specificity, accuracy and positive-predictive value were the highest for BSGI (56%, 80% and 85%, respectively). X was significantly higher for malignant lesions (mean, 4.27) and differed significantly between ductal types (mean, 4.53) and the other histopathological entities (mean, 3.12). Conclusion: Semi-quantitative BSGI with calculation of the relative uptake factor (X) can help to characterize breast lesions. BSGI negativity may obviate the need for biopsy of breast lesions >1 cm with low or intermediate prevalence for malignancy. Advances in knowledge: Compared with morphological imaging modalities, specificity, positive

  12. Efficiency of Core Biopsy for BI-RADS-5 Breast Lesions.

    PubMed

    Wolf, Ronald; Quan, Glenda; Calhoun, Kris; Soot, Laurel; Skokan, Laurie

    2008-01-01

    Stereotactic biopsy has proven more cost effective for biopsy of lesions associated with moderately suspicious mammograms. Data regarding selection of stereotactic biopsy (CORE) instead of excisional biopsy (EB) as the first diagnostic procedure in patients with nonpalpable breast lesions and highest suspicion breast imaging-reporting and data system (BI-RADS)-5 mammograms are sparse. Records from a regional health system radiology database were screened for mammograms associated with image-guided biopsy. A total of 182 nonpalpable BI-RADS-5 lesions were sampled in 178 patients over 5 years, using CORE or EB. Initial surgical margins, number of surgeries, time from initial procedure to last related surgical procedure, and hospital and professional charges for related admissions were compared using chi-squared, t-test, and Wilcoxon Mann-Whitney tests. A total of 108 CORE and 74 EB were performed as the first diagnostic procedure. Invasive or in situ carcinoma was diagnosed in 156 (86%) of all biopsies, 95 in CORE and 61 in EB groups. Negative margins of the first surgical procedure were more frequent in CORE (n = 70, 74%) versus EB (n = 17, 28%), p < 0.05. Use of CORE was associated with fewer total surgical procedures per lesion (1.29 +/- 0.05 versus 1.8 +/- 0.05, p < 0.05). Time of initial diagnostic procedure to final treatment did not vary significantly according to group (27 +/- 2 days versus 22 +/- 2 days, CORE versus EB). Mean charges including the diagnostic procedure and all subsequent surgeries were not different between CORE and EB groups ($10,500 +/- 300 versus $11,500 +/- 500, p = 0.08). Use of CORE as the first procedure in patients with highly suspicious mammograms is associated with improved pathologic margins and need for fewer surgical procedures than EB, and should be considered the preferred initial diagnostic approach. PMID:18821933

  13. Simulation and assessment of realistic breast lesions using fractal growth models.

    PubMed

    Rashidnasab, A; Elangovan, P; Yip, M; Diaz, O; Dance, D R; Young, K C; Wells, K

    2013-08-21

    A new method of generating realistic three dimensional simulated breast lesions known as diffusion limited aggregation (DLA) is presented, and compared with the random walk (RW) method. Both methods of lesion simulation utilize a physics-based method for inserting these simulated lesions into 2D clinical mammogram images that takes into account the polychromatic x-ray spectrum, local glandularity and scatter. DLA and RW masses were assessed for realism via a receiver operating characteristic (ROC) study with nine observers. The study comprised 150 images of which 50 were real pathology proven mammograms, 50 were normal mammograms with RW inserted masses and 50 were normal mammograms with DLA inserted masses. The average area under the ROC curve for the DLA method was 0.55 (95% confidence interval 0.51-0.59) compared to 0.60 (95% confidence interval 0.56-0.63) for the RW method. The observer study results suggest that the DLA method produced more realistic masses with more variability in shape compared to the RW method. DLA generated lesions can overcome the lack of complexity in structure and shape in many current methods of mass simulation. PMID:23892735

  14. Simulation and assessment of realistic breast lesions using fractal growth models

    NASA Astrophysics Data System (ADS)

    Rashidnasab, A.; Elangovan, P.; Yip, M.; Diaz, O.; Dance, D. R.; Young, K. C.; Wells, K.

    2013-08-01

    A new method of generating realistic three dimensional simulated breast lesions known as diffusion limited aggregation (DLA) is presented, and compared with the random walk (RW) method. Both methods of lesion simulation utilize a physics-based method for inserting these simulated lesions into 2D clinical mammogram images that takes into account the polychromatic x-ray spectrum, local glandularity and scatter. DLA and RW masses were assessed for realism via a receiver operating characteristic (ROC) study with nine observers. The study comprised 150 images of which 50 were real pathology proven mammograms, 50 were normal mammograms with RW inserted masses and 50 were normal mammograms with DLA inserted masses. The average area under the ROC curve for the DLA method was 0.55 (95% confidence interval 0.51-0.59) compared to 0.60 (95% confidence interval 0.56-0.63) for the RW method. The observer study results suggest that the DLA method produced more realistic masses with more variability in shape compared to the RW method. DLA generated lesions can overcome the lack of complexity in structure and shape in many current methods of mass simulation.

  15. Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors

    PubMed Central

    Cooke, Gillian E.; Wetter, Nathan C.; Banducci, Sarah E.; Mackenzie, Michael J.; Zuniga, Krystle E.; Awick, Elizabeth A.; Roberts, Sarah A.; Sutton, Brad P.; McAuley, Edward; Kramer, Arthur F.

    2016-01-01

    Increased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment. PMID:26915025

  16. Role of cyclin D1 immunoreactivity and AgNOR staining in the evaluation of benign and malignant lesions of the prostate

    PubMed Central

    Gupta, Veena; Garg, Monika; Chaudhry, Manish; Singh, Sunita; Sen, Rajeev; Gill, Meenu; Sangwaiya, Ashok

    2014-01-01

    Purpose: Prostatic carcinoma is a common and growing public health problem. Histological evaluation is fairly adequate for assessing tumor differentiation, but tumor proliferative activity is difficult to measure. Increasing evidence suggests that the factors controlling cell cycle progression also modulate the rate of ribosome biogenesis. Despite the influence of cyclin D1 and argyrophilic nuclear organizer region (AgNOR) on prostate cancer proliferation, few studies have evaluated the diagnostic importance of these markers. Therefore, the present study was carried out to analyze the diagnostic value of the proliferative markers cyclin D1 and AgNOR in various prostatic lesions and to determine whether any association or relation between these markers and different Gleason grades exists. Methods: A total 50 cases of various prostatic lesions were studied. Tumor grade, AgNOR staining, and cyclin D1 expression were evaluated in all cases. Correlations between the intensity and differential localization of these markers and Gleason grades were evaluated. Results: The mean AgNOR count in cases of prostatic intraepithelial neoplasia was high compared with cases of benign prostatic hyperplasia (BPH) but lower than that of carcinoma cases. The intensity of cyclin D1 expression was high in carcinoma. A total of 14 cases (46.67%) showed strong positivity. No significant correlation was found between the intensity of cyclin D1 expression, AgNOR count, and histologic grades of prostatic carcinoma, whereas a significant correlation was observed between intensity and percentage expression of cyclin D1 in BPH and carcinoma (P<0.01). Nuclear as well as cytoplasmic positivity was seen among various grades of carcinoma. Conclusions: AgNOR count and cyclin D1 may be helpful in distinguishing between BPH and carcinoma of the prostate but may not be used as reliable indicators of the grade of prostatic adenocarcinoma because of overlapping values in various grades. However, further

  17. Assessment of Diagnostic Accuracy and Efficiency of Categories 4 and 5 of the Second Edition of the BI-RADS Ultrasound Lexicon in Diagnosing Breast Lesions.

    PubMed

    Zou, Xuebin; Wang, Jianwei; Lan, Xiaowen; Lin, Qingguang; Han, Feng; Liu, Longzhong; Li, Anhua

    2016-09-01

    The purpose of this study was to evaluate the diagnostic accuracy and efficiency of categories 4 and 5 of the second edition of the Breast Imaging Reporting and Data System (BI-RADS) ultrasound (US) lexicon in diagnosing breast lesions. In our retrospective study, 579 lesions in 544 patients were assessed by US as the preliminary diagnosis and classified in subcategories 4a-4c and category 5 based on the second edition of the BI-RADS US lexicon with some obvious changes, such as the redefined margin, new calcification type, associated features and some special cases. Inter-observer agreement was determined. Ultrasound results were compared with the pathologic results for confirmation. Positive predictive values (PPVs) of subcategories 4a-4c were compared with theoretical values using the χ(2) test; the binomial test was used for category 5 lesions. Of the 579 lesions, 212 were confirmed as benign (36.61%), and the remaining 367 lesions were confirmed as borderline/malignant (63.39%). Inter-observer agreement was moderate for subcategories 4a-4c (κ = 0.52), moderate for subcategories 4a-4c and category 5 (κ = 0.56) and substantial for categories 4 and 5 (κ = 0.67). The PPVs for subcategories 4a-4c were 23.74%, 70.67% and 81.25%, respectively. In addition, the total PPV for category 4 was 46.92% (183/390), and the total PPV for category 5 was 97.35% (184/189). Statistical results revealed that the PPVs of subcategories 4a and 4b differed significantly from the theoretical values (p < 0.05); the PPVs of subcategory 4c and category 5 were significantly correlated with the theoretical PPVs (p > 0.05). In conclusion, subcategories 4a and 4b have lower diagnostic efficiency than subcategory 4c and category 5. Inter-observer agreement for subcategories 4a-4c remains to be improved. The most common features of subcategories 4a-4c differ, but overlap. It is recommended that inexperienced doctors in primary hospitals not classify lesions into subcategories in

  18. Mixed tumour of salivary gland type of the male breast.

    PubMed

    Simha, M R; Doctor, V M; Udwadia, T E

    1992-03-01

    Benign breast tumours with a mixed cartilaginous and epithelial component are distinctly rare as evident from the literature. A case of Mixed Tumour of the breast presenting pre-operatively as a hard mass in a 65 year old male is reported. Histologically, it was composed of a mixture of benign cartilage, myoepithelial cells, tubules and a myxoid stroma in fat. A brief review of cartilage bearing lesions and mixed tumour in the mammary region is discussed. PMID:1328037

  19. Proteomic profile of saliva and plasma from women with impalpable breast lesions

    PubMed Central

    Delmonico, Lucas; Bravo, Maryah; Silvestre, Rafaele Tavares; Ornellas, Maria Helena Faria; De Azevedo, Carolina Maria; Alves, Gilda

    2016-01-01

    The present study evaluated the proteomic profile of saliva and plasma from women with impalpable breast lesions using nano-liquid chromatography-quadrupole-time-of-flight (nLC-Q-TOF) technology. Plasma and saliva from patients with fibroadenoma (n=10), infiltrating ductal carcinoma (n=10) and healthy control groups (n=8) were assessed by combinations of inter/intra-group analyses, revealing significant quantitative and qualitative differences. The major differentially-expressed proteins in the saliva of patients compared with the controls were α2-macroglobulin and ceruloplasmin, but the proteins that met the minimum fold-change and P-value cut-offs were leukocyte elastase inhibitor and α-enolase, and deleted in malignant brain tumors 1. Concerning plasma, α-2-macroglobulin and ceruplasmin were upregulated, while other proteins such as haptoglobin, hemopexin and vitamin D-binding protein were downregulated compared with the control. The changes in immune, molecular transport and signaling pathways were the most representative in the proteomic profile of the saliva and plasma. This is the first study to describe the proteome of saliva and plasma from the same women with impalpable breast lesions. PMID:27602154

  20. Pathological aspects of core needle biopsy for non-palpable breast lesions.

    PubMed

    Usami, Shin; Moriya, Takuya; Kasajima, Atsuko; Suzuki, Akihiko; Ishida, Takanori; Sasano, Hironobu; Ohuchi, Noriaki

    2005-01-01

    Recently, the incidence of non-palpable or noninvasive breast cancer has increased. Consequently, criteria for choosing procedures to obtain pathological materials had changed. Fine needle aspiration biopsy cytology (FNA) and core needle biopsy (CNB) are both reliable procedures for detecting breast cancer. However, for non-palpable lesions, the diagnostic accuracy of CNB is higher. The main limits of FNA are the high rate of insufficient sampling and inability to determine invasiveness. CNB is an established alternative to surgical biopsy, and CNB can avoid excess surgical biopsies in a large number of patients. In addition to accurate histological diagnosis, there is interest in obtaining prognostic information from CNB, especially for patients being considered for preoperative (neoadjuvant) therapy. CNB provides useful information about histologic type and grade. However, an unavoidable problem of CNB is underestimation of invasion. On the other hand, there is good concordance in particular for estrogen receptor (ER) and progesterone receptor (PR) between CNB and surgical excision. Several aspects of CNB remains controversial, such as diagnosing papillary lesions by CNB, problems regarding tumor cell displacement after CNB, and management of lobular neoplasia (LN) on CNB. PMID:16286907

  1. Breast MRI, digital mammography and breast tomosynthesis: Comparison of three methods for early detection of breast cancer

    PubMed Central

    Roganovic, Dragana; Djilas, Dragana; Vujnovic, Sasa; Pavic, Dag; Stojanov, Dragan

    2015-01-01

    Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. with significant difference between breast tomosynthesis and digital mammography (p<0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20). PMID:26614855

  2. Differential diagnosis of breast masses in South Korean premenopausal women using diffuse optical spectroscopic imaging

    NASA Astrophysics Data System (ADS)

    Leproux, Anaïs; Kim, You Me; Min, Jun Won; McLaren, Christine E.; Chen, Wen-Pin; O'Sullivan, Thomas D.; Lee, Seung-ha; Chung, Phil-Sang; Tromberg, Bruce J.

    2016-07-01

    Young patients with dense breasts have a relatively low-positive biopsy rate for breast cancer (˜1 in 7). South Korean women have higher breast density than Westerners. We investigated the benefit of using a functional and metabolic imaging technique, diffuse optical spectroscopic imaging (DOSI), to help the standard of care imaging tools to distinguish benign from malignant lesions in premenopausal Korean women. DOSI uses near-infrared light to measure breast tissue composition by quantifying tissue concentrations of water (ctH2O), bulk lipid (ctLipid), deoxygenated (ctHHb), and oxygenated (ctHbO2) hemoglobin. DOSI spectral signatures specific to abnormal tissue and absent in healthy tissue were also used to form a malignancy index. This study included 19 premenopausal subjects (average age 41±9), corresponding to 11 benign and 10 malignant lesions. Elevated lesion to normal ratio of ctH2O, ctHHb, ctHbO2, total hemoglobin (THb=ctHHb+ctHbO2), and tissue optical index (ctHHb×ctH2O/ctLipid) were observed in the malignant lesions compared to the benign lesions (p<0.02). THb and malignancy index were the two best single predictors of malignancy, with >90% sensitivity and specificity. Malignant lesions showed significantly higher metabolism and perfusion than benign lesions. DOSI spectral features showed high discriminatory power for distinguishing malignant and benign lesions in dense breasts of the Korean population.

  3. The Er/Ki-67 Proportion in Breast Tumours - An Immunohistochemical Study

    PubMed Central

    Rai, M K

    2016-01-01

    Introduction Breast tumours are classified as benign, proliferative and invasive tumours. Estrogen hormone influences the proliferative activity and progression of the tumour. Estrogen Receptor (ER) status and proliferative index (Ki 67) are important histopathological factors in the development and prognosis of these tumours. Aim The present study was aimed to evaluate the variations in ER and Ki-67 expression in three broad categories of breast lesions namely benign breast disease, proliferative breast disease and malignant breast disease. Materials and Methods ER% and Ki-67% was evaluated on the histopathological tissues of 15 patients each of benign, proliferative and invasive breast tumours. The ER+/ Ki-67± ratio was calculated and the variation of expression between the three categories was analyzed using student’s t-test. Pearson’s coefficient of correlation was used to correlate ER and Ki-67 positivity within each category. Results The mean ER+/Ki-67+ in benign, proliferative and invasive tumours was 0.81, 0.87 and 1.42 respectively. A statistically significant difference in ER+/Ki-67+ proportions was observed between proliferative breast disease category and malignant breast disease category and also between benign breast disease category and malignant breast disease category (p<0.05). However, no significant difference was observed in benign breast disease category and proliferative breast disease category (p>0.05). A significant correlation was observed in proliferative breast disease and malignant breast disease categories. However, no significant correlation was observed in benign breast disease category Conclusion ER+/Ki-67+ ratio is an important determinant of the invasive breast cancer and can be used to differentiate invasive cancers from benign and proliferative breast tumours. PMID:27190810

  4. Wavelet-Based 3D Reconstruction of Microcalcification Clusters from Two Mammographic Views: New Evidence That Fractal Tumors Are Malignant and Euclidean Tumors Are Benign

    PubMed Central

    Batchelder, Kendra A.; Tanenbaum, Aaron B.; Albert, Seth; Guimond, Lyne; Kestener, Pierre; Arneodo, Alain; Khalil, Andre

    2014-01-01

    The 2D Wavelet-Transform Modulus Maxima (WTMM) method was used to detect microcalcifications (MC) in human breast tissue seen in mammograms and to characterize the fractal geometry of benign and malignant MC clusters. This was done in the context of a preliminary analysis of a small dataset, via a novel way to partition the wavelet-transform space-scale skeleton. For the first time, the estimated 3D fractal structure of a breast lesion was inferred by pairing the information from two separate 2D projected mammographic views of the same breast, i.e. the cranial-caudal (CC) and mediolateral-oblique (MLO) views. As a novelty, we define the “CC-MLO fractal dimension plot”, where a “fractal zone” and “Euclidean zones” (non-fractal) are defined. 118 images (59 cases, 25 malignant and 34 benign) obtained from a digital databank of mammograms with known radiologist diagnostics were analyzed to determine which cases would be plotted in the fractal zone and which cases would fall in the Euclidean zones. 92% of malignant breast lesions studied (23 out of 25 cases) were in the fractal zone while 88% of the benign lesions were in the Euclidean zones (30 out of 34 cases). Furthermore, a Bayesian statistical analysis shows that, with 95% credibility, the probability that fractal breast lesions are malignant is between 74% and 98%. Alternatively, with 95% credibility, the probability that Euclidean breast lesions are benign is between 76% and 96%. These results support the notion that the fractal structure of malignant tumors is more likely to be associated with an invasive behavior into the surrounding tissue compared to the less invasive, Euclidean structure of benign tumors. Finally, based on indirect 3D reconstructions from the 2D views, we conjecture that all breast tumors considered in this study, benign and malignant, fractal or Euclidean, restrict their growth to 2-dimensional manifolds within the breast tissue. PMID:25222610

  5. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

    PubMed Central

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-01-01

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features. PMID:27079888

  6. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans.

    PubMed

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-01-01

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features. PMID:27079888

  7. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

    NASA Astrophysics Data System (ADS)

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-04-01

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features.

  8. Mammary radioiodine accumulation due to functional sodium iodide symporter expression in a benign fibroadenoma

    SciTech Connect

    Berger, F.; Unterholzner, S.; Diebold, J.; Knesewitsch, P.; Hahn, K.; Spitzweg, C. . E-mail: Christine.Spitzweg@med.uni-muenchen.de

    2006-11-03

    The sodium iodide symporter (NIS) has been characterized to mediate the active transport of iodide not only in the thyroid gland but also in various non-thyroidal tissues, including lactating mammary gland and the majority of breast cancers, thereby offering the possibility of diagnostic and therapeutic radioiodine application in breast cancer. In this report, we present a 57-year-old patient with multifocal papillary thyroid carcinoma, who showed focal radioiodine accumulation in a lesion in the right breast on a posttherapy {sup 131}I scan following radioiodine therapy. CT and MR-mammography showed a focal solid lesion in the right breast suggestive of a fibroadenoma, which was confirmed by histological examination. Immunostaining of paraffin-embedded tumor tissue sections using a human NIS antibody demonstrated NIS-specific immunoreactivity confined to epithelial cells of mammary ducts. In conclusion, in a thyroid cancer patient we identified a benign fibroadenoma of the breast expressing high levels of functionally active NIS protein as underlying cause of focal mammary radioiodine accumulation on a posttherapy {sup 131}I scan. These data show for the first time that functional NIS expression is not restricted to lactating mammary gland and malignant breast tissue, but can also be detected in benign breast lesions, such as fibroadenomata of the breast.

  9. Development and comparative assessment of Raman spectroscopic classification algorithms for lesion discrimination in stereotactic breast biopsies with microcalcifications

    PubMed Central

    Dingari, Narahara Chari; Barman, Ishan; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2014-01-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. Here, we develop and compare different approaches for developing Raman classification algorithms to diagnose invasive and in situ breast cancer, fibrocystic change and fibroadenoma that can be associated with microcalcifications. In this study, Raman spectra were acquired from tissue cores obtained from fresh breast biopsies and analyzed using a constituent-based breast model. Diagnostic algorithms based on the breast model fit coefficients were devised using logistic regression, C4.5 decision tree classification, k-nearest neighbor (k-NN) and support vector machine (SVM) analysis, and subjected to leave-one-out cross validation. The best performing algorithm was based on SVM analysis (with radial basis function), which yielded a positive predictive value of 100% and negative predictive value of 96% for cancer diagnosis. Importantly, these results demonstrate that Raman spectroscopy provides adequate diagnostic information for lesion discrimination even in the presence of microcalcifications, which to the best of our knowledge has not been previously reported. Raman spectroscopy and multivariate classification provide accurate discrimination among lesions in stereotactic breast biopsies, irrespective of microcalcification status. PMID:22815240

  10. Hand-held and automated breast ultrasound

    SciTech Connect

    Bassett, L.W.; Gold, R.H.; Kimme-Smith, C.

    1985-01-01

    The book is a guide for physicians and technologists who use US as an adjunct to mammography; it carefully outlines the pros and cons of US of the breast and its role in the diagnosis of benign and malignant diseases. After an introduction that discusses the philosophy of breast US, the chapters cover the physics of US and instrumentation (both hand-held transducers as well as automated water path scanners), then proceed to a discussion of the normal breast. Sections on benign disorders, malignant lesions, and pitfalls of diagnosis are followed by quiz cases.

  11. Breast cancer detection using phase contrast diffuse optical tomography

    NASA Astrophysics Data System (ADS)

    Liang, Xiaoping; Zhang, Qizhi; Li, Changqing; Grobmyer, Stephen R.; Fajardo, Laurie L.; Jiang, Huabei

    2007-02-01

    In this report, a phase-contrast diffuse optical tomography system, which can measure the refractive indices of human breast masses in vivo, is described. To investigate the utility of phase-contrast diffuse optical tomography (PCDOT) for differentiation of malignant and benign breast masses in humans, and to compare PCDOT with conventional diffuse optical tomography (DOT) for analysis of breast masses in humans. 35 breast masses were imaged in 33 patients (mean age = 51 years; range 22-80 years) using PCDOT. Images characterizing the tissue refractive index, absorption and scattering of breast masses were obtained with a finite element-based reconstruction algorithm. The accuracies of absorption and scattering images were compared with images of refractive index in light of the pathology results. Absorption and scattering images were unable to accurately discriminate benign from malignant lesions. Malignant lesions tended to have decreased refractive index allowing them to discriminate from benign lesions in most cases. The sensitivity, specificity, false positive value, and overall accuracy for refractive index were 81.8%, 70.8%, 29.2%, and 74.3%, respectively. Overall we show that benign and malignant breast masses in humans demonstrate different refractive index and differences in refractive index properties can be used to discriminate benign from malignant masses in patients with high accuracy. This opens up a new avenue for improved breast cancer detection using NIR diffusing light.

  12. Progression risk of columnar cell lesions of the breast diagnosed in core needle biopsies.

    PubMed

    Verschuur-Maes, Anoek H J; Witkamp, Arjen J; de Bruin, Peter C; van der Wall, Elsken; van Diest, Paul J

    2011-12-01

    Columnar cell lesions (CCLs) of the breast are recognized as putative precursor lesions of invasive carcinoma, but their management remains controversial. We therefore conducted a retrospective study on 311 CCLs, diagnosed in 4,164 14-gauge core needle biopsies (CNB): 221 CCLs without atypia (CCL), 69 with atypia (CCL-A), and 21 atypical ductal hyperplasias originating in CCL (ADH-CCL). Two groups were identified: "immediate treatment" group undergoing excision within four months after the CNB diagnosis of CCL (N = 52) and the "wait-and-see" group followed up to 8 years (median 3.5 years, N = 259). In 7 of 31 women (22.5%, 1 CCL, 4 CCL-A, 2 ADH-CCL) who underwent immediate surgical excision and were initially biopsied for microcalcifications, ductal carcinoma in situ (DCIS) was present and in 2/31 women (6.5%, 1 CCL, 1 CCL-A) invasive carcinoma. In 2/21 excisions (9.5%, 1 CCL, 1 CCL-A) initially biopsied for a density, DCIS was present and invasive carcinoma in 5/21 excisions (23.8%, 2 CCL, 3 CCL-A). In the wait-and-see group, 9/259 women (3.5%) developed invasive carcinoma, 6 ipsi, and 3 contralaterally. Progression risks of CCL-A and ADH-CCL were 18% and 22%,versus 2% for CCL without atypia (p < 0.001). In conclusion, CCL-A or ADH-CCL in a CNB were associated with a high risk of DCIS/invasive carcinoma in immediate surgical excision biopsies. The 8-years progression risks for CCL-A and ADH-CCL were around 20%. This illustrates that an atypical CCL in a CNB may signal the presence of concurrent lesions or development of advanced lesions in future and may justify ("mini") surgical excision. PMID:21225627

  13. Differentiation between Focal Malignant Marrow-Replacing Lesions and Benign Red Marrow Deposition of the Spine with T2*-Corrected Fat-Signal Fraction Map Using a Three-Echo Volume Interpolated Breath-Hold Gradient Echo Dixon Sequence

    PubMed Central

    Kim, Yong Pyo; Kannengiesser, Stephan; Paek, Mun-Young; Chung, Tae-Sub; Yoo, Yeon Hwa; Yoon, Choon-Sik; Song, Ho-Taek; Lee, Young Han; Suh, Jin-Suck

    2014-01-01

    Objective To assess the feasibility of T2*-corrected fat-signal fraction (FF) map by using the three-echo volume interpolated breath-hold gradient echo (VIBE) Dixon sequence to differentiate between malignant marrow-replacing lesions and benign red marrow deposition of vertebrae. Materials and Methods We assessed 32 lesions from 32 patients who underwent magnetic resonance imaging after being referred for assessment of a known or possible vertebral marrow abnormality. The lesions were divided into 21 malignant marrow-replacing lesions and 11 benign red marrow depositions. Three sequences for the parameter measurements were obtained by using a 1.5-T MR imaging scanner as follows: three-echo VIBE Dixon sequence for FF; conventional T1-weighted imaging for the lesion-disc ratio (LDR); pre- and post-gadolinium enhanced fat-suppressed T1-weighted images for the contrast-enhancement ratio (CER). A region of interest was drawn for each lesion for parameter measurements. The areas under the curve (AUC) of the parameters and their sensitivities and specificities at the most ideal cutoff values from receiver operating characteristic curve analysis were obtained. AUC, sensitivity, and specificity were respectively compared between FF and CER. Results The AUCs of FF, LDR, and CER were 0.96, 0.80, and 0.72, respectively. In the comparison of diagnostic performance between the FF and CER, the FF showed a significantly larger AUC as compared to the CER (p = 0.030), although the difference of sensitivity (p = 0.157) and specificity (p = 0.157) were not significant. Conclusion Fat-signal fraction measurement using T2*-corrected three-echo VIBE Dixon sequence is feasible and has a more accurate diagnostic performance, than the CER, in distinguishing benign red marrow deposition from malignant bone marrow-replacing lesions. PMID:25469090

  14. Medical devices; obstetrical and gynecological devices; classification of the breast lesion documentation system. Final rule.

    PubMed

    2003-07-28

    The Food and Drug Administration (FDA) is classifying the breast lesion documentation system into class II (special controls). The special controls that will apply to this device are discussed later in this document. The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997 (FDAMA). The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is publishing a notice of availability of a guidance document that is the special control for this device. PMID:12884877

  15. A modified Seeded Region Growing algorithm for vessel segmentation in breast MRI images for investigating the nature of potential lesions

    NASA Astrophysics Data System (ADS)

    Glotsos, D.; Vassiou, K.; Kostopoulos, S.; Lavdas, El; Kalatzis, I.; Asvestas, P.; Arvanitis, D. L.; Fezoulidis, I. V.; Cavouras, D.

    2014-03-01

    The role of Magnetic Resonance Imaging (MRI) as an alternative protocol for screening of breast cancer has been intensively investigated during the past decade. Preliminary research results have indicated that gadolinium-agent administrative MRI scans may reveal the nature of breast lesions by analyzing the contrast-agent's uptake time. In this study, we attempt to deduce the same conclusion, however, from a different perspective by investigating, using image processing, the vascular network of the breast at two different time intervals following the administration of gadolinium. Twenty cases obtained from a 3.0-T MRI system (SIGNA HDx; GE Healthcare) were included in the study. A new modification of the Seeded Region Growing (SRG) algorithm was used to segment vessels from surrounding background. Delineated vessels were investigated by means of their topology, morphology and texture. Results have shown that it is possible to estimate the nature of the lesions with approximately 94.4% accuracy, thus, it may be claimed that the breast vascular network does encodes useful, patterned, information, which can be used for characterizing breast lesions.

  16. A comparison of lesion detection accuracy using digital mammography and flat-panel CT breast imaging (Honorable Mention Poster Award)

    NASA Astrophysics Data System (ADS)

    Gong, Xing; Vedula, Aruna A.; Thacker, Samta; Glick, Stephen J.

    2005-04-01

    Although conventional mammography is currently the best modality to detect early breast cancer, it is limited in that the recorded image represents the superposition of a 3D object onto a 2D plane. As an alternative, cone-beam CT breast imaging with a CsI based flat-panel imager (CTBI) has been proposed with the ability to provide 3D visualization of breast tissue. To investigate possible improvements in lesion detection accuracy using CTBI over digital mammography (DM), a computer simulation study was conducted using simulated lesions embedded into a structured 3D breast model. The computer simulation realistically modeled x-ray transport through a breast model, as well as the signal and noise propagation through the flat-panel imager. Polyenergetic x-ray spectra of W/Al 50 kVp for CTBI and Mo/Mo 28 kVp for DM were modeled. For the CTBI simulation, the intensity of the x-ray spectra for each projection view was determined so as to provide a total mean glandular dose (MGD) of 4 mGy, which is approximately equivalent to that given in a conventional two-view screening mammography study. Since only one DM view was investigated here, the intensity of the DM x-ray spectra was defined to give 2 mGy MGD. Irregular lesions were simulated by using a stochastic growth algorithm providing lesions with an effective diameter of 5 mm. Breast tissue was simulated by generating an ensemble of backgrounds with a power law spectrum. To evaluate lesion detection accuracy, a receiver operating characteristic (ROC) study was performed with 4 observers reading an ensemble of images for each case. The average area under the ROC curves (Az) was 0.94 for CTBI, and 0.81 for DM. Results indicate that a 5 mm lesion embedded in a structured breast phantom can be detected by CT breast imaging with statistically significant higher confidence than with digital mammography.

  17. Nuclear shape descriptors by automated morphometry may distinguish aggressive variants of squamous cell carcinoma from relatively benign skin proliferative lesions: a pilot study.

    PubMed

    Yang, Weixi; Tian, Rong; Xue, Tongqing

    2015-08-01

    We evaluated whether degrees of dysplasia may be consistently accessed in an automatic fashion, using different kinds of non-melanoma skin cancer (NMSC) as a validatory model. Namely, we compared Bowen disease, actinic keratosis, basal cell carcinoma, low-grade squamous cell carcinoma, and invasive squamous cell carcinoma. We hypothesized that characterizing the shape of nuclei may be important to consistently diagnose the aggressiveness of a skin tumor. While basal cell carcinoma is comparatively relatively benign, management of squamous cell carcinoma is controversial because of its potential to recur and intraoperative dilemma regarding choice of the margin or the depth for the excision. We provide evidence here that progressive nuclear dysplasia may be automatically estimated through the thresholded images of skin cancer and quantitative parameters estimated to provide a quasi-quantitative data, which can thenceforth guide the management of the particular cancer. For circularity, averaging more than 2500 nuclei in each group estimated the means ± SD as 0.8 ± 0.007 vs. 0.78 ± 0.0063 vs. 0.42 ± 0.014 vs. 0.63 ± 0.02 vs. 0.51 ± 0.02 (F = 318063.56, p < 0.0001, one-way analyses of variance). The mean aspect ratios were (means ± SD) 0.97 ± 0.0014 vs. 0.95 ± 0.002 vs. 0.38 ± 0.018 vs. 0.84 ± 0.0035 vs. 0.74 ± 0.019 (F = 1022631.931, p < 0.0001, one-way analyses of variance). The Feret diameters averaged over 2500 nuclei in each group were the following: 1 ± 0.0001 vs. 0.9 ± 0.002 vs. 5 ± 0.031 vs. 1.5 ± 0.01 vs. 1.9 ± 0.004 (F = 33105614.194, p < 0.0001, one-way analyses of variance). Multivariate analyses of composite parameters potentially detect aggressive variants of squamous cell carcinoma as the most dysplastic form, in comparison to locally occurring squamous cell carcinoma and basal cell carcinoma, or benign skin lesions. PMID:25753477

  18. Exclusion of the retinoblastoma gene and chromosome 13q as the site of a primary lesion for human breast cancer.

    PubMed Central

    Bowcock, A M; Hall, J M; Hebert, J M; King, M C

    1990-01-01

    Chromosome 13q has been suggested as the site of a gene predisposing to human breast cancer, because loss of heterozygosity of alleles on this chromosome has been observed in some ductal breast tumors and because two breast cancer lines are altered at the retinoblastoma gene (RB1) at 13q14. To test this possibility, linkage of breast cancer susceptibility to 14 loci on chromosome 13q loci was assessed in extended families in which breast cancer is apparently inherited as an autosomal dominant trait. RB1 was excluded as the site of a breast cancer gene by a lod score of Z = -7.60 at close linkage for 13 families. Multipoint analysis yielded negative lod scores throughout the region between 13q12 and 13q34; over most of this distance, Z less than -2.0. Therefore, chromosome 13q appears to be excluded as the site of primary lesion for breast cancer in these families. In addition, comparison of tumor versus normal tissues of nonfamilial breast cancer patients revealed an alteration at the 5' end of RB1 in a mucoid carcinoma but no alterations of RB1 in five informative ductal adenocarcinomas. Linkage data and comparisons of tumor and normal tissues suggest that changes in the RBI locus either are secondary alterations associated with progression of some tumors or occur by chance. Images Figure 2 PMID:2294744

  19. Fluorescence diagnostics of metastatic lesion of regional lymph nodes upon surgical treatment of breast cancer

    NASA Astrophysics Data System (ADS)

    Filonenko, E. V.; Pak, D. D.; Yanikova, A. G.

    2013-06-01

    We have performed intraoperative fluorescence diagnostics of 60 patients for metastases of breast cancer to regional lymph nodes. All the patients were divided into two groups. The first group consisted of 50 patients, which were surgically treated at the first stage. The second group consisted of ten patients, which underwent combined treatment. At the first stage, they received from two to four courses of neoadjuvant chemotherapy, and, at the second stage, the surgical intervention was performed. The intraoperative fluorescence diagnostics was performed using the preparation alasens (precursor of protoporphyrin IX in the human organism). The occurrence of fluorescence of alasens-induced protoporphyrin IX was determined visually and using the local fluorescence spectroscopy method. Altogether, 498 lymph nodes were examined: 408 in the first group and 90 in the second one. For the first group, the sensitivity of the method was found to be 87.2%, and its specificity, 94.8%; in the second group, these parameters were determined to be 77 and 78%, respectively. The first experience of the application of the intraoperative fluorescence diagnostics of metastatic lesion of lymph nodes in patients with breast cancer has shown its high efficiency and application potential.

  20. Breast Cancer Cells Induce Osteolytic Bone Lesions In vivo through a Reduction in Osteoblast Activity in Mice

    PubMed Central

    Gregory, Laura S.; Choi, Wilson; Burke, Leslie; Clements, Judith A.

    2013-01-01

    Bone metastases are severely debilitating and have a significant impact on the quality of life of women with metastatic breast cancer. Treatment options are limited and in order to develop more targeted therapies, improved understanding of the complex mechanisms that lead to bone lesion development are warranted. Interestingly, whilst prostate-derived bone metastases are characterised by mixed or osteoblastic lesions, breast-derived bone metastases are characterised by osteolytic lesions, suggesting unique regulatory patterns. This study aimed to measure the changes in bone formation and bone resorption activity at two time-points (18 and 36 days) during development of the bone lesion following intratibial injection of MDA-MB-231 human breast cancer cells into the left tibiae of Severely Combined Immuno-Deficient (SCID) mice. The contralateral tibia was used as a control. Tibiae were extracted and processed for undecalcified histomorphometric analysis. We provide evidence that the early bone loss observed following exposure to MDA-MB-231 cells was due to a significant reduction in mineral apposition rate, rather than increased levels of bone resorption. This suggests that osteoblast activity was impaired in the presence of breast cancer cells, contrary to previous reports of osteoclast-dependent bone loss. Furthermore mRNA expression of Dickkopf Homolog 1 (DKK-1) and Noggin were confirmed in the MDA-MB-231 cell line, both of which antagonise osteoblast regulatory pathways. The observed bone loss following injection of cancer cells was due to an overall thinning of the trabecular bone struts rather than perforation of the bone tissue matrix (as measured by trabecular width and trabecular separation, respectively), suggesting an opportunity to reverse the cancer-induced bone changes. These novel insights into the mechanisms through which osteolytic bone lesions develop may be important in the development of new treatment strategies for metastatic breast cancer

  1. Modeling invasive breast cancer: growth factors propel progression of HER2-positive premalignant lesions

    PubMed Central

    Pradeep, C-R; Zeisel, A; Köstler, WJ; Lauriola, M; Jacob-Hirsch, J; Haibe-Kains, B; Amariglio, N; Ben-Chetrit, N; Emde, A; Solomonov, I; Neufeld, G; Piccart, M; Sagi, I; Sotiriou, C; Rechavi, G; Domany, E; Desmedt, C; Yarden, Y

    2013-01-01

    The HER2/neu oncogene encodes a receptor-like tyrosine kinase whose overexpression in breast cancer predicts poor prognosis and resistance to conventional therapies. However, the mechanisms underlying aggressiveness of HER2 (human epidermal growth factor receptor 2)-overexpressing tumors remain incompletely understood. Because it assists epidermal growth factor (EGF) and neuregulin receptors, we overexpressed HER2 in MCF10A mammary cells and applied growth factors. HER2-overexpressing cells grown in extracellular matrix formed filled spheroids, which protruded outgrowths upon growth factor stimulation. Our transcriptome analyses imply a two-hit model for invasive growth: HER2-induced proliferation and evasion from anoikis generate filled structures, which are morphologically and transcriptionally analogous to preinvasive patients’ lesions. In the second hit, EGF escalates signaling and transcriptional responses leading to invasive growth. Consistent with clinical relevance, a gene expression signature based on the HER2/EGF-activated transcriptional program can predict poorer prognosis of a subgroup of HER2-overexpressing patients. In conclusion, the integration of a three-dimensional cellular model and clinical data attributes progression of HER2-overexpressing lesions to EGF-like growth factors acting in the context of the tumor's microenvironment. PMID:22139081

  2. Early Breast Cancer Precursor Lesions: Lessons Learned from Molecular and Clinical Studies.

    PubMed

    Sinn, Hans-Peter; Elsawaf, Zeinab; Helmchen, Birgit; Aulmann, Sebastian

    2010-08-01

    Atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and lobular neoplasia (LN) form a group of early precursor lesions that are part of the low-grade pathway in breast cancer development. This concept implies that the neoplastic disease process begins at a stage much earlier than in situ carcinoma. We have performed a review of the published literature for the upgrade risk to ductal carcinoma in situ or invasive carcinoma in open biopsy after a diagnosis of ADH, FEA, or LN in core needle biopsy. This has revealed the highest upgrade risk for ADH (28.2% after open biopsy), followed by LN (14.9%), and FEA (10.2%). With LN, the pleomorphic subtype is believed to confer a higher risk than classical LN. With all types of precursor lesions, careful attention must be paid to the clinicopathological correlation for the guidance of the clinical management. Follow-up biopsies are generally indicated in ADH, and if there is any radiological-pathological discrepancy, also in LN or FEA. PMID:22590441

  3. Differential expression of gp200-MR6 molecule in benign hyperplasia and down-regulation in invasive carcinoma of the breast.

    PubMed Central

    al-Tubuly, A. A.; Luqmani, Y. A.; Shousha, S.; Melcher, D.; Ritter, M. A.

    1996-01-01

    In this study, we used immunohistochemical and biochemical analysis to show that gp200-MR6, a 200 kDa molecule that is functionally associated with the human interleukin 4 (IL-4) receptor complex, is expressed at high levels on normal breast epithelial tissues, at lower levels on in situ carcinomas, and that the expression is lost in the invasive carcinoma of the breast. Furthermore, a preliminary study showed that benign epithelial hyperplasia of the breast expresses the gp200-MR6 heterogeneously. Two populations of cells have been observed: MR6 positive and MR6 negative. Interestingly, MR6-positive cells were observed to have different morphology from those that were MR6 negative; the nuclei of the former were larger and rounded in shape, whereas the nuclei of the latter were relatively small and oval in shape. In sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting, monoclonal antibody MR6 detects the same molecular weight molecule in both normal and transformed tissue, indicating that the molecule is not a product of a truncated gene. The intensity of the gp200-MR6 bands correlates with the immunohistochemical data, indicating that the molecule is expressed at high levels in normal tissue and at lower levels in malignant tissue. These results suggest that analysis of gp200-MR6 expression may be useful in tumour grading and prognostic evaluation in breast cancer. Moreover, the molecule may be involved early in the process of tumorigenesis of the breast, in which a loss or a down-regulation of gp200-MR6 could contribute towards tumour development and progression via an effect on cell growth and differentiation. Images Figure 1 Figure 3 Figure 4 Figure 5 PMID:8855966

  4. Transformation of the female breast during compression at mammography with special reference to the importance for localization of a lesion.

    PubMed

    Novak, R

    1988-01-01

    The effects of compression during mammography were studied in 187 breasts. The aims of this study were to investigate: 1) How the skin moves, 2) how the gland tissue is transformed, 3) if there is a relationship between outer and inner alterations and 4) the practical implications for aspiration biopsy. In this study, several experiments were carried out to investigate the effects of compression during clinical mammography in adult female breasts. The transformation of the breast during compression was investigated by means of external skin markings and internal markings using the biopsy needle and the hookwire at preoperative localization. The extent of the mammary gland was measured in the different standard projections during mammography. The calculation of the depth of a lesion during cranio-caudal compression was performed on the latero-medial radiographs. The result was checked with water-soluble radiographic contrast medium. The mean value of differences between observed and calculated depth was 3.7 mm. 1. The breast transforms during compression. 2. The biopsy needle in the breast and the barium markings on the skin incline ventrally in 96 per cent during latero-medial compression. The preoperative hookwire inclines ventrally in 92 per cent. 3. The extension of the gland parenchyma (the longest diagonal) is almost equal in all standard projections, including the medio-lateral oblique one. 4. The skin in the inframammary sulcus is firmly attached to the thoracic wall. This form of fixation determines principally the movements of the breast and limits the transformation during compression. 5. The movements of the skin are connected to the movements of the dense tissue, gland parenchyma. There is a connection between the ventral and descending inclination. These inclinations are caused by the same transformation of the breast. 6. Due to the regular movements of the breast during different compression directions, it is possible to predict the location of a

  5. Investigating the use of texture features for analysis of breast lesions on contrast-enhanced cone beam CT

    NASA Astrophysics Data System (ADS)

    Wang, Xixi; Nagarajan, Mahesh B.; Conover, David; Ning, Ruola; O'Connell, Avice; Wismueller, Axel

    2014-04-01

    Cone beam computed tomography (CBCT) has found use in mammography for imaging the entire breast with sufficient spatial resolution at a radiation dose within the range of that of conventional mammography. Recently, enhancement of lesion tissue through the use of contrast agents has been proposed for cone beam CT. This study investigates whether the use of such contrast agents improves the ability of texture features to differentiate lesion texture from healthy tissue on CBCT in an automated manner. For this purpose, 9 lesions were annotated by an experienced radiologist on both regular and contrast-enhanced CBCT images using two-dimensional (2D) square ROIs. These lesions were then segmented, and each pixel within the lesion ROI was assigned a label - lesion or non-lesion, based on the segmentation mask. On both sets of CBCT images, four three-dimensional (3D) Minkowski Functionals were used to characterize the local topology at each pixel. The resulting feature vectors were then used in a machine learning task involving support vector regression with a linear kernel (SVRlin) to classify each pixel as belonging to the lesion or non-lesion region of the ROI. Classification performance was assessed using the area under the receiver-operating characteristic (ROC) curve (AUC). Minkowski Functionals derived from contrastenhanced CBCT images were found to exhibit significantly better performance at distinguishing between lesion and non-lesion areas within the ROI when compared to those extracted from CBCT images without contrast enhancement (p < 0.05). Thus, contrast enhancement in CBCT can improve the ability of texture features to distinguish lesions from surrounding healthy tissue.

  6. A finite element model of remote palpation of breast lesions using radiation force: factors affecting tissue displacement.

    PubMed

    Nightingale, K R; Nightingale, R W; Palmeri, M L; Trahey, G E

    2000-01-01

    The early detection of breast cancer reduces patient mortality. The most common method of breast cancer detection is palpation. However, lesions that lie deep within the breast are difficult to palpate when they are small. Thus, a method of remote palpation, which may allow the detection of small lesions lying deep within the breast, is currently under investigation. In this method, acoustic radiation force is used to apply localized forces within tissue (to tissue volumes on the order of 2 mm3) and the resulting tissue displacements are mapped using ultrasonic correlation based methods. A volume of tissue that is stiffer than the surrounding medium (i.e., a lesion) distributes the force throughout the tissue beneath it, resulting in larger regions of displacement, and smaller maximum displacements. The resulting displacement maps may be used to image tissue stiffness. A finite-element-model (FEM) of acoustic remote palpation is presented in this paper. Using this model, a parametric analysis of the affect of varying tissue and acoustic beam characteristics on radiation force induced tissue displacements is performed. The results are used to evaluate the potential of acoustic remote palpation to provide useful diagnostic information in a clinical setting. The potential for using a single diagnostic transducer to both generate radiation force and track the resulting displacements is investigated. PMID:10823496

  7. Breast Elastography: How We Do It.

    PubMed

    Gkali, Christina A; Chalazonitis, Athanasios N; Feida, Eleni; Sotiropoulou, Maria; Giannos, Aris; Tsigginou, Alexandra; Dimitrakakis, Constantine

    2015-12-01

    In recent years, the use of elastography in addition to sonography has become a routine clinical tool for the characterization of breast masses. Studies have investigated the improvement of specificity in differentiating benign from malignant breast masses. Therefore, additional use of elastography could help reduce the number of unnecessary biopsies in benign breast lesions especially in category IV lesions of the ultrasound breast imaging reporting data system. Ultrasound elastography is a cheap, readily available, useful, quick, noninvasive method, but it needs specific training as well as acknowledging technical and pathological factors, which may influence it. Both strain and acoustic radiation force impulse (ARFI) methods have been evaluated in breast lesions. Whereas strain elastography results in qualitative imaging of tissue stiffness due to induced compression, ARFI elastography displays quantitative and qualitative information of tissue displacement. A standardized imaging protocol is essential for an adequate and effective examination, also helping reduce the dependence from operators. Furthermore, knowledge of pitfalls that can be encountered when ultrasound elastography is performed may help avoid erroneous image interpretation. In this article, we describe a practical examination protocol for both strain and ARFI elastography and demonstrate the elastographic imaging findings in benign and malignant breast lesions. Short video clips displaying the technique are included as supplementary material. PMID:26327432

  8. Benign bone tumors.

    PubMed

    Gilday, D L; Ash, J M

    1976-01-01

    There is little information in the literature concerning the role of bone scanning in benign bone neoplasms except for sporadic reports. Since the advent of 99mTc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone pain, such as in osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of hyperemia in the immediate postinjection period favors the diagnosis of a benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone tumors, including simple and aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas, all of which had minimal or no increased uptake of the radiopharmaceutical, unless traumatized. Although osteochondromas and enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions. PMID:1082170

  9. Breast reshaping with dermaglandular flaps after giant lipoma removal: versatility of oncoplastic techniques.

    PubMed

    Bonomi, Stefano; Salval, André; Settembrini, Fernanda; Musumarra, Gaetano; Rapisarda, Vincenzo

    2012-04-01

    Lipomas of the breast are benign lesions that do not raise great interest in the literature and their incidence is unclear. They usually are small, benign soft tissue tumors of fat cells that can be treated by simple excision. Although lipoma is a banal condition, it often causes diagnostic and therapeutic uncertainty. The first reason for this is the normal fatty composition of the breast. Second, it may be difficult to distinguish a lipoma from other benign or malignant lumps. This report presents a rare case involving giant lipoma of the breast that compromised most of the mass of the breast. After resection, the remaining breast was reshaped using multiple dermaglandular flaps to restore the breast mound, and contralateral breast mammaplasty was performed for symmetry. This case is a good illustration of the oncoplastic reconstruction options available after wide local excision. PMID:22042358

  10. Pseudoangiomatous stromal hyperplasia of the breast: a case report of a 12-year-old girl.

    PubMed

    Almohawes, Eman; Khoumais, Nuha; Arafah, Maria

    2015-10-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion, characterized by a dense proliferation of stromal mesenchymal cells of myofibroblastic origin forming empty, slit-like channels. We report PASH in a 12-year-old girl with a huge rapidly enlarged right breast. Biopsy of the mass showed histopathologic features characteristic of PASH. Immunohistochemical studies revealed diffuse positive membranous immunoreactivity to CD34. Although it is a benign lesion, lumpectomy was performed to minimize the damage from developing breast tissue. PMID:26649107

  11. Pseudoangiomatous stromal hyperplasia of the breast: a case report of a 12-year-old girl

    PubMed Central

    Almohawes, Eman; Khoumais, Nuha; Arafah, Maria

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion, characterized by a dense proliferation of stromal mesenchymal cells of myofibroblastic origin forming empty, slit-like channels. We report PASH in a 12-year-old girl with a huge rapidly enlarged right breast. Biopsy of the mass showed histopathologic features characteristic of PASH. Immunohistochemical studies revealed diffuse positive membranous immunoreactivity to CD34. Although it is a benign lesion, lumpectomy was performed to minimize the damage from developing breast tissue. PMID:26649107

  12. Development and Feasibility Testing of Image-Guided Minimally Invasive Tissue for Diagnosis Treatment of Benign and Malignant Breast Disease

    NASA Technical Reports Server (NTRS)

    Jeffrey, Stefanie S.

    1999-01-01

    Dr. Robert Mah and Dr. Stefanie Jeffrey worked on the development of the NASA Smart Probe in its application as a device to measure and interpret physiologic and image-based parameters of breast tissue. To date the following has been achieved: 1 . Choice of candidate sensors to be tested in breast tissue. 2. Preliminary designs for probe tip, specifically use of different tip shapes, cutting edges, and sensor configuration. 3. Design of sonographic guidance system. 4. Design of data extraction and analysis tool using scanned information of images of the breast tissue to provide a higher dimension of information for breast tissue characterization and interpretation. 5. Initial ex-vivo (fruit and tofu) and in-vivo (rodent) testing to confirm unique substance and tissue characterization by the Smart Probe software.

  13. Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery.

    PubMed

    Rabban, Joseph T; Garg, Karuna; Crawford, Beth; Chen, Lee-may; Zaloudek, Charles J

    2014-06-01

    Early detection of sporadic pelvic serous carcinoma remains an elusive goal. In women at high risk for hereditary breast and ovarian cancer syndrome who undergo prophylactic salpingectomy, systematic pathologic examination of the fallopian tubes will detect occult tubal cancer, mostly in the fimbriae, of a minority of women. Such tubal cancers are the putative precursor to advanced-stage pelvic cancer. We hypothesized that early tubal cancer detection can also be accomplished in women at low risk using a similar approach. In this study, we performed complete and systematic examination of the fallopian tubes removed during surgery performed for benign indications. Among 522 women, 4 cases of serous tubal intraepithelial carcinoma (STIC) were identified. Three of these cases would have gone undetected using the current standard of care of sampling only a single random section of the tube. The fourth case was accompanied by occult ovarian carcinoma. The fimbriae contained STIC in 3 of the 4 cases and atypical mucosa in 1 case in which the STIC was in the nonfimbriated portion of the tube. The morphologic and immunohistochemical features (aberrant p53 and MIB-1) of these STICs were similar to those expected in high-risk women. All 4 patients with STIC underwent BRCA1 and BRCA2 gene testing; no germline mutations were identified in any patient. An additional 11 specimens contained atypical mucosal proliferations that fell short of morphologic and immunohistochemical criteria for STIC. Two of these 11 fulfilled criteria for a serous tubal intraepithelial lesion, and the remaining atypical proliferations exhibited normal p53 and MIB-1. For most specimens, the fimbriae could be completely submitted in 1 or 2 cassettes per tube. These results demonstrate that systematic examination of the tubal fimbriae can serve as a form of early detection of sporadic tubal cancer without incurring significant labor or cost. We propose that the tubal fimbriae should be completely examined

  14. Post-mastectomy benign lymphangioendothelioma of the skin following chronic lymphedema for breast carcinoma: a teaching case mimicking low-grade angiosarcoma and masquerading as Stewart-Treves syndrome.

    PubMed

    Yamada, Sohsuke; Yamada, Yoko; Kobayashi, Miwa; Hino, Ryosuke; Nawata, Aya; Noguchi, Hirotsugu; Nakamura, Motonobu; Nakayama, Toshiyuki

    2014-01-01

    Benign lymphangioendothelioma (BL) represents a very rare lymphatic vascular proliferation. Our aim is to be aware that owing to its characteristic features, pathologists can easily misinterpret it as cutaneous low-grade angiosarcoma when examining only small specimens. In the present case, multiple small and yellowish to reddish soft nodules were noticed in the edematous left arm of a 54-year-old Japanese female 4 years after the radical mastectomy with axillary lymph nodes dissection and following radiotherapy to the chest for the left breast carcinoma. The biopsy specimen showed an ill-defined lesion composed of a proliferation of irregular and sometimes anastomosing vascular structures in the dermis, lined by endothelial cells having mildly hyperchromatic and pleomorphic nuclei, but no mitotic figures. As the lesion grew within deeper dermis, these proliferating vessels dissected dermal collagenous bands, occasionally arranged in low-papillary projections and/or characteristic hobnail cytomorphology. We first interpreted it as low-grade angiosarcoma following chronic lymphedema due to the operation, i.e., the so-called Stewart-Treves syndrome. Although additional treatments were performed for 7 years, she had neither local invasion nor metastases of these tumors, respectively, and was alive and well. Retrospective immunohistochemical findings demonstrated that these mildly atypical endothelial cells were strongly positive for lymphatic vessel endothelial hyaluronan receptor (LYVE)-1 as well, and MIB-1 labeling index was less than 1%. Therefore, we finally made a diagnosis of BL of the skin. MIB-1 labeling index might be useful and adjunctive aids for reaching the correct diagnosis of cutaneous BL, especially in case of small or inadequate specimens.Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_197. PMID:25358645

  15. Are Breast Masses in Teenagers Always Benign? Undifferentiated Mesenchymal Sarcoma in a 14-Year-Old Girl

    PubMed Central

    Tekbas, Guven; Ince, Tülay; Kapan, Murat; Ekici, Faysal; Önder, Akin; Kucukonen, Mehmet; Bilici, Aslan; Gumus, Hatice

    2012-01-01

    Background This article is concerned with the evaluation of an adolescent breast mass using imaging methods. Case Report A 14-year-old girl presented with progressive asymmetric enlargement of the left breast. She had felt a breast lump about 4 months earlier, and over the last 2 months it had been growing progressively. Tumor markers, including AFP, CEA, CA15-3, and CA125, were all normal. Ultrasonography showed a hypoechoichyperechoic, solid mass. Magnetic resonance imaging of the breast revealed a well marginated mass with hypointensity on T1-weighted images and mild hyperintensity on T2-weighted images, which showed mild contrast uptake. Biopsy revealed an undifferentiated malignant mesenchymal sarcoma. The patient underwent mastectomy with axillary lymph node sampling. After the operation, she received 3 cycles of chemotherapy and radiotherapy. Conclusion Due to the rarity of breast sarcoma and inadequate imaging methods to establish an exact diagnosis, radiologists and clinicians may misdiagnose and merely follow these tumors. As in our case, the histology of the patient may be the leading factor in the management of these tumors. Even in very young patients, progressively growing breast masses should alert the clinician to check for malignancy verified by biopsy. PMID:22740802

  16. Ultrasound - Breast

    MedlinePlus

    ... discharge) and to characterize potential abnormalities seen on mammography or breast magnetic resonance imaging (MRI). Ultrasound imaging ... supply in breast lesions . Supplemental Breast Cancer Screening Mammography is the only screening tool for breast cancer ...

  17. Development and comparative assessment of Raman spectroscopic classification algorithms for lesion discrimination in stereotactic breast biopsies with microcalcifications.

    PubMed

    Dingari, Narahara Chari; Barman, Ishan; Saha, Anushree; McGee, Sasha; Galindo, Luis H; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-04-01

    Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. Here, we develop and compare different approaches for developing Raman classification algorithms to diagnose invasive and in situ breast cancer, fibrocystic change and fibroadenoma that can be associated with microcalcifications. In this study, Raman spectra were acquired from tissue cores obtained from fresh breast biopsies and analyzed using a constituent-based breast model. Diagnostic algorithms based on the breast model fit coefficients were devised using logistic regression, C4.5 decision tree classification, k-nearest neighbor (k -NN) and support vector machine (SVM) analysis, and subjected to leave-one-out cross validation. The best performing algorithm was based on SVM analysis (with radial basis function), which yielded a positive predictive value of 100% and negative predictive value of 96% for cancer diagnosis. Importantly, these results demonstrate that Raman spectroscopy provides adequate diagnostic information for lesion discrimination even in the presence of microcalcifications, which to the best of our knowledge has not been previously reported. PMID:22815240

  18. Comparative serum proteome analysis of human lymph node negative/positive invasive ductal carcinoma of the breast and benign breast disease controls via label-free semiquantitative shotgun technology.

    PubMed

    Hu, Xiaofang; Zhang, Yan; Zhang, Aili; Li, Yingzi; Zhu, Zhenmin; Shao, Zhimin; Zeng, Rong; Xu, Lisa X

    2009-08-01

    Serum proteomics provides a useful tool to identify potential biomarkers associated with cancer progression. In the present study, a two-dimensional liquid chromatography-tandem mass spectrometry (2D-LC-MS/MS) on a linear ion trap was utilized to identify and compare serum proteins from breast cancer patients. Three groups of 21 human sera, 7 from patients with lymph node-negative invasive ductal carcinoma (IDCB), 7 from patients with lymph node-positive IDCB, and 7 controls from patients with benign breast diseases, were analyzed. Through proteomic analysis, a total of 2,078 proteins were identified with at least two unique peptide hits. By quantification with label-free spectral counting, a fruitful list of serum proteins with significant differences in abundance accompanying the progression of breast cancer was found. Through hierarchical cluster analysis based on the differently expressed proteins in selection, we found that different groups of sera could be distinguished. Among the selected proteins, tenascin-XB (TNXB) was further validated by the ELISA method in 131 serum samples as a promising biomarker for early metastasis of breast cancer. These experiments revealed the valuable potential of label-free quantitative 2D-LC-MS/MS for identification of novel biomarkers for disease progression. PMID:19624269

  19. Fibrocystic breast disease

    MedlinePlus

    Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes ... made in the ovaries may make a woman's breasts feel swollen, lumpy, or painful before or during ...

  20. Identification of error making patterns in lesion detection on digital breast tomosynthesis using computer-extracted image features

    NASA Astrophysics Data System (ADS)

    Wang, Mengyu; Zhang, Jing; Grimm, Lars J.; Ghate, Sujata V.; Walsh, Ruth; Johnson, Karen S.; Lo, Joseph Y.; Mazurowski, Maciej A.

    2016-03-01

    Digital breast tomosynthesis (DBT) can improve lesion visibility by eliminating the issue of overlapping breast tissue present in mammography. However, this new modality likely requires new approaches to training. The issue of training in DBT is not well explored. We propose a computer-aided educational approach for DBT training. Our hypothesis is that the trainees' educational outcomes will improve if they are presented with cases individually selected to address their weaknesses. In this study, we focus on the question of how to select such cases. Specifically, we propose an algorithm that based on previously acquired reading data predicts which lesions will be missed by the trainee for future cases (i.e., we focus on false negative error). A logistic regression classifier was used to predict the likelihood of trainee error and computer-extracted features were used as the predictors. Reader data from 3 expert breast imagers was used to establish the ground truth and reader data from 5 radiology trainees was used to evaluate the algorithm performance with repeated holdout cross validation. Receiver operating characteristic (ROC) analysis was applied to measure the performance of the proposed individual trainee models. The preliminary experimental results for 5 trainees showed the individual trainee models were able to distinguish the lesions that would be detected from those that would be missed with the average area under the ROC curve of 0.639 (95% CI, 0.580-0.698). The proposed algorithm can be used to identify difficult cases for individual trainees.

  1. Assessment and Management of Challenging BI-RADS Category 3 Mammographic Lesions.

    PubMed

    Michaels, Aya Y; Birdwell, Robyn L; Chung, Chris SungWon; Frost, Elisabeth P; Giess, Catherine S

    2016-01-01

    Breast Imaging Reporting and Data System (BI-RADS) category 3 lesions are probably benign by definition and are recommended for short-interval follow-up after a diagnostic workup has been completed. Although the original lexicon-derived BI-RADS category 3 definition applied to lesions without prior imaging studies (when stability could not be determined), in clinical practice, many lesions with prior images may be assigned to BI-RADS category 3. Although the BI-RADS fifth edition specifically delineates lesions that are appropriate for categorization as probably benign, it also specifies that the interpreting radiologist may use his or her discretion and experience to justify a "watchful waiting" approach for lesions that do not meet established criteria. Examples of such lesions include evolving masses or calcifications suggestive of prior trauma and instances when stability cannot be ascertained because of image quality. Although interval change is an important feature of malignancy, many benign lesions also change over time; thus, use of prior imaging studies and ongoing imaging surveillance to demonstrate the evolution of a probably benign lesion is justified. Some examples of common pitfalls associated with inappropriate BI-RADS category 3 assessment include failure to use proper BI-RADS descriptors, failure to perform a complete diagnostic workup, and overreliance on negative ultrasonographic findings. When appropriately used, short-interval follow-up saves many patients from undergoing biopsy of benign lesions, without decreasing the rate of cancer detection. (©)RSNA, 2016. PMID:27541437

  2. Histopathologic findings in breast reduction specimens.

    PubMed

    Kececi, Yavuz; Tasli, Funda Alkan; Yagcı, Ayse; Sır, Emin; Canpolat, Selin; Vardar, Enver

    2014-04-01

    Reduction mammaplasty is a commonly performed operation for treatment of breast hypertrophy. It allows examination of specimens from a seemingly healthy population. Although there are many publications reporting the incidence of occult breast carcinomas, only a few studies have specifically examined the incidence of other breast lesions in reduction mammaplasty specimens. The authors conducted a single-centre retrospective chart review examining the incidence of benign and precancerous lesions in breast reduction specimens. Both age and the number of tissue sections were evaluated for the association with important pathologic findings. Of the 95 patients who underwent reduction mammaplasty, eight patients (8.4%) had atypical lesions. Fourteen patients (15%) had proliferative and 54 patients (57%) had non-proliferative breast lesions. No occult invasive breast cancer was identified in the breast reduction specimens. The existence of significant pathologic findings was not associated with age (p = 0.231, student t-test). On the other hand, it was found to be associated with the number of tissue sections (p = 0.046, Mann-Whitney U-test). This study reveals that breast reduction specimens should be analyzed histologically since a considerable amount of patients have breast lesions with increased cancer risk. Therefore, this analysis would guide the management of these patients in the follow-up period. PMID:23879776

  3. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic

    PubMed Central

    Reddington, Justin A.; Mendez, Gustavo A.; Ching, Alex; Kubicky, Charlotte Dai; Klimo, Paul; Ragel, Brian T.

    2016-01-01

    Background: Surgeons treating metastatic spine disease can use computed tomography (CT) imaging to determine whether lesions are osteolytic, osteoblastic, or mixed. This enables treatment that considers the structural integrity of the vertebral body (VB), which is impaired with lytic lesions but not blastic lesions. The authors analyzed CT imaging characteristics of spine metastasis from breast, lung, prostate, and renal cell carcinomas (RCCs) to determine the metastasis patterns of each of these common tumors. Methods: The authors identified patients with metastatic spine disease treated during a 3-year period. Variables studied included age, sex, and cancer type. Lesions from breast, lung, prostate, and RCC primary lesions were selected for imaging analysis. Results: Sixty-six patients were identified: 17 had breast metastasis, 14 prostate, 18 lung, and 17 RCC. Breast cancer metastasis involved 33% of VBs with 56%, 20%, and 24% osteolytic, osteoblastic, and mixed, respectively. Prostate cancer metastasis involved 35% of VBs with 14%, 62%, and 24% osteolytic, osteoblastic, and mixed, respectively. Lung cancer metastasis involved 13% of VBs with 64%, 33%, and 3% osteolytic, osteoblastic, and mixed, respectively. RCC metastasis involved 11% of VBs with 91%, 7%, and 2% osteolytic, osteoblastic, and mixed lesions, respectively. Conclusions: To improve surgical planning, we advocate the use of CT prior to surgery to evaluate whether spine metastases are osteolytic or osteoblastic. In cases of osteolytic lesions, the concern is of segmental instability requiring reconstruction and the risk for screw pull out should instrumentation be considered. In cases of osteoblastic lesions, surgeons should consider debulking dense bone. PMID:27274410

  4. Stent type used does not impact complication rate or placement time but can decrease treatment cost for benign and malignant esophageal lesions

    PubMed Central

    McGaw, Camille; Alkaddour, Ahmad; Vega, Kenneth J; Munoz, Juan Carlos

    2016-01-01

    AIM: To evaluate if differences exist between self-expanding esophageal metal stents (SEMS) and self-expanding esophageal plastic stents (SEPS) when used for benign or malignant esophageal disorders with regard to safety, efficacy, clinical outcomes, placement ease and cost. METHODS: A retrospective analysis was performed to evaluate outcome in patients having SEPS/SEMS placed for malignant or benign esophageal conditions from January 2005 to April 2012. Inclusion criteria was completed SEMS/SEPS placement. Outcomes assessed included technical success of and time required for stent placement, procedure-related complications, need for repeat intervention, hospital stay, mortality and costs. RESULTS: Forty-three patients underwent stent placement for either benign/malignant esophageal disease during the study period. Thirty patients had SEMS (25 male, mean age 59.6 years old) and 13 patients had SEPS (10 male, mean age 61.7 years old). Placement outcome as well as complication rate (SEPS 23.1%, SEMS 25.2%) and in-hospital mortality (SEPS 7.7%, SEMS 6.7%) after placement did not differ between stent types. Migration was the most frequent complication reported occurring equally between types (SEPS 66.7%, SEMS 57.1%). SEPS was less costly than SEMS, decreasing institutional cost by $255/stent. CONCLUSION: SEPS and SEMS have similar outcomes when used for benign or malignant esophageal conditions. However, SEPS use results in decreased costs without impacting care. PMID:27076872

  5. Evaluation of clinical breast examination and breast ultrasonography among pregnant women in Abakaliki, Nigeria

    PubMed Central

    Ezeonu, Paul Olisaemeka; Ajah, Leonard Ogbonna; Onoh, Robinson Chukwudi; Lawani, Lucky Osaheni; Enemuo, Vincent Chidi; Agwu, Uzoma MaryRose

    2015-01-01

    Background Breast cancer in pregnancy accounts for 2%–3% of all breast cancers. The increased vascularity and lymphatic drainage from the breast during pregnancy potentiate the metastatic spread of the cancer to the regional lymph nodes. However, the increased breast density in pregnancy makes it difficult to detect breast lesions early. Aim To evaluate and compare the detection rate of breast lesions using clinical breast examination (CBE) and breast ultrasonography among pregnant women. Methodology A cross-sectional comparative study involving antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, was conducted between March 3, 2014, and December 31, 2014. CBE and breast ultrasonography were done in the participants at booking and repeated at 6 weeks postpartum. Fine-needle aspiration cytology and histology were done in women with suspicious breast lesions on CBE or breast ultrasonography or both. Data analysis was both descriptive and inferential at the 95% confidence level using the Statistical Package for the Social Sciences (SPSS) software version 17.0. Test of significance was done using chi-square test. A P-value of less than or equal to 0.05 was considered statistically significant. Results A total of 320 pregnant women participated in the study. Of these, 267 (83.4%) were aware of breast cancer. Although more lesions were detected with breast ultrasonography than by CBE, there was no statistically significant difference between them (25 versus 17; P=0.26). The histology of the lesions revealed 21 benign lesions and 4 normal breast tissues. The sensitivity of breast ultrasonography was 95.2%, while that of CBE was 66.7%. The specificity, positive predictive value, and negative predictive value were similar between CBE and breast ultrasonography. Conclusion The detection rates of breast lesions by both CBE and breast ultrasonography were equivalent during pregnancy and 6 weeks postpartum, making CBE a convenient and very cost

  6. Can synaptophysin be used as a marker of breast cancer diagnosed by core-needle biopsy in epithelial proliferative diseases of the breast?

    PubMed

    Maeda, Ichiro; Tajima, Shinya; Ariizumi, Yasushi; Doi, Masatomo; Endo, Akira; Naruki, Saeko; Hoshikawa, Masahiro; Koizumi, Hirotaka; Kanemaki, Yoshihide; Ueno, Takahiko; Tsugawa, Koichiro; Takagi, Masayuki

    2016-07-01

    The differential diagnosis of epithelial proliferative disease using core needle biopsy (CNB) is problematic because it is difficult to differentiate between intraductal papilloma, ductal hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma. Many studies have reported that breast cancer lesions are positive for neuroendocrine (NE) markers, whereas only a small number of studies have reported immunopositivity for NE markers in normal mammary tissues or benign lesions. We asked whether NE factors could be used as markers of breast cancer. We determined the immunopositivity rate of synaptophysin, an NE marker, in 204 lesions excised from the breast using CNB in patients who visited a university-affiliated comprehensive medical facility and examined whether synaptophysin is a marker of breast cancer. The specimens were classified as synaptophysin-negative cases (56 benign, 99 malignant); equivocal cases (<1 %: 2 benign, 15 malignant); and synaptophysin-positive cases (1 benign, 31 malignant). The sensitivity, specificity, positive predictive value, and negative predictive value for malignancy of the lesions classified as synaptophysin positive were 23.3 %, 98.2 %, 96.9 %, and 36.1 %, respectively. The respective values for lesions classified as equivocal were 11.6 %, 96.6 %, 88.2 %, and 36.1 %. Synaptophysin may provide a marker of breast cancer diagnosed by CNB. PMID:27239051

  7. RET/PTC rearrangements in thyroid nodules: studies in irradiated and not irradiated, malignant and benign thyroid lesions in children and adults.

    PubMed

    Elisei, R; Romei, C; Vorontsova, T; Cosci, B; Veremeychik, V; Kuchinskaya, E; Basolo, F; Demidchik, E P; Miccoli, P; Pinchera, A; Pacini, F

    2001-07-01

    Rearrangements of the RET proto-oncogene may occur in both naturally occurring and radiation-induced papillary thyroid carcinomas. Conflicting results on the frequency and type of RET/PTC rearrangements have been reported in relation to age, radiation exposure, and histological tumor variant. We designed the present study to evaluate in a single laboratory, using the same methodologies, the pattern of RET/PTC activation in thyroid tumors from different groups of patients (exposed or not exposed to radiation, children or adults, with benign or malignant tumors) in relationship to the above mentioned variables. We studied 154 patients with benign nodules (n = 65) or papillary thyroid cancer (n = 89). In the last group, 25 were Belarus children exposed to the post-Chernobyl radioactive fallout, 17 were Italian adults exposed to external radiotherapy for benign diseases, and 47 were Italian subjects (25 children and 22 adults) with no history of radiation exposure. Among patients with benign thyroid nodules, 21 were Belarus subjects (18 children and 3 adults) exposed to the post-Chernobyl radioactive fallout, 8 were Italian adults exposed to external radiation on the head and neck, and 36 were Italian adults with naturally occurring benign nodules. The overall frequency of RET/PTC rearrangements in papillary thyroid cancer was 55%. The highest frequency was found in post-Chernobyl children and was significantly higher (P = 0.02) than that found in Italian children not exposed to radiation, but not significantly higher than that found in adults exposed to external radiation. No difference of RET/PTC rearrangements was found between samples from irradiated (external x-ray) or not irradiated adult patients, as well as between children and adults with naturally occurring, not irradiated, thyroid cancer. When analyzing the type of RET/PTC rearrangement (RET/PTC1 or RET/PTC3), no major difference was apparent. In addition, eight cases with an unknown RET/PTC rearrangement

  8. Analysis of human breast tissues with Raman microspectroscopy

    NASA Astrophysics Data System (ADS)

    Liu, Gang; Zhang, Lin; Liu, Jianhong; Yu, Fan; Sun, Shizhong

    2006-01-01

    Raman microspectroscopy was used to study normal, benign and malignant human breast tissues. The Raman spectrum of normal breast tissue recorded with 514.5 nm line of Ar + laser excitation contains features attributed to carotenoids and lipids. The CH II bending mode near 1447 cm -1 in normal tissue shifts up to 1454 cm -1 in diseased tissues (benign and malignant). The band near 1660 cm -1 in normal tissue is narrow and sharp; whereas the band is broaden in the diseased tissues. In the region of C-H stretching mode, the 2902-/2860-cm -1 intensity ratio shows differences among normal, benign and malignant breast tissues. The ratio is the smallest in carcinoma tissue. The observed spectra differences may be used to probe breast lesion. The results show that Raman spectroscopic technique may have clinical applications.

  9. B3-lesions of the breast and cancer risk - an analysis of mammography screening patients

    PubMed Central

    HOFFMANN, OLIVER; STAMATIS, GESINA ATHINA; BITTNER, ANN-KATHRIN; ARNOLD, GEORG; SCHNABEL, ROLF; KRÜGER, KARLGEORG; KIMMIG, RAINER; HEUBNER, MARTIN

    2016-01-01

    The use of mammography screening, followed by needle core biopsy (NCB), is associated with an increasing amount of invasive procedures. A considerable amount of specimens must be classified as lesions with uncertain malignant potential (B3-lesion). In these cases, an open biopsy is indicated for further diagnosis. We evaluated patients with B3-lesions to determine the risk of malignancy corresponding to the histopathological NCB results and the type of radiological lesion identified. A total of 95 patients participating in the German mammography screening program with a B3-lesion following NCB (104 B3-lesions in total) were included in our analysis. We analyzed the correlation between the initial histopathological findings from the NCB specimen and cancer risk. We further analyzed the correlations of malignant results with the type of mammographic lesion. In 23 cases (22%), histopathological examination following excision revealed a malignant lesion, including invasive and in situ carcinoma. The positive predictive value of the subgroups of B3-lesions ranged between 0.11 and 0.31; the B3-lesion associated with the highest cancer risk was the atypical ductal hyperplasia; however, no significant difference was observed between the B3-lesion subgroups (P=0.309) regarding the risk of malignancy. Comparing the different types of mammographic findings, such as radiological mass or microcalcifications, there was no significant difference in the risk for malignancy (P=0.379). The different types of B3-lesions did not exhibit differences in the risk for malignancy, and the morphological type of mammographic lesion does not appear to be correlated with cancer risk; therefore, our results underline the need for open biopsy in patients with B3-lesions following NCB. PMID:27123266

  10. Joint estimation of shape and deformation for the detection of lesions in dynamic contrast-enhanced breast MRI

    NASA Astrophysics Data System (ADS)

    Hong, Byung-Woo

    2013-11-01

    We propose a mathematical framework for simultaneously delineating the boundary of object and estimating its temporal motion in the application of lesion detection in a dynamic contrast-enhanced (DCE) breast MRI sequence where both the appearance and the shape of region of interest is assumed to change in time. A unified energy functional for a joint segmentation and registration is proposed based on the assumption that the statistical properties of dynamic intensity curves within a region of interest are homogeneous. Our algorithm is designed to provide the morphological properties of the enhanced region and its dynamic intensity profiles, called kinetic signatures, in the analysis of DCE imagery since these features are considered as significant cues in understanding images. The proposed energy comprises a combination of a segmentation energy and a registration energy. The segmentation energy is developed based on a convex formulation being insensitive to the initialization. The registration energy is designed to compensate motion artifacts that are usually involved in the temporal imaging procedure. The major objective of this work is to provide a mathematical framework for a joint segmentation and registration on a dynamic sequence of images, and we demonstrate the mutual benefit of the estimation of temporal deformations for the registration step and the localization of regions of interest for the segmentation step. The effectiveness of the developed algorithm has been demonstrated on a number of clinical DCE breast MRI data in the application of breast lesion detection and the results show its potential to improve the accuracy and the efficiency in the diagnosis of breast cancer.

  11. Joint estimation of shape and deformation for the detection of lesions in dynamic contrast-enhanced breast MRI.

    PubMed

    Hong, Byung-Woo

    2013-11-01

    We propose a mathematical framework for simultaneously delineating the boundary of object and estimating its temporal motion in the application of lesion detection in a dynamic contrast-enhanced (DCE) breast MRI sequence where both the appearance and the shape of region of interest is assumed to change in time. A unified energy functional for a joint segmentation and registration is proposed based on the assumption that the statistical properties of dynamic intensity curves within a region of interest are homogeneous. Our algorithm is designed to provide the morphological properties of the enhanced region and its dynamic intensity profiles, called kinetic signatures, in the analysis of DCE imagery since these features are considered as significant cues in understanding images. The proposed energy comprises a combination of a segmentation energy and a registration energy. The segmentation energy is developed based on a convex formulation being insensitive to the initialization. The registration energy is designed to compensate motion artifacts that are usually involved in the temporal imaging procedure. The major objective of this work is to provide a mathematical framework for a joint segmentation and registration on a dynamic sequence of images, and we demonstrate the mutual benefit of the estimation of temporal deformations for the registration step and the localization of regions of interest for the segmentation step. The effectiveness of the developed algorithm has been demonstrated on a number of clinical DCE breast MRI data in the application of breast lesion detection and the results show its potential to improve the accuracy and the efficiency in the diagnosis of breast cancer. PMID:24140912

  12. Histopathological Features of Non-Neoplastic Breast Parenchyma Do Not Predict BRCA Mutation Status of Patients with Invasive Breast Cancer

    PubMed Central

    Bayraktar, Soley; Qiu, Hongming; Liu, Diane; Shen, Yu; Gutierrez-Barrera, Angelica M; Arun, Banu K; Sahin, Aysegul A

    2015-01-01

    BACKGROUND Several studies have evaluated histologic features of non-neoplastic breast parenchyma in patients with BRCA1/2 mutations, but the results are conflicting. The limited data suggest a much higher prevalence of high-risk precursor lesions in BRCA carriers. Therefore, we designed this study to compare the clinicopathological characteristics of peritumoral benign breast tissue in patients with and without deleterious BRCA mutations. METHODS Women with breast cancer (BC) who were referred for genetic counseling and underwent BRCA genetic testing in 2010 and 2011 were included in the study. RESULTS Of the six benign histological features analyzed in this study, only stromal fibrosis grade 2/3 was found to be statistically different, with more BRCA noncarriers having stromal fibrosis grade 2/3 than BRCA1/2 carriers (P = 0.04). CONCLUSION There is no significant association between mutation risk and the presence of benign histologic features of peritumoral breast parenchyma. PMID:26327783

  13. Application of adaptive boosting to EP-derived multilayer feed-forward neural networks (MLFN) to improve benign/malignant breast cancer classification

    NASA Astrophysics Data System (ADS)

    Land, Walker H., Jr.; Masters, Timothy D.; Lo, Joseph Y.; McKee, Dan

    2001-07-01

    A new neural network technology was developed for improving the benign/malignant diagnosis of breast cancer using mammogram findings. A new paradigm, Adaptive Boosting (AB), uses a markedly different theory in solutioning Computational Intelligence (CI) problems. AB, a new machine learning paradigm, focuses on finding weak learning algorithm(s) that initially need to provide slightly better than random performance (i.e., approximately 55%) when processing a mammogram training set. Then, by successive development of additional architectures (using the mammogram training set), the adaptive boosting process improves the performance of the basic Evolutionary Programming derived neural network architectures. The results of these several EP-derived hybrid architectures are then intelligently combined and tested using a similar validation mammogram data set. Optimization focused on improving specificity and positive predictive value at very high sensitivities, where an analysis of the performance of the hybrid would be most meaningful. Using the DUKE mammogram database of 500 biopsy proven samples, on average this hybrid was able to achieve (under statistical 5-fold cross-validation) a specificity of 48.3% and a positive predictive value (PPV) of 51.8% while maintaining 100% sensitivity. At 97% sensitivity, a specificity of 56.6% and a PPV of 55.8% were obtained.

  14. Plasma DNA integrity index as a potential molecular diagnostic marker for breast cancer.

    PubMed

    Kamel, Azza M; Teama, Salwa; Fawzy, Amal; El Deftar, Mervat

    2016-06-01

    Plasma DNA integrity index is increased in various malignancies including breast cancer, the most common cancer in women worldwide; early detection is crucial for successful treatment. Current screening methods fail to detect many cases of breast cancer at an early stage. In this study, we evaluated the level of plasma DNA integrity index in 260 females (95 with breast cancer, 95 with benign breast lesions, and 70 healthy controls) to verify its potential value in discriminating malignant from benign breast lesions. The criteria of the American Joint Committee on Cancer were used for staging of breast cancer patients. DNA integrity index was measured by real-time PCR. DNA integrity index was significantly higher in breast cancer than in benign breast patients and healthy subjects (P = <0.001). DNA integrity index is correlated with TNM stage. Given 100 % specificity, the highest sensitivity achieved in detecting cancer group was 85.3 % at 0.55 DNA integrity index cutoff. In conclusion, the plasma DNA integrity index may be a promising molecular diagnostic marker of malignancy in breast lesions. PMID:26684805

  15. Vegetable protein and vegetable fat intakes in pre-adolescent and adolescent girls, and risk for benign breast disease in young women.

    PubMed

    Berkey, Catherine S; Willett, Walter C; Tamimi, Rulla M; Rosner, Bernard; Frazier, A Lindsay; Colditz, Graham A

    2013-09-01

    Previous investigations, of adolescent diet recalled in adulthood, found lower risk for benign breast disease (BBD) with higher intakes of vegetable fat and nuts during high school. We investigate whether vegetable protein and fat, derived from diets reported during pre-adolescence and adolescence, are associated with subsequent risk for BBD in young women. The Growing Up Today Study includes 9,039 females, 9-15 years in 1996, who completed questionnaires annually through 2001, and then in 2003, 2005, 2007, and 2010. Food frequency questionnaires (1996-2001) obtained intake data on a variety of foods. Beginning in 2005, women (18-30 years) reported whether they had ever been diagnosed with BBD that was confirmed by breast biopsy (n = 112 cases). Logistic regression estimated associations between intakes of vegetable protein and fat and biopsy-confirmed BBD. Those individual foods that were the largest contributors of protein and fat in this cohort were also investigated. In analyses of intakes from 1996 through 1998, when our cohort was youngest, vegetable fat (OR = 0.72/(10 gm/day), 95 % CI 0.53-0.98; p = 0.04) was inversely associated with BBD risk. The greatest sources of vegetable fat and protein in these girls were peanut butter, peanuts, nuts, beans (beans, lentils, and soybeans), and corn. A daily serving of any one of these was associated with lower risk (OR = 0.32/(serv/day), 95 % CI 0.13-0.79; p = 0.01). Peanut butter (and nuts) at age 11 years was inversely associated with risk (p = 0.01). In analyses of intakes at age 14 years, vegetable protein was associated with lower BBD risk (OR = 0.64/(10 gm/day), 95 % CI 0.43-0.95; p = 0.03). A daily serving at 14 years of any one of the foods was associated with lower risk (OR = 0.34, 95 % CI 0.16-0.75; p = 0.01), as was peanut butter (and nuts) (p = 0.02). Girls with a family history of breast cancer had significantly lower risk if they consumed these foods or vegetable fat. In conclusion, consumption of

  16. Pseudoangiomatous stromal hyperplasia (PASH) of the breast: intraductal appearance.

    PubMed

    Gur, Akif Serhat; Unal, Bulent; Edington, Howard; Kanbour-Shakir, Amal; Soran, Atilla

    2009-08-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative lesion of breast stroma. The diagnosis of PASH can be made using imaging techniques such as ultrasound, magnetic resonance or mammography. Ductoscopy is a relatively new technique which is used for imaging the intraductal surface. We report a patient with PASH in whom ductoscopy was performed successfully. PMID:19751351

  17. Molecular breast imaging—A phantom study on the impact of collimator selection on the detection of sub-10 mm breast lesions

    NASA Astrophysics Data System (ADS)

    Hruska, Carrie B.; O'Connor, Michael K.

    2006-12-01

    Molecular breast imaging (MBI) with a dedicated breast gamma camera system can detect small breast lesions with a sensitivity of >85%. The objective of this study was to determine the optimal collimation for tumor detection based on count densities obtained from clinical MBI studies. Seven collimators were evaluated using a cadmium zinc telluride detector designed for breast imaging. These included LEUHR, LEHR, LEGP, LEHS, and LEUHS collimators and two system-specific collimators—a long bore (LB) and general-purpose (GP) collimator with square holes matched to the detector elements. Collimators were evaluated using a breast phantom comprising a 20×20×20 cm plastic box containing 16 glass "tumors" with internal diameters ranging from 4-10 mm. Breast thickness was set to 6 cm and tumor depth was varied from 1-5 cm. The phantom and spheres were filled with water and Tc-99m to give a tumor to background ( T/ B) ratio varying from 3:1 to 35:1. Total counts acquired in each image simulated the range of count densities observed clinically. Counts acquired were adjusted to compensate for differences in collimator sensitivity. Tumor signal-to-noise ratio (SNR) was measured through ROI analysis. Images acquired at clinical count densities contained significant amounts of noise, especially at T/ B ratios of 10:1 or less. Highest tumor SNR was obtained with the LEHS collimator for the 6, 8, and 9 mm tumors at depths of 1 and 3 cm. At a tumor depth of 5 cm, the highest SNR was obtained with either the matched GP or LEHS collimators for the 6-9 mm tumors. Low SNR was obtained with all collimators for the 4 mm tumors at 1 and 3 cm and no 4 mm tumors were visible at a depth of 5 cm. High sensitivity collimators may be better than high-resolution collimators for detecting tumors <1 cm in low count images of the breast, especially for tumors located within 1-4 cm of the collimator face, but proper collimator design to eliminate aliasing artifacts is important for pixilated

  18. Docosahexaenoic Acid in Preventing Recurrence in Breast Cancer Survivors

    ClinicalTrials.gov

    2016-06-20

    Benign Breast Neoplasm; Ductal Breast Carcinoma In Situ; Invasive Breast Carcinoma; Lobular Breast Carcinoma In Situ; Paget Disease of the Breast; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  19. Pseudoangio-matous stromal hyperplasia: A rare tumor of the breast.

    PubMed

    Shahi, Kedar Singh; Bhandari, Geeta; Gupta, Rakesh Kumar; Sawai, Malvika

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast entity described first by Vuitch et al., in 1986. PASH is a benign stromal lesion containing complex anastomosing channels lined by slender spindle cells. It can be mistaken with fibroadenoma on ultrasound examination and histologically with low-grade angiosarcoma and phyllodes tumor. Here, presented is a case report of a 30-year-old female who presented with huge palpable lump in left breast. Ultrasonography revealed the lesion as giant fibroadenoma and fine needle aspiration cytology report was suggestive of cystosarcoma phyllodes. Excision and reduction mammoplasty was done and histopathology report was suggestive of PASH. PMID:26881624

  20. Imaging Factors That Influence Surgical Margins After Preoperative 125I Radioactive Seed Localization of Breast Lesions: Comparison With Wire Localization

    PubMed Central

    Dryden, Mark J.; Dogan, Basak E.; Fox, Patricia; Wang, Cuiyan; Black, Dalliah M.; Hunt, Kelly; Yang, Wei Tse

    2016-01-01

    Objective The objective of this study was to compare the potential Influence of imaging variables on surgical margins after preoperative radioactive seed localization (RSL) and wire localization (WL) techniques. Materials and Methods A total of 565 women with 660 breast lesions underwent RSL or WL between May 16, 2012, and May 30, 2013. Patient age, lesion type (mass, calcifications, mass with associated calcifications, other), lesion size, number of seeds or wires used, surgical margin status (close positive or negative margins), and reexcision and mastectomy rates were recorded. Results Of 660 lesions, 127 (19%) underwent RSL and 533 (81%) underwent WL pre-operatively. Mean lesion size was 1.8 cm in the RSL group and 1.8 cm in the WL group (p = 0.35). No difference in lesion type was identified in the RSL and WL groups (p = 0.63). RSL with a single seed was used in 105 of 127 (83%) RSLs compared with WL with a single wire in 349 of 533 (65%) WLs (p = 0.0003). The number of cases with a close positive margin was similar for RSLs (26/127, 20%) and WLs (104/533, 20%) (p = 0.81). There was no difference between the RSL group and the WL group in close positive margin status (20% each, p = 0.81), reexcision rates (20% vs 16%, respectively; p = 0.36), or mastectomy rates (6% each, p = 0.96). Lesions containing calcifications were more likely to require more than one wire (odds ratio [OR], 4.44; 95% CI, 2.8–7.0) or more than one seed (OR, 7.03; 95% CI, 1.6–30.0) when compared with masses alone (p < 0.0001). Increasing lesion size and the presence of calcifications were significant predictors of positive margins, whereas the use of more than one wire or seed was not (OR, 0.9; 95% CI, 0.5–1.5) (p = 0.75). Conclusion Close positive margin, reexcision, and mastectomy rates remained similar in the WL group and RSL group. The presence of calcifications and increasing lesion size increased the odds of a close positive margin in both the WL and RSL groups, whereas the use

  1. Benign follicular tumors*

    PubMed Central

    Tellechea, Oscar; Cardoso, José Carlos; Reis, José Pedro; Ramos, Leonor; Gameiro, Ana Rita; Coutinho, Inês; Baptista, António Poiares

    2015-01-01

    Benign follicular tumors comprise a large and heterogeneous group of neoplasms that share a common histogenesis and display morphological features resembling one or several portions of the normal hair follicle, or recapitulate part of its embryological development. Most cases present it as clinically nondescript single lesions and essentially of dermatological relevance. Occasionally, however, these lesions be multiple and represent a cutaneous marker of complex syndromes associated with an increased risk of visceral neoplasms. In this article, the authors present the microscopic structure of the normal hair follicle as a basis to understand the type and level of differentiation of the various follicular tumors. The main clinicopathological features and differential diagnosis of benign follicular tumors are then discussed, including dilated pore of Winer, pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma, proliferating trichilemmal cyst/tumor, trichoblastoma and its variants, pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and trichofolliculoma. In addition, the main syndromes presenting with multiple follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the diagnosis of follicular tumors relies on histological examination, we highlight the importance of their knowledge for the clinician, especially when in presence of patients with multiple lesions that may be the cutaneous marker of a cancer-prone syndrome. The dermatologist is therefore in a privileged position to recognize these lesions, which is extremely important to provide further propedeutic, appropriate referral and genetic counseling for these patients. PMID:26734858

  2. Invasive breast carcinoma arising in microglandular adenosis: two case reports.

    PubMed

    Choi, Jung Eun; Bae, Young Kyung

    2013-12-01

    Microglandular adenosis (MGA) is a rare benign disease that shows an infiltrative growth pattern of small glands, and it may progress to include atypia and carcinoma. Here we report two cases of breast carcinoma arising in MGA. Case 1 was a 44-year-old woman with a previous history of ductal carcinoma in situ in her right breast. During a follow-up, a 1.8 cm mass-like lesion was found in her left breast. An excisional biopsy suggested that the lesion was breast carcinoma. Case 2 was a 57-year-old woman with a 2.9 cm mass in her right breast. A core needle biopsy of the lesion suggested invasive carcinoma. Both patients underwent modified radical mastectomy with sentinel lymph node biopsy. Both tumors lacked a myoepithelial cell layer and stained positively for S-100, lysozyme, and α1-antitrypsin, which is typical of MGA. Both cases showed invasive carcinoma arising in MGA. PMID:24454466

  3. Giant pseudoangiomatous stromal hyperplasia presenting in the breast of a prepubertal child.

    PubMed

    Abdelrahman, Tarig; Young, Philippa; Kozyar, Olexandra; Davies, Eleri; Dojcinov, Stefan; Mansel, Robert E

    2015-01-01

    Large benign lesions of the breasts are rare in children. We present a case of a 35 cm mass, weighing 2.7 kg in a 13-year-old girl with small developing breasts. Despite the enormity of the lesion, the patient managed to keep it concealed from her parents for 8 months. While initially suspicious of sarcoma a diagnosis of pseudoangiomatous stromal hyperplasia was suggested radiologically and confirmed histologically. Excision with reduction mammoplasty was performed, care taken not to disrupt the remaining breast tissue to facilitate future breast development. 18 months on, the cosmetic appearance of the breasts is good, with healthy underlying breast tissue developing. To the best of our knowledge this case is the largest documented breast tumour of this type in a patient of this age and illustrates the challenge of treating such tumours in the developing breast. PMID:26002664

  4. Comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density.

    PubMed

    Devolli-Disha, Emine; Manxhuka-Kërliu, Suzana; Ymeri, Halit; Kutllovci, Arben

    2009-05-01

    Breast cancer is the most common cancer and the second most common cause of death from cancer in women.The aim of this studywas to determine which is more accurate imaging test mammography or ultrasound for diagnosis of breast cancer based on the women's age and breast density. We examined 546 patients with breast symptoms, by clinical breast examination, mammography and ultrasound. A total of 546 breast lesions were examined by histopathology analyses. Histopathology results revealed the presence of 259 invasive cancers, and 287 benign lesions. Sensitivity varied significantly with age and breast density. In the 259 women who had both tests, ultrasound had a higher sensitivity than mammography in women younger than 45 years, whereas mammography had a higher sensitivity than ultrasound in women older than 60 years. The sensitivity according to age was 52,1% for mammography and 72,6% for ultrasound. The specificity according to age was 88, 5% for ultrasound and 73, 9% for mammography. Comparing the sensitivity of mammography and ultrasound according to the breast density indicates that mammographic sensitivity was 82,2% among women with predominantly fatty breast, but 23.7% in women with heterogeneous dense breasts, with the increase of fibro glandular density the level of sensitivity with mammography decreases, while ultrasonographic sensitivity was 71,1% among women with predominantly fatty breast and 57,0% for heterogeneous dense breasts. Our data indicate that sensitivity and specificity of ultrasound was statistically significantly greater than mammography in patients with breast symptoms for the detection of breast cancer and benign lesions particularly in dense breast and in young women. PMID:19485945

  5. Intra-operative specimen analysis using faxitron microradiography for excision of mammographically suspicious, non-palpable breast lesions.

    PubMed

    Muttalib, M; Tisdall, M; Scawn, R; Shousha, S; Cummins, R S; Sinnett, H D

    2004-08-01

    Recent advances in digital imaging have made Faxitron microradiography an attractive alternative to intra-operative conventional specimen radiography (CSR) for the excision of wire-localized breast lesions. Faxitron specimen analysis time, usefulness of digital image manipulation and re-excision rates were evaluated in comparison to CSR in 299 consecutive wire-localized excisions for mammographically suspicious non-palpable breast lesions (172 procedures with Faxitron, 127 with CSR) in a non-randomized study. The corresponding mean operation times were 34.7 vs. 42.7 min and the respective re-excision rates were 19.8% vs. 31.5% (no significant difference on chi analysis P < 0.1). Faxitron digital image manipulation led to cavity biopsies in 50% (60/121) of the cancer excisions. In 19 of these (16%), histological excision margins were converted from incomplete to complete. The shorter Faxitron mean operating time enables an additional wire-localized operation per theatre list. Digital imaging guides the surgeon for additional cavity biopsies, resulting in re-excision rates as good as CSR. PMID:15325665

  6. Pseudo-angiomatous stromal hyperplasia of the breast detecting in mammography: case report and review of the literature.

    PubMed

    Deniz, Senem; Vardar, Enver; Öztürk, Rafet; Zihni, İsmail; Yaǧcı, Ayşe; Taşlı, Funda

    2014-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion that can present as a palpable nodule or as an incidental finding in breast biopsies. The development of PASH is subject to hormonal influence and is most commonly seen in premenopausal woman. Imaging findings are indistinguishable from those of the more common type of fibroadenoma, and they are categorized as BIRADS type 3 lesions (probably benign lesions). Their benign condition and behavior compared with other similar cases, allows the recommendation that surgical excision be avoided, and the patients monitored with periodic follow-up. Here we report a case of PASH presenting in a 41-years-old woman who had breast mass which was sent for intra-operative frozen-section procedure by surgery to our pathology laboratory. PMID:24254442

  7. Large pseudoangiomatous stromal hyperplasia complicated with gynecomastia and lobular differentiation in a male breast.

    PubMed

    Mizutou, Akiko; Nakashima, Kazutaka; Moriya, Takuya

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion often observed in parts of the mammary stroma in a variety of breast diseases. It is characterized by stromal myofibroblastic proliferation that possesses irregularly anastomosing slit-like pseudovascular spaces lined by a layer of spindle cells. PASH commonly occurs in premenopausal women; however, it has also been observed in men with gynecomastia. Although tumor-forming lesions are rare, we report on a case with a large PASH in a male breast complicated with gynecomastia. Imaging showed a tumor with a diameter of >10 cm in the left breast, and aspiration cytology revealed a benign lesion. Since the tumor was large and gradually increased in size, a simple mastectomy was performed. The tumorous lesion was diagnosed as PASH based on the pathological and immunohistological findings. It was complicated by gynecomastia with acinar and lobular formation, which resembled female mammary gland secretory activity that is observed during lactation. PMID:26101734

  8. Benign Phyllodes Tumor of the Vulva: A Case Report and Literature Review

    PubMed Central

    Denlinger, LeAnn N.; Lokhandwala, Parvez M.

    2015-01-01

    Phyllodes tumor is an uncommon breast lesion with characteristic histologic appearance when examined by hematoxylin and eosin staining: leaf-like fronds projecting into cystic spaces on low-power microscopy, and biphasic (epithelial and stromal) components on high-power microscopy. We report a rare primary case of this tumor arising within the vulva. A 34-year old African American female presented with a 3 cm slow-growing vulvar mass initially thought to be an inclusion cyst. The lesion was excised and histologic examination demonstrated this lesion to be a rare case of benign phyllodes tumor with morphologic features similar to those arising from breast tissue. Patient received no further treatment and did not exhibit any recurrence or metastasis. Nearly two years after excision, the patient died due to an unrelated medical cause. This rare tumor should be considered in the differential diagnosis for women presenting with a slow-growing vulvar mass. PMID:26788277

  9. Benign Phyllodes Tumor of the Vulva: A Case Report and Literature Review.

    PubMed

    Denlinger, LeAnn N; Lokhandwala, Parvez M; Abendroth, Catherine S

    2015-12-29

    Phyllodes tumor is an uncommon breast lesion with characteristic histologic appearance when examined by hematoxylin and eosin staining: leaf-like fronds projecting into cystic spaces on low-power microscopy, and biphasic (epithelial and stromal) components on high-power microscopy. We report a rare primary case of this tumor arising within the vulva. A 34-year old African American female presented with a 3 cm slow-growing vulvar mass initially thought to be an inclusion cyst. The lesion was excised and histologic examination demonstrated this lesion to be a rare case of benign phyllodes tumor with morphologic features similar to those arising from breast tissue. Patient received no further treatment and did not exhibit any recurrence or metastasis. Nearly two years after excision, the patient died due to an unrelated medical cause. This rare tumor should be considered in the differential diagnosis for women presenting with a slow-growing vulvar mass. PMID:26788277

  10. Optimization of spectral shape in digital mammography: dependence on anode material, breast thickness, and lesion type.

    PubMed

    Fahrig, R; Yaffe, M J

    1994-09-01

    It has been proposed that breast cancer detection can be improved through the use of digital mammography. It is hypothesized that the choice of proper shape of the x-ray spectrum incident upon the breast can yield an improved image signal-to-noise ratio (SNR) for a given dose. To test this hypothesis, an energy transport model incorporating measured breast tissue attenuation coefficients and published exposure-to-dose conversion values was developed to describe the image acquisition process. The choice of applied kilovoltage and filter for Mo and W target x-ray sources has been optimized with respect to SNR and absorbed dose for detectors based on a Gd2O2S scintillating screen under the conditions of perfect coupling of light between the screen and a solid state photodetector. For the W spectra, the optimum filter-kVp combinations could provide 41%, 13%, and 42% improvements in SNR for 2-cm, 6-cm and 8-cm breasts, respectively, over the conventional Mo filtration, for a practical imaging time of 1.0 s. W and Mo spectra produce similar SNR values for a given filter thickness except for the 4-cm breast. Given the limitations of current technology, however, the W spectra produce the optimum SNRs in a shorter imaging time for breast thicknesses greater than and less than 4 cm. The maximum SNR for imaging both infiltrating ductal carcinoma and calcifications is provided by the same filter-kVp combination, allowing optimization based on breast thickness and composition only. The model can now be used to compare and improve upon novel detector designs. PMID:7838059

  11. EDITORIAL: Optical mammography: Imaging and characterization of breast lesions by pulsed near-infrared laser light (OPTIMAMM)

    NASA Astrophysics Data System (ADS)

    Hebden, Jeremy C.; Rinneberg, Herbert

    2005-06-01

    The Commission of the European Union (EU) conceived its Fifth Framework Programme (FP5) to identify the priorities for the European Union's research, technological development and demonstration activities for the period 1998-2002. By encouraging collaborative research between groups in different member countries, FP5 was intended to help solve problems the EU is facing and respond to major socio-economic challenges. The programme focused on a number of objectives and areas combining technological, industrial, economic, social and cultural aspects. A specific call was made, under its `Quality of Life and Management of Living Resources' section, for proposals which aim to explore improvements in non-invasive methods of imaging for early diagnosis and clinical evaluation of disease. Among the projects successfully funded under the FP5 programme was one entitled `Optical mammography: Imaging and characterization of breast lesions by pulsed near-infrared laser light', known by its acronym OPTIMAMM. The project involved a consortium of nine partners, comprising ten applied science and clinical research groups based in six EU countries, with overall administration and management provided by the Physikalisch-Technische Bundesanstalt, Berlin, Germany. The broad aim of the OPTIMAMM project was to combine multi-disciplinary basic (physics, engineering, mathematics, computer science) and clinical (oncology, histology) research to assess the diagnostic potential of time-domain optical and photoacoustic mammography as novel, non-invasive imaging modalities for the detection and clinical evaluation of breast lesions. Funding for the project, at a total cost of about 1.67 MEuro, began in December 2000 for a period of three years, although a zero-cost extension was granted to enable the ongoing project activities to continue until the end of May 2004. The importance of developing new tools for the detection and diagnosis of breast disease is evident from the very high incidence and

  12. A multi-gene approach to differentiate papillary thyroid carcinoma from benign lesions: gene selection using support vector machines with bootstrapping

    PubMed Central

    Fujarewicz, Krzysztof; Jarząb, Michał; Eszlinger, Markus; Krohn, Knut; Paschke, Ralf; Oczko-Wojciechowska, Małgorzata; Wiench, Małgorzata; Kukulska, Aleksandra; Jarząb, Barbara; Świerniak, Andrzej

    2007-01-01

    Selection of novel molecular markers is an important goal of cancer genomics studies. The aim of our analysis was to apply the multivariate bioinformatical tools to rank the genes – potential markers of papillary thyroid cancer (PTC) according to their diagnostic usefulness. We also assessed the accuracy of benign/malignant classification, based on gene expression profiling, for PTC. We analyzed a 180-array dataset (90 HG-U95A and 90 HG-U133A oligonucleotide arrays), which included a collection of 57 PTCs, 61 benign thyroid tumors, and 62 apparently normal tissues. Gene selection was carried out by the support vector machines method with bootstrapping, which allowed us 1) ranking the genes that were most important for classification quality and appeared most frequently in the classifiers (bootstrap-based feature ranking, BBFR); 2) ranking the samples, and thus detecting cases that were most difficult to classify (bootstrap-based outlier detection). The accuracy of PTC diagnosis was 98.5% for a 20-gene classifier, its 95% confidence interval (CI) was 95.9–100%, with the lower limit of CI exceeding 95% already for five genes. Only 5 of 180 samples (2.8%) were misclassified in more than 10% of bootstrap iterations. We specified 43 genes which are most suitable as molecular markers of PTC, among them some well-known PTC markers (MET, fibronectin 1, dipeptidylpeptidase 4, or adenosine A1 receptor) and potential new ones (UDP-galactose-4-epimerase, cadherin 16, gap junction protein 3, sushi, nidogen, and EGF-like domains 1, inhibitor of DNA binding 3, RUNX1, leiomodin 1, F-box protein 9, and tripartite motif-containing 58). The highest ranking gene, metallophosphoesterase domain-containing protein 2, achieved 96.7% of the maximum BBFR score. PMID:17914110

  13. Breast fibroadenomas in adolescents: current perspectives

    PubMed Central

    Lee, Michelle; Soltanian, Hooman T

    2015-01-01

    Fibroadenomas are one of the most common benign tumors of the breast in the adolescent population. They account for 68% of all breast masses and 44%–94% of all biopsied breast lesions. Fibroadenomas can range from asymptomatic masses to painful and rapidly growing tumors that can cause significant esthetic distortions of the breast. Given the prevalence of fibroadenomas in the adolescent population and the psychosocial morbidity of finding a mass in the adolescent breast, it is imperative for physicians treating adolescent patients to be familiar and up to date with this disease process. The goal of this article is to provide a brief review of the classification, etiology, symptoms, initial work-up, and update on the management of breast fibroadenomas in the adolescent population. PMID:26366109

  14. Pseudoangiomatous stromal hyperplasia causing massive breast enlargement.

    PubMed

    Bourke, Anita Geraldine; Tiang, Stephen; Harvey, Nathan; McClure, Robert

    2015-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal proliferative process, initially described by Vuitch et al. We report an unusual case of a 46-year-old woman who presented with a 6-week history of bilateral massive, asymmetrical, painful enlargement of her breasts, without a history of trauma. On clinical examination, both breasts were markedly enlarged and oedematous, but there were no discrete palpable masses. Preoperative image-guided core biopsies and surgery showed PASH. PASH is increasingly recognised as an incidental finding on image-guided core biopsy performed for screen detected lesions. There are a few reported cases of PASH presenting as rapid breast enlargement. In our case, the patient presented with painful, asymmetrical, massive breast enlargement. Awareness needs to be raised of this entity as a differential diagnosis in massive, painful breast enlargement. PMID:26475873

  15. Significance of Additional Non-Mass Enhancement in Patients with Breast Cancer on Preoperative 3T Dynamic Contrast Enhanced MRI of the Breast

    PubMed Central

    Cho, Yun Hee; Cho, Kyu Ran; Park, Eun Kyung; Seo, Bo Kyoung; Woo, Ok Hee; Cho, Sung Bum; Bae, Jeoung Won

    2016-01-01

    Background In preoperative assessment of breast cancer, MRI has been shown to identify more additional breast lesions than are detectable using conventional imaging techniques. The characterization of additional lesions is more important than detection for optimal surgical treatment. Additional breast lesions can be included in focus, mass, and non-mass enhancement (NME) on MRI. According to the fifth edition of the breast imaging reporting and data system (BI-RADS®), which includes several changes in the NME descriptors, few studies to date have evaluated NME in preoperative assessment of breast cancer. Objectives We investigated the diagnostic accuracy of BI-RADS descriptors in predicting malignancy for additional NME lesions detected on preoperative 3T dynamic contrast enhanced MRI (DCE-MRI) in patients with newly diagnosed breast cancer. Patients and Methods Between January 2008 and December 2012, 88 patients were enrolled in our study, all with NME lesions other than the index cancer on preoperative 3T DCE-MRI and all with accompanying histopathologic examination. The MRI findings were analyzed according to the BI-RADS MRI lexicon. We evaluated the size, distribution, internal enhancement pattern, and location of NME lesions relative to the index cancer (i.e., same quadrant, different quadrant, or contralateral breast). Results On histopathologic analysis of the 88 NME lesions, 73 (83%) were malignant and 15 (17%) were benign. Lesion size did not differ significantly between malignant and benign lesions (P = 0.410). Malignancy was more frequent in linear (P = 0.005) and segmental (P = 0.011) distributions, and benignancy was more frequent in focal (P = 0.004) and regional (P < 0.001) NME lesions. The highest positive predictive value (PPV) for malignancy occurred in segmental (96.8%), linear (95.1%), clustered ring (100%), and clumped (92.0%) enhancement. Asymmetry demonstrated a high positive predictive value of 85.9%. The frequency of malignancy was higher

  16. The differentiation of malignant and benign human breast tissue at surgical margins and biopsy using x-ray interaction data and Bayesian classification

    NASA Astrophysics Data System (ADS)

    Mersov, A.; Mersov, G.; Al-Ebraheem, A.; Cornacchi, S.; Gohla, G.; Lovrics, P.; Farquharson, M. J.

    2014-02-01

    Worldwide, about 1.3 million women are diagnosed with breast cancer annually with an estimated 465,000 deaths. Accordingly, there is a need for high accuracy and speed in diagnosis of lesions suspected of being cancerous. This study assesses the interaction data collected from low energy x-rays within breast tissue samples. Trace element concentrations are assessed using x-ray fluorescence, as well as electron density, and molecular structure which are examined using incoherent and coherent scatter, respectively. Our work to date has shown that such data can provide a quantitative measure of certain tissue characterising parameters and hence, through appropriate modelling, could be used to classify samples for uses such as surgical margin detection and biopsy examination. The parameters used in this study for comparing the normal and tumour tissue sample populations are: levels of elements Ca, Cu, Fe, Br, Zn, Rb, K; the area, FWHM and amplitude from peaks fitted to the coherent scatter profile that are associated with fat, fibre and water content; the ratio of the Compton and coherent scatter peak area, FWHM and amplitude from the incoherent scatter profile. The novelty of the approach to this work lies in the fact that the classification process does not rely on one source of data but combines several measurements, the data from which in this application are modelled using a method based on Bayesian classification. The reliability of the classifications was assessed by its application to diagnostically known data that was not itself included in the thresholds determination. The results of the classification of over 70 breast tissue samples will be presented in this study. Bayesian modelling was carried out using selected significant parameters for classification resulting in 71% of normal tissue samples (n=35) and 66% of tumour tissue samples (n=35) being correctly classified when using all the samples. Bayesian classification using the same variables on all

  17. Effect of 18F-FDG uptake time on lesion detectability in PET imaging of early stage breast cancer

    PubMed Central

    Wangerin, Kristen A.; Muzi, Mark; Peterson, Lanell M.; Linden, Hannah M.; Novakova, Alena; O'Sullivan, Finbarr; Kurland, Brenda F.; Mankoff, David A.; Kinahan, Paul E.

    2016-01-01

    Prior reports have suggested that delayed FDG-PET oncology imaging can improve the contrast-to-noise ratio (CNR) for known lesions. Our goal was to estimate realistic bounds for lesion detectability for static measurements with one to four hours between FDG injection and image acquisition. Tumor and normal tissue kinetic model parameters were estimated from dynamic PET studies of patients with early stage breast cancer. These were used to generate time-activity curves (TACs) out to four hours, for which we assumed both nonreversible and reversible models with different rates of FDG dephosphorylation (k4). For each pair of tumor and normal tissue TACs, 600 PET sinogram realizations were generated, and images were reconstructed using OSEM. Test statistics for each tumor and normal tissue region of interest were output from the computer model observers and evaluated using an ROC analysis with the calculated AUC providing a measure of lesion detectability. For the nonreversible model (k4 = 0), the AUC increased in 11/23 (48%) of patients for one to two hours after the current standard post-radiotracer injection imaging window of one hour. This improvement was driven by increased tumor/normal tissue contrast before the impact of increased noise due to radiotracer decay began to dominate the imaging signal. As k4 was increased from 0 to 0.01 min−1, the time of maximum detectability shifted earlier, as the decreasing FDG concentration in the tumor lowered the CNR. These results imply that delayed PET imaging may reveal low-conspicuity lesions that would have otherwise gone undetected. PMID:26807443

  18. [Improving practice in breast pathology: 34-months experience of the regional SENOPATH network and webinars as a tool for diagnosis of difficult lesions of the breast].

    PubMed

    Quintyn-Ranty, Marie-Laure; Gordien, Karine; Caveriviere, Paul; Mery, Éliane; Jamme-Lallemand, Muriel; Wuithier, Pascal; Palasse, Julien; Reyre, Joelle; Laborie, Vincent; Despax, Brigitte; Rolland, Véronique; Thibaut, Isabelle; Maissongrosse, Véronique; Escourrou, Ghislaine; Duprez-Paumier, Raphaëlle; Bauvin, Éric; Jacob, Michel; Lacroix-Triki, Magali

    2015-10-01

    Pathologists commonly face breast lesions that are difficult to diagnose. To reduce second opinion delay, erase geographical barrier and provide continuing education, we aimed to develop a telepathology-based regional network of pathologists. With the support of ONCOMIP network, we founded a peer-group named SENOPATH, composed of experienced breast pathologists practising in private laboratories, university hospitals or comprehensive cancer center in the region of Midi-Pyrénées in France. Submitted cases are digitalized at the University Hospital, stored in a shared space with a possible access via Internet prior to the SENOPATH sessions. The group meets monthly, via a synchronized webinar and multihead microscope session. A consensual diagnosis and final pathology report is issued for each case, and sent to the referring clinician via the patient medical file securely hosted by ONCOMIP. Between 2012 and 2014, 142 cases were reviewed, for either diagnostic 'routine' difficulty or rare histological type. The SENOPATH group, also regularly called by oncologists to solve difficult cases, has considerably improved the pathologist network in Southern France. Supported by the webinar tool, its educational impact is prominent, with a considerable progress in the region with regards to standardization of pathology processes, literature review and knowledge sharing. PMID:26384691

  19. Magnetic Resonance Imaging Features of Adenosis in the Breast

    PubMed Central

    Gity, Masoumeh; Arabkheradmand, Ali; Shakiba, Madjid; Khademi, Yassaman; Bijan, Bijan; Sadaghiani, Mohammad Salehi; Jalali, Amir Hossein

    2015-01-01

    Purpose Adenosis lesions of the breast, including sclerosing adenosis and adenosis tumors, are a group of benign proliferative disorders that may mimic the features of malignancy on imaging. In this study, we aim to describe the features of breast adenosis lesions with suspicious or borderline findings on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods In our database, we identified 49 pathologically proven breast adenosis lesions for which the final assessment of the breast MRI report was classified as either category 4 (n=45) or category 5 (n=4), according to the Breast Imaging Reporting and Data System (BI-RADS) published by the American College of Radiology (ACR). The lesions had a final diagnosis of either pure adenosis (n=33, 67.3%) or mixed adenosis associated with other benign pathologies (n=16, 32.7%). Results Of the 49 adenosis lesions detected on DCE-MRI, 32 (65.3%) appeared as enhancing masses, 16 (32.7%) as nonmass enhancements, and one (2.1%) as a tiny enhancing focus. Analysis of the enhancing masses based on the ACR BI-RADS lexicon revealed that among the mass descriptors, the most common features were irregular shape in 12 (37.5%), noncircumscribed margin in 20 (62.5%), heterogeneous internal pattern in 16 (50.0%), rapid initial enhancement in 32 (100.0%), and wash-out delayed en-hancement pattern in 21 (65.6%). Of the 16 nonmass enhancing lesions, the most common descriptors included focal distribution in seven (43.8%), segmental distribution in six (37.5%), clumped internal pattern in nine (56.3%), rapid initial enhancement in 16 (100.0%), and wash-out delayed enhancement pattern in eight (50.0%). Conclusion Adenosis lesions of the breast may appear suspicious on breast MRI. Awareness of these suspi-cious-appearing features would be helpful in obviating unnecessary breast biopsies. PMID:26155296

  20. Lesions with unclear malignant potential (B3) after minimally invasive breast biopsy: evaluation of vacuum biopsies performed in Switzerland and recommended further management

    PubMed Central

    Haueisen, Harald; Kampmann, Gert; Oehlschlegel, Christian; Seifert, B; Rageth, Luzi; Rageth, Christoph; Stadlmann, S; Kubik-Huch, Rahel A

    2015-01-01

    Background Histopathological B3 lesions after minimal invasive breast biopsy (VABB) are a particular challenge for the clinician, as there are currently no binding recommendations regarding the subsequent procedure. Purpose To analyze all B3 lesions, diagnosed at VABB and captured in the national central Swiss MIBB database and to provide a data basis for further management in this subgroup of patients. Material and Methods All 9,153 stereotactically, sonographically, or magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsies, performed in Switzerland between 2009 and 2011, captured in a central database, were evaluated. The rate of B3 lesions and the definitive pathological findings in patients who underwent surgical resection were analyzed. Results The B3 rate was 17.0% (1532 of 9000 biopsies with B classification). Among the 521 lesions with a definitive postoperative diagnosis, the malignancy rate (invasive carcinoma or DCIS) was 21.5%. In patients with atypical ductal hyperplasia, papillary lesions, flat epithelial atypia, lobular neoplasia, and radial scar diagnosed by VABB, the malignancy rates were 25.9%, 3.1%, 18.3%, 26.4%, and 11.1%, respectively. Conclusion B3 lesions, comprising 17%, of all analyzed biopsies, were common and the proportion of malignancies in those lesions undergoing subsequent surgical excision was high (21.5%). PMID:26552694

  1. Assessing Detection, Discrimination, and Risk of Breast Cancer According to Anisotropy Parameters of Diffusion Tensor Imaging

    PubMed Central

    Jiang, Ruisheng; Zeng, Xiangmin; Sun, Shihang; Ma, Zhijun; Wang, Ximing

    2016-01-01

    Background The aim of this study was to investigate whether the anisotropy parameters are helpful in the detection and discrimination of breast cancers, and to determine its value in predicting the risk of cancers. Material/Methods There were 56 patients with 56 lesions (34 malignant, 22 benign) included in the study. DTI was performed in every patient and apparent diffusion coefficient (ADC), fractional anisotropy (FA), and eigenvalues E1, E2, and E3 were measured in every lesion and the normal breast tissue. Results ADC, FA, and eigenvalues of E1, E2, E3, and E1–E3 in breast cancers were all significantly lower than in normal tissue (P<0.001 for all) with mean reduction of (32±17)%, (24±13)%, (33±19)%, (32±17)%, (31±18)%, and (37±20)% for ADC, FA, E1, E2, E3, and E1–E3, respectively. These parameters were also statistically lower in cancers than in benign lesions (P<0.01 for all), except FA (P>0.05). ADC, E1, E2, and E3 were very similar in discriminating breast cancers and benign lesions, with area under the curve (AUC) 0.885–0.898, sensitivity 73.5–85.3%, and specificity 90.9–100%. Conclusions ADC, E1, E2, E3, and E1–E3 are much lower in breast cancers than in normal tissue and benign lesions. The reduction of ADC, E1, E2, E3, and E1–E3 of a mass in the breast is highly associated with the risk of breast cancer, but the FA has no utility in breast cancer risk prediction. PMID:27094307

  2. Pursuing shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) for concomitant detection of breast lesions and microcalcifications

    NASA Astrophysics Data System (ADS)

    Zheng, Chao; Shao, Wanting; Paidi, Santosh Kumar; Han, Bing; Fu, Tong; Wu, Di; Bi, Lirong; Xu, Weiqing; Fan, Zhimin; Barman, Ishan

    2015-10-01

    Although tissue staining followed by morphologic identification remains the gold standard for diagnosis of most cancers, such determinations relying solely on morphology are often hampered by inter- and intra-observer variability. Vibrational spectroscopic techniques, in contrast, offer objective markers for diagnoses and can afford disease detection prior to alterations in cellular and extracellular architecture by furnishing a rapid ``omics''-like view of the biochemical status of the probed specimen. Here, we report a classification approach to concomitantly detect microcalcification status and local pathological state in breast tissue, featuring a combination of vibrational spectroscopy that focuses on the tumor and its microenvironment, and multivariate data analysis of spectral markers reflecting molecular expression. We employ the unprecedented sensitivity and exquisite molecular specificity offered by Au@SiO2 shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) to probe the presence of calcified deposits and distinguish between normal breast tissues, fibroadenoma, atypical ductal hyperplasia, ductal carcinoma in situ (DCIS), and invasive ductal carcinoma (IDC). By correlating the spectra with the corresponding histologic assessment, we developed partial least squares-discriminant analysis derived decision algorithm that provides excellent diagnostic power in the fresh frozen sections (overall accuracy of 99.4% and 93.6% using SHINs for breast lesions with and without microcalcifications, respectively). The performance of this decision algorithm is competitive with or supersedes that of analogous algorithms employing spontaneous Raman spectroscopy while enabling facile detection due to the considerably higher intensity of SHINERS. Our results pave the way for rapid tissue spectral pathology measurements using SHINERS that can offer a novel stain-free route to accurate and economical diagnoses without human interpretation.Although tissue staining

  3. Prevalence of human papilloma virus among women with breast cancer since 2005-2009 in Isfahan

    PubMed Central

    Manzouri, Leila; Salehi, Rasoul; Shariatpanahi, Shervin; rezaie, Parisa

    2014-01-01

    Background: Human papilloma virus (HPV) DNA has been detected in breast carcinoma by different laboratorial techniques, suggesting that the virus could play a role in the pathogenesis of this tumor. Materials and Methods: It was a descriptive study. Systematic random sampling was used for selecting 55 cases of breast cancer and 51 controls of benign breast lesions from the file of Seyedshohada hospital of Isfahan since 2005-2009. A total of 106 paraffin-embedded specimens were selected and HPV DNA was analyzed by polymerase chain reaction and sequenced for different types of HPV in case of positivity for HPV DNA. Data analysis was performed by SPSS 16 software using descriptive statistic, Chi-square, and Fisher's exact tests. Results: Out of 55 malignant and 51 benign breast specimens, 18.2% (10) and 13.7% (7) were positive to HPV DNA, respectively (P = 0.53); 70% (7) malignant and 43% (3) benign breast specimens were positive to high-risk HPV genotypes. In malignant specimens, the most common high- and low-risk genotypes were HPV-16 (3.6%) and HPV-11 (3.6%), respectively. In benign specimens, the most common high- and low-risk genotypes were HPV-31 (3.9%) and HPV-43 (3.9%), respectively. Among malignant and benign specimens, ductal carcinoma and fibro adenoma were the most common lesions positive to different types of HPV, respectively. Conclusion: This study demonstrated the presence of HPV genome in both malignant and benign tumor tissues in women with breast lesions in Isfahan; therefore, further larger epidemiologic studies need to be analyzed to establish the exact role of this virus in the pathogenesis of breast cancer. PMID:24627883

  4. Phyllodes Tumor in a Lactating Breast

    PubMed Central

    Murthy, Sudha S.; Raju, K. V. V. N.; Nair, Haripreetha G.

    2016-01-01

    Phyllodes tumor is attributed to a small fraction of primary tumors of the breast. Such tumors occur rarely in pregnancy and lactation. We report a case of a 25-year-old lactating mother presenting with a lump in the left breast. Core needle biopsy was opined as phyllodes tumor with lactational changes, and subsequent wide local excision confirmed the diagnosis of benign phyllodes tumor with lactational changes. The characteristic gross and microscopic findings of a well-circumscribed lesion with leaf-like fibroepithelial growth pattern and typical nonuniform or diffuse stromal proliferation with periductal accentuation even in the absence of mitotic figures can help clinch the diagnosis. Benign phyllodes is known for its recurrence and requires wide excision and close follow-up. It is vital to identify these lesions even on limited biopsies as therapeutic options differ. This case is presented for its rarity and the diagnostic challenge it poses in limited biopsy. PMID:27081326

  5. Phyllodes Tumor in a Lactating Breast.

    PubMed

    Murthy, Sudha S; Raju, K V V N; Nair, Haripreetha G

    2016-01-01

    Phyllodes tumor is attributed to a small fraction of primary tumors of the breast. Such tumors occur rarely in pregnancy and lactation. We report a case of a 25-year-old lactating mother presenting with a lump in the left breast. Core needle biopsy was opined as phyllodes tumor with lactational changes, and subsequent wide local excision confirmed the diagnosis of benign phyllodes tumor with lactational changes. The characteristic gross and microscopic findings of a well-circumscribed lesion with leaf-like fibroepithelial growth pattern and typical nonuniform or diffuse stromal proliferation with periductal accentuation even in the absence of mitotic figures can help clinch the diagnosis. Benign phyllodes is known for its recurrence and requires wide excision and close follow-up. It is vital to identify these lesions even on limited biopsies as therapeutic options differ. This case is presented for its rarity and the diagnostic challenge it poses in limited biopsy. PMID:27081326

  6. A Case of Secondary Angiosarcoma of the Breast after Breast-conserving Surgery and Radiation: Review of Radiologic and Pathologic Findings

    PubMed Central

    Eppelheimer, Christine N; Marti, Jennifer L; Eisenberg, Amanda; Gan, Qiong; Shabalova, Rena; Cohen, Jean-Marc; Fulop, Tamara

    2015-01-01

    Angiosarcoma of the breast is a rare and potentially life-threatening disease. It can present as a palpable mass or subtle erythematous lesion, depending on the predisposing clinical factors. Erythematous skin lesions may be confused for a benign process, which may lead to a delay in diagnosis. We present a case of an 80-year-old woman who developed secondary angiosarcoma after undergoing breast-conserving therapy for Stage IA breast cancer. In this article, we review our experience with a case of secondary angiosarcoma of the breast and discuss the presentation, evaluation, and treatment of this disease. This case demonstrates the importance of vigilance regarding erythematous or papular breast lesions in the setting of prior local radiation. PMID:26430538

  7. Columnar cell lesions of the canine mammary gland: pathological features and immunophenotypic analysis

    PubMed Central

    2010-01-01

    Background It has been suggested that columnar cell lesions indicate an alteration of the human mammary gland involved in the development of breast cancer. They have not previously been described in canine mammary gland. The aim of this paper is describe the morphologic spectrum of columnar cell lesions in canine mammary gland specimens and their association with other breast lesions. Methods A total of 126 lesions were subjected to a comprehensive morphological review based upon the human breast classification system for columnar cell lesions. The presence of preinvasive (epithelial hyperplasia and in situ carcinoma) and invasive lesions was determined and immunophenotypic analysis (estrogen receptor (ER), progesterone receptor (PgR), high molecular weight cytokeratin (34βE-12), E-cadherin, Ki-67, HER-2 and P53) was perfomed. Results Columnar cell lesions were identified in 67 (53.1%) of the 126 canine mammary glands with intraepithelial alterations. They were observed in the terminal duct lobular units and characterized at dilated acini may be lined by several layers of columnar epithelial cells with elongated nuclei. Of the columnar cell lesions identified, 41 (61.2%) were without and 26 (38.8%) with atypia. Association with ductal hyperplasia was observed in 45/67 (67.1%). Sixty (89.5%) of the columnar cell lesions coexisted with neoplastic lesions (20 in situ carcinomas, 19 invasive carcinomas and 21 benign tumors). The columnar cells were ER, PgR and E-cadherin positive but negative for cytokeratin 34βE-12, HER-2 and P53. The proliferation rate as measured by Ki-67 appeared higher in the lesions analyzed than in normal TDLUs. Conclusions Columnar cell lesions in canine mammary gland are pathologically and immunophenotypically similar to those in human breast. This may suggest that dogs are a suitable model for the comparative study of noninvasive breast lesions. PMID:20178635

  8. A Pilot Study of Improved Lesion Characterization in Breast MRI Using a 3D Radial Balanced SSFP Technique With Isotropic Resolution and Efficient Fat-Water Separation

    PubMed Central

    Moran, Catherine J.; Kelcz, Frederick; Jung, Youngkyoo; Brodsky, Ethan K.; Fain, Sean B.; Block, Walter F.

    2013-01-01

    Purpose To assess a 3D radial balanced steady state free precession technique that provides sub-millimeter isotropic resolution and inherently registered fat and water image volumes in comparison to conventional T2-weighted RARE imaging for lesion characterization in breast MRI. Materials and Methods 3D PRojection SSFP (3DPR-SSFP) combines a dual half-echo radial k-space trajectory with a linear combination fat/water separation technique (Linear Combination SSFP). A pilot study was performed in 20 patients to assess fat suppression and depiction of lesion morphology using 3DPR-SSFP. For all patients fat suppression was measured for the 3DPR-SSFP image volumes and depiction of lesion morphology was compared against corresponding T2-weighted Fast Spin Echo (FSE) datasets for 15 lesions in 11 patients. Results The isotropic 0.63 mm resolution of the 3DPR-SSFP sequence demonstrated improved depiction of lesion morphology in comparison to FSE. The 3DPR-SSFP fat and water datasets were available in a 5 minute scan time while average fat suppression with 3DPR-SSFP was 71% across all twenty patients. Conclusion 3DPR-SSFP has the potential to improve the lesion characterization information available in breast MRI, particularly in comparison to conventional FSE. A larger study is warranted to quantify the effect of 3DPR-SSFP on specificity. PMID:19557728

  9. Diagnosing Common Benign Skin Tumors.

    PubMed

    Higgins, James C; Maher, Michael H; Douglas, Mark S

    2015-10-01

    Patients will experience a wide range of skin growths and changes over their lifetime. Family physicians should be able to distinguish potentially malignant from benign skin tumors. Most lesions can be diagnosed on the basis of history and clinical examination. Lesions that are suspicious for malignancy, those with changing characteristics, symptomatic lesions, and those that cause cosmetic problems may warrant medical therapy, a simple office procedure (e.g., excision, cryosurgery, laser ablation), or referral. Acrochordons are extremely common, small, and typically pedunculated benign neoplasms. Simple scissor or shave excision, electrodesiccation, or cryosurgery can be used for treatment. Sebaceous hyperplasia presents as asymptomatic, discrete, soft, pale yellow, shiny bumps on the forehead or cheeks, or near hair follicles. Except for cosmesis, they have no clinical significance. Lipomas are soft, flesh-colored nodules that are easily moveable under the overlying skin. Keratoacanthomas are rapidly growing, squamoproliferative benign tumors that resemble squamous cell carcinomas. Early simple excision is recommended. Pyogenic granuloma is a rapidly growing nodule that bleeds easily. Treatment includes laser ablation or shave excision with electrodesiccation of the base. Dermatofibromas are an idiopathic benign proliferation of fibroblasts. No treatment is required unless there is a change in size or color, bleeding, or irritation from trauma. Epidermal inclusion cysts can be treated by simple excision with removal of the cyst and cyst wall. Seborrheic keratoses and cherry angiomas generally do not require treatment. PMID:26447443

  10. 99Tcm-MIBI scintimammography in the evaluation of breast lesions and axillary involvement: a comparison with mammography and histopathological diagnosis.

    PubMed

    Arslan, N; Oztürk, E; Ilgan, S; Urhan, M; Karaçalioglu, O; Pekcan, M; Tufan, T; Bayhan, H

    1999-04-01

    The aim of this prospective study was to determine the diagnostic value of prone lateral 99Tcm-MIBI scintimammography in the detection of primary breast cancer and axillary lymph node involvement in patients with breast lesions. We evaluated 83 palpable and 22 non-palpable lesions in 77 consecutive patients with a clinically palpable mass and/or suspicious mammographic finding. Early and late scintimammograms were performed after the intravenous injection of 740 MBq 99Tcm-MIBI. The overall sensitivity of both scintimammography and mammography in the detection of primary breast cancer was 94%. The overall specificity was 84% and 56% for scintimammography and mammography respectively. In the patients with palpable masses, the sensitivity of scintimammography was 97% and the specificity was 84%; in those with non-palpable masses, the sensitivity was 35% and the specificity 100%. For the detection of axillary lymph node involvement, the sensitivity and specificity of scintimammography were 68% and 93% respectively. However, conventional mammography showed 37% sensitivity and 86% specificity. In conclusion, scintimammography is an accurate and clinically valuable tool for evaluating palpable and non-palpable breast abnormalities. In addition to its high sensitivity, it improves the specificity of mammography both in the evaluation of breast masses and in the detection of axillary involvement. PMID:10319351

  11. The diagnostic importance of evaluation of solid breast masses by sonoelastography

    PubMed Central

    Yerli, Hasan; Yılmaz, Tuğbahan; Ural, Banu; Gülay, Hüseyin

    2013-01-01

    Objective: The aim of this study was to determine whether the use of a scoring method by sonoelastography in solid breast masses is helpful in differentiating benign and malignant lesions. Material and Methods: One hundred and eighty solid breast masses in 155 patients (147 benign, 33 malignant) were prospectively evaluated in a two-year period. For each lesion, B-mode sonography and sonoelastography images were obtained. Elasticity scores of the lesions were determined with a 5-point scoring method by sonoelastography. The findings were compared with histopathology. The diagnostic performances of the sonoelastographic scoring and B-mode sonography methods were determined. Results: The mean scores on sonoelastography were 2.61±0.62 for benign lesions and 3.73±0.69 for malignant lesions. When a cutoff point between scores 3 and 4 was used, accuracy, sensitivity, specificity, positive and negative predictive values for B-mode sonography were found as 81%, 89%, 79%, 46% and 97%, respectively; these were 87%, 73%, 91%, 69% and 92% for the sonoelastographic scoring method. Conclusion: After B-mode sonography analysis, the evaluation with the 5-point scoring method by sonoelastography might be a complementary method that increases specificity when differentiating between benign and malignant solid breast masses. PMID:25931849

  12. Lactating Adenoma of the Breast.

    PubMed

    Barco Nebreda, Israel; Vidal, M Carmen; Fraile, Manel; Canales, Lydia; González, Clarisa; Giménez, Nuria; García-Fernández, Antonio

    2016-08-01

    Lactating adenoma is an uncommon breast palpable lesion occurring in pregnancy or lactation. Although it is a benign condition, it often requires core biopsy or even surgery to exclude malignancy. As with other solid lesions in pregnancy and lactation, lactating adenoma needs an accurate evaluation in order to ensure its benign nature. Work-up must include both imaging and histologic findings. Ultrasound evaluation remains the first step in assessing the features of the lesion. Some authors consider magnetic resonance imaging as a useful tool in cases of inconclusive evaluation after ultrasound and histologic exam in an attempt to avoid surgery. Most lactating adenomas resolve spontaneously, whereas others persist or even increase in size and must be removed. The authors present a case of a 35-year-old woman at 6 months postpartum with a lactating adenoma in her right breast. After surgical removal, breastfeeding was perfectly continued within the next 24 hours, which highlights the fact that breast surgery is most often compatible with breastfeeding. PMID:27197575

  13. Vitronectin: a promising breast cancer serum biomarker for early diagnosis of breast cancer in patients.

    PubMed

    Hao, Wende; Zhang, Xuhui; Xiu, Bingshui; Yang, Xiqin; Hu, Shuofeng; Liu, Zhiqiang; Duan, Cuimi; Jin, Shujuan; Ying, Xiaomin; Zhao, Yanfeng; Han, Xiaowei; Hao, Xiaopeng; Fan, Yawen; Johnson, Heather; Meng, Di; Persson, Jenny L; Zhang, Heqiu; Feng, XiaoYan; Huang, Yan

    2016-07-01

    Breast cancer is the most common cancer in women worldwide, identification of new biomarkers for early diagnosis and detection will improve the clinical outcome of breast cancer patients. In the present study, we determined serum levels of vitronectin (VN) in 93 breast cancer patients, 30 benign breast lesions, 9 precancerous lesions, and 30 healthy individuals by enzyme-linked immunosorbent assays. Serum VN level was significantly higher in patients with stage 0-I primary breast cancer than in healthy individuals, patients with benign breast lesion or precancerous lesions, as well as those with breast cancer of higher stages. Serum VN level was significantly and negatively correlated with tumor size, lymph node status, and clinical stage (p < 0.05 in all cases). In addition, VN displayed higher area under curve (AUC) value (0.73, 95 % confidence interval (CI) [0.62-0.84]) than carcinoembryonic antigen (CEA) (0.64, 95 % CI [0.52-0.77]) and cancer antigen 15-3 (CA 15-3) (0.69, 95 % CI [0.58-0.81]) when used to distinguish stage 0-I cancer and normal control. Importantly, the combined use of three biomarkers yielded an improvement in receiver operating characteristic curve with an AUC of 0.83, 95 % CI [0.74-0.92]. Taken together, our current study showed for the first time that serum VN is a promising biomarker for early diagnosis of breast cancer when combined with CEA and CA15-3. PMID:26753956

  14. Pseudoangiomatous stromal hyperplasia in a complex neoplastic lesion involving anogenital mammary-like glands.

    PubMed

    Vazmitel, Marina; Pavlovsky, Michal; Kacerovska, Denisa; Michal, Michal; Kazakov, Dmitry V

    2009-10-01

    Anogenital mammary-like glands (AMLG) may give rise to various pathologic lesions identical to those known in mammary pathology. Pseudoangiomatous stromal hyperplasia (PASH), a relatively frequent hormonal change associated with different benign and malignant processes in the breast, was only once mentioned in the literature concerning the pathology of AMLG. We present here a new case of PASH in a lesion of AMLG. The present case of PASH is remarkable because of its occurrence within a complex lesion evidencing the changes identical to or reminiscent of blunt duct adenosis, fibroadenoma and hidradenoma papilliferum. PMID:19508499

  15. Dedicated Cone-beam Breast Computed Tomography and Diagnostic Mammography: Comparison of Radiation Dose, Patient Comfort, And Qualitative Review of Imaging Findings in BI-RADS 4 and 5 Lesions

    PubMed Central

    O’Connell, Avice M.; Kawakyu-O’Connor, Daniel

    2012-01-01

    Objective: This pilot study was undertaken to compare radiation dose, relative visibility/conspicuity of biopsy-proven lesions, and relative patient comfort in diagnostic mammography and dedicated cone-beam breast computed tomography (CBBCT) in Breast Imaging-Reporting and Data System (BI-RADS)® 4 or 5 lesions. Materials and Methods: Thirty-six consecutive patients (37 breasts) with abnormal mammographic and/or ultrasound categorized as BI-RADS® 4 or 5 lesions were evaluated with CBBCT prior to biopsy. Administered radiation dose was calculated for each modality. Mammograms and CBBCT images were compared side-by-side and lesion visibility/conspicuity was qualitatively scored. Histopathology of lesions was reviewed. Patients were administered a survey for qualitative evaluation of comfort between the two modalities. Results: CBBCT dose was similar to or less than diagnostic mammography, with a mean dose of 9.4 mGy (±3.1 SD) for CBBCT vs. 16.9 mGy (±6.9 SD) for diagnostic mammography in a total of 37 imaged breasts (P<0.001). Thirty-three of 34 mammographic lesions were scored as equally or better visualized in CBBCT relative to diagnostic mammography. Characterization of high-risk lesions was excellent. Patients reported greater comfort in CBBCT imaging relative to mammography. Conclusion: Our experience of side-by-side comparison of CBBCT and diagnostic mammography in BI-RADS® 4 and 5 breast lesions demonstrated a high degree of correlation between the two modalities across a variety of lesion types. Owing to favorable radiation dose profile, excellent visualization of lesions, and qualitative benefits including improved patient comfort, excellent field-of-view, and more anatomical evaluation of lesion margins, CBBCT offers a promising modality for diagnostic evaluation of breast lesions. PMID:22439131

  16. Diffusion weighted MRI of the breast: Protocol optimization, guidelines for interpretation, and potential clinical applications

    PubMed Central

    Partridge, Savannah C.; McDonald, Elizabeth S.

    2013-01-01

    Synopsis There has been increasing interest in the use of diffusion weighted MRI (DWI) for breast imaging. This technique has shown promise for improving the positive predictive value of breast MRI for detection of breast cancer, evaluating tumor response to neoadjuvant chemotherapy, and as a non-contrast MRI alternative for breast cancer screening. However, there is currently no standardized approach to DWI of the breast and data quality varies widely. Prior to implementing DWI into clinical practice, it is important to understand the pertinent technical considerations and current evidence of clinical applications of DWI of the breast. This article provides an overview of basic principles of DWI, optimization of breast DWI protocols, imaging features of benign and malignant breast lesions, promising clinical applications, and potential future directions. PMID:23928248

  17. Classification of ultrasonic B-mode images of breast masses using Nakagami distribution.

    PubMed

    Shank