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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. Clinical significance of interval changes in breast lesions initially categorized as probably benign on breast ultrasound

    PubMed Central

    Jang, Ja Yoon; Kim, Sun Mi; Kim, Jin Hwan; Jang, Mijung; La Yun, Bo; Lee, Jong Yoon; Lee, Soo Hyun; Kim, Bohyoung

    2017-01-01

    Abstract The aims of this study were to determine the malignancy rate of probably benign lesions that show an interval change on follow-up ultrasound and to evaluate the differences seen on imaging between benign and malignant lesions initially categorized as probably benign but with interval change on follow-up breast ultrasound. We retrospectively reviewed 11,323 lesions from ultrasound-guided core-biopsies performed between June 2004 and December 2014 and identified 289 lesions (266 patients) with an interval change from probably benign (Breast Imaging Reporting and Data System [BI-RADS] category 3) in the previous 2 years. Malignancy rates were compared according to the ultrasound findings and the characteristics of the interval changes, including changes in morphology and/or diameter. The malignancy rate for probably benign lesions that showed an interval change on follow-up ultrasound was 6.9% (20/289). The malignancy rate was higher for clustered cysts (33.3%) and irregular or noncircumscribed masses (12.7%) than for circumscribed oval masses (5%) or complicated cysts (5%) seen on initial ultrasound (P = 0.043). Fifty-five percent of the malignancies were found to be ductal carcinoma in situ and there was 1 case of lymph node metastasis among the patients with invasive disease in whom biopsy was delayed by 6 to 15 months. The extent of invasiveness was greater in missed cases. There was a significant difference in the maximal diameter change between the 20 malignant lesions and the 269 benign lesions (4.0 mm vs 2.7 mm, P = 0.002). The cutoff value for maximal diameter change per initial diameter was 39.0% for predicting malignancy (sensitivity 95%, specificity 53.5%). The malignancy rate for morphologically changed lesions was significantly higher than for morphologically stable lesions (13.6% vs 4.9%; P = 0.024) Our 6.9% of probably benign lesions that showed an interval change finally turned out to be malignancy was mostly DCIS. The

  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. Estimate of tissue composition in malignant and benign breast lesions by time-domain optical mammography

    PubMed Central

    Quarto, Giovanna; Spinelli, Lorenzo; Pifferi, Antonio; Torricelli, Alessandro; Cubeddu, Rinaldo; Abbate, Francesca; Balestreri, Nicola; Menna, Simona; Cassano, Enrico; Taroni, Paola

    2014-01-01

    The optical characterization of malignant and benign breast lesions is presented. Time-resolved transmittance measurements were performed in the 630-1060 nm range by means of a 7-wavelength optical mammograph, providing both imaging and spectroscopy information. A total of 62 lesions were analyzed, including 33 malignant and 29 benign lesions. The characterization of breast lesions was performed applying a perturbation model based on the high-order calculation of the pathlength of photons inside the lesion, which led to the assessment of oxy- and deoxy-hemoglobin, lipids, water and collagen concentrations. Significant variations between tumor and healthy tissue were observed in terms of both absorption properties and constituents concentration. In particular, benign lesions and tumors show a statistically significant discrimination in terms of absorption at several wavelengths and also in terms of oxy-hemoglobin and collagen content. PMID:25360382

  5. Image-detected 'probably benign' breast lesions: a significant reason for referral from primary care.

    PubMed

    Brennan, M E; Houssami, N

    2006-10-01

    In Australia, and many health care provider systems, primary care physicians are the first to see women with breast symptoms and are responsible for making decisions on whether to investigate and when to refer to specialist teams. We present an audit of new patient referrals from primary care triaged to a 'low-risk' (low likelihood of cancer) clinic on the basis of benign findings. The most common reason for referral was 'breast lump' (38%) followed by 'image-detected' abnormality (26%.) We have identified that (outside of population screening services) many women are being referred from primary care to specialist clinics for management of screen-detected lesions considered benign on imaging. Further research is needed to identify the reasons for such referrals and to develop appropriate educational strategies and clinical policy, both for the primary care and the specialist breast practitioner.

  6. Benign and malignant papillary lesions of the breast. A cytomorphologic study.

    PubMed

    Jeffrey, P B; Ljung, B M

    1994-04-01

    Fine-needle aspiration cytology of benign and malignant papillary lesions of the breast has been infrequently described. To define the cytologic features of benign and malignant papillary breast lesions better, the authors retrospectively reviewed the fine-needle aspiration cytology of five cases of histologically proven intracystic papillary carcinoma (IPC) and six cases of histologically proven papilloma. Clinical information was obtained from the medical records in each case. Intracystic papillary carcinoma tended to present as a larger tumor (average, 5 cm) in older women (average, 65.4 years). Papilloma, however, tended to present as a smaller tumor (average, 1.5 cm) in younger women (average, 43 years). Eighty percent of the IPC cases (4/5) and 50% of the papilloma cases (3/6) yielded highly cellular aspirates with complex vascular papillae and single columnar cells. Macrophages were a constant feature of IPC and were present in all but one case of papilloma. Although cellular atypia was not a prominent feature in either IPC or papilloma, moderate atypia was noted in one case of IPC and two cases of papilloma. Severe atypia was noted in a single case of IPC. Although IPC tended to yield a harvest with higher cellularity and single intact cells, no single feature or constellation of findings was consistently reliable in distinguishing IPC from papilloma. The authors found that papillary lesions of the breast demonstrate a distinct cytomorphology characterized by complex vascular papillae, columnar cells, and macrophages. They concluded, however, that, in the absence of overt cytologic malignancy, distinguishing between benign and malignant papillary breast lesions is difficult, if not impossible.

  7. Predictive Factors for Upgrading Patients with Benign Breast Papillary Lesions Using a Core Needle Biopsy

    PubMed Central

    Hong, Young Ran; Song, Byung Joo; Jung, Sang Seol; Kang, Bong Joo; Kim, Sung Hun

    2016-01-01

    Purpose Intraductal papilloma (IDP) is a benign breast disease with malignant potential, for which complete surgical excision is usually recommended. The aim of the present study was to investigate predictive factors for upgrading patients with a benign papillary lesion (BPL). Methods This study was an observational study using a prospectively collected cohort. In total, 13,049 patients who underwent a core needle biopsy (CNB) for a breast lesion between January 2009 and May 2015 were enrolled. We reviewed all patients with pathologically confirmed BPL from a CNB. Results Surgical treatment was performed for 363 out of a total of 592 lesions. According to the pathological differences, the lowest upgrade rate was shown in IDP without atypia (without atypia, 6.0%; with atypia, 26.8%; papillary neoplasm, 31.5%; p<0.001). The univariate analysis showed that, in IDP without atypia, the age at diagnosis, size of BPL on ultrasonography, and density on mammography were associated with upgrading. The multivariate analysis revealed that age >54 years and lesion size >1 cm were significantly associated with upgrade to malignancy (odds ratio [OR]=4.351, p=0.005 and OR=4.236, p=0.001, respectively). Conclusion The indications for surgical treatment can be defined as age >54 years and mass size >1 cm, even in IDP without atypia in the CNB results; this also includes cases of IDP with atypia or papillary neoplasm. Therefore, we suggest that close observation without surgery is sufficient for younger women with a small IDP without atypia. PMID:28053629

  8. 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

  9. Study of nuclear morphometry on cytology specimens of benign and malignant breast lesions: A study of 122 cases

    PubMed Central

    Kashyap, Anamika; Jain, Manjula; Shukla, Shailaja; Andley, Manoj

    2017-01-01

    Background: Breast cancer has emerged as a leading site of cancer among women in India. Fine needle aspiration cytology (FNAC) has been routinely applied in assessment of breast lesions. Cytological evaluation in breast lesions is subjective with a “gray zone” of 6.9–20%. Quantitative evaluation of nuclear size, shape, texture, and density parameters by morphometry can be of diagnostic help in breast tumor. Aims: To apply nuclear morphometry on cytological breast aspirates and assess its role in differentiating between benign and malignant breast lesions with derivation of suitable cut-off values between the two groups. Settings and Designs: The present study was a descriptive cross-sectional hospital-based study of nuclear morphometric parameters of benign and malignant cases. Materials and Methods: The study included 50 benign breast disease (BBD), 8 atypical ductal hyperplasia (ADH), and 64 carcinoma cases. Image analysis was performed on Papanicolaou-stained FNAC slides by Nikon Imaging Software (NIS)–Elements Advanced Research software (Version 4.00). Nuclear morphometric parameters analyzed included 5 nuclear size, 2 shape, 4 texture, and 2 density parameters. Results: Nuclear morphometry could differentiate between benign and malignant aspirates with a gradually increasing nuclear size parameters from BBD to ADH to carcinoma. Cut-off values of 31.93 μm2, 6.325 μm, 5.865 μm, 7.855 μm, and 21.55 μm for mean nuclear area, equivalent diameter, minimum feret, maximum ferret, and perimeter, respectively, were derived between benign and malignant cases, which could correctly classify 7 out of 8 ADH cases. Conclusion: Nuclear morphometry is a highly objective tool that could be used to supplement FNAC in differentiating benign from malignant lesions, with an important role in cases with diagnostic dilemma. PMID:28182052

  10. The use of colour-coded and spectral Doppler ultrasound in the differentiation of benign and malignant breast lesions.

    PubMed Central

    Peters-Engl, C.; Medl, M.; Leodolter, S.

    1995-01-01

    The aim of this study was to evaluate the role of colour-coded and spectral Doppler sonography to predict the benign or malignant nature of breast lesions. A total of 112 women with mammographically suspicious breast lesions were investigated prior to surgery. Thirty-nine breast carcinomas and 73 benign lesions were evaluated for the resistance index, pulsatility index and the flow velocity. A resistance index of > or = 0.70 was characteristic of malignant tumours with a sensitivity of 82% and a specificity of 81%. The positive predictive value was 70% and the negative predictive value 89%. Doppler sonography offers one possible method for further investigation of patients with mammographic abnormalities. PMID:7819029

  11. Population Based Assessment of MHC Class I Antigens Down Regulation as Markers of Increased Risk for Development and Progression of Breast Cancer from Benign Breast Lesions

    DTIC Science & Technology

    2007-01-01

    Manuscript attached: Appendix A- 2 C: EXPRESSION OF MHC CLASS I AND II EXPRESSION SIGNIFICANTLY DISCRIMINATES AMONG BENIGN, CARCINOMA IN SITU, AND...Tumor aggressiveness and MHC class I and II antigens in laryngeal and breast cancer. Semin Cancer Biol. 2 :47-54; 1991. 5. Sawtell, NM., DiPersio, L... 2 , 3). In breast lesions examined for expression of MHC class I, approximately half (51%) of carcinomas had an abnormally low content of HLA-A, -B

  12. 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.

  13. Non-invasive optical estimate of tissue composition to differentiate malignant from benign breast lesions: A pilot study

    NASA Astrophysics Data System (ADS)

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

    2017-01-01

    Several techniques are being investigated as a complement to screening mammography, to reduce its false-positive rate, but results are still insufficient to draw conclusions. This initial study explores time domain diffuse optical imaging as an adjunct method to classify non-invasively malignant vs benign breast lesions. We estimated differences in tissue composition (oxy- and deoxyhemoglobin, lipid, water, collagen) and absorption properties between lesion and average healthy tissue in the same breast applying a perturbative approach to optical images collected at 7 red-near infrared wavelengths (635–1060 nm) from subjects bearing breast lesions. The Discrete AdaBoost procedure, a machine-learning algorithm, was then exploited to classify lesions based on optically derived information (either tissue composition or absorption) and risk factors obtained from patient’s anamnesis (age, body mass index, familiarity, parity, use of oral contraceptives, and use of Tamoxifen). Collagen content, in particular, turned out to be the most important parameter for discrimination. Based on the initial results of this study the proposed method deserves further investigation.

  14. Non-invasive optical estimate of tissue composition to differentiate malignant from benign breast lesions: A pilot study

    PubMed Central

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

    2017-01-01

    Several techniques are being investigated as a complement to screening mammography, to reduce its false-positive rate, but results are still insufficient to draw conclusions. This initial study explores time domain diffuse optical imaging as an adjunct method to classify non-invasively malignant vs benign breast lesions. We estimated differences in tissue composition (oxy- and deoxyhemoglobin, lipid, water, collagen) and absorption properties between lesion and average healthy tissue in the same breast applying a perturbative approach to optical images collected at 7 red-near infrared wavelengths (635–1060 nm) from subjects bearing breast lesions. The Discrete AdaBoost procedure, a machine-learning algorithm, was then exploited to classify lesions based on optically derived information (either tissue composition or absorption) and risk factors obtained from patient’s anamnesis (age, body mass index, familiarity, parity, use of oral contraceptives, and use of Tamoxifen). Collagen content, in particular, turned out to be the most important parameter for discrimination. Based on the initial results of this study the proposed method deserves further investigation. PMID:28091596

  15. Non-invasive optical estimate of tissue composition to differentiate malignant from benign breast lesions: A pilot study.

    PubMed

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

    2017-01-16

    Several techniques are being investigated as a complement to screening mammography, to reduce its false-positive rate, but results are still insufficient to draw conclusions. This initial study explores time domain diffuse optical imaging as an adjunct method to classify non-invasively malignant vs benign breast lesions. We estimated differences in tissue composition (oxy- and deoxyhemoglobin, lipid, water, collagen) and absorption properties between lesion and average healthy tissue in the same breast applying a perturbative approach to optical images collected at 7 red-near infrared wavelengths (635-1060 nm) from subjects bearing breast lesions. The Discrete AdaBoost procedure, a machine-learning algorithm, was then exploited to classify lesions based on optically derived information (either tissue composition or absorption) and risk factors obtained from patient's anamnesis (age, body mass index, familiarity, parity, use of oral contraceptives, and use of Tamoxifen). Collagen content, in particular, turned out to be the most important parameter for discrimination. Based on the initial results of this study the proposed method deserves further investigation.

  16. Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring.

    PubMed

    Sadigh, Gelareh; Carlos, Ruth C; Neal, Colleen H; Dwamena, Ben A

    2012-05-01

    There has been controversy regarding the accuracy of breast ultrasound elastography (USE) compared to conventional B-mode Ultrasound (USB). The purpose of this study was to conduct a direct comparative effectiveness analysis of USB versus USE or their combination in differentiating breast lesions through systematically reviewing recent literature. An extensive literature search of PubMed and other medical and general purpose databases from inception through August 2011 was conducted. Published studies that reported a direct comparison of the diagnostic performance of USE, using elasticity score versus USB, using breast imaging reporting and data system (BIRADS) for characterization of focal breast lesions were included. Summary diagnostic performance measures were assessed for each of the tests and their combination using bivariate generalized linear mixed modeling. The two tests were combined as: (1) conjunctive, where the outcome of the combination of tests is positive only if both test results are positive; (2) disjunctive, where the outcome of a combination of tests is negative only if both tests are negative. Twenty nine studies provided relevant information on 5,511 breast masses (2,065 cancers, 3,446 benign lesions). Sensitivity of USB, USE, and their conjunctive and disjunctive combinations were 96% (95% credible interval (CrI), 93-98%), 79% (95% CrI, 74-83%), 73% (95% CrI, 67-78%), and 99% (95% CrI, 98-99%), respectively. Specificity of USB, USE, and their conjunctive and disjunctive combinations were 70% (95% CrI, 55-83%), 88% (95% CrI, 82-92%), 97% (95% CrI, 95-99%), and 56% (95% CrI, 43-69%), respectively. The application of USE as a single test is not superior to USB alone. However, in low risk patients it is recommended to perform an USE following a positive USB result to decrease the rate of unnecessary biopsies.

  17. The Spatial Relationship of Malignant and Benign Breast Lesions with Respect to the Fat-Gland Interface on Magnetic Resonance Imaging

    PubMed Central

    Kim, Won Hwa; Li, MuLan; Han, Wonshik; Ryu, Han Suk; Moon, Woo Kyung

    2016-01-01

    The fat-gland interface in the breast is noteworthy in that major vessels and lymphatic channels supplying the breast are located there; however, the relationship between breast lesion formation and the fat-gland interface is poorly understood. Here we evaluate the location of malignant and benign breast lesions with respect to the fat-gland interface in 881 women 50 years of age and younger, utilizing MR imaging. We find that most breast lesions are located in or near the interface in qualitative (89.7%) and quantitative (90.0%, 1 cm within the interface) analyses. This propensity for the fat-gland interface is not accounted for by breast anatomy, whereby 12.3% and 55.7% of breast volume is within 2 mm and 1 cm of the interface, respectively. Malignant lesions were located in or near the interface in significantly higher proportions than benign lesions in qualitative (94.3% vs. 67.3%, P < 0.001) and quantitative (49.7% vs. 34.5%, P < 0.001, 2 mm within the interface) analyses. This phenomenon may reflect a biological importance of the fat-gland interface in breast cancer development and progression. PMID:27966625

  18. The Spatial Relationship of Malignant and Benign Breast Lesions with Respect to the Fat-Gland Interface on Magnetic Resonance Imaging.

    PubMed

    Kim, Won Hwa; Li, MuLan; Han, Wonshik; Ryu, Han Suk; Moon, Woo Kyung

    2016-12-14

    The fat-gland interface in the breast is noteworthy in that major vessels and lymphatic channels supplying the breast are located there; however, the relationship between breast lesion formation and the fat-gland interface is poorly understood. Here we evaluate the location of malignant and benign breast lesions with respect to the fat-gland interface in 881 women 50 years of age and younger, utilizing MR imaging. We find that most breast lesions are located in or near the interface in qualitative (89.7%) and quantitative (90.0%, 1 cm within the interface) analyses. This propensity for the fat-gland interface is not accounted for by breast anatomy, whereby 12.3% and 55.7% of breast volume is within 2 mm and 1 cm of the interface, respectively. Malignant lesions were located in or near the interface in significantly higher proportions than benign lesions in qualitative (94.3% vs. 67.3%, P < 0.001) and quantitative (49.7% vs. 34.5%, P < 0.001, 2 mm within the interface) analyses. This phenomenon may reflect a biological importance of the fat-gland interface in breast cancer development and progression.

  19. Computer-aided diagnosis of mass-like lesion in breast MRI: differential analysis of the 3-D morphology between benign and malignant tumors.

    PubMed

    Huang, Yan-Hao; Chang, Yeun-Chung; Huang, Chiun-Sheng; Wu, Tsung-Ju; Chen, Jeon-Hor; Chang, Ruey-Feng

    2013-12-01

    This study aimed to evaluate the value of using 3-D breast MRI morphologic features to differentiate benign and malignant breast lesions. The 3-D morphological features extracted from breast MRI were used to analyze the malignant likelihood of tumor from ninety-five solid breast masses (44 benign and 51 malignant) of 82 patients. Each mass-like lesion was examined with regards to three categories of morphologic features, including texture-based gray-level co-occurrence matrix (GLCM) feature, shape, and ellipsoid fitting features. For obtaining a robust combination of features from different categories, the biserial correlation coefficient (|r(pb)|)≧0.4 was used as the feature selection criterion. Receiver operating characteristic (ROC) curve was used to evaluate performance and Student's t-test to verify the classification accuracy. The combination of the selected 3-D morphological features, including conventional compactness, radius, spiculation, surface ratio, volume covering ratio, number of inside angular regions, sum of number of inside and outside angular regions, showed an accuracy of 88.42% (84/95), sensitivity of 88.24% (45/51), and specificity of 88.64% (39/44), respectively. The AZ value was 0.8926 for these seven combined morphological features. In conclusion, 3-D MR morphological features specified by GLCM, tumor shape and ellipsoid fitting were useful for differentiating benign and malignant breast masses.

  20. 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

  1. 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.

  2. Immunohistochemical localisation of pS2 protein in ductal carcinoma in situ and benign lesions of the breast.

    PubMed Central

    Luqmani, Y. A.; Campbell, T.; Soomro, S.; Shousha, S.; Rio, M. C.; Coombes, R. C.

    1993-01-01

    The expression of pS2 was examined histochemically in paraffin sections taken from biopsy material from patients diagnosed with ductal carcinoma in situ (DCIS). Often intense immunoreactivity, to an anti-pS2 monoclonal antibody, was observed in comedo, solid, cribriform and micropapillary types of DCIS, with significant positivity found in 63-67% of cases. In 15 samples analysed, we found a good correlation between pS2 expression and presence of progesterone receptor positive cells, but not with estrogen receptor. There was only a limited degree of correspondence between the cells staining with these anti-sera. Some pS2 positive cells were also seen in normal acini in areas adjacent to cancer but much less frequently in sections of normal breast from reduction mammoplasty. Most normal areas were negative, as were cysts. In benign proliferative conditions (seen in sections with and without DCIS) such as adenosis, sclerosing adenosis, mild and florid ductal epithelial hyperplasia, significant pS2 positivity was seen in about 50% of cases. These results suggest that there is a progressive increase in pS2 from normal to benign to cancer cells and that this gene is expressed in both the invasive and pre-invasive forms of breast cancer. Images Figure 1 Figure 2 Figure 3 PMID:8385977

  3. Population Based Assessment of MHC Class 1 Antigens Down Regulation as Marker in Increased Risk for Development and Progression of Breast Cancer From Benign Breast Lesions

    DTIC Science & Technology

    2006-01-01

    Risk for Development and Progression of Breast Cancer from Benign Breast Lesions” antigen retrieval solution in the microwave . Lastly, tissue... Microwave and citrate buffer antigen-retrieval substitutions yielded comparable results. Lab 2 demonstrated that a negative control is useful as an...the infiltrating lymphocytes in germinal centers and dendritic cells as seen in case 1. Microsatellite Analysis Labs 1, 2, and 4 performed

  4. Benign Breast Problems and Conditions

    MedlinePlus

    ... with a needle. Another example is a simple fibroadenoma . Simple fibroadenomas usually shrink or go away on their own. ... Cyst: A sac or pouch filled with fluid. Fibroadenoma: A type of solid, benign breast mass. Hormone: ...

  5. 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

  6. Benign Breast Conditions

    MedlinePlus

    ... tissue.Female breasts are very complex. The female breast is filled with parts called glands (organs that produce milk in women who have ... birth), fat, and fibrous (connecting) tissue. Within each breast, there are ... of glands and fibrous tissue. Most people associate breast abnormalities ...

  7. Benign lesions of the external auditory canal.

    PubMed

    Tran, L P; Grundfast, K M; Selesnick, S H

    1996-10-01

    Benign mass lesions of the external auditory canal, such as exostoses and osteomas, are common findings on physical examination but most often do not require treatment. The differential diagnosis of lesions in the external auditory canal, however, should not be limited to those benign processes discussed here, but should also include infectious, dermatologic, congenital, and malignant processes.

  8. Differentiation of malignant and benign breast lesions: Added value of the qualitative analysis of breast lesions on diffusion-weighted imaging (DWI) using readout-segmented echo-planar imaging at 3.0 T

    PubMed Central

    Kim, Sung Hun

    2017-01-01

    Objective To determine the added value of qualitative analysis as an adjunct to quantitative analysis for the discrimination of benign and malignant lesions in patients with breast cancer using diffusion-weighted imaging (DWI) with readout-segmented echo-planar imaging (rs-EPI). Methods A total of 99 patients with 144 lesions were reviewed from our prospectively collected database. DWI data were obtained using rs-EPI acquired at 3.0 T. The diagnostic performances of DWI in the qualitative, quantitative, and combination analyses were compared with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Additionally, the effect of lesion size on the diagnostic performance of the DWI combination analysis was evaluated. Results The strongest indicators of malignancy on DWI were a heterogeneous pattern (P = 0.005) and an apparent diffusion coefficient (ADC) value <1.0 × 10–3 mm2/sec (P = 0.002). The area under the curve (AUC) values for the qualitative analysis, quantitative analysis, and combination analysis on DWI were 0.732 (95% CI, 0.651–0.803), 0.780 (95% CI, 0.703–0.846), and 0.826 (95% CI, 0.754–0.885), respectively (P<0.0001). The AUC for the combination analysis on DWI was superior to that for DCE-MRI alone (0.651, P = 0.003) but inferior to that for DCE-MRI plus the ADC value (0.883, P = 0.03). For the DWI combination analysis, the sensitivity was significantly lower in the size ≤1 cm group than in the size >1 cm group (80% vs. 95.6%, P = 0.034). Conclusions Qualitative analysis of tumor morphology was diagnostically applicable on DWI using rs-EPI. This qualitative analysis adds value to quantitative analyses for lesion characterization in patients with breast cancer. PMID:28358833

  9. Efficacy of Sonoelastography in Distinguishing Benign from Malignant Breast Masses

    PubMed Central

    Balçık, Adile; Polat, Ahmet Veysel; Bayrak, İlkay Koray; Polat, Ayfer Kamalı

    2016-01-01

    Objective The study aimed to evaluate the influence of sonoelastographic strain ratio in distinguishing benign from malignant breast masses. Materials and Methods Patients who were referred for diagnostic biopsy of a breast mass were examined by ultrasound and sonoelastography prior to percutaneous biopsy. Sonoelastography was performed twice by the same observer in the same session. The strain ratios (SR) were calculated for both measurements as well as the mean strain ratio. Results were compared with histopathologic findings. For each strain ratio, a threshold value was determined using a ROC analysis for the differentiation of benign and malignant masses. Results After histopathological examination of 135 mass lesions in 132 female patients (mean age 48±12 years), 65 masses were diagnosed as benign and 70 as malignant. According to the Tsukuba classification with 5 scores; 44 of 65 benign masses had scores of either 1 or 2 while 56 of 70 malignant lesions had scores of either 4 or 5. No benign lesion was classified as score 5, and no malignant lesion as score 1. The mean cut-off in the two ROC measurements in distinguishing benign from malignant lesions was calculated as 4.52. When a threshold value of 4.52 was used for the mean strain ratio: the sensitivity, specificity, PPV, NPV, and accuracy rates were determined as 85.5%, 84.8%, 85.5%, 84.8% and 85.2%, respectively. Conclusion The threshold value for strain ratio in the differentiation of benign and malignant masses was detected as 4.52, and a significant intra-observer difference was not observed in this study. The diagnostic value of sonoelastograghy in distinguishing benign from malignant breast masses was higher in comparison to conventional ultrasound.

  10. Incidental Breast Lesions Detected on Computed Thorax Tomography

    PubMed Central

    Poyraz, Necdet; Emlik, Ganime Dilek; Keskin, Suat; Kalkan, Havva

    2015-01-01

    Objective Although mammography is the primary imaging method of the breast, incidental benign and malignant breast lesions are increasingly being detected on computed tomographies (CTs) performed to detect different pathologies. Therefore, the detection and accurate identification of these lesions is important. In this study, we aimed to evaluate the frequency, morphological features, and results of incidental breast lesions on CTs performed for the detection of extramammarian pathologies. Materials and Methods Incidental breast lesions on CTs performed in our department between 2011 and 2013 were evaluated. Patients who had previously diagnosed breast lesions were excluded from the study. The inclusion criteria were histopathologic diagnose and being followed-up for at least 2 years. Results The study population consisted of 33 women whose mean age was 55±1.38 (37–78) years. Of the 33 women, 12 (36%) had malignant and 21 (64%) had benign or normal findings. The most common malignant lesion was invasive ductal carcinoma, and the most common benign lesion was fibroadenoma. Ill-defined contour and lymphadenopathy in malignant lesions and well-defined contour in benign lesions were the most important CT findings. Conclusion Breast must be carefully evaluated if it is included in the scans. An accurate report of breast lesions gives an opportunity for early diagnosis and treatment.

  11. Probably Benign Lesions at Screening Breast US in a Population with Elevated Risk: Prevalence and Rate of Malignancy in the ACRIN 6666 Trial

    PubMed Central

    Zhang, Zheng; Cormack, Jean B.; Mendelson, Ellen B.; Berg, Wendie A.

    2013-01-01

    Purpose To prospectively validate predefined breast ultrasonographic (US) Breast Imaging Reporting and Data System (BI-RADS) category 3 criteria in a multicenter setting in an elevated-risk population. Materials and Methods The American College of Radiology Imaging Network 6666 database was reviewed for prospectively defined BI-RADS category 3 lesions. Patient characteristics, lesion US features at initial detection, and work-up recommendations were analyzed with descriptive statistics. Exact 95% confidence intervals (CIs) were given, where appropriate. Lesion reference standard was biopsy or a minimum of 1-year follow-up. In addition, malignancy rate for lesions that had at least 2 years of follow-up data or that had biopsy data was calculated. Results Of 2662 participants, 519 (19.5%) had 745 BI-RADS category 3 lesions (25.5% of 2916 US lesions other than simple cysts), with a median size of 7 mm (range, 2–135 mm). The number of new BI-RADS category 3 lesions decreased with year 2–3 screening, but the percentage of new BI-RADS category 3 lesions was stable at 26.4% (506 of 1920 lesions), 23.6% (142 of 601 lesions), and 24.6% (97 of 395 lesions), respectively. Of 745 BI-RADS category 3 lesions, 124 (16.6%) were ultimately sampled for biopsy. Six malignancies (0.8% of BI-RADS category 3 lesions; 95% confidence interval [CI]: 0.3%, 1.7%) occurred in five (1.0%) of 519 participants: Five malignancies were invasive (median size, 10 mm; size range, 2–18 mm), and one was node positive. When the analysis is limited to lesions with at least 2-year follow-up or biopsy, the malignancy rate among BI-RADS category 3 lesions is 0.9% (95% CI: 0.3%, 2.0%). Three malignant BI-RADS category 3 lesions were sampled for biopsy because of a suspicious change at follow-up (two N0 lesions, one each at 6- and 12-month follow-up; one N1 lesion at 24-month follow-up), one was sampled for biopsy because of an upgrade after additional mammography (NX), one was found at mastectomy for

  12. 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

  13. Breast papillary lesions: an analysis of 70 cases

    PubMed Central

    Boin, Dahiana Pulgar; Baez, Jaime Jans; Guajardo, Militza Petric; Benavides, David Oddo; Ortega, Maria Elena Navarro; Valdés, Dravna Razmilic; Apphun, Mauricio Camus

    2014-01-01

    Introduction Papillary breast lesions are rare and constitute less than 10% of benign breast lesions and less than 1% of breast carcinomas. Objective To analyse the clinical presentation, preoperative evaluation, and surgical and anatomopathological characteristics of the patients operated on for papillary breast lesions. Material and Methods Retrospective descriptive and analytical study. We analysed the database of patients with definitive histopathological diagnosis of papillary breast lesions operated on at our institution from January 2004 to May 2013. Results During the period described, 70 patients with histopathological diagnosis of papillary breast lesions were operated upon. The median age was 50 years (19–86 years). Thirty-seven patients (52.8%) were symptomatic at diagnosis. Preoperative ultrasound was reported to be altered in all patients. A mammography showed pathologic findings in only 50% of cases. All patients underwent partial mastectomy, after needle localisation under ultrasound, if the lesion was not palpable on physical examination. The final pathological diagnosis was: benign papillary lesion in 55 patients (78.6%) and malignant in 15 patients (21.4%). Adjuvant treatment was performed in all malignant cases. Median follow-up was 46 months (3–115 months). Conclusions Patients with papillary breast lesions presented with symptoms in half of all cases. There was a high frequency of malignancy (21.4%), therefore surgical resection was recommended for papillary breast lesions. PMID:25228917

  14. 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

  15. 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.

  16. Benign breast disease: when to treat, when to reassure, when to refer.

    PubMed

    Vaidyanathan, Lakshmi; Barnard, Karen; Elnicki, D Michael

    2002-05-01

    Many women have breast symptoms-swelling and tenderness, nodularity, pain, palpable lumps, nipple discharge, or breast infections and inflammation. Fortunately, relatively few have breast cancer. Physicians must distinguish benign breast conditions from malignant ones, and know when to refer the patient to a specialist. We have included some of the newer diagnostic techniques and the approach to patients with nonpalpable lesions detected on a screening mammogram.

  17. The Role of MR Mammography in Differentiating Benign from Malignant in Suspicious Breast Masses

    PubMed Central

    Balasubramanian, Padhmini; Murugesan, Vijaya Karthikeyan

    2016-01-01

    Introduction Magnetic Resonance (MR) Mammography is being increasingly used now-a-days for the evaluation of breast lesions. Aim To find out the effectiveness and the exact role of MR mammography in differentiating benign lesions from malignant lesions in patients with palpable, suspicious breast masses found on routine conventional imaging techniques. Materials and Methods It was a prospective study wherein patients with suspicious breast lesions were subjected to MR mammography. The morphological feature (smooth vs irregular margin) and the enhancement patterns (Type Ia/Ib vs Type II vs Type III) of the lesions were assessed and finally the effectiveness of MR mammography in differentiating benign and malignant lesions was judged by taking the histopathological diagnosis as the gold standard. Results A total of 33 patients with 35 breast lesions were finally analysed. The sensitivity, specificity, Positive Predictive Value (PPV) and the Negative Predictive Value (NPV) in differentiating benign from malignant breast lesion for the type of margin on MR mammography was 95.45%, 84.6%, 91.3% and 91.7%, while for the type of enhancement curve it was 76.2%, 90.9%, 94.1% and 66.7% respectively. The sensitivity and negative predictive value for the type of margins was statistically better when compared to the type of enhancement curve in differentiating benign from malignant lesions but the specificity and PPV though better for the type of enhancement curve was not found to be statistically significant. Conclusion MR mammography was found to be an effective tool in differentiating benign from malignant suspicious breast lesions. The type of margin and the enhancement patterns both individually and in combination provide the clinicians with ample information so as to decide on further management. PMID:27790545

  18. Cytomorphology of male breast lesions: diagnostic pitfalls and clinical implications.

    PubMed

    Rosa, Marilin; Masood, Shahla

    2012-02-01

    Because lesions of the male breast have been exceeded in number by those of the female breast, marginal attention was given to these lesions in the past. Fortunately, this has changed over the years leading to an increased awareness about male breast cancer. Although male breast cancer constitutes only about 1% of all diagnosed breast cancer cases, an increased mortality is seen in this patient population. This is probably caused by late diagnosis as a consequence of low level of concern about breast cancer among male patients. However, the vast majority of lesions of the male breast are benign, gynecomastia being the number one cause of unilateral or bilateral breast mass. Since it is important to avoid unnecessary surgical treatment without missing malignancy, accurate diagnostic tools are necessary in order to triage these patients. Fine-needle aspiration biopsy has demonstrated excellent accuracy in the diagnosis and management of breast lesions in female patients. In addition, several authors have proven the value of this technique in the evaluation of lesions of the male breast. Fine-needle aspiration biopsy permits accurate diagnosis in many lesions arising in the male breast. It also allows gathering cytological material that can be used for ancillary studies which enhances the diagnostic value of this technique.

  19. Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions

    PubMed Central

    Ng, Wei Lin; Rahmat, Kartini; Fadzli, Farhana; Rozalli, Faizatul Izza; Mohd-Shah, Mohammad Nazri; Chandran, Patricia Ann; Westerhout, Caroline Judy; Vijayananthan, Anushya; Abdul Aziz, Yang Faridah

    2016-01-01

    Abstract The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions. One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis. The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of ≥ 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of ≥80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions. SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions. PMID:27015196

  20. Benign acral lesions showing parallel ridge pattern on dermoscopy.

    PubMed

    Tanioka, Miki

    2011-01-01

    One of the recent advances in dermoscopy is the significance of parallel ridge pattern (PRP), which has 99% specificity in detecting both melanoma in situ and advanced melanoma on the acral volar skin. This review features exceptionally benign acral lesions showing PRP on dermoscopy. These benign lesions can be distinguished from malignant melanoma, because of the typical clinical history and associated symptoms. However, it is sometimes difficult for dermatologists to exclude malignant melanoma and a subsequent skin biopsy should be strongly recommended. These benign lesions include pigmentation due to a dye such as para-phenylenediamine, acral pigmented macules associated with Peutz-Jeghers syndrome, anti-cancer drug-induced hyperpigmentation on the volar skin, acral subcorneal hemorrhage and pigmented warts.

  1. Measuring shape complexity of breast lesions on ultrasound images

    NASA Astrophysics Data System (ADS)

    Yang, Wei; Zhang, Su; Chen, Yazhu; Li, Wenying; Chen, Yaqing

    2008-03-01

    The shapes of malignant breast tumors are more complex than the benign lesions due to their nature of infiltration into surrounding tissues. We investigated the efficacy of shape features and presented a method using polygon shape complexity to improve the discrimination of benign and malignant breast lesions on ultrasound. First, 63 lesions (32 benign and 31 malignant) were segmented by K-way normalized cut with the priori rules on the ultrasound images. Then, the shape measures were computed from the automatically extracted lesion contours. A polygon shape complexity measure (SCM) was introduced to characterize the complexity of breast lesion contour, which was calculated from the polygonal model of lesion contour. Three new statistical parameters were derived from the local integral invariant signatures to quantify the local property of the lesion contour. Receiver operating characteristic (ROC) analysis was carried on to evaluate the performance of each individual shape feature. SCM outperformed the other shape measures, the area under ROC curve (AUC) of SCM was 0.91, and the sensitivity of SCM could reach 0.97 with the specificity 0.66. The measures of shape feature and margin feature were combined in a linear discriminant classifier. The resubstitution and leave-one-out AUC of the linear discriminant classifier were 0.94 and 0.92, respectively. The distinguishing ability of SCM showed that it could be a useful index for the clinical diagnosis and computer-aided diagnosis to reduce the number of unnecessary biopsies.

  2. Outcome after a liver resection of benign lesions

    PubMed Central

    Hoffmann, Katrin; Unsinn, Michael; Hinz, Ulf; Weiss, Karl Heinz; Waldburger, Nina; Longerich, Thomas; Radeleff, Boris; Schirmacher, Peter; Büchler, Markus W; Schemmer, Peter

    2015-01-01

    Background Benign liver tumours represent a challenge in clinical management. There is considerable controversy with respect to the indications for surgery as the evidence for surgical treatment is variable. The aim of this retrospective study was to analyse the indication and outcome after resection of benign, solid liver lesions. Methods Data of 79 patients, who underwent liver resection between 2001 and 2012, were analysed for demographic and outcome parameters. Results Thirty-eight patients with focal nodular hyperplasia (48%), 23 patients with haemangioma (29%) and 18 patients with hepatocellular adenoma (23%) underwent a hepatic resection. A major hepatic resection was performed in 23 patients (29%) and a minor resection in 56 patients (71%). The post-operative mortality rate was zero and the 30-day morbidity rate 13.9%. After a median follow-up of 64 months, 75 patients (95%) were alive, and no patient had developed recurrent disease. Fifty-four patients (68%) were pre-operatively symptomatic, of which, 87% had complete or partial relief of symptoms after a liver resection. The incidence of symptoms increased with the lesions' size. Discussion The management of benign liver lesions necessitates an individualized therapy within a multidisciplinary, evidence-based, treatment algorithm. Resection of benign liver lesions can be performed safely in well-selected patients without mortality and low post-operative morbidity. PMID:26456947

  3. 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.

  4. Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report.

    PubMed

    Neto, Guerino Barbalaco; Rossetti, Claudia; Souza, Natalia A; LA Fonseca, Fernando; Azzalis, Ligia Ajaime; Junqueira, Virginia Berlanga Campos; Valenti, Vitor E; de Abreu, Luiz Carlos

    2012-04-25

    This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. The patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional.

  5. Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report

    PubMed Central

    2012-01-01

    This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. The patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional. PMID:22534285

  6. Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

    DTIC Science & Technology

    2006-06-01

    fibroadenoma , or columnar changes were consid- ered nonproliferative unless they also contained one of the lesions denoted above. statistical analysis...Cancer 1989;64: 1977-83. 16. Dupont WD, Page DL, Parl FF, et al. Long-term risk of breast cancer in women with fibroadenoma . N Engl J Med 1994;331...PDWA), and AH. NP fibrocystic changes included cyst formation, stromal fibrosis, apocrine metaplasia, and noncomplex fibroadenoma . Proliferative

  7. Argon laser-assisted treatment of benign eyelid lesions.

    PubMed

    Korkmaz, Şafak; Ekici, Feyzahan; Sül, Sabahattin

    2015-02-01

    We investigated the treatment of benign eyelid lesions with argon laser as an alternative therapy to surgical excision. The charts of 73 patients with 95 lesions treated with argon laser photocoagulation were reviewed retrospectively. In all patients, the procedure was performed for cosmetic reasons. The laser spot size ranged from 50 to 200 μm, the power varied from 300 to 700 mW, and the exposure time ranged between 0.1 and 0.2 s. The lesions were mostly located on the upper eyelid (66%); the lid margin was involved in 30 cases. The mean follow-up time was 7.2 ± 3.5 months (range 3-15 months). A histopathological diagnosis was confirmed for 81 lesions (85.3%). All patients were satisfied with the cosmetic result. No intraoperative complications occurred, and none of the patients complained of pain during laser application. All wounds epithelialized in 3-4 weeks with skin that appeared normal. Hypopigmentation of the treated areas were observed in three cases. No recurrence occurred during the follow-up period. Argon laser-assisted benign eyelid tumor excision is a useful, cheap, accessible, and well-tolerated alternative to traditional surgery.

  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. Breast cancer. Part 1: Awareness and common benign diseases.

    PubMed

    Harmer, Victoria

    Breast cancer is the most common cancer for women in the United Kingdom and topic on which there is much information. This article discusses the principles behind breast awareness and breast health, detailing common benign breast diseases that cause disproportionate anxiety. The NHS Breast Screening Programme is celebrating 20 years of screening this year, and in all randomized controlled trials of women aged 50 and over, mortality from breast cancer is reduced in those offered screening compared with unscreened controls (although the reduction is not statistically significant in all trials). Once a breast cancer is diagnosed, the different characteristics and stage of the disease can be identified through histopathology and scans. These factors will be discussed later in this article, including illustrating if a cancer is hormone sensitive or HER-2 positive, for example. These factors enable clinicians to recommend a treatment pathway suitable for each individual.

  10. 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.

  11. Dermatology of the head and neck: skin cancer and benign skin lesions.

    PubMed

    Halem, Monica; Karimkhani, Chanté

    2012-10-01

    Skin lesions are extremely common, and early detection of dangerous lesions makes skin cancer one of the most highly curable malignancies. By simply becoming aware of common lesions and their phenotypic presentation, dental professionals are empowered to detect suspicious dermatologic lesions in unaware patients. This article serves as an introduction to skin cancer and benign skin lesions for dental professionals.

  12. 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

  13. Breast Imaging Reporting and Data System Category 3 Lesions Detected on Whole-Breast Screening Ultrasound

    PubMed Central

    Nam, Sang Yu; Ko, Eun Young; Han, Boo-Kyung; Shin, Jung Hee; Hahn, Soo Yeon

    2016-01-01

    Purpose This study assessed the incidence and cancer rate of probably benign lesions detected on bilateral whole-breast screening ultrasound (US), which corresponded to US Breast Imaging Reporting and Data System (BI-RADS) category 3, and evaluated the proper management of those lesions. Methods This study was approved by the Institutional Review Board in our institution, which waived informed patient consent. We retrospectively reviewed US images of 1,666 patients who underwent bilateral whole-breast screening US as a supplemental screening test to negative screening mammography or screening US only. The incidence, clinical course, and cancer rate of screening US-detected probably benign lesions corresponding to US BI-RADS category 3 were investigated, and the size and multiplicity of screening US-detected category 3 lesions were evaluated. Results Probably benign lesions corresponding to US BI-RADS category 3 were detected in 689 of 1,666 patients (41.4%) who underwent screening US. Among them, 653 had follow-up US images for at least 24 months, and among these 653, 190 (29.1%) had multiple bilateral category 3 lesions. Moreover, 539 of 1,666 patients (32.4%) had lesions ≤1 cm in size and 114 of 1,666 (6.8%) had lesions >1 cm (median, 0.82 cm; range, 0.3–4.2 cm). Four of the 653 patients (0.6%) showed suspicious interval changes and were categorized into BI-RADS category 4. Biopsy analysis confirmed only one lesion as invasive ductal carcinoma at the 6-month follow-up; another lesion was an intraductal papilloma and the remaining two were fibroadenomas. Overall cancer rate of the screening US-detected BI-RADS category 3 lesions was 0.2%. Conclusion The incidence of category 3 lesions detected on screening US only was very high, but the cancer rate was very low. Therefore, in an average-risk population, routine screening US is preferable over short-term follow-up for BI-RADS category 3 lesions detected on whole-breast screening US. PMID:27721880

  14. 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.

  15. Benign, Premalignant, and Malignant Lesions Encountered in Bariatric Surgery

    PubMed Central

    Kini

    2012-01-01

    Background: Obesity is associated with several comorbidities like diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. It is also well established that obese patients have an increased risk of several types of cancer like kidney, pancreas, endometrial, breast, and others. The bariatric surgeon needs to be aware of the problem of benign tumors and cancer in obese patients as well as the optimal management of these conditions that may be present at the time of evaluation for bariatric surgery, during the surgical procedure, and in the postoperative period. Database: A PubMed search for the words “cancer” and “bariatric surgery” and subsequent review of the abstracts identified 40 articles concerning cancerous, benign, and premalignant conditions in bariatric surgery patients. Data were then extracted from full-text articles. Conclusion: Bariatric surgery decreases cancer risk especially in women. RYGB can be an effective treatment for Barrett's esophagus. Patients having esophageal cancer should not undergo bariatric surgery, while those who develop the same postoperatively are usually managed by a combined abdominal and thoracic approach (Ivor Lewis technique). Gastric cancer of the remnant stomach is usually managed by a remnant gastrectomy. A remnant gastrectomy during RYGB would be necessary in conditions that require endoscopic surveillance of the stomach like gastric polyps, intestinal metaplasia, and carcinoid tumors. Sleeve gastrectomy is an excellent option in a patient with GIST or a carcinoid who needs a bariatric operation. Preoperative endoscopy usually does not detect malignant conditions. Postoperative evaluation of the bypassed stomach is possible using various percutaneous and novel endoscopic techniques. PMID:23318060

  16. 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.

  17. Diagnostic features of quantitative comb-push shear elastography for breast lesion differentiation

    PubMed Central

    Denis, Max; Gregory, Adriana; Mehrmohammadi, Mohammad; Kumar, Viksit; Meixner, Duane; Fazzio, Robert T.; Fatemi, Mostafa

    2017-01-01

    Background Lesion stiffness measured by shear wave elastography has shown to effectively separate benign from malignant breast masses. The aim of this study was to evaluate different aspects of Comb-push Ultrasound Shear Elastography (CUSE) performance in differentiating breast masses. Methods With written signed informed consent, this HIPAA- compliant, IRB approved prospective study included patients from April 2014 through August 2016 with breast masses identified on conventional imaging. Data from 223 patients (19–85 years, mean 59.93±14.96 years) with 227 suspicious breast masses identifiable by ultrasound (mean size 1.83±2.45cm) were analyzed. CUSE was performed on all patients. Three regions of interest (ROI), 3 mm in diameter each, were selected inside the lesion on the B-mode ultrasound which also appeared in the corresponding shear wave map. Lesion elasticity values were measured in terms of the Young’s modulus. In correlation to pathology results, statistical analyses were performed. Results Pathology revealed 108 lesions as malignant and 115 lesions as benign. Additionally, 4 lesions (BI-RADS 2 and 3) were considered benign and were not biopsied. Average lesion stiffness measured by CUSE resulted in 84.26% sensitivity (91 of 108), 89.92% specificity (107 of 119), 85.6% positive predictive value, 89% negative predictive value and 0.91 area under the curve (P<0.0001). Stiffness maps showed spatial continuity such that maximum and average elasticity did not have significantly different results (P > 0.21). Conclusion CUSE was able to distinguish between benign and malignant breast masses with high sensitivity and specificity. Continuity of stiffness maps allowed for choosing multiple quantification ROIs which covered large areas of lesions and resulted in similar diagnostic performance based on average and maximum elasticity. The overall results of this study, highlights the clinical value of CUSE in differentiation of breast masses based on their

  18. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

    PubMed Central

    2012-01-01

    Background Although Helicobacter Pylori (HP) was detected in some cases of chronic laryngitis, the results were not confirmed by polymerase chain reaction (PCR). By this time, it has not been found in laryngeal lesions by in house PCR, the most sensitive method for detecting the genome tracks. Regarding the previous results and also few numbers of studies about the presence of HP in benign laryngeal lesions, specifically by PCR, we aimed to investigate the presence of HP in benign laryngeal lesions by in-house PCR. Methods The samples were taken from 55 patients with benign laryngeal lesions and frozen in −20°C. One milliliter (ml) of lysis buffer was added to 100 mg (mg) of each sample and the tube was placed in 56°C overnight. Then DNA extraction was carried out. Results To find HP DNA, in-house PCR was performed that revealed 5 positive results among 55 patients with benign laryngeal lesions. Of them, 3 were polyp, 1 was nodule and 1 was papilloma. Conclusion Although the number of positive results was not a lot in this study, it was in contrast with previous studies which could not find any HP tracks in benign laryngeal lesions by other methods. More studies about the prevalence of HP in benign laryngeal lesions improve judging about the effect of this infection on benign laryngeal lesions. PMID:22515206

  19. 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....

  20. 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

  1. Periareolar incision for the management of benign breast tumors.

    PubMed

    Kong, Xiangnan; Chen, Xi; Jiang, Liyu; Ma, Tingting; Han, Baosan; Yang, Qifeng

    2016-11-01

    Benign breast tumors (BBTs) are common in women. The traditional surgical resection method for the various types of BBT leaves obvious scars and affects the appearance of the breast. The present study introduces the experience of a single institution in the treatment of BBT by periareolar incision. The clinical data of 153 patients (182 breasts) with BBT who had undergone a resection via a periareolar incision between January 2010 and December 2012 in Qilu Hospital, Shandong University (Jinan, Shandong, China), was retrospectively analyzed. All incisions were primary healing. Of the 153 patients, 1 (0.7%) developed a hematoma and 2 (1.3%) developed slight nipple ischemia. No infections or other complications were observed. During 1 month to 3 years of follow-up, the cosmetic effects were assessed. Periareolar incision is not only suitable for all types of breast surgery for benign tumor resection, but also has the advantage of a hidden incision, a small scar, no ischemic necrosis of the nipple areola, high patient satisfaction and good post-operative cosmetic effect. The technique is therefore a good surgical incision choice that is worthy of note.

  2. Periareolar incision for the management of benign breast tumors

    PubMed Central

    Kong, Xiangnan; Chen, Xi; Jiang, Liyu; Ma, Tingting; Han, Baosan; Yang, Qifeng

    2016-01-01

    Benign breast tumors (BBTs) are common in women. The traditional surgical resection method for the various types of BBT leaves obvious scars and affects the appearance of the breast. The present study introduces the experience of a single institution in the treatment of BBT by periareolar incision. The clinical data of 153 patients (182 breasts) with BBT who had undergone a resection via a periareolar incision between January 2010 and December 2012 in Qilu Hospital, Shandong University (Jinan, Shandong, China), was retrospectively analyzed. All incisions were primary healing. Of the 153 patients, 1 (0.7%) developed a hematoma and 2 (1.3%) developed slight nipple ischemia. No infections or other complications were observed. During 1 month to 3 years of follow-up, the cosmetic effects were assessed. Periareolar incision is not only suitable for all types of breast surgery for benign tumor resection, but also has the advantage of a hidden incision, a small scar, no ischemic necrosis of the nipple areola, high patient satisfaction and good post-operative cosmetic effect. The technique is therefore a good surgical incision choice that is worthy of note. PMID:27899991

  3. 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

  4. 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.

  5. 3-Dimensional shear wave elastography of breast lesions

    PubMed Central

    Chen, Ya-ling; Chang, Cai; Zeng, Wei; Wang, Fen; Chen, Jia-jian; Qu, Ning

    2016-01-01

    Abstract Color patterns of 3-dimensional (3D) shear wave elastography (SWE) is a promising method in differentiating tumoral nodules recently. This study was to evaluate the diagnostic accuracy of color patterns of 3D SWE in breast lesions, with special emphasis on coronal planes. A total of 198 consecutive women with 198 breast lesions (125 malignant and 73 benign) were included, who underwent conventional ultrasound (US), 3D B-mode, and 3D SWE before surgical excision. SWE color patterns of Views A (transverse), T (sagittal), and C (coronal) were determined. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were calculated. Distribution of SWE color patterns was significantly different between malignant and benign lesions (P = 0.001). In malignant lesions, “Stiff Rim” was significantly more frequent in View C (crater sign, 60.8%) than in View A (51.2%, P = 0.013) and View T (54.1%, P = 0.035). AUC for combination of “Crater Sign” and conventional US was significantly higher than View A (0.929 vs 0.902, P = 0.004) and View T (0.929 vs 0.907, P = 0.009), and specificity significantly increased (90.4% vs 78.1%, P = 0.013) without significant change in sensitivity (85.6% vs 88.0%, P = 0.664) as compared with conventional US. In conclusion, combination of conventional US with 3D SWE color patterns significantly increased diagnostic accuracy, with “Crater Sign” in coronal plane of the highest value. PMID:27684820

  6. Light shadowing effect of large breast lesions imaged by optical tomography in reflection geometry.

    PubMed

    Xu, Chen; Zhu, Quing

    2010-01-01

    When a large, highly absorbing breast lesion is imaged by optical tomography in reflection geometry, most of the photons are absorbed by the top portion of the lesion. As a result, the lower portion of the lesion is not quantified correctly. This posterior light shadowing effect is similar to the sound shadowing effect frequently seen in pulse-echo ultrasound images. The presence of significant posterior shadowing of a lesion in ultrasound images suggests malignance. The light shadowing effect due to optical contrast is characterized using a simple measure and validated by the Monte Carlo photon-tracking method and phantom experiments. Clinical examples of large malignant and benign lesions are presented to demonstrate the shadowing effect and the utility of the measure. Understanding and quantifying the shadowing effect due to optical contrast is important for characterizing larger malignant cancers from benign lesions.

  7. Precursor lesions of invasive breast cancer.

    PubMed

    Schreer, Ingrid; Lüttges, Jutta

    2005-04-01

    The increasing application of mammography, mainly in screening programs for the early detection of breast cancer, and the high technical standard of imaging has resulted in the detection of clinically occult breast tumors. Considering that only diagnosis at an early stage will be able to change the prognosis of breast cancer, this diagnostic challenge appears to be the most exciting field in both breast imaging and breast pathology. Especially the precursor lesions need to be diagnosed and defined precisely to understand their prognostic significance. In imaging, the morphologic appearance of precursor lesions is usually neither typical nor pathognomonic. They have to be assessed histologically using percutaneous interventions. Recent molecular studies have demonstrated various genetic alterations in the ductal epithelium, with the earliest onset in atypical ductal hyperplasia. The recent WHO classification, which is based on molecular data and histopathological features, attempts to define in particular the precursor lesions and low grade intraductal carcinomas. The clinical importance of the various grades has to be assessed. Intimate cooperation between diagnostic radiologist and pathologist is essential.

  8. Assessment of texture analysis on DCE-MRI data for the differentiation of breast tumor lesions

    NASA Astrophysics Data System (ADS)

    Loose, Jennifer; Harz, Markus T.; Laue, Hendrik; Twellmann, Thorsten; Bick, Ulrich; Rominger, Marga; Hahn, Horst K.; Peitgen, Heinz-Otto

    2009-02-01

    Breast cancer diagnosis based on magnetic resonance images (breast MRI) is increasingly being accepted as an additional diagnostic tool to mammography and ultrasound, with distinct clinical indications.1 Its capability to detect and differentiate lesion types with high sensitivity and specificity is countered by the fact that visual human assessment of breast MRI requires long experience. Moreover, the lack of evaluation standards causes diagnostic results to vary even among experts. The most important MR acquisition technique is dynamic contrast enhanced (DCE) MR imaging since different lesion types accumulate contrast material (CM) differently. The wash-in and wash-out characteristic as well as the morphologic characteristic recorded and assessed from MR images therefore allows to differentiate benign from malignant lesions. In this work, we propose to calculate second order statistical features (Haralick textures) for given lesions based on subtraction and 4D images and on parametermaps. The lesions are classified with a linear classification scheme into probably malignant or probably benign. The method and model was developed on 104 histologically graded lesions (69 malignant and 35 benign). The area under the ROC curve obtained is 0.91 and is already comparable to the performance of a trained radiologist.

  9. Benign Spine Lesions: Advances in Techniques for Minimally Invasive Percutaneous Treatment.

    PubMed

    Tomasian, A; Wallace, A N; Jennings, J W

    2017-02-09

    Minimally invasive percutaneous imaging-guided techniques have been shown to be safe and effective for the treatment of benign tumors of the spine. Techniques available include a variety of tumor ablation technologies, including radiofrequency ablation, cryoablation, microwave ablation, alcohol ablation, and laser photocoagulation. Vertebral augmentation may be performed after ablation as part of the same procedure for fracture stabilization or prevention. Typically, the treatment goal in benign spine lesions is definitive cure. Painful benign spine lesions commonly encountered in daily practice include osteoid osteoma, osteoblastoma, vertebral hemangioma, aneurysmal bone cyst, Paget disease, and subacute/chronic Schmorl node. This review discusses the most recent advancement and use of minimally invasive percutaneous therapeutic options for the management of benign spine lesions.

  10. Volumetric texture analysis of breast lesions on contrast-enhanced magnetic resonance images.

    PubMed

    Chen, Weijie; Giger, Maryellen L; Li, Hui; Bick, Ulrich; Newstead, Gillian M

    2007-09-01

    Automated image analysis aims to extract relevant information from contrast-enhanced magnetic resonance images (CE-MRI) of the breast and improve the accuracy and consistency of image interpretation. In this work, we extend the traditional 2D gray-level co-occurrence matrix (GLCM) method to investigate a volumetric texture analysis approach and apply it for the characterization of breast MR lesions. Our database of breast MR images was obtained using a T1-weighted 3D spoiled gradient echo sequence and consists of 121 biopsy-proven lesions (77 malignant and 44 benign). A fuzzy c-means clustering (FCM) based method is employed to automatically segment 3D breast lesions on CE-MR images. For each 3D lesion, a nondirectional GLCM is then computed on the first postcontrast frame by summing 13 directional GLCMs. Texture features are extracted from the nondirectional GLCMs and the performance of each texture feature in the task of distinguishing between malignant and benign breast lesions is assessed by receiver operating characteristics (ROC) analysis. Our results show that the classification performance of volumetric texture features is significantly better than that based on 2D analysis. Our investigations of the effects of various of parameters on the diagnostic accuracy provided means for the optimal use of the approach.

  11. 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

  12. Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography.

    PubMed

    Buchberger, W; Niehoff, A; Obrist, P; DeKoekkoek-Doll, P; Dünser, M

    2000-08-01

    With recent significant advances in ultrasound technology, the potential of high-resolution sonography to improve the sensitivity of cancer diagnosis in women with dense breasts has become a matter of interest for breast imagers. To determine how often physician-performed high-resolution sonography can detect nonpalpable breast cancers that are not revealed by mammography, 8,970 women with breast density grades 2 through 4 underwent high-resolution sonography as an adjunct to mammography. All sonographically detected, clinically and mammographically occult breast lesions that were not simple cysts were prospectively classified into benign, indeterminate, or malignant categories. Diagnoses were confirmed by ultrasound-guided fine-needle aspiration, core-needle biopsy, or surgical biopsy. In 8,103 women with normal findings at mammography and physical examination, 32 cancers and 330 benign lesions were detected in 273 patients with sonography only. Eight additional cancers were found in 867 patients with a malignant (n = 5) or a benign (n = 3) palpable or mammographically detected index lesion. The overall prevalence of cancers detected with screening sonography was 0.41%, and the proportion of sonographically detected cancers to the total number of nonpalpable cancers was 22%. The mean size of invasive cancers detected only by sonography was 9.1 mm, and was not statistically different from the mean size of invasive cancers detected by mammography. The sensitivity of prospective sonographic classification for malignancy was 100%, and the specificity was 31%. In conclusion, the use of high-resolution sonography as an adjunct to mammography in women with dense breasts may lead to detection of a significant number of otherwise occult cancers that are no different in size from nonpalpable mammographically detected cancers. Prospective classification of these lesions based on sonographic characteristics resulted in an acceptable benign-to-malignant biopsy rate of 6.3:1.

  13. (99)mTc-3PRGD2 scintimammography in palpable and nonpalpable breast lesions.

    PubMed

    Liu, Lin; Song, Yan; Gao, Shi; Ji, Tiefeng; Zhang, Haishan; Ji, Bin; Chen, Ben; Jia, Bing; Wang, Fan; Xu, Zheli; Ma, Qingjie

    2014-01-01

    The aim of this study was to explore the diagnostic performance of 99mTc-3(poly-(ethylene glycol),PEG)4-RGD2 (99mTc-3PRGD2) scintimammography (SMM) in patients with either palpable or nonpalpable breast lesions and compare SMM to mammography to assess the possible incremental value of SMM in breast cancer detection. We also investigated the αvβ3 expression in malignant and benign breast lesions. Ninety-four patients with 110 lesions were included in this study. Mammograms were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) by a specialized imaging radiologist. Prone SMM was performed 1 hour after injection of 99mTc-3PRGD2. Scintigraphic images were interpreted independently by two experienced nuclear medicine physicians using a three-point system, and the kappa value was calculated to determine the interreader agreement. The McNemar test was used to compare SMM and mammography with respect to sensitivity, specificity, and accuracy. Diagnostic values for breast cancer detection were evaluated for each lesion. Immunohistochemistry was performed to evaluate integrin αvβ3 expression. Histopathology revealed 46 malignant lesions and 64 benign lesions. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SMM were 83%, 73%, 77%, 69%, and 85%, respectively. The kappa value between the two reviewers was 0.63. The diagnostic values of SMM were higher than those of mammography in evaluating overall breast lesions. A sensitivity of 91% was achieved when SMM and mammography results were combined with 60% of all false-negative mammography findings classified as true-positive results by SMM. Integrin αvβ3 expression was positively identified using SMM imaging. SMM is a promising tool to avoid unnecessary biopsies when used in addition to mammography and can be used to image αvβ3 expression in breast cancer with good image quality.

  14. Diagnostic Pitfalls in Papillary Lesions of the Breast: Experience from a Single Tertiary Care Center

    PubMed Central

    Basavaiah, Sridevi Hanaganahalli; Sreeram, Saraswathy; Suresh, Pooja Kundapur; Kini, Hema; Adiga, Deepa; Sahu, Kausalya Kumari; Pai, Radha R

    2016-01-01

    Introduction Papillary neoplasms are a group of lesions that are characterized by presence of papillae supported by fibrovascular cores lined by epithelial cells with or without myoepithelial cell layer. These neoplasms may be benign, atypical or malignant. Aims This study was conducted to analyse the clinicopathological characteristics of papillary lesions of the breast. Materials and Methods A retrospective and prospective analysis of 34 cases of papillary lesions received over a period of 7 years from 2009 to 2015 was done. The patient’s clinical details were collected from medical archives and the histopathological findings were reviewed. The lesions were classified into benign, atypical and malignant categories. Results During the study period, there were 34 cases of papillary lesions of breast. The mean age was 58 years. The central quadrant was the most common location (66.6%). The most common presenting complaint was lump (76.5% cases). Papillary lesions presented more commonly as solitary lump (82.4%) rather than multifocal disease. Benign papillary lesions were more common than the atypical and malignant lesions. The most common papillary lesion accounting for 43% of the cases was intraductal papilloma. Malignant lesions accounted for 41.2% cases with intraductal papillary carcinoma and invasive papillary carcinoma constituting 14.7% cases each. Conclusion Diagnosis of papillary carcinoma is challenging and its classification includes different entities that have specific diagnostic criteria. Due to their heterozygosity in morphology with benign, atypical and malignant subtypes, morphological features such as type of fibrovascular core and continuity of myoepithelial layer along with immunohistochemical stains for myoepithelial cells should be considered for proper and accurate diagnosis. PMID:27656446

  15. 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

  16. Quantitative analysis of vascular heterogeneity in breast lesions using contrast-enhanced 3-D harmonic and subharmonic ultrasound imaging.

    PubMed

    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

    2015-03-01

    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.

  17. Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

    DTIC Science & Technology

    2009-06-01

    An Analysis of Breast Cancer Risk in Women With Single, Multiple, and Atypical Papilloma Jason T . Lewis, MD,* Lynn C. Hartmann, MD,t Rober! A...beltavior. From the Divisions of *An3lomic Pathology, t Medical Onoology; and t Biostatisti<:s, Mayo Clinic, Rochester, MN 55905. Repri nts: Dr Jason ...probabilities for brea.<r cancer-susceptibility gertes 13RCAI and BRCA2. Am J ll um Genet: 62:145-58. I �. 19. Berry DA, Iversen Jr ES, Gutfbjartsson

  18. Vocal improvement after voice therapy in the treatment of benign vocal fold lesions.

    PubMed

    Schindler, A; Mozzanica, F; Ginocchio, D; Maruzzi, P; Atac, M; Ottaviani, F

    2012-10-01

    Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after voice therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 voice therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of voice therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of voice quality can be achieved after voice therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If voice therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of voice therapy in the management of benign vocal fold

  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. 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.

  1. Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

    PubMed Central

    Hahn, Markus; Okamgba, Stella; Scheler, Peter; Freidel, Klaus; Hoffmann, Gerald; Kraemer, Bernhard; Wallwiener, Diethelm; Krainick-Strobel, Ute

    2008-01-01

    Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB) systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a) diagnostic reliability, b) complication rate and c) subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg). Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain). The mean age of the patients was 53 years (30 – 88). Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher. PMID:18489771

  2. Benign Schwannoma Mimicking Metastatic Lesion on F-18 FDG PET/CT in Differentiated Thyroid Cancer.

    PubMed

    Kang, Sungmin

    2013-06-01

    We report a case of benign schwannoma mimicking metastatic carcinoma. A 55-year-old female with papillary thyroid carcinoma underwent total thyroidectomy. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) demonstrated a focal hypermetabolic lesion with maximum standardized uptake value (SUVmax) 5.3 at the right chest wall. Conventional chest CT demonstrated a 5.4 cm ovoid mass lesion between the intercostal muscles and liver. Pathology revealed a schwannoma by tumor excision. This case demonstrates that benign schwannoma may demonstrate FDG uptake mimicking metastatic carcinoma.

  3. 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.

  4. 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.

  5. 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

  6. Mismatch repair system proteins in oral benign and malignant lesions.

    PubMed

    Amaral-Silva, Gleyson Kleber do; Martins, Manoela Domingues; Pontes, Hélder Antônio Rebelo; Fregnani, Eduardo Rodrigues; Lopes, Márcio Ajudarte; Fonseca, Felipe Paiva; Vargas, Pablo Agustin

    2017-04-01

    Different environmental agents may cause DNA mutations by disrupting its double-strand structure; however, even normal DNA polymerase function may synthesize mismatch nucleotide bases, occasionally demonstrating failure in its proofreading activity. To overcome this issue, mismatch repair (MMR) system, a group of proteins specialized in finding mispairing bases and small loops of insertion or deletion, works to avoid the occurrence of mutations that could ultimately lead to innumerous human diseases. In the last decades, the role of MMR proteins in oral carcinogenesis and in the development of other oral cavity neoplasms has grown, but their importance in the pathogenesis and their prognostic potential for patients affected by oral malignancies, especially oral squamous cell carcinoma (OSCC), remain unclear. Therefore, in this manuscript we aimed to review and critically discuss the currently available data on MMR proteins expression in oral potentially malignant lesions, in OSCC, and in other oral neoplasms to better understand their relevance in these lesions.

  7. Computerized Analysis of MR and Ultrasound Images of Breast Lesions

    DTIC Science & Technology

    2001-07-01

    Yearbook of Radiology) 3. Horsch K, Giger ML, Venta LA, Huo Z, Vyborny CJ; Computer-aided diagnosis of breast lesions on ultrasound. Proceedings...International Workshop on Digital Mammography. Toronto, Canada, June, 2000. 4. Horsch K, Giger ML, Venta LA, Vyborny CJ: Automatic segmentation of breast...lesions on ultrasound. Medical Physics (in press). 5. Horsch K, Giger ML, Venta LA, Vyborny CJ: Computerized diagnosis of breast lesions on ultrasound

  8. Ultrasound guided fine-needle aspiration cytology of breast lesions.

    PubMed

    Pagani, C; Coscia, D R; Dellabianca, C; Bonardi, M; Alessi, S; Calliada, F

    2011-12-01

    Breast biopsy consists in the collection of cells or tissue fragments from a breast lesion and their analysis by a pathologist. There are several types of breast biopsy defined on the basis of the type of needle used: fine-needle aspiration and biopsy performed with a spring-based needle. This article focuses on fine-needle aspiration performed under sonographic guidance.It is used mainly to assess cysts that appear to contain vegetations or blood or that are associated with symptoms; lesions and solid nodules that are not unequivocally benign; and axillary lymph nodes that appear suspicious on physical examination and/or sonography.In addition to distinguishing between benign and malignant lesions, ultrasound guided fine-needle aspiration also plays an important role in tumor grading and in immunocytochemical identifying specific tumor markers. This article describes the technique used and the possible causes of false negative and false positive findings. Despite its limitations, fine-needle aspiration has become a fundamental tool for the identification and preoperative management of malignant breast lesions.

  9. Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions

    PubMed Central

    Bandos, Andriy I.; Ganott, Marie A.; Sumkin, Jules H.; Kelly, Amy E.; Catullo, Victor J.; Rathfon, Grace Y.; Lu, Amy H.; Gur, David

    2013-01-01

    Purpose: To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Materials and Methods: Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31–60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS–based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy–based area under the receiver operating characteristic (ROC) curve. Results: Average probability-of-malignancy–based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of

  10. Noninvasive evaluation of nuclear morphometry in breast lesions using multispectral diffuse optical tomography.

    PubMed

    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.

  11. Role of morphometry in the cytological differentiation of benign and malignant thyroid lesions

    PubMed Central

    Khatri, Pallavi; Choudhury, Monisha; Jain, Manjula; Thomas, Shaji

    2017-01-01

    Context: Thyroid nodules represent a common problem, with an estimated prevalence of 4–7%. Although fine needle aspiration cytology (FNAC) has been accepted as a first line diagnostic test, the rate of false negative reports of malignancy is still high. Nuclear morphometry is the measurement of nuclear parameters by image analysis. Image analysis can merge the advantages of morphologic interpretation with those of quantitative data. Aims: To evaluate the nuclear morphometric parameters in fine needle aspirates of thyroid lesions and to study its role in differentiating benign from malignant thyroid lesions. Material and Methods: The study included 19 benign and 16 malignant thyroid lesions. Image analysis was performed on Giemsa-stained FNAC slides by Nikon NIS-Elements Advanced Research software (Version 4.00). Nuclear morphometric parameters analyzed included nuclear size, shape, texture, and density parameters. Statistical Analysis: Normally distributed continuous variables were compared using the unpaired t-test for two groups and analysis of variance was used for three or more groups. Tukey or Tamhane's T2 multiple comparison test was used to assess the differences between the individual groups. Categorical variables were analyzed using the chi square test. Results and Conclusion: Five out of the six nuclear size parameters as well as all the texture and density parameters studied were significant in distinguishing between benign and malignant thyroid lesions (P < 0.05). Cut-off values were derived to differentiate between benign and malignant cases. PMID:28182069

  12. Parametric imaging using subharmonic signals from ultrasound contrast agents in patients with breast lesions.

    PubMed

    Eisenbrey, John R; Dave, Jaydev K; Merton, Daniel A; Palazzo, Juan P; Hall, Anne L; Forsberg, Flemming

    2011-01-01

    Parametric maps showing perfusion of contrast media can be useful tools for characterizing lesions in breast tissue. In this study we show the feasibility of parametric subharmonic imaging (SHI), which allows imaging of a vascular marker (the ultrasound contrast agent) while providing near complete tissue suppression. Digital SHI clips of 16 breast lesions from 14 women were acquired. Patients were scanned using a modified LOGIQ 9 scanner (GE Healthcare, Waukesha, WI) transmitting/receiving at 4.4/2.2 MHz. Using motion-compensated cumulative maximum intensity (CMI) sequences, parametric maps were generated for each lesion showing the time to peak (TTP), estimated perfusion (EP), and area under the time-intensity curve (AUC). Findings were grouped and compared according to biopsy results as benign lesions (n = 12, including 5 fibroadenomas and 3 cysts) and carcinomas (n = 4). For each lesion CMI, TTP, EP, and AUC parametric images were generated. No significant variations were detected with CMI (P = .80), TTP (P = .35), or AUC (P = .65). A statistically significant variation was detected for the average pixel EP (P = .002). Especially, differences were seen between carcinoma and benign lesions (mean ± SD, 0.10 ± 0.03 versus 0.05 ± 0.02 intensity units [IU]/s; P = .0014) and between carcinoma and fibroadenoma (0.10 ± 0.03 versus 0.04 ± 0.01 IU/s; P = .0044), whereas differences between carcinomas and cysts were found to be nonsignificant. In conclusion, a parametric imaging method for characterization of breast lesions using the high contrast to tissue signal provided by SHI has been developed. While the preliminary sample size was limited, results show potential for breast lesion characterization based on perfusion flow parameters.

  13. Borderline breast lesions diagnosed at core needle biopsy: can magnetic resonance mammography rule out associated malignancy? Preliminary results based on 79 surgically excised lesions.

    PubMed

    Linda, Anna; Zuiani, Chiara; Bazzocchi, Massimo; Furlan, Alessandro; Londero, Viviana

    2008-04-01

    The purpose of this study is to assess whether magnetic resonance mammography (MRM) can exclude associated malignancy in case of diagnosis of borderline breast lesions (B3) at core needle biopsy (CNB). Retrospective analysis of MRM findings of 79 borderline breast lesions (26 benign papillomas, 29 radial sclerosing lesions, 6 atypical ductal hyperplasias, 18 lobular neoplasias) diagnosed at CNB was performed. Lesions were classified as "non-suspicious" or "suspicious" according to Fischer score. These findings were compared to the results of histological analysis of the excisional specimens. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of MRM in predicting the presence of malignancy were calculated. Out of 24 (30.4%) lesions classified as "suspicious", 8 (33.3%) proved to be malignant and 16 (66.7%) benign. Among the 55 (69.6%) "non-suspicious" lesions, only 1 (1.8%) was malignant (low-grade ductal carcinoma in situ), while the remaining 54 (98.2%) proved to be benign. MRM sensitivity, specificity, PPV, and NPV were 88.9%, 77.1%, 33.3%, and 98.2%, respectively. When a borderline lesion is diagnosed on CNB, in case of mild or no enhancement at MRM, follow-up rather than excisional biopsy might be prompted.

  14. Adamantinoma of the tibia mimicking a benign cystic lesion: a case report.

    PubMed

    Mavrogenis, Andreas F; Galanakos, Spyridon; Savvidou, Olga D; Papagelopoulos, Panayiotis J

    2010-01-01

    Adamantinoma of the long bones is a rare primary malignant bone tumor accounting for less than 1% of all primary malignant bone tumors. Most typical imaging findings include heterogeneous osteolytic cortical lesions showing multiple sharply circumscribed lucent zones of various sizes with sclerotic bone surroundings, interspersing between, and extending above and below the lucent zones by the thinning and bulging cortex. Advanced or recurrent lesions may be associated with destruction of the cortex and soft tissue extension. In this article, the authors present a case report of a patient with a distal tibia adamantinoma mimicking a benign cystic lesion.

  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.

  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. Distinct profile of the mitochondrial DNA common deletion in benign skin lesions.

    PubMed

    Hafner, Christian; Kamenisch, York; Landthaler, Michael; Berneburg, Mark

    2011-02-01

    Mutations of mitochondrial (mt) DNA, particularly the 4977 bp long common deletion, are increased in aging tissues and preferentially found in chronologically and photoaged skin. Mutations of human mitochondrial DNA (mtDNA) have also been identified in malignant tumors of the skin and of other organs. However, benign skin lesions have not yet been investigated. We analyzed the frequency of the common deletion in 27 benign skin lesions [8 seborrheic keratoses (SK), 5 epidermal nevi (EN), 14 solar lentigos (SL)] by quantitative real-time PCR, because SK and especially SL have been related to (photo)aged skin. All SK and four of five EN displayed reduced common deletion levels compared with adjacent normal skin. In contrast, 50% of SL revealed a higher percentage of the common deletion than the adjacent normal skin, and some SL showed very high absolute common deletion levels up to 14% of total mtDNA. Our results show that the amount of the common deletion is significantly different in benign skin lesions and raise further questions regarding the pathogenesis of SL and its possible role as a precursor lesion of SK.

  18. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

    PubMed

    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  19. A prospective pilot clinical trial evaluating the utility of a dynamic near-infrared imaging device for characterizing suspicious breast lesions

    PubMed Central

    Xu, Ronald X; Young, Donn C; Mao, Jimmy J; Povoski, Stephen P

    2007-01-01

    Introduction Characterizing and differentiating between malignant tumors, benign tumors, and normal breast tissue is increasingly important in the patient presenting with breast problems. Near-infrared diffuse optical imaging and spectroscopy is capable of measuring multiple physiologic parameters of biological tissue systems and may have clinical applications for assessing the development and progression of neoplastic processes, including breast cancer. The currently available application of near-infrared imaging technology for the breast, however, is compromised by low spatial resolution, tissue heterogeneity, and interpatient variation. Materials and methods We tested a dynamic near-infrared imaging schema for the characterization of suspicious breast lesions identified on diagnostic clinical ultrasound. A portable handheld near-infrared tissue imaging device (P-Scan; ViOptix Inc., Fremont, CA, USA) was utilized. An external mechanical compression force was applied to breast tissue. The tissue oxygen saturation and hemoglobin concentration were recorded simultaneously by the handheld near-infrared imaging device. Twelve categories of dynamic tissue parameters were derived based on real-time measurements of the tissue hemoglobin concentration and the oxygen saturation. Results Fifty suspicious breast lesions were evaluated in 48 patients. Statistical analyses were carried out on 36 out of 50 datasets that satisfied our inclusion criteria. Suspicious breast lesions identified on diagnostic clinical ultrasound had lower oxygenation and higher hemoglobin concentration than the surrounding normal breast tissue. Furthermore, histopathologic-proven malignant breast tumors had a lower differential hemoglobin contrast (that is, the difference of hemoglobin concentration variability between the suspicious breast lesion and the normal breast parenchyma located remotely elsewhere within the ipsilateral breast) as compared with histopathologic-proven benign breast lesions

  20. Optical biopsy of non-melanin pigmented cutaneous benign and malignant lesions

    NASA Astrophysics Data System (ADS)

    Borisova, E.; Troyanova, P.; Avramov, L.

    2006-03-01

    In recent years, there has been growing interest in the common use of laser-induced autofluorescence (LIAF) and reflectance spectroscopy (RS) to differentiate disease from normal surrounding tissue - so called optical biopsy method. The goals of this work were investigation of cutaneous benign and malignant lesions by the methods of LIAFS and RS. Spectra from healthy skin areas near to the lesion were detected to be used posterion to reveal changes between healthy and lesion skin spectra. Before spectral measurements lesions were classified clinically and dermatoscopically by specialist (P.T.). After procedures all lesions were excised and were investigated by standard histological methods. The set-up consists of a nitrogen laser (337 nm, 14 μJ, 10 Hz), halogen lamp (400-900 nm, 50 W), lenses, filters, optical fibers, and a microspectrometer (PC2000, 'Ocean Optics", USA). A computer controls these systems. The results, obtained were used to develop multispectral diagnostic algorithms based on the most prominent spectral features from the fluorescence and reflectance spectra of the lesions investigated. In comparison between normal skin and different cutaneous lesion types and between lesion types themselves sensitivities and specificities higher than 90 % were achieved in all cases. These results show a perspective possibility to develop an optical biopsy system for diagnosis and differentiation of the benign and malignant non-melanin pigmented cutaneous lesions with wide clinical applications. Non-invasive and high-sensitive in vivo detection by means of appropriate light sources and detectors should be possible, related to real-time determination of existing pathological conditions.

  1. [Anogenital mammary-like glands and related lesions. Part 1. Benign tumors and tumor-like disorders].

    PubMed

    Konstantinova, A M; Belousova, I E; Kacerovska, D; Michal, M; Shelekhova, K V; Kazakov, D V

    2017-01-01

    Anogenital mammary-like glands represent a normal anatomic constituent of the anogenital area and may give rise to many benign and malignant tumors that morphologically mimic similar breast diseases. The literature review is complemented by a description of 286 cases of benign tumors and tumor-like processes in the mammary-like glands. The paper presents the clinical and morphological characteristics of papillary hidradenoma, fibroadenoma, benign phyllodes tumor, lactating adenoma, sclerosing adenosis, pseudoangiomatous stromal hyperplasia, etc.

  2. A lexicon for hepatocellular carcinoma surveillance ultrasonography: benign versus malignant lesions

    PubMed Central

    An, Chansik; Rakhmonova, Gulbahor; Han, Kyunghwa; Seo, Nieun; Lee, Jin Young; Kim, Myeong-Jin; Park, Mi-Suk

    2017-01-01

    Background/Aims To suggest a lexicon for liver ultrasonography and to identify radiologic features indicative of benign or malignant lesions on surveillance ultrasonography. Methods This retrospective study included 188 nodules (benign, 101; malignant, 87) from 175 at-risk patients identified during surveillance ultrasonography for hepatocellular carcinoma. We created a lexicon for liver ultrasonography by reviewing relevant literature regarding the ultrasonographic features of hepatic lesions. Using this lexicon, two abdominal radiologists determined the presence or absence of each ultrasonographic feature for the included hepatic lesions. Independent factors associated with malignancy and interobserver agreement were determined by logistic regression analysis and kappa statistics, respectively. Results Larger tumor size (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06-1.183; P<0.001), multinodular confluent morphology (OR, 7.712; 95% CI, 1.053-56.465; P=0.044), thick hypoechoic rim (OR, 5.878; 95% CI, 2.681-12.888; P<0.001), and posterior acoustic enhancement (OR, 3.077; 95% CI, 1.237-7.655; P=0.016) were independently associated with malignant lesions. In a subgroup analysis of lesions <2 cm, none of the ultrasonographic features were significantly associated with malignancy or benignity. Interobserver agreement for morphology was fair (κ=0.36), while those for rim (κ=0.427), echogenicity (κ=0.549), and posterior acoustic enhancement (κ=0.543) were moderate. Conclusions For hepatic lesions larger than 2 cm, some ultrasonography (US) features might be suggestive of malignancy. We propose a lexicon that may be useful for surveillance US. PMID:28349678

  3. Optimised nuclear medicine method for tumour marking and sentinel node detection in occult primary breast lesions.

    PubMed

    De Cicco, C; Trifirò, G; Intra, M; Marotta, G; Ciprian, A; Frasson, A; Prisco, G; Luini, A; Viale, G; Paganelli, G

    2004-03-01

    The aim of this study was to evaluate the feasibility of sentinel node (SN) biopsy in occult breast lesions with different radiopharmaceuticals and to establish the optimal lymphoscintigraphic method to detect both occult lesions and SNs (SNOLL: sentinel node and occult lesion localisation). Two hundred and twenty-seven consecutive patients suspected to have clinically occult breast carcinoma were enrolled in the study. In addition to the radioguided occult lesion localisation (ROLL) procedure, using macroaggregates of technetium-99m labelled human serum albumin (MAA) injected directly into the lesion, lymphoscintigraphy was performed with nanocolloids (NC) injected in a peritumoral (group I) or a subdermal site (group II). In group III, a sole injection of NC was done into the lesion in order to perform both ROLL and SNOLL. Overall, axillary SNs were identified in 205 of the 227 patients (90.3%). In 12/62 (19.4%) patients of group I and 9/79 (11.4%) patients of group III, radioactive nodes were not visualised, whereas SNs were successfully localised in 85 of 86 patients of group II ( P<0.001). Pathological findings revealed breast carcinoma in 148/227 patients (65.2%) and benign lesions in 79 (34.8%). A total of 131 axillary SNs were removed in 118 patients with breast carcinoma; intraoperative examination of the SNs revealed metastatic involvement in 16 out of 96 cases of invasive carcinoma (16.7%). It is concluded that the combination of the ROLL procedure with direct injection of MAA into the lesion and lymphoscintigraphy performed with subdermal injection of radiocolloids represents the method of choice for accurate localisation of both non-palpable lesions and SNs.

  4. 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.

  5. 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

  6. Evaluation of solid breast lesions with power Doppler: value of penetrating vessels as a predictor of malignancy

    PubMed Central

    Ibrahim, Rositaa; Rahmat, Kartini; Fadzli, Farhana; Rozalli, Faizatul Izza; Westerhout, Caroline Judy; Alli, Kasumawati; Vijayananthan, Anushya; Moosa, Fatimah

    2016-01-01

    INTRODUCTION This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy. METHODS Greyscale ultrasonography (US) and PDUS were prospectively performed on 91 women in Malaysia with histopathologically proven breast lesions. The diagnostic accuracy of greyscale US, PDUS, and both greyscale US and PDUS was calculated and compared. RESULTS The 91 women had 102 breast lesions (55 benign, 47 malignant). Of the 47 malignant lesions, 36 demonstrated intratumoural penetrating vessels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of greyscale US findings in diagnosing malignancy were 100.0%, 71.4%, 74.1% and 100.0%, respectively. The presence of calcification in the breast lesion and the margin, shape and posterior acoustic features of the lesion were significant parameters in predicting malignancy (p < 0.01). The sensitivity, specificity, PPV and NPV of the presence of intratumoural penetrating vessels in predicting malignancy were 76.5%, 80.0%, 76.5% and 80.0%, respectively. When both greyscale US and PDUS were used, there was a significant correlation in predicting malignancy (p < 0.05). The specificity and PPV values of the combined greyscale US and PDUS method (89.0% and 85.7%, respectively) were higher than those of greyscale US or PDUS alone. CONCLUSION Flow patterns revealed by PDUS can be useful for differentiating benign and malignant breast lesions. The visualisation of penetrating vessels in solid breast lesions can be used to complement greyscale US findings in predicting malignancy. PMID:27872938

  7. Application of Single Voxel 1H Magnetic Resonance Spectroscopy in Hepatic Benign and Malignant Lesions

    PubMed Central

    Yang, Zifeng; Sun, Shiqiang; Chen, Yuanli; Li, Rui

    2016-01-01

    Background To quantify the metabolite changes in hepatic tumors by single-voxel 1H magnetic resonance spectroscopy (MRS) at 3.0 T and explore the application value of 1HMRS in the diagnosis of hepatic benign and malignant lesions. Material/Methods A total of 45 patients (55 lesions) diagnosed with hepatic lesions by ultrasound and/or computer topography (CT) from November 2006 to March 2007 were included in this study. All patients underwent 3D-dynamic enhanced scan with liver acquisition with acceleration volume acquisition (LAVA) sequence and single-voxel 1HMRS imaging with PRESS (point-resolved spectroscopy) sequence. The metabolite concentrations such as choline (Cho) and lipids (Lip) were measured. Results There was significant difference regarding the occurrence rate of the obvious elevated Cho peaks between benign and malignant tumors (7/27 vs. 21/28, p=0.000). There was statistical significant differences regarding the Cho/Lip ratios in hepatic benign (0.0686±0.0283, 95% CI: 0.0134–0.1245) and malignant (0.1266±0.1124, 95% CI: 0.0937–0.2203) lesions (p<0.05). When compared with the pathological results, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were 85.7% (24/28), 92.6% (25/27), 92.3% (24/26), 86.2% (25/29), and 89.1% (49/55) respectively for the MRI assessment, and 92.6% (26/28), 88.9% (24/27), 89.7 (26/29), 92.3 (24/26), and 90.9% (50/55) respectively for 1HMRS combined with MRI assessment. Conclusions Single Cho peaks or Lip peaks cannot be used for the diagnosis of hepatic benign and malignant lesions. Combined use of 1HMRS and MRI can greatly improve the application value of MRI assessment in the diagnosis of hepatic benign and malignant lesions with a higher sensitivity, negative predictive value, and overall accuracy. PMID:27992399

  8. 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.

  9. 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

  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. Liver resection for benign hepatic lesions: A retrospective analysis of 827 consecutive cases

    PubMed Central

    Feng, Zhi-Qiang; Huang, Zhi-Qiang; Xu, Li-Ning; Liu, Rong; Zhang, Ai-Qun; Huang, Xiao-Qiang; Zhang, Wen-Zhi; Dong, Jia-Hong

    2008-01-01

    AIM: To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions. METHODS: A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation. RESULTS: The effect of operative and perioperative factors on the outcome of patients were analyzed. Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%, 316 (38.21%) required transfusion of blood products during operation. The average operating time was 220.59 ± 109.13 min, the average hospital stay after operation was 13.55 ± 9.38 d. Child-Pugh A accounted for 98.13%. The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%. Multivariate analysis showed that operating time (P = 0.004, OR = 1.003) and albumin value (P = 0.040, OR = 0.938) were the independent predictors of morbidity and indicated that operating time, blood transfusion, complication rate, and LOS had a trend to decrease. CONCLUSION: Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality, provided that it is carried out with optimized perioperative management and an innovative surgical technique. PMID:19084942

  12. Research on the lesion segmentation of breast tumor MR images based on FCM-DS theory

    NASA Astrophysics Data System (ADS)

    Zhang, Liangbin; Ma, Wenjun; Shen, Xing; Li, Yuehua; Zhu, Yuemin; Chen, Li; Zhang, Su

    2017-03-01

    Magnetic resonance imaging (MRI) plays an important role in the treatment of breast tumor by high intensity focused ultrasound (HIFU). The doctors evaluate the scale, distribution and the statement of benign or malignancy of breast tumor by analyzing variety modalities of MRI, such as the T2, DWI and DCE images for making accurate preoperative treatment plan and evaluating the effect of the operation. This paper presents a method of lesion segmentation of breast tumor based on FCM-DS theory. Fuzzy c-means clustering (FCM) algorithm combined with Dempster-Shafer (DS) theory is used to process the uncertainty of information, segmenting the lesion areas on DWI and DCE modalities of MRI and reducing the scale of the uncertain parts. Experiment results show that FCM-DS can fuse the DWI and DCE images to achieve accurate segmentation and display the statement of benign or malignancy of lesion area by Time-Intensity Curve (TIC), which could be beneficial in making preoperative treatment plan and evaluating the effect of the therapy.

  13. 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

  14. Optimized lesion detection in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Chawla, Amarpreet S.; Samei, Ehsan; Lo, Joseph Y.

    2009-02-01

    While diagnostic improvement via breast tomosynthesis has been notable, the full potential of tomosynthesis has not yet been realized. This is because of the complex task of optimizing multiple parameters that constitute image acquisition and thus affect tomosynthesis performance. Those parameters include dose, number of angular projections, and the total angular span of those projections. In this study, we investigated the effects of acquisition parameters, independent of each other, on the overall diagnostic image quality of tomosynthesis. Five mastectomy specimens were imaged using a prototype tomosynthesis system. 25 angular projections of each specimen were acquired at 6.2 times typical single-view mammographic dose level. Images at lower dose levels were then simulated using a noise modification routine. Each projection image was supplemented with 84 simulated 3 mm 3D lesions embedded at the center of 84 non-overlapping ROIs. The projection images were then reconstructed using a filtered-back projection (FBP) algorithm at 224 different combinations of acquisition parameters to investigate which one of the many possible combinations maximized performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. Results showed that performance improved with an increase in the total acquisition dose level and the angular span. At a constant dose level and angular span, the performance rolled-off beyond a certain number of projections, indicating that simply increasing the number of projections in tomosynthesis may not necessarily improve its performance. The best performance was obtained with 15-17 projections spanning an angular arc of ~45° - the maximum tested in our study, and for an acquisition dose equal to single-view mammography. The optimization framework developed in this framework is applicable to other reconstruction techniques and other multi-projection systems.

  15. 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]).

  16. 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

  17. Lesion classification on breast MRI through topological characterization of morphology over time

    NASA Astrophysics Data System (ADS)

    Nagarajan, Mahesh B.; Huber, Markus B.; Schlossbauer, Thomas; Ray, Lawrence A.; Krol, Andrzej; Wismüller, Axel

    2011-03-01

    Morphological characterization of lesions on dynamic breast MRI exams through texture analysis has typically involved the computation of gray-level co-occurrence matrices (GLCM), which serve as the basis for second order statistical texture features. This study aims to characterize lesion morphology through the underlying topology and geometry with Minkowski Functionals (MF) and investigate the impact of using such texture features extracted dynamically over a time series in classifying benign and malignant lesions. 60 lesions (28 malignant & 32 benign) were identified and annotated by experienced radiologists on 54 breast MRI exams of female patients where histopathological reports were available prior to this investigation. 13 GLCM-derived texture features and 3 MF features were then extracted from lesion ROIs on all five post-contrast images. These texture features were combined into high dimensional texture feature vectors and used in a lesion classification task. A fuzzy k-nearest neighbor classifier was optimized using random sub-sampling cross-validation for each texture feature and the classification performance was calculated on an independent test set using the area under the ROC curve (AUC); AUC distributions of different features were compared using a Mann- Whitney U-test. The MF feature 'Area' exhibited significantly improvements in classification performance (p<0.05) when compared to all GLCM-derived features while the MF feature 'Perimeter' significantly outperformed 12 out of 13 GLCM features (p<0.05) in the lesion classification task. These results show that dynamic texture tracking of morphological characterization that relies on topological texture features can contribute to better lesion character classification.

  18. 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

  19. Imaging features of complex sclerosing lesions of the breast

    PubMed Central

    2014-01-01

    Purpose: The purpose of this study was to evaluate the imaging features of complex sclerosing lesions of the breast and to assess the rate of upgrade to breast cancer. Methods: From March 2008 to May 2012, seven lesions were confirmed as complex sclerosing lesions by ultrasonography-guided core needle biopsy. Final results by either surgical excision or follow-up imaging studies were reviewed to assess the rate of upgrade to breast cancer. Two radiologists retrospectively analyzed the imaging findings according to the Breast Imaging Reporting and Data System classification. Results: Five lesions underwent subsequent surgical excision and two of them revealed ductal carcinoma in situ (n=1) and invasive ductal carcinoma (n=1). Our study showed a breast cancer upgrade rate of 28.6% (2 of 7 lesions). Two lesions were stable on imaging follow-up beyond 1 year. The mammographic features included masses (n=4, 57.1%), architectural distortion (n=2, 28.6%), and focal asymmetry (n=1, 14.3%). Common B-mode ultrasonographic features were irregular shape (n=6, 85.7%), spiculated margin (n=5, 71.4 %), and hypoechogenicity (n=7, 100%). The final assessment categories were category 4 (n=6, 85.7%) and category 5 (n=1, 14.3%). Conclusion: The complex sclerosing lesions were commonly mass-like on mammography and showed the suspicious ultrasonographic features of category 4. Due to a high underestimation rate, all complex sclerosing lesions by core needle biopsy should be excised. PMID:24936496

  20. Mood disorder in a patient with a benign thalamic cystic lesion: a case report

    PubMed Central

    2013-01-01

    Introduction The thalamus is increasingly gaining importance in psychiatric disorders. There are case reports in the literature of neuropsychiatric symptoms associated with thalamic infarcts. The present report elucidates the complexities of linking neuropsychiatric symptoms to a benign thalamic brain lesion, and its impact on management. Case presentation We present the case of a Caucasian man in his early 30s, who presented with a difficult to treat bipolar illness and coexisting thalamic lesion. Conclusions In this report we explore the possible links between our patient’s symptoms and his brain lesion. We discuss the possible neuronal mechanisms that may be involved and debate the most appropriate management strategies. We hope this report will assist further insights into the role of the thalamus in psychiatric disorders. PMID:23594838

  1. 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.

  2. Transanal Endoscopic Operation for Benign Rectal Lesions and T1 Carcinoma

    PubMed Central

    Yoshihara, Emi; Dedrye, Lieven; Vindevoghel, Koen; Nuytens, Frederiek; Pottel, Hans

    2017-01-01

    Background and Objectives: Transanal endoscopic operation (TEO) is a minimally invasive technique used for local excision of benign and selected malignant rectal lesions. The purpose of this study was to investigate the feasibility, safety, and oncological outcomes of the procedure and to report the experience in 3 centers. Methods: Retrospective review of a prospectively collected database was performed of all patients with benign lesions or ≤cT1N0 rectal cancer who underwent TEO with curative intent at 3 Belgian centers (2012 through 2014). Results: Eighty-three patients underwent 84 TEOs for 89 rectal lesions (37 adenomas, 43 adenocarcinomas, 1 gastrointestinal stromal tumor, 1 lipoma, 2 neuroendocrine tumors, and 5 scar tissues). Operative time was associated with lesion size (P < .001). Postoperative complications occurred in 13 patients: 7 hemorrhages, 1 urinary tract infection, 1 urinary retention, 2 abscesses, 1 anastomotic stenosis, and 1 entrance into the peritoneal cavity. Median hospital stay was 3 days (range, 1–8). During a median follow-up of 13 months (range, 2–27), there was 1 recurrence. Conclusion: Although longer follow-up is still necessary, TEO appears to be an effective method of excising benign tumors and low-risk T1 carcinomas of the rectum. However, TEO should be considered as part of the diagnostic work-up. Furthermore, the resected specimen of a TEO procedure allows adequate local staging in contrast to an endoscopic piecemeal excision. Nevertheless, definitive histology must be appreciated, and in case of unfavorable histology, radical salvage resection still has to be performed. PMID:28144126

  3. BUBR1 expression in benign oral lesions and squamous cell carcinomas: correlation with human papillomavirus.

    PubMed

    Lira, Régia C P; Miranda, Fabiana A; Guimarães, Márcia C M; Simões, Renata T; Donadi, Eduardo A; Soares, Christiane P; Soares, Edson G

    2010-04-01

    Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Only in Brazil, the estimate is for 14,160 new cases in 2009. HPV is associated with increasing risk of oral cancer, but its role in carcinogenesis is still controversial. BUBR1, an important protein in the mitotic spindle assembly checkpoint (SAC), has been associated with some virus-encoded proteins and cancer. The aim of the present study was to evaluate the expression of BUBR1 in non-malignant oral lesions and OSCC with and without metastasis associated with HPV infection. We performed immunohistochemistry for BUBR1 in 70 OSCC biopsies divided into three groups (in situ tumors, invasive tumors without metastasis and invasive tumors with metastasis) with their respective lymph nodes from samples with metastasis and in 16 non-malignant oral lesions. PCR was performed in order to detect HPV DNA. Significantly higher BUBR1 expression associated with shorter survival (p=0.0479) was observed in malignant lesions. There was also a significant correlation (r=1.000) with BUBR1 expression in lesions with metastasis and their lymph nodes. Ninety percent of OSCC and 100% of benign lesions were HPV positive. HPV16 and HVP18 were present in 13 and 24% of HPV-positive OSCC samples, respectively. HPV was more prevalent (76%) in samples with a high BUBR1 expression and the absence of viral DNA had no influence on BUBR1 expression. These findings suggest that HPV could be associated with overexpression of BUBR1 in OSCC, but not in benign oral lesions.

  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. Total and lipid-bound serum sialic acid in benign and malignant breast disease.

    PubMed

    Romppanen, J; Eskelinen, M; Tikanoja, S; Mononen, I

    1997-01-01

    Elevation in the total sialic acid (TSA), TSA/total protein (TSA/TP) and lipid-bound sialic acid (LASA) concentration in serum occurs in breast cancer and we have studied the applicability of the assays in classification of undefined breast tumors. Sialic acid was determined by HPLC and the statistical evaluation included the receiver operating characteristic (ROC) and Youden's index analyses. In cancer patients, the serum LASA and TSA concentration was significantly higher (p < 0.05) than in patients with benign breast disease and all the markers were significantly higher (p < 0.0001) than in normal controls. All the markers had a low accuracy (AUCs < 0.75) in differentiating between breast cancer and benign breast disease and at the specificity level of 0.95 the corresponding sensitivities were 0.32 (TSA), 0.14 (TSA/TP) and 0.23 (LASA). The results indicate that both breast cancer and benign breast disease cause elevation of TSA, TSA/TP and LASA values in serum and do not provide reliable classification of undefined breast tumors.

  6. New diagnostic approach to intracystic lesions of the breast by fiberoptic ductoscopy.

    PubMed

    Yamamoto, D; Ueda, S; Senzaki, H; Shoji, T; Haijima, H; Gondo, H; Tanaka, K

    2001-01-01

    Intracystic tumors of the breast are uncommon and, at the time of ultrasonography and aspiration cytology, it is difficult to distinguish cancer from a benign tumor. The Fiberoptic Ductoscopy System (FDS) is an emerging technique allowing direct visual access to the ductal system of the breast. FDS was inserted through the cannulae into the cavity and we observed the intracystic tumors (3 intracystic papillomas and 2 intracytsic papillary carcinomas). The appearance of the malignant tumors was irregular, rough-shaped and they tended to bleed. On the contrary, benign tumors had smooth surfaces without bleeding. Cytological findings showed malignant cells in one out of two breast cancer patients. In addition, in the immunohistochemical study of resected tumor tissues from 5 patients, we observed positive reactions with anti-ErbB-2 antibody in 2 intracystic papillary carcinomas. In contrast, none of the histologically confirmed benign lesions (3 intracystic papillomas) gave positive results. In conclusion, the use of FDS as a non-invasive technique may provide valuable information.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. Automated segmentation of breast lesions in ultrasound images.

    PubMed

    Liu, Xu; Huo, Zhimin; Zhang, Jiwu

    2005-01-01

    Breast cancer is one of the leading causes of death in women. As a convenient and safe diagnosis method, ultrasound is most commonly used second to mammography for early detection and diagnosis of breast cancer. Here we proposed an automatic method to segment lesions in ultrasound images. The images are first filtered with anisotropic diffusion algorithm to remove speckle noise. The edge is enhanced to emphasize the lesion regions. Normalized cut is a graph theoretic that admits combination of different features for image segmentation, and has been successfully used in object parsing and grouping. In this paper we combine normalized cut with region merging method for the segmentation. The merging criteria are derived from the empirical rules used by radiologists when they interpret breast images. In the performance evaluation, we compared the computer-detected lesion boundaries with manually delineated borders. The experimental results show that the algorithm has efficient and robust performance for different kinds of lesions.

  13. Ultrasonic Nakagami imaging: a strategy to visualize the scatterer properties of benign and malignant breast tumors.

    PubMed

    Tsui, Po-Hsiang; Yeh, Chih-Kuang; Liao, Yin-Yin; Chang, Chien-Cheng; Kuo, Wen-Hung; Chang, King-Jen; Chen, Chiung-Nien

    2010-02-01

    Previous studies have demonstrated the usefulness of the Nakagami parameter in characterizing breast tumors by ultrasound. However, physicians or radiologists may need imaging tools in a clinical setting to visually identify the properties of breast tumors. This study proposed the ultrasonic Nakagami image to visualize the scatterer properties of breast tumors and then explored its clinical performance in classifying benign and malignant tumors. Raw data of ultrasonic backscattered signals were collected from 100 patients (50 benign and 50 malignant cases) using a commercial ultrasound scanner with a 7.5 MHz linear array transducer. The backscattered signals were used to form the B-scan and the Nakagami images of breast tumors. For each tumor, the average Nakagami parameter was calculated from the pixel values in the region-of-interest in the Nakagami image. The receiver operating characteristic (ROC) curve was used to evaluate the clinical performance of the Nakagami image. The results showed that the Nakagami image shadings in benign tumors were different from those in malignant cases. The average Nakagami parameters for benign and malignant tumors were 0.69 +/- 0.12 and 0.55 +/- 0.12, respectively. This means that the backscattered signals received from malignant tumors tend to be more pre-Rayleigh distributed than those from benign tumors, corresponding to a more complex scatterer arrangement or composition. The ROC analysis showed that the area under the ROC curve was 0.81 +/- 0.04 and the diagnostic accuracy was 82%, sensitivity was 92% and specificity was 72%. The results showed that the Nakagami image is useful to distinguishing between benign and malignant breast tumors.

  14. Evaluating lesion segmentation on breast sonography as related to lesion type.

    PubMed

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

    2013-09-01

    Breast sonography currently provides a complementary diagnosis when other modalities are not conclusive. However, lesion segmentation on sonography is still a challenging problem due to the presence of artifacts. To solve these problems, Markov random fields and maximum a posteriori-based methods are used to estimate a distortion field while identifying regions of similar intensity inhomogeneity. In this study, different initialization approaches were exhaustively evaluated using a database of 212 B-mode breast sonograms and considering the lesion types. Finally, conclusions about the relationship between the segmentation results and lesions types are described.

  15. Benign Breast Disease Team Project — EDRN Public Portal

    Cancer.gov

    To identify women diagnosed with atypical ductal hyperplasia (ADH) who are at increased risk of developing invasive breast cancer (IBC) and who might benefit from risk reduction with the use of chemoprevention agents such as Tamoxifen. (Note: A companion protocol will study women with DCIS and their risk for invasive breast cancer.)

  16. Breast self-examination and adherence to mammographic follow-up: an intriguing diptych after benign breast biopsy.

    PubMed

    Zografos, George C; Sergentanis, Theodoros N; Zagouri, Flora; Papadimitriou, Christos A; Domeyer, Philip; Kontogianni, Panagiota N; Nonni, Afroditi; Tsigris, Christos; Patsouris, Efstratios

    2010-01-01

    This study evaluates the effect of palpability upon breast self-examination (BSE) and adherence to annual mammogram after benign breast biopsy (BBB). Seven hundred and fifty-two women with palpable (WP, n = 359) or nonpalpable (WNP, n = 393) lesions were evaluated 2 years before and after BBB. BSE was considered adequate when it was performed at least once per month, and inadequate when it was performed with a frequency of less than once per month. Prebiopsy/postbiopsy adherence was characterized as inadequate when at least one session of mammographic examination was lost within the 2-prebiopsy/postbiopsy (including the last visit) years, respectively. The prebiopsy frequency of adequate BSE was higher in WP [49 (176 of 359) vs. 38.9% (153 of 393) for WNP; Pearson's chi2 (1) = 7.77, P = 0.005]. However, the opposite happened regarding the prebiopsy adherence to mammogram, as the frequency of adequate adherence was 64.1% (252 of 393) in WNP, but only 46.0% (165 of 359) in WP. After BBB, adherence to mammogram significantly increased in both groups, reaching 76.1% (299 of 393) for WNP and 65.2% (234 of 359) for WP. However, BSE increased significantly only in WNP. Regarding the WP group, the postBBB BSE did not exhibit any significant change. Noticeably, the aforementioned increase in BSE among WNP resulted in the disappearance of the initial WP-WNP discrepancy regarding BSE; the postBBB BSE did not differ between WP and WNP. However, concerning adherence to mammogram, the superiority of WNP versus WP persisted (76.1 vs. 65.2%, respectively). In conclusion WP and WNP may perceive BBB differently, as reflected upon the differentially modified patterns.

  17. 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

  18. 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...

  19. 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.

  20. Serum anti - TPO levels in benign and malignant breast tumors.

    PubMed

    Sabitha; Suneetha; Mohanty, Shruti; Rao, Pragna

    2009-07-01

    Breast cancer is a hormone dependent neoplasm. Conflicting results regarding the clinical correlation between breast cancer and thyroid diseases have been reported. The objective of this study was to determine the association of anti - TPO levels in patients having complaints of a lump in breast. Serum samples and Fine needle aspiration cytology (FNAC) samples were collected from 31 female patients with a lump in breast between the age group of 20-75 years. 31 age matched normal healthy controls were also examined for the same parameters. Serum samples were analyzed for its anti - TPO levels. FNAC reports confirmed patients as having duct cell carcinoma. They had raised serum anti - TPO levels compared to controls. FNAC results of others (n=26) were reported as fibroadenoma whose anti - TPO levels were less than the controls.

  1. Successful surgery in lesional epilepsy secondary to posterior quandrant ulegyria coexisting with benign childhood focal epilepsy: A case report.

    PubMed

    Wang, Fengpeng; Zheng, Honghua; Zhang, Xiaobin; Li, Yanfang; Gao, Zhiying; Wang, Yuanqing; Liu, Xiaowei; Yao, Yi

    2016-10-01

    The present study reports, for the first time, a rare case of benign childhood focal epilepsy(BCFE) coexisting with lesional epilepsy secondary to parietooccipital ulegyria. The patient underwent right parietooccipital lobe disconnection plus tailored resection of temporooccipitoparietal junction cortex under electrocorticography (ECoG) monitoring. Post-operatively, there was no impairment of neurological function and the patient only experiences a few breakthrough benign partial seizures during sleep.

  2. Nonlinear analysis using Lyapunov exponents in breast thermograms to identify abnormal lesions

    NASA Astrophysics Data System (ADS)

    EtehadTavakol, M.; Ng, E. Y. K.; Lucas, C.; Sadri, S.; Ataei, M.

    2012-07-01

    Breast diseases are one of the major issues in women's health today. Early detection of breast cancer plays a significant role in reducing the mortality rate. Breast thermography is a potential early detection method which is non-invasive, non-radiating, passive, fast, painless, low cost, risk free with no contact with the body. By identifying and removing malignant tumors in early stages before they metastasize and spread to neighboring regions, cancer threats can be minimized. Cancer is often characterized as a chaotic, poorly regulated growth. Cancerous cells, tumors, and vasculature defy have irregular shapes which have potential to be described by a nonlinear dynamical system. Chaotic time series can provide the tools necessary to generate the procedures to evaluate the nonlinear system. Computing Lyapunov exponents is thus a powerful means of quantifying the degree of the chaos. In this paper, we present a novel approach using nonlinear chaotic dynamical system theory for estimating Lyapunov exponents in establishing possible difference between malignant and benign patterns. In order to develop the algorithm, the first hottest regions of breast thermal images are identified first, and then one dimensional scalar time series is obtained in terms of the distance between each subsequent boundary contour points and the center of the mass of the first hottest region. In the next step, the embedding dimension is estimated, and by time delay embedding method, the phase space is reconstructed. In the last step, the Lyapunov exponents are computed to analyze normality or abnormality of the lesions. Positive Lyapunov exponents indicates abnormality while negative Lyapunov exponents represent normality. The normalized errors show the algorithm is satisfactorily, and provide a measure of chaos. It is shown that nonlinear analysis of breast thermograms using Lyapunov exponents may potentially capable of improving reliability of thermography in breast tumor detection as

  3. 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.

  4. Spontaneous feline mammary intraepithelial lesions as a model for human estrogen receptor- and progesterone receptor-negative breast lesions

    PubMed Central

    2010-01-01

    Background Breast cancer is the most frequently diagnosed cancer in women. Intraepithelial lesions (IELs), such as usual ductal hyperplasia (UH), atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS) are risk factors that predict a woman's chance of developing invasive breast cancer. Therefore, a comparative study that establishes an animal model of pre-invasive lesions is needed for the development of preventative measures and effective treatment for both mammary IELs and tumors. The purpose of this study was to characterize the histologic and molecular features of feline mammary IELs and compare them with those in women. Methods Formalin-fixed, paraffin-embedded specimens (n = 205) from 203 female cats with clinical mammary disease were retrieved from the archives of the Purdue University Animal Disease Diagnostic Laboratory and Veterinary Teaching Hospital (West Lafayette, IN), and the Department of Pathology and Veterinary Clinic, School of Veterinary Medicine (Sassari, Italy). Histologic sections, stained with hematoxylin and eosin (HE), were evaluated for the presence of IELs in tissue adjacent to excised mammary tumors. Lesions were compared to those of humans. Immunohistochemistry for estrogen receptor (ER-alpha), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2/neu) and Ki-67 was performed in IELs and adjacent tumor tissues. Results Intraepithelial lesions were found in 57 of 203 (28%) feline mammary specimens and were categorized as UH (27%), ADH (29%), and DCIS (44%). Most IELs with atypia (ADH and DCIS) were associated with mammary cancer (91%), whereas UH was associated with benign lesions in 53% of cases. Feline IELs were remarkably similar to human IELs. No ER or PR immunoreactivity was detected in intermediate-grade or high-grade DCIS or their associated malignant tumors. HER-2 protein overexpression was found in 27% of IELs. Conclusion The remarkable similarity of feline mammary IELs to those of humans

  5. 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

  6. Classification of small lesions in dynamic breast MRI: Eliminating the need for precise lesion segmentation through spatio-temporal analysis of contrast enhancement over time.

    PubMed

    Nagarajan, Mahesh B; Huber, Markus B; Schlossbauer, Thomas; Leinsinger, Gerda; Krol, Andrzej; Wismüller, Axel

    2013-10-01

    Characterizing the dignity of breast lesions as benign or malignant is specifically difficult for small lesions; they don't exhibit typical characteristics of malignancy and are harder to segment since margins are harder to visualize. Previous attempts at using dynamic or morphologic criteria to classify small lesions (mean lesion diameter of about 1 cm) have not yielded satisfactory results. The goal of this work was to improve the classification performance in such small diagnostically challenging lesions while concurrently eliminating the need for precise lesion segmentation. To this end, we introduce a method for topological characterization of lesion enhancement patterns over time. Three Minkowski Functionals were extracted from all five post-contrast images of sixty annotated lesions on dynamic breast MRI exams. For each Minkowski Functional, topological features extracted from each post-contrast image of the lesions were combined into a high-dimensional texture feature vector. These feature vectors were classified in a machine learning task with support vector regression. For comparison, conventional Haralick texture features derived from gray-level co-occurrence matrices (GLCM) were also used. A new method for extracting thresholded GLCM features was also introduced and investigated here. The best classification performance was observed with Minkowski Functionals area and perimeter, thresholded GLCM features f8 and f9, and conventional GLCM features f4 and f6. However, both Minkowski Functionals and thresholded GLCM achieved such results without lesion segmentation while the performance of GLCM features significantly deteriorated when lesions were not segmented (p < 0.05). This suggests that such advanced spatio-temporal characterization can improve the classification performance achieved in such small lesions, while simultaneously eliminating the need for precise segmentation.

  7. 1H-MRS evaluation of breast lesions by using total choline signal-to-noise ratio as an indicator of malignancy: a meta-analysis.

    PubMed

    Wang, Xin; Wang, Xiang Jiang; Song, Hui Sheng; Chen, Long Hua

    2015-05-01

    The aim of this study was to evaluate the diagnostic performance of the use of total choline signal-to-noise ratio (tCho SNR) criteria in MRS studies for benign/malignant discrimination of focal breast lesions. We conducted (1) a meta-analysis based on 10 studies including 480 malignant breast lesions and 312 benign breast lesions and (2) a subgroup meta-analysis of tCho SNR ≥ 2 as cutoff for malignancy based on 7 studies including 371 malignant breast lesions and 239 benign breast lesions. (1) The pooled sensitivity and specificity of proton MRS with tCho SNR were 0.74 (95 % CI 0.69-0.77) and 0.76 (95 % CI 0.71-0.81), respectively. The PLR and NLR were 3.67 (95 % CI 2.30-5.83) and 0.25 (95 % CI 0.14-0.42), respectively. From the fitted SROC, the AUC and Q* index were 0.89 and 0.82. Publication bias was present (t = 2.46, P = 0.039). (2) Meta-regression analysis suggested that neither threshold effect nor evaluated covariates including strength of field, pulse sequence, TR and TE were sources of heterogeneity (all P value >0.05). (3) Subgroup meta-analysis: The pooled sensitivity and specificity were 0.79 and 0.72, respectively. The PLR and NLR were 3.49 and 0.20, respectively. The AUC and Q* index were 0.92 and 0.85. The use of tCho SNR criteria in MRS studies was helpful for differentiation between malignant and benign breast lesions. However, pooled diagnostic measures might be overestimated due to publication bias. A tCho SNR ≥ 2 as cutoff for malignancy resulted in higher diagnostic accuracy.

  8. 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

  9. Diagnostic Value of Diffusion-weighted Imaging and Apparent Diffusion Coefficient Values in the Differentiation of Breast Lesions, Histpathologic Subgroups and Correlatıon with Prognostıc Factors using 3.0 Tesla MR

    PubMed Central

    Akın, Yasin; Uğurlu, M. Ümit; Kaya, Handan; Arıbal, Erkin

    2016-01-01

    Objective The aim of this study was to evaluate the effect of the apparent diffusion coefficient (ADC) and diffusion-weighted imaging in differentiating benign from malignant breast lesions, histopathologic subtypes of breast tumors, and to find a correlation with prognostic factors using 3T MR. Materials and Methods A total of 165 patients aged between 16 and 78 years with 181 histopathologically-verifed breast lesions were enrolled in this study. A 3T MR system and bilateral phased array breast coil was used. Diffusion-weighted imaging was performed with spin echo “echo planar” with “b” values: 50, 400, and 800 seconds/mm2. ADC values were calculated for normal fibroglandular tissue and breast lesions. ADC values of independent groups were compared using Student’s t-test. ROC analysis was used to find a threshold ADC value in the differentiation of lesions. Results The mean ADC values were 1.35±0.16 × 10−3 mm2/s for normal fibroglandular tissue, 1.41±0.24 × 10−3 mm2/s for benign breast lesions and 0.83±0.19 × 10−3 mm2/s for malignant breast lesions. The AUC with ROC analysis was 0.945 and the threshold for ADC was 1.08 × 10−3 mm2/s with a sensitivity and specificity of 92% and 92%, respectively. The threshold value for ADC ratio was 0.9 with 96% sensitivity and 89% specificity. The mean ADC of malignant breast lesions was statistically lower for benign lesions (p<0.01). We found no correlation between the mean ADC values and ER-PR receptor, Her2, and Ki-67 values. Conclusion Diffusion-weighted imaging has high diagnostic value with high sensitivity and specificity in differentiating malignant and benign breast lesions.

  10. Effect of the chest wall on breast lesion reconstruction

    PubMed Central

    Ardeshirpour, Yasaman; Huang, Minming; Zhu, Quing

    2009-01-01

    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. PMID:19725717

  11. 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.

  12. 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.

  13. Data-driven breast decompression and lesion mapping from digital breast tomosynthesis.

    PubMed

    Wels, Michael; Kelm, B M; Hammon, M; Jerebko, Anna; Sühling, M; Comaniciu, Dorin

    2012-01-01

    Digital breast tomosynthesis (DBT) emerges as a new 3D modality for breast cancer screening and diagnosis. Like in conventional 2D mammography the breast is scanned in a compressed state. For orientation during surgical planning, e.g., during presurgical ultrasound-guided anchor-wire marking, as well as for improving communication between radiologists and surgeons it is desirable to estimate an uncompressed model of the acquired breast along with a spatial mapping that allows localizing lesions marked in DBT in the uncompressed model. We therefore propose a method for 3D breast decompression and associated lesion mapping from 3D DBT data. The method is entirely data-driven and employs machine learning methods to predict the shape of the uncompressed breast from a DBT input volume. For this purpose a shape space has been constructed from manually annotated uncompressed breast surfaces and shape parameters are predicted by multiple multi-variate Random Forest regression. By exploiting point correspondences between the compressed and uncompressed breasts, lesions identified in DBT can be mapped to approximately corresponding locations in the uncompressed breast model. To this end, a thin-plate spline mapping is employed. Our method features a novel completely data-driven approach to breast shape prediction that does not necessitate prior knowledge about biomechanical properties and parameters of the breast tissue. Instead, a particular deformation behavior (decompression) is learned from annotated shape pairs, compressed and uncompressed, which are obtained from DBT and magnetic resonance image volumes, respectively. On average, shape prediction takes 26s and achieves a surface distance of 15.80 +/- 4.70 mm. The mean localization error for lesion mapping is 22.48 +/- 8.67 mm.

  14. Papillary lesions of the breast: outcomes of 156 patients managed without excisional biopsy.

    PubMed

    Wyss, Paloma; Varga, Zsuzsanna; Rössle, Matthias; Rageth, Christoph J

    2014-01-01

    Papillomas of the breast are benign epithelial neoplasms. Because of the low, but continued potential for malignancy, the treatment options after initial diagnosis remain controversial. The aim of this study was to analyze the clinical course of patients with papilloma who were managed by active surveillance following initial diagnosis by core needle biopsy or vacuum-assisted biopsy. This retrospective study analyzed 174 patients with 180 papillomas that were diagnosed by core needle biopsy (113 cases) or vacuum-assisted biopsy (67 cases) at the Breast Center Seefeld Zurich between February 2002 and May 2011. We excluded 24 cases that underwent excisional biopsy for removal of the lesion. Over a mean follow-up of 3.5 years, 13 further events occurred in 156 cases (8%). These events included two cases of ductal carcinoma in situ (one after 4 and one after 6 years), one case of atypical ductal hyperplasia, one radial scar, eight cases of papilloma, and one case of flat epithelial atypia. No invasive carcinomas occurred during the follow-up period. Conservative management of 156 papillary lesions with removal by vacuum-assisted biopsy and surveillance was not associated with invasive cancer over a median follow-up of 3.5 years. Therefore, this approach seems to be a safe option for the clinical management of papillary lesions.

  15. [The attitude before subclinical breast lesions on mammography].

    PubMed

    Blidaru, A; Sebeni, M; Bordea, C; Viişoreanu, C; Bălănescu, I

    2000-01-01

    Mammographic screening and improvement of mammography resolution have resulted in the increasingly frequent identification of small-size mammary lesions that have no clinical expression. If in Western countries, approximately one quarter of breast cancers are discovered when clinically occult, in Romania such cases are rare and, most of the times, discovered merely by chance. Infraclinical mammary lesions identified by mammography pose problems concerning the appropriate response. The paper assesses the various diagnosis and therapy choices as well as the localization techniques to be employed in order to establish the best approach. We describe twelve cases of infraclinical mammary lesions identified by mammography. In two of this cases fine needle aspiration biopsy with cytological examination was used, and in one case we performed core biopsy and histological examination. In those cases, lesion localization has been performed using stereotactic X-ray devices. In nine cases, we performed excisional biopsy with histologic assessment. In four of those cases, the lesions proved to be malignant. Preoperative localization was performed with hookwires placed in the proximity of the lesion under mammographic control. In five of those cases, lesion coordinates have been determined by stereotaxy. Using this technique, we removed, in all cases, the clinical lesions identified by mammography. We believe surgical excision to be the best approach in such lesions. Total removal of the lesion enables a thorough histopathological examination resulting in more accurate diagnosis. Curative surgery is also possible within the same surgical procedure. Unless preoperative localization is performed the surgeon is in the position to excise an image that has no clinical expression. Under this circumstances surgical removal is performed blind, as the lesion is hard to be found even intraoperatory. Preoperative localization provides guidance to the surgeon, ensures removal of the lesion

  16. In Vivo Quantification of the Nonlinear Shear Modulus in Breast Lesions: Feasibility Study.

    PubMed

    Bernal, Miguel; Chamming's, Foucauld; Couade, Mathieu; Bercoff, Jeremy; Tanter, Mickaël; Gennisson, Jean-Luc

    2016-01-01

    Breast cancer detection in the early stages is of great importance since the prognosis, and the treatment depends more on this. Multiple techniques relying on the mechanical properties of soft tissues have been developed to help in early detection. In this study, we implemented a technique that measures the nonlinear shear modulus (NLSM) (μ(NL)) in vivo and showed its utility to detect breast lesions from healthy tissue. The technique relies on the acoustoelasticity theory in quasi-incompressible media. In order to recover μ(NL), static elastography and supersonic shear imaging are combined to subsequently register strain maps and shear modulus maps while the medium is compressed. Then, μ(NL) can be recovered from the relationship between the stress, deduced from strain maps, and the shear modulus. For this study, a series of five nonlinear phantoms were built using biological tissue (pork liver) inclusions immersed in an agar-gelatin gel. Furthermore, 11 in vivo acquisitions were performed to characterize the NLSM of breast tissue. The phantom results showed a very good differentiation of the liver inclusions when measuring μ(NL) with a mean value of -114.1 kPa compared to -34.7 kPa for the gelatin. Meanwhile, values for the shear modulus for the liver and the gelatin were very similar, 3.7 and 3.4 kPa, respectively. In vivo NLSM mean value for the healthy breast tissue was of -95 kPa, while mean values of the benign and the malignant lesions were -619 and -806 kPa with a strong v ariability, respectively. This study shows the potential of the acoustoelasticity theory in quasi-incompressible medium to bring a new parameter for breast cancer diagnosis.

  17. 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

  18. The effect of decreased caffeine consumption on benign proliferative breast disease: a randomized clinical trial.

    PubMed

    Allen, S S; Froberg, D G

    1987-06-01

    A single-blind, randomized clinical trial of 56 female subjects was conducted to determine whether decreased consumption of caffeine decreases breast pain/tenderness or nodularity in patients with suspected benign proliferative breast disease. The subjects were randomly assigned to one of three groups--a control group (no dietary restrictions), a placebo group (cholesterol-free diet), and an experimental group (caffeine-free diet). At the initial examination, the subjects reported on the presence of breast pain, the degree to which pain affects daily activities, the frequency of pain, the degree of pain associated with breast examinations, and the degree of pain associated with close-fitting clothing. Subjects were then examined and the four quadrants of each breast were rated on a scale of 0 to 3 (0 = normal, fatty tissue, 1 = little seedy bumps or fine nodularity, 2 = discrete nodules or ropy tissue, 3 = confluent areas, hard or soft masses). Subjects in all three groups returned for 2- and 4-month follow-up examinations. Total nodularity scores, degree of pain/tenderness, and compliance with dietary restrictions were analyzed. The data showed that decreased caffeine consumption did not result in a significant reduction of palpable breast nodules or in a lessening of breast pain/tenderness.

  19. Could ADC values be a promising diagnostic criterion for differentiating malignant and benign hepatic lesions in Asian populations

    PubMed Central

    Peng, Jing; Li, Jing-Jin; Li, Jiang; Li, He-Wen; Xu, Guo-Ping; Jia, Rong-Rong; Zhang, Xue-Ning; Zhao, Yang

    2016-01-01

    Abstract Background: Liver cancer exhibits geographic and ethnic differences in its prevalence and biology, which implies that it is impractical to develop universal guidelines for all patients. Thus, a meta-analysis was conducted to identify the accuracy of apparent diffusion coefficients (ADCs) for discriminating malignant from benign liver lesions in Asians. Methods: Eligible studies published in PubMed, Ovid, and Embase/Medline were updated onto October 2014. STATA 12.0 and Meta-Disc 1.4 were used to perform this meta-analysis. Results: Eight studies comprising 661 benign liver lesions and 598 malignant liver lesions fulfilled all the inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.88 (95% confidence interval [CI] 0.75–0.95), 0.93 (95% CI 0.86–0.97), 12.42 (95% CI 6.09–25.31), 0.13 (95% CI 0.06–0.29), and 95.58 (95% CI 35.29–258.89), respectively. Overall, the area under the summary receiver-operating characteristic curve was 0.96 (95% CI 0.94–0.98). Heterogeneity was found to originate potentially from the type of benign lesion. A subgroup analysis showed that differentiating between hemangiomas, cysts, and malignant liver lesions produced a significantly higher diagnostic accuracy than that of solid liver lesions. Conclusion: Our meta-analysis indicated that ADC could be promising for characterizing liver lesions among Asians, indicating that the ADC value is a promising diagnostic criterion candidate. Meanwhile, the use of dual b values could be sufficient for liver lesion characterization. However, large-scale, high-quality trials should be conducted to identify specific standards, including cut-off values for further development of diffusion-weighted imaging as a routine clinical application among Asian populations. PMID:27902599

  20. Differentiating malignant from benign gastric mucosal lesions with quantitative analysis in dual energy spectral computed tomography

    PubMed Central

    Meng, Xiaoyan; Ni, Cheng; Shen, Yaqi; Hu, Xuemei; Chen, Xiao; Li, Zhen; Hu, Daoyu

    2017-01-01

    Abstract To investigate the value of quantitative analysis in dual energy spectral computed tomography (DESCT) for differentiating malignant gastric mucosal lesions from benign gastric mucosal lesions (including gastric inflammation [GI] and normal gastric mucosa [NGM]). This study was approved by the ethics committee, and all patients provided written informed consent. A total of 161 consecutive patients (63 with gastric cancer [GC], 48 with GI, and 50 with NGM) who underwent dual-phase contrast enhanced DESCT scans in the arterial phase (AP) and portal venous phase (PVP) were included in this study. Iodine concentration (IC) in lesions was derived from the iodine-based material-decomposition images and normalized to that in the aorta to obtain normalized IC (nIC). The ratios of IC and nIC between the AP and PVP were calculated. Diagnostic confidence for GC and GI was evaluated with reviewing the features including gastric wall thickness, focal, and eccentric on the conventional polychromatic images. All statistical analyses were performed by using statistical software SPSS 17.0 (SPSS, Chicago, IL). IC and nIC in GC differed significantly from those in GI and NGM, except for nICAP in comparing GC with GI. Mean nIC values of GC (0.18 ± 0.06 in AP and 0.62 ± 0.16 in PVP) were significantly higher than that of NGM (0.12 ± 0.03 in AP and 0.37 ± 0.08 in PVP) (all P < 0.05). There was also significant difference for IC values in GC, GI, and NGM (24.19 ± 8.27, 19.07 ± 5.82, and 13.61 ± 2.52 mg/mL, respectively, in AP and 28.00 ± 7.01, 24.66 ± 6.55, and 16.94 ± 3.06 mg/mL, respectively, in PVP). Based on Receiver Operating Characteristic Curve analysis, nIC and IC in PVP had high sensitivities of 88.89% and 90.48%, respectively, in differentiating GC from NGM, while the sensitivities were 71.43% and 88.89% during AP. Ratios IC and nIC ratios did not provide adequate diagnostic accuracy with their area under curves

  1. 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.

  2. Percutaneous microwave ablation for benign focal liver lesions: Initial clinical results

    PubMed Central

    Cheng, Zhigang; Liang, Ping; Yu, Xiaoling; Han, Zhiyu; Liu, Fangyi; Yu, Jie; Li, Xin

    2017-01-01

    Benign focal liver lesions (BFLLs) have become a common disease diagnosed in the clinical setting following the advancement of imaging techniques. The aim of the present study was to evaluate the safety and clinical outcomes of percutaneous microwave (MW) ablation, guided by ultrasound (US), for the treatment of BFLLs. Between May 2005 and January 2011, 44 BFLLs (mean maximum diameter, 33.9±13.1 mm) in 37 patients (23 women and 14 men) were treated by US-guided percutaneous MW ablation with cooled-shaft antennae. The pathological diagnosis of a BFLL was confirmed in 91.9% (34/37) of patients using a US-guided core needle biopsy prior to ablation. The BFLLs in the other 3 cases were diagnosed by typical presentations on contrast-enhanced imaging, as the patients refused to undergo biopsies. Five inclusion criteria, including indeterminate diagnoses of nodules on contrast-enhanced imaging prior to pathological verification, were recommended. The median follow-up period was 27.0 months (range, 6–73 months). The mean MW ablation energy and time were 55.0±41.6 kJ (range, 13.5–207 kJ) and 1,039.9±706.2 sec (range, 270–3,450 sec) per lesion, respectively. In total, 40 nodules (90.9%) were completely ablated, and no evidence of recurrence was demonstrated on contrast-enhanced imaging follow-up. The other 4 nodules (9.1%) were partially ablated due to the proximity of adjacent vital organs. Minor complications without sequelae included local pain and transient hemoglobinuria and no major complications occurred in peri-ablation. Overall, US-guided percutaneous MW ablation is a safe, effective and minimally invasive therapy for BFLLs in selected patients who are non-surgical candidates. PMID:28123578

  3. Percutaneous microwave ablation for benign focal liver lesions: Initial clinical results.

    PubMed

    Cheng, Zhigang; Liang, Ping; Yu, Xiaoling; Han, Zhiyu; Liu, Fangyi; Yu, Jie; Li, Xin

    2017-01-01

    Benign focal liver lesions (BFLLs) have become a common disease diagnosed in the clinical setting following the advancement of imaging techniques. The aim of the present study was to evaluate the safety and clinical outcomes of percutaneous microwave (MW) ablation, guided by ultrasound (US), for the treatment of BFLLs. Between May 2005 and January 2011, 44 BFLLs (mean maximum diameter, 33.9±13.1 mm) in 37 patients (23 women and 14 men) were treated by US-guided percutaneous MW ablation with cooled-shaft antennae. The pathological diagnosis of a BFLL was confirmed in 91.9% (34/37) of patients using a US-guided core needle biopsy prior to ablation. The BFLLs in the other 3 cases were diagnosed by typical presentations on contrast-enhanced imaging, as the patients refused to undergo biopsies. Five inclusion criteria, including indeterminate diagnoses of nodules on contrast-enhanced imaging prior to pathological verification, were recommended. The median follow-up period was 27.0 months (range, 6-73 months). The mean MW ablation energy and time were 55.0±41.6 kJ (range, 13.5-207 kJ) and 1,039.9±706.2 sec (range, 270-3,450 sec) per lesion, respectively. In total, 40 nodules (90.9%) were completely ablated, and no evidence of recurrence was demonstrated on contrast-enhanced imaging follow-up. The other 4 nodules (9.1%) were partially ablated due to the proximity of adjacent vital organs. Minor complications without sequelae included local pain and transient hemoglobinuria and no major complications occurred in peri-ablation. Overall, US-guided percutaneous MW ablation is a safe, effective and minimally invasive therapy for BFLLs in selected patients who are non-surgical candidates.

  4. Detection of benign proliferative lesions on vocal cords with voice handicap index.

    PubMed

    Huang, Xuekun; Zhang, Gehua; Liu, Xiujin; Wang, Tao; Zhu, Ling

    2012-10-01

    The aim of this study was to investigate the significance and practical applicability of the voice handicap index (VHI) in the diagnosis of benign proliferative lesions of the vocal cords (BLVCs). The detection of VHI included the calculation of functional (F), physical (P) and emotional (E) domains, and the score of each domain and total score (TVH). The VHI was scored in patients with BLVCs and healthy controls. Eighty-four patients with BLVCs and 27 healthy controls were enrolled in the present study. The F, P, E and TVH scores were 10.40±7.84, 19.88±8.81, 9.39±8.49 and 39.37±21.83, respectively, in the BLVC group and 0.78±0.97, 0.85±1.06, 0.26±0.72 and 1.89±2.31, respectively, in the control group. A significant difference was found between the two groups (P<0. 01). The daily duration of speech and course of BLVCs did not correlate with the VHI score in BLVC patients (P>0.05). There was no marked difference in the VHI score between voice-consuming and non-voice consuming occupations (P>0.05) or between males and females (P>0.05). In BLVC patients, VHI may subjectively express the voice handicap, while daily duration of speech, course of BLVC, occupation and gender have no impact on VHI.

  5. Stealth surgery: Subcutaneous endoscopic excision of benign lesions of head, neck and trunk in children

    PubMed Central

    Teja, Veeramaneni Shravan; Agarwal, Prakash; Bagdi, Raj Kishore

    2017-01-01

    BACKGROUND: Subcutaneous endoscopic excision of benign lesions of the head, neck and trunk is a new dimension in paediatric minimally invasive surgery. This study is a case series where cases are operated endoscopically with minimal scars. PATIENTS AND METHODS: This is a prospective study where in 13 patients who underwent Stealth surgery were enrolled in this study. Factors such as intraoperative time, blood loss, intraoperative complications, postoperative recovery and appearance and placing of minimal scars at inconspicuous sites were taken into consideration. RESULTS: All patients underwent successful surgery without converting to open surgery. Out of 13 patients, five were torticollis, four were suprasternal dermoid, one had chest wall swelling, one had swelling of arm, one had back lipoma and one had forehead lipoma. The mean operation time was 50 min (range 32-70). All patients were followed up regularly postoperatively. All patients were operated as daycare, less postoperative pain, no evident scars, lower complications related to scars. CONCLUSION: Subcutaneous endoscopic surgery addresses concerns related to scarring by replacing large visible incisions with smaller incisions placed in inconspicuous locations. This is a safe and effective procedure of early recovery. PMID:28281473

  6. Diminished number or complete loss of myoepithelial cells associated with metaplastic and neoplastic apocrine lesions of the breast.

    PubMed

    Tramm, Trine; Kim, Jee-Yeon; Tavassoli, Fattaneh A

    2011-02-01

    The presence of myoepithelial (ME) cells is considered an important feature in the vast majority of benign breast lesions. Recently, a case showing the absence of myoepithelium in a mammary duct with apocrine metaplasia was reported. To investigate the status of ME cells associated with apocrine metaplasia, the distribution of ME cells in 59 metaplastic and intraductal proliferative apocrine lesions was evaluated using immunohistochemical expression of p63 and Calponin. p63 showed a diminished number of ME cells and increased intermyoepithelial nuclear distance in ducts with all variants of apocrine metaplasia and proliferation compared with normal glands. In the majority of cases, Calponin showed a continuous ME layer. In 6 cases, including an apocrine papilloma, there were definitive ME gaps confirmed by both markers, in the absence of atypia and with preservation of the basement membrane. In all cases, there was frequent heterogeneity in the distribution of ME cells in ducts harboring apocrine cells and even in various papillae within papillary lesions. In summary, benign and noninvasive apocrine lesions can show reduction and occasional complete loss of ME cells. This observation is particularly important when evaluating apocrine papillary proliferations, in which the absence of ME cells may lead to overdiagnosis of atypia and/or malignancy. The observation suggests that at least 2 ME markers should be used when evaluating apocrine lesions, and that a malignant diagnosis should be based on features of the proliferating cells until more data become available on the significance, if any, of the absence of ME cells in apocrine lesions.

  7. 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

  8. Introducing Cichorium Pumilum as a potential therapeutical agent against drug-induced benign breast tumor in rats.

    PubMed

    Al-Akhras, M-Ali H; Aljarrah, Khaled; Al-Khateeb, Hasan; Jaradat, Adnan; Al-Omari, Abdelkarim; Al-Nasser, Amjad; Masadeh, Majed M; Amin, Amr; Hamza, Alaaeldin; Mohammed, Karima; Al Olama, Mohammad; Daoud, Sayel

    2012-12-01

    Cichorium Pumilum (chicory) is could be a promising cancer treatment in which a photosensitizing drug concentrates in benign tumor cells and activated by quanta at certain wavelength. Such activated extracts could lead to cell death and tumor ablation. Previous studies have shown that Cichorium Pumilum (chicory) contains photosensitive compounds such as cichoriin, anthocyanins, lactucin, and Lactucopicrin. In the present study, the protective effect of sun light-activated Cichorium against the dimethylbenz[a]anthracene (DMBA) induced benign breast tumors to female Sprague-Dawley rats was investigated. Chicory's extract has significantly increase P.carbonyl (PC) and malondialdehyde (MDA) and decreases the hepatic levels of total antioxidant capacity (TAC) and superoxide dismutase (SOD) in benign breast tumors-induced group compared to control. It also significantly decrease the number of estrogen receptors ER-positive cells in tumor masses. These results suggest that chicory extracts could be used as herbal photosensitizing agent in treating benign breast tumor in rats.

  9. 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

  10. 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

  11. Vacuum-assisted core-needle biopsy as a diagnostic and therapeutic method in lesions radiologically suspicious of breast fibroadenoma

    PubMed Central

    Połom, Karol; Murawa, Dawid; Nowaczyk, Piotr; Adamczyk, Beata; Giles, Elizabeth; Fertsch, Sonia; Michalak, Michal; Murawa, Paweł

    2010-01-01

    Background Treatment of breast fibroadenoma remains a subject of clinical discussion. Recommended methods include clinical observation or surgical excision of the lesion. The procedure involves hospitalisation and anaesthesia, leaving a scar on the breast. Aim The aim of this study was to present the Centre's experience in removing lesions radiologically suspicious of fibroadenoma by means of an ultrasound-guided vacuum-assisted core-needle biopsy as an alternative to a classical surgery. Materials and methods Between March 2007 and April 2010, 196 ultrasound-guided vacuum-assisted biopsies were performed in the Mammotome Biopsy Laboratory of the 1st Surgical Oncology and General Surgery Department at the Greater Poland Cancer Centre in Poznań. The procedure was delivered to female patients aged 17–91 years (mean 40.8, median 39). Qualified for removal were ultrasound identified lesions described as fibroadenomas. Results The average size of excised lesions according to pre-biopsy ultrasound image was 13.53 ± 8.92 mm (median 11 mm, range 4–60 mm). In 184 cases (93.9%), benign lesions were found in the final histopathologic examination. Pre-cancer lesions were found in 10 cases, and invasive lesions in two cases. Overall, after follow-up ultrasound examination, four patients were qualified for subsequent surgical resection of lesions that had been left behind. Conclusion Vacuum core-needle biopsy is an effective tool enabling removal of breast fibroadenomas. It combines features of a lesion resection and histopathologic material collection providing an access with minimum invasiveness. PMID:24376952

  12. Bioimpedance spectroscopy can precisely discriminate human breast carcinoma from benign tumors

    PubMed Central

    Du, Zhenggui; Wan, Hangyu; Chen, Yu; Pu, Yang; Wang, Xiaodong

    2017-01-01

    Abstract Intraoperative frozen pathology is critical when a breast tumor is not diagnosed before surgery. However, frozen tumor tissues always present various microscopic morphologies, leading to a high misdiagnose rate from frozen section examination. Thus, we aimed to identify breast tumors using bioimpedance spectroscopy (BIS), a technology that measures the tissues’ impedance. We collected and measured 976 specimens from breast patients during surgery, including 581 breast cancers, 190 benign tumors, and 205 normal mammary gland tissues. After measurement, Cole-Cole curves were generated by a bioimpedance analyzer and parameters R0/R∞, fc, and α were calculated from the curve. The Cole-Cole curves showed a trend to differentiate mammary gland, benign tumors, and cancer. However, there were some curves overlapped with other groups, showing that it is not an ideal model. Subsequent univariate analysis of R0/R∞, fc, and α showed significant differences between benign tumor and cancer. However, receiver operating characteristic (ROC) analysis indicated the diagnostic value of fc and R0/R∞ were not superior to frozen sections (area under curve [AUC] = 0.836 and 0.849, respectively), and α was useless in diagnosis (AUC = 0.596). After further research, we found a scatter diagram that showed a synergistic effect of the R0/R∞ and fc, in discriminating cancer from benign tumors. Thus, we used multivariate analysis, which revealed that these two parameters were independent predictors, to combine them. A simplified equation, RF′ = 0.2fc + 3.6R0/R∞, based on multivariate analysis was developed. The ROC curve for RF′ showed an AUC = 0.939, and the sensitivity and specificity were 82.62% and 95.79%, respectively. To match a clinical setting, the diagnostic criteria were set at 6.91 and 12.9 for negative and positive diagnosis, respectively. In conclusion, RF′ derived from BIS can discriminate benign tumor and cancers, and integrated criteria

  13. Optical mammography: a new technique for visualizing breast lesions in women presenting non palpable BIRADS 4-5 imaging findings: preliminary results with radiologic-pathologic correlation.

    PubMed

    Athanasiou, Alexandra; Vanel, Daniel; Fournier, Laure; Balleyguier, Corinne

    2007-02-28

    The purpose of this prospective study is to determine the diagnostic accuracy of near-infrared breast optical absorption imaging in patients with Breast Imaging Reporting and Data System (BIRADS) 4-5 non-palpable lesions scheduled for biopsy, using pathology after core or excisional biopsy as a reference. The patient's breast was positioned onto a panel of red light-emitting diodes (640 nm). A soft membrane was inflated to exert a uniform pressure on the breast. Transmitted light was detected using a CCD camera. The entire acquisition sequence took 1 minute. Image processing generated dynamic images displayed in colour scale, to reveal time-dependent changes in the transmitted light intensity caused by the pressure change. Dynamic curves were classified in two categories: consistently decreasing intensity suspicious for malignancy, and sinusoidal increasing intensity considered as benign. Seventy-eight women consulting for non-palpable breast lesions were initially included in the study. An imaging-histology correlation was obtained for seventy-two patients, the remaining six patients were excluded for technical optical scan reasons. We experienced an overall sensitivity of 73% and specificity of 38%, the false negative results being mainly small size (<10 mm) infiltrating malignant lesions and ductal carcinoma in situ (DCIS). False positive results were seen in benign proliferative lesions. Dynamic optical breast imaging is a novel, low-cost, non-invasive technique yielding a new type of information about the physiology of breast lesions. Absorption is due to haemoglobin and its products, therefore reflecting the angiogenic status of breast tumours.

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

    PubMed

    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.

  15. Histopathology of a benign bile duct lesion in the liver: Morphologic mimicker or precursor of intrahepatic cholangiocarcinoma

    PubMed Central

    Lee, Kyoung-Bun

    2016-01-01

    A bile duct lesion originating from intrahepatic bile ducts is generally regarded as an incidental pathologic finding in liver specimens. However, a recent study on the molecular classification of intrahepatic cholangiocarcinoma has focused on the heterogeneity of this carcinoma and has suggested that the cells of different origins present in the biliary tree may have a major role in the mechanism of oncogenesis. In this review, benign intrahepatic bile duct lesions—regarded in the past as reactive changes or remnant developmental anomalies and now noted to have potential for developing precursor lesions of intrahepatic cholangiocarcinoma—are discussed by focusing on the histopathologic features and its implications in clinical practice. PMID:27729636

  16. 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.

  17. Quantitative Evaluation of DNA Hypermethylation in Malignant and Benign Breast Tissue and Fluids

    PubMed Central

    Zhu, Weizhu; Qin, Wenyi; Hewett, John E.; Sauter, Edward R.

    2012-01-01

    The assessment of DNA had demonstrated altered methylation in malignant compared to benign breast tissue.The purpose of our study was to 1) confirm the predictive ability of methylation assessment in breast tissue, and 2) use the genes found to be cancer predictive in tissue to evaluate the diagnostic potential of hypermethylation assessment in nipple aspirate fluid (NAF) and mammary ductoscopic (MD) samples. Quantitative methylation specific (qMS)-PCR was conducted on three specimen sets: 44 malignant (CA) and 34 normal (NL) tissue specimens, 18 matched CA, adjacent normal (ANL) tissue and NAF specimens, and 119 MD specimens. Training and validation tissue sets were analyzed to determine the optimal group of cancer predictive genes for NAF and MD analysis. NAF and MD cytologic review were also performed. Methylation of CCND-2, p16, RAR-β and RASSF-1a was significantly more prevalent in tumor than in normal tissue specimens. Receiver operating characteristic curve analysis demonstrated an area under the curve of 0.96. For the 18 matched CA, ANL and NAF specimens, the four predictive genes identified in cancer tissue contained increased methylation in CA vs. ANL tissue; NAF samples had higher methylation than ANL specimens. Methylation frequency was higher in MD specimens from breasts with cancer than benign samples for p16 and RASSF-1a. In summary, 1) routine quantitative DNA methylation assessment in NAF and MD samples is possible, and 2) genes hypermethylated in malignant breast tissue are also altered in matched NAF and in MD samples, and may be useful to assist in early breast cancer detection. PMID:19618401

  18. 808-nm diode lasers with and without exogenous chromophore in the treatment of benign facial pigmented and vascular lesions

    NASA Astrophysics Data System (ADS)

    Marangoni, Ovidio; Magaton Rizzi, G.; Trevisan, G.

    2001-10-01

    Aim: To evaluate the safety and efficacy of an 808 nm diode laser for the treatment of benign facial pigmented and vascular lesions, with and without the use of an exogenous chromophore. Method: Thirty-eight patients were treated with an 808 nm diode laser (Eufoton, Italy), in some cases using a chromophore (1% methylene blue, SALF, Bergamo). Pigmented lesions: 21 patients, (15 pigmented keratoses, 6 melanoses). All the lesions were evaluated by dermatoscopy (Videocap 200, DS Medica, Italy) before the treatment. Fluence levels were 10 - 30 J/cmq; pulse lengths were 10 - 50 ms; spot size was 2 mm. Five hypopigmented keratoses were artificially pigmented using exogenous chromophore. Two melanoses required an additional laser session. Vascular lesions: 17 patients, (12 small angiomas, 5 teleangectasias). Fluences were 50 - 100 J/cmq; pulse lengths were 10 - 50 ms; spot size was 2 mm. Eight angiomas were pigmented with exogenous chromophore prior to the treatment. In all cases the areas surrounding the lesions were cooled. The patients were followed at 1, 4 and 8 weeks after the procedure. Results: The keratoses healed completely within two weeks. Four melanoses healed after four weeks. In the two melanoses that were re-treated after eight weeks there remained slight hypopigmentation of the area. All the vascular lesions healed after 15 days without any residual scarring. Considerations: The use of the 808 nm diode laser in the treatment of benign facial pigmented and vascular lesions appears to be justified on the grounds of efficacy and safety of the device, and good degree of acceptance by the patients. By increasing absorption of the 808 nm beam and reducing its penetration, the pigmentation of superficial lesions with exogenous chromophore allowed us to decrease fluences and reduce irradiation times.

  19. Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

    NASA Astrophysics Data System (ADS)

    Ertas, Gokhan; Doran, Simon; Leach, Martin O.

    2011-12-01

    In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

  20. 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

  1. 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

    2016-01-01

    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.

  2. High prevalence of preinvasive lesions adjacent to BRCA1/2-associated breast cancers.

    PubMed

    Arun, Banu; Vogel, Kristen J; Lopez, Adriana; Hernandez, Mike; Atchley, Deann; Broglio, Kristine R; Amos, Christopher I; Meric-Bernstam, Funda; Kuerer, Henry; Hortobagyi, Gabriel N; Albarracin, Constance T

    2009-02-01

    Mutations in BRCA1 and BRCA2 increase a woman's lifetime risk of developing breast cancer by 43% to 84%. It was originally postulated that BRCA1/2-associated breast cancers develop more rapidly than sporadic cancers and may lack preinvasive lesions. More recent studies have found preinvasive lesions in prophylactic mastectomy specimens from mutation carriers; however, there is little information on the presence of preinvasive lesions in tissue adjacent to breast cancers. Our aim is to investigate the role of preinvasive lesions in BRCA-associated breast carcinogenesis. We retrospectively compared BRCA1/2-associated breast cancers and sporadic breast cancers for the prevalence of preinvasive lesions [ductal carcinoma in situ (DCIS), lobular carcinoma in situ, and atypical lobular hyperplasia] in tissue adjacent to invasive breast cancers. Pathology was reviewed for 73 BRCA1/2-associated tumors from patients with breast cancer. We selected 146 patients with mutation-negative breast cancer as age-matched controls. Among the BRCA1/2-associated breast cancers, 59% had at least one associated preinvasive lesion compared with 75% of controls. Preinvasive lesions were more prevalent in BRCA2 mutation carriers than in BRCA1 mutation carriers (70% versus 52%, respectively). The most common preinvasive lesion in both groups was DCIS; 56% of BRCA1/2-associated breast cancers and 71% of the sporadic breast cancers had adjacent intraductal disease, respectively. Preinvasive lesions, most notably DCIS, are common in BRCA1/2-associated breast cancers. These findings suggest that BRCA1/2-associated breast cancers progress through the same intermediate steps as sporadic breast cancers, and that DCIS should be considered as a part of the BRCA1/2 tumor spectrum.

  3. High Prevalence of Pre-invasive Lesions Adjacent to BRCA1/2-Associated Breast Cancers

    PubMed Central

    Arun, Banu; Vogel, Kristen J.; Lopez, Adriana; Hernandez, Mike; Atchley, Deann; Broglio, Kristine R.; Amos, Christopher I.; Meric-Bernstam, Funda; Kuerer, Henry; Hortobagyi, Gabriel N.; Albarracin, Constance T.

    2015-01-01

    Purpose Mutations in BRCA1 and BRCA2 increase a woman's lifetime risk of developing breast cancer to 43%-84%. It was originally postulated that BRCA1/2-associated breast cancers develop more rapidly than sporadic cancers and may lack pre-invasive lesions. More recent studies have found pre-invasive lesions in prophylactic mastectomy specimens from mutation carriers; however, there is little information on the presence of pre-invasive lesions in tissue adjacent to breast cancers. Our aim is to investigate the role of pre-invasive lesions in BRCA-associated breast carcinogenesis. Methods We retrospectively compared BRCA1/2-associated breast cancers and sporadic breast cancers for the prevalence of pre-invasive lesions (ductal carcinoma in situ [DCIS], lobular carcinoma in situ [LCIS], and atypical lobular hyperplasia [ALH]) in tissue adjacent to invasive breast cancers. Results Pathology was reviewed for 73 BRCA1/2-associated tumors from breast cancer patients. We selected 146 mutation-negative breast cancer patients as age-matched controls. Of BRCA1/2-associated breast cancers, 59% had at least one associated pre-invasive lesion compared with 75% of controls. Pre-invasive lesions were more prevalent in BRCA2 mutation carriers than in BRCA1 mutation carriers (70% vs. 52%, respectively). The most common pre-invasive lesion in both groups was DCIS; 56% of BRCA1/2-associated breast cancers and 71% of the sporadic breast cancers had adjacent intraductal disease, respectively. Conclusions Pre-invasive lesions, most notably DCIS, are common in BRCA1/2-associated breast cancers. These findings suggest that BRCA1/2-associated breast cancers progress through the same intermediate steps as sporadic breast cancers, and that DCIS should be considered as a part of the BRCA1/2 tumor spectrum. PMID:19174581

  4. Molecular forms of prostate-specific antigen in the serum of women with benign and malignant breast diseases.

    PubMed Central

    Borchert, G. H.; Melegos, D. N.; Tomlinson, G.; Giai, M.; Roagna, R.; Ponzone, R.; Sgro, L.; Diamandis, E. P.

    1997-01-01

    Using a highly sensitive immunofluorometric procedure, we measured the total prostate-specific antigen (PSA) concentration in 632 sera obtained from female blood donors and women with idiopathic hirsutism, breast cancer or benign breast diseases. A total of 50 sera with total PSA > 15 ng l(-1) were fractionated by high-performance liquid chromatography (HPLC) in order to resolve the two immunoreactive molecular forms, i.e. free PSA (approximately 30 kDa) and PSA bound to alpha1-antichymotrypsin (PSA-ACT, 100 kDa). We found that breast cancer patients have presurgical serum total PSA levels similar to those of blood donors. Total serum PSA concentration decreases with age in women with idiopathic hirsutism, in cancer patients and in patients with benign breast diseases. The major molecular form of PSA in the serum of all normal and hirsute women (n = 15) is PSA bound to the proteinase inhibitor alpha1-antichymotrypsin. The major molecular form in 44% of presurgical cancer patient sera is free PSA. A total of 58% of benign breast disease patients also have in their serum mainly free PSA. We conclude that about half the patients with breast cancer or benign breast diseases have free PSA as the major molecular form in their serum, whereas patients without breast pathologies (normal blood donors, idiopathic hirsutism) have PSA bound to alpha1-antichymotrypsin as the major molecular form. The ratio of PSA/PSA-ACT may have value as a simple biochemical test for diagnosis of breast pathologies including breast cancer. PMID:9376271

  5. Sclerosing odontogenic carcinoma with benign fibro-osseous lesion of the mandible: an extremely rare case report.

    PubMed

    Irié, Tarou; Ogawa, Ikuko; Takata, Takashi; Toyosawa, Satoru; Saito, Noriko; Akiba, Masakazu; Isobe, Tomohide; Hokazono, Chie; Tachikawa, Tetsuhiko; Suzuki, Yoshio

    2010-10-01

    A case of sclerosing odontogenic carcinoma (SOC) admixed with a benign fibro-osseous lesion (BFOL) is reported herein. A 67-year-old male had paresthesia in the mental region. Computed tomography detected an intragnathic mass that was focally expansile with disappearance of cortical bone, and contained admixed radiolucency and radio-opacity. Under the pathological diagnosis as benign fibro-osseous lesion, it was surgically removed by curettage. Microscopic analysis showed that a few parts of the resected materials contained dispersed thin cords and small nests of epithelial cells accompanied by fibrous stroma. Cellular atypia and mitotic figures were not evident. The diagnosis of BFOL with hyperplastic and metaplastic odontogenic epithelia was ultimately made. Eight months after the operation, the lesion recurred and segmental mandibulectomy was carried out. Histologically, the lesion was predominantly occupied by the fibro-osseous component with irregular-shaped foci of epithelial component. The epithelial component exhibited mostly thin cord or small nest patterns and showed definite perineural infiltration. Immunohistochemically, the epithelial cells were positive for p63, cytokeratin (CK) 6 and CK19, and focally positive for CK7 but negative for vimentin. MIB-1 positive nuclei were inconspicuous. To the best of our knowledge, this report is the first case of SOC with BFOL.

  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. 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

  8. Assessment of p53 protein expression in normal mucosa and benign and malignant lesions of the nasal cavity.

    PubMed

    Fang, S Y; Yan, J J; Ohyama, M

    1998-01-01

    p53 gene mutation is documented in head and neck cancer. No reports exist relating this mutation to normal mucosa or benign and malignant lesions of the nasal cavity. We investigate p53 overexpression using immunohistochemical techniques improved by an antigen retrieval method. p53 protein was analyzed in the following cases: normal, benign [papilloma and inverted papilloma (IP)] and malignant [squamous-cell carcinoma (SCC) arising in IP, SCC alone, adenocarcinoma and small-cell carcinoma]. Both the intensity and rate of positive p53 immunostaining were evaluated using a quantitative Auto-CAD program. Overexpression of p53 protein was not identified in normal mucosa, benign or premalignant lesions; however, approximately 60% is correlated to nasal cancer. p53 overexpression correlates with heavy smoking. Both the IP and SCC portions of SCC synchronous with IP showed similar p53 immunoreactivity. SCC arising in IP shows a lower p53 immunoreactivity than SCC alone. Thus, smoking along with a p53 mutation may be a mutagenic agent in nasal cancers. Alteration of the p53 protein may play an important role in the early stages of the malignant transformation of IP. A low p53 immunoreactivity indicates the presence of wild-type p53 protein. This may show a better response to radiation therapy yielding a better prognosis for SCC arising in IP compared to SCC alone. However, further clinical trials are required to investigate this possibly worthwhile prognostic marker.

  9. Analysis of 3D Subharmonic Ultrasound Signals from Patients with Known Breast Masses for Lesion Differentiation

    DTIC Science & Technology

    2014-12-01

    ductal carcinomas (23/35) made up the majority of the malignant cases, while fibroadenoma (30/99) was the most prevalent classification of the benign...heterogeneity plot of a benign case (a fibroadenoma ) across the peripheral and central sections. The presence of vascularity in the central sections is...heterogeneity plots of (a) benign ( fibroadenoma ) and (b) malignant (invasive ductal carcinoma) across the peripheral and central sections of the lesion

  10. Low-contrast lesion detection in tomosynthetic breast imaging using a realistic breast phantom

    NASA Astrophysics Data System (ADS)

    Zhou, Lili; Oldan, Jorge; Fisher, Paul; Gindi, Gene

    2006-03-01

    Tomosynthesis mammography is a potentially valuable technique for detection of breast cancer. In this simulation study, we investigate the efficacy of three different tomographic reconstruction methods, EM, SART and Backprojection, in the context of an especially difficult mammographic detection task. The task is the detection of a very low-contrast mass embedded in very dense fibro-glandular tissue - a clinically useful task for which tomosynthesis may be well suited. The project uses an anatomically realistic 3D digital breast phantom whose normal anatomic variability limits lesion conspicuity. In order to capture anatomical object variability, we generate an ensemble of phantoms, each of which comprises random instances of various breast structures. We construct medium-sized 3D breast phantoms which model random instances of ductal structures, fibrous connective tissue, Cooper's ligaments and power law structural noise for small scale object variability. Random instances of 7-8 mm irregular masses are generated by a 3D random walk algorithm and placed in very dense fibro-glandular tissue. Several other components of the breast phantom are held fixed, i.e. not randomly generated. These include the fixed breast shape and size, nipple structure, fixed lesion location, and a pectoralis muscle. We collect low-dose data using an isocentric tomosynthetic geometry at 11 angles over 50 degrees and add Poisson noise. The data is reconstructed using the three algorithms. Reconstructed slices through the center of the lesion are presented to human observers in a 2AFC (two-alternative-forced-choice) test that measures detectability by computing AUC (area under the ROC curve). The data collected in each simulation includes two sources of variability, that due to the anatomical variability of the phantom and that due to the Poisson data noise. We found that for this difficult task that the AUC value for EM (0.89) was greater than that for SART (0.83) and Backprojection (0.66).

  11. The evaluation of human papillomavirus and p53 gene mutation in benign and malignant conjunctiva and eyelid lesions.

    PubMed

    Joanna, Reszec; Renata, Zalewska; Witold, Pepiński; Małgorzata, Skawronska; Bernaczyk, Piotr; Chyczewski, Lech

    2010-12-01

    Papillomas and squamous cell carcinomas are the most common conjunctival and eyelid lesions. The etiology is still unclear and recently human papillomavirus infection and p53 gene mutation have been taken into consideration. The aim of our study was the evaluation of HPV DNApresence and p53 gene mutation in 45 benign and 38 malignant squamous lesions of the conjunctiva and eyelid. For HPV detection PCR-RFLP and immunohistochemical reaction were used; for p53 gene mutation PCR-SSCP was used. Only 8.8% papillomas, 9.1% squamous cell cancers and 3.7% basal cell cancers (using PCR-RFLP method) and 26.6% papillomas, 7.4% squamous cell cancers and 9.1% basal cell cancers (using immunohisto-chemical reaction) were HPV positive. p53 gene mutation was evaluated in 24.4% papillomas, 54.5% squamous cell cancers and 22.2% basal cell cancers; most commonly in 6 and 7 exon. Human papillomavirus infection, opposite to p53 gene mutation, is not a significant etiological factor of the benign and malignant conjunctival and eyelid lesions development.

  12. Pseudo-winging of scapula due to benign lesions of ventral surface of scapula – Two unusual causes

    PubMed Central

    Tittal, Praveen; Pawar, Inder; Kapoor, Sudhir K.

    2014-01-01

    Winging of the scapula due to benign lesion of ventral surface of scapula is one of the rare cause and difficult to diagnose in first place. We present two unusual cases of pseudo winging of scapula due to benign lesions of scapula. First case was of 23 year old male with solitary osteochondroma of ventral surface of scapula. Second was 38 year old female with hemangioma involving subscapular muscles. Both the patients presented to us with dull aching pain over right scapular and shoulder region of 6 months duration with gradually increasing pseudo-winging of scapula. On examination there was mild tenderness over superomedial border of scapula with scapular snapping5 or 'clunk' on hyper abduction of shoulder. Further radiographic evaluation of right scapular region revealed solitary osteochondroma of ventral surface of right scapula in first case whereas MRI revealed hemangioma of subscapular muscles in second case. Hemangioma was initially treated by weekly injecting sclerosing agent (Inj. Polidocanol) locally for 4 weeks. Both lesions were later treated by excision and subsequent follow up revealed disappearance of pain and winging of scapula. Conclusion Winging of the scapula due to solitary osteochondroma and subscapular hemangioma of the scapula may present with an initial diagnostic difficulty but appropriate knowledge of literature and diagnostic acumen can give excellent results. PMID:26549949

  13. Preclinical study of using multiphoton microscopy to diagnose liver cancer and differentiate benign and malignant liver lesions

    NASA Astrophysics Data System (ADS)

    Yan, Jun; Zhuo, Shuangmu; Chen, Gang; Wu, Xiufeng; Zhou, Dong; Xie, Shusen; Jiang, Jiahao; Ying, Mingang; Jia, Fan; Chen, Jianxin; Zhou, Jian

    2012-02-01

    Recently, the miniaturized multiphoton microscopy (MPM) and multiphoton probe allow the clinical use of multiphoton endoscopy for diagnosing cancer via ``optical biopsy''. The purpose of this study was to establish MPM optical diagnostic features for liver cancer and evaluate the sensitivity, specificity, and accuracy of MPM optical diagnosis. Firstly, we performed a pilot study to establish the MPM diagnostic features by investigating 60 surgical specimens, and found that high-resolution MPM images clearly demonstrated apparent differences between benign and malignant liver lesions in terms of their tissue architecture and cell morphology. Cancer cells, characterized by irregular size and shape, enlarged nuclei, and increased nuclear-cytoplasmic ratio, were identified by MPM images, which were comparable to hematoxylin-eosin staining images. Secondly, we performed a blinded study to evaluate the sensitivity, specificity, and accuracy of MPM optical diagnosis by investigating another 164 specimens, and found that the sensitivity, specificity, and accuracy of MPM diagnosis was 96.32%, 96.43%, and 96.34%, respectively. In conclusion, it is feasible to use MPM to diagnose liver cancer and differentiate benign and malignant liver lesions. This preclinical study provides the groundwork for further using multiphoton endoscopy to perform real-time noninvasive ``optical biopsy'' for liver lesions in the near future.

  14. Vacuum-assisted breast biopsy on digital stereotaxic table of nonpalpable lesions non-recognisable by ultrasonography.

    PubMed

    Apesteguía, L; Mellado, M; Sáenz, J; Cordero, J L; Repáraz, B; De Miguel, C

    2002-03-01

    The aim of this study was to evaluate accuracy of 11 G vacuum-assisted percutaneous biopsy (VAPB) carried out on digital stereotaxic table, on breast non-palpable lesions (NPLs), non-visible by US. Prospective study on 132 consecutive NPLs (126 patients) not reliably found by US; 82% showed microcalcifications. Surgical confirmation was obtained in all malignant cases and when VAPB reported atypical lesion (ductal or lobular), radial scar or atypical papillary lesion. All patients with benign results were included in a mammographic follow-up programme. Two cases could not be dealt with due to technical difficulties. One to 26 cylinders were obtained from the remaining 130 NPLs. Sixty-four lesions were surgically confirmed. Forty-six of the 47 malignancies were correctly diagnosed. In one case of a malignant tumour, an atypical lesion was classified with VAPB. All cases of histologically verified lobular carcinoma in situ, atypical ductal or lobular hyperplasia, radial scar or atypical papillary lesion were correctly diagnosed preoperatively. The remaining lesions were benign in VAPB, and after 1 year of follow-up, no false negative has been found. Based on this short-term follow-up, absolute sensitivity was 97.9%, absolute specificity 84.3% and accuracy was 99.2%. For predicting invasion, accuracy was 89.1%. Vacuum-assisted percutaneous biopsy is a very accurate technique for NPLs which are not detectable by US. It can replace approximately 90% of DSB with no important complications, avoiding scars and providing a higher level of comfort.

  15. Surveillance of probably benign (BI-RADS 3) lesions in mammography: what is the right follow-up protocol?

    PubMed

    Buch, Karen A; Qureshi, Muhammad M; Carpentier, Bianca; Cunningham, Deborah A; Stone, Michael; Jaffe, Carl; Quinn, Marie; Gonzalez, Carlos; LaVoye, Justine; Hines, Neely; Bloch, Boris Nicolas

    2015-01-01

    BI-RADS-3 is a category in mammography for probably benign lesions and for which periodic follow-up with repeat imaging is recommended. At our institution repeated mammograms are performed at 6, 12, 18, and 24 months. The purpose of this study was to assess the significance of 18-month mammogram for evaluation of BI-RADS-3 lesions. Following IRB approval, electronic medical records and picture archiving and communications system were used to review 121,862 consecutive mammograms between February, 2002-May, 2009. A total of 8,400 patients with BI-RADS-3 mammograms were identified. Of these, 7,632 patients were followed until completion of 24 month mammogram or biopsy following an upgrade in their BI-RADS status. Over the follow-up, 197 patients received an upgrade in their BI-RADS status of which 179 were biopsied. Histopathologic results were reviewed. The majority of the BI-RADS-3 lesions were upgraded at 6-month mammogram (n = 150, 76.1%) followed by 32 (16.2%), 11 (5.6%), and 4 (2.0%) at 12, 18, and 24 month mammograms respectively. Thirty-four of 179 upgraded and biopsied lesions were found to be malignant. From these 27 (79.4%), 3 (8.8%), 3 (8.8%), and 1 (2.9%) lesions were identified at 6, 12, 18, and 24 month mammograms respectively. At the 18-month mammogram 3/7,632 lesions (0.04%) were found to be malignant. The vast majority of malignant lesions (88.2%) were detected within the first 12-months of follow-up. Only three of 179 biopsies (1.7%) were malignant at 18-month follow-up. Based on those results a 6-, 12-, and 24-month follow-up protocol for BI-RADS-3 lesions is sufficient.

  16. Implementation and analysis of relief patterns of the surface of benign and malignant lesions of the skin by microtopography.

    PubMed

    del Carmen López Pacheco, María; da Cunha Martins-Costa, Manuel Filipe Pereira; Zapata, Aura Judith Pérez; Cherit, Judith Domínguez; Gallegos, Eva Ramón

    2005-12-07

    The objective of this study was to be able to distinguish between healthy skin tissue and malignant ones, furthermore determining a unique pattern of roughness for each skin lesion by microtopographic analysis of the skin surface of Mexican patients during the period from April to October 2002. The standard technique used in this study for the diagnosis of skin cancer and the comparison of the results was the haematoxylin-eosin histopathological technique. Latex impressions were taken from skin lesions as well as from the healthy skin of each patient to serve as control samples. These impressions were analysed by the MICROTOP.03.MFC microtopographic system inspection. It was observed that when the tumour becomes rougher, more malign will be the lesion. On average, the melanoma present an increase of roughness of 67% compared to healthy skin, obtaining a roughness relation of 1:2.54. The percentage decreases to 49% (49%, 1:60) in the case of basal cell carcinoma and to 40% in pre-malignant lesions such as melanocytic nevus (40%, 1:150). In benign lesions such as the seborrhoea keratosis only a small increase in roughness was noted (4%, 1:0.72). Microtopographic inspection of the skin surface can be considered as a complementary diagnostic technique for skin cancer.

  17. Apparent Diffusion Coefficient Measurement in Mediastinal Lymphadenopathies: Differentiation between Benign and Malignant Lesions

    PubMed Central

    Ustabasioglu, Fethi Emre; Samanci, Cesur; Alis, Deniz; Samanci, Nilay Sengul; Kula, Osman; Olgun, Deniz Cebi

    2017-01-01

    Objectives: We aimed to prospectively assess the diagnostic value of apparent diffusion coefficient (ADC) measurement in the differentiation of benign and malignant mediastinal lymphadenopathies. Materials and Methods: The study included 63 consecutive patients (28 women, 35 men; mean age 59.3 years) with 125 mediastinal lymphadenopathies. Echoplanar diffusion-weighted magnetic resonance imaging of the mediastinum was performed with b-factors of 0 and 600 mm2/s before mediastinoscopy and mediastinotomy, and ADC values were measured. The ADC values were compared with the histological results, and statistical analysis was done. P < 0.05 was considered statistically significant. Results: The mean ADC value of malignant mediastinal lymphadenopathy (1.030 ± 0.245 × 10−3 mm2/s) was significantly lower (P < 0.05) when compared to benign lymphadenopathies (1.571 ± 0.559 × 10−3 mm2/s). For differentiating malignant from benign mediastinal lymphadenopathy, the best result was obtained when an ADC value of 1.334 × 10−3 mm2/s was used as a threshold value; area under the curve 0.848, accuracy 78.4%, sensitivity 66%, specificity of 86%, positive predictive value 76.7%, and negative predictive value of 79.2%. Interobserver agreement was excellent for ADC measurements. Conclusions: ADC measurements could be considered an important supportive method in differentiating benign from malignant mediastinal lymphadenopathies.

  18. Can galactography-guided stereotactic, 11-gauge, vacuum-assisted breast biopsy of intraductal lesions serve as an alternative to surgical biopsy?

    PubMed

    Reiner, Caecilia S; Helbich, Thomas H; Rudas, Margaretha; Ponhold, Lothar; Riedl, Christopher C; Kropf, Nina; Fuchsjäger, Michael H

    2009-12-01

    The purpose of this study was to determine the value of galactography-guided, stereotactic, vacuum-assisted breast biopsy (VABB) for the assessment of intraductal breast lesions and its potential as a therapeutic tool that could eliminate the need for surgical excision. Eighteen patients (median age 64 years, range 37-80) with nipple discharge and galactography-verified intraductal lesions underwent galactography-guided, stereotactic, 11-gauge VABB followed by surgery. Histopathology findings from VABB and subsequent surgery were compared. Underestimation and false-negative rates were assessed. After VABB, histopathology revealed invasive ductal carcinoma (IDC) in three (17%), ductal carcinoma in situ (DCIS) in six (33%), high-risk lesions in six (33%) and benign lesions in three (17%) cases. After surgical biopsy, histopathology confirmed the previously established diagnosis in 11 lesions (61%). The underestimation rate for high-risk lesions and DCIS was 50% (6/12). The false-negative rate was 7% (1/14). Histopathology examination after surgery showed that not a single lesion had been completely removed at VABB. Galactography-guided VABB is a feasible diagnostic tool. However, its value as a therapeutic procedure is limited because of the high number of underestimated and missed lesions and because of the histopathological detection of lesions' remnants in every case. Surgical excision should be the therapeutic gold standard in cases of pathological nipple discharge and galactography abnormalities.

  19. Incidentally detected breast lesions on chest CT with US correlation: a pictorial essay

    PubMed Central

    Son, Jung Hee; Jung, Hyun Kyung; Song, Jong Woon; Baek, Hye Jin; Doo, Kyung Won; Kim, Woogyeong; Kim, Yeon Mee; Kim, Woon Won; Lee, Jung Sun; Cho, Een Young

    2016-01-01

    With the increasing use of computed tomography (CT), incidental breast lesions are detected more frequently. When interpreting chest CT findings, it is important for radiologists to carefully review the breast to recognize any abnormal findings that could affect patient management. The purpose of this study is to discuss incidental breast lesions on chest CT with ultrasonography correlation that may be encountered in routine clinical practice. PMID:27707680

  20. Insulin, estrogen, inflammatory markers, and risk of benign proliferative breast disease.

    PubMed

    Catsburg, Chelsea; Gunter, Marc J; Chen, Chu; Cote, Michele L; Kabat, Geoffrey C; Nassir, Rami; Tinker, Lesley; Wactawski-Wende, Jean; Page, David L; Rohan, Thomas E

    2014-06-15

    Women with benign proliferative breast disease (BPBD) are at increased risk for developing breast cancer. Evidence suggests that accumulation of adipose tissue can influence breast cancer development via hyperinsulinemia, increased estrogen, and/or inflammation. However, there are limited data investigating these pathways with respect to risk of BPBD. We evaluated serologic markers from these pathways in a case-control study of postmenopausal women nested within the Women's Health Initiative Clinical Trial. Cases were the 667 women who developed BPBD during follow-up, and they were matched to 1,321 controls. Levels of insulin, estradiol, C-reactive protein (CRP), and adiponectin were measured in fasting serum collected at baseline. Conditional logistic regression models were used to estimate ORs for the association of each factor with BPBD risk. Among nonusers of hormone therapy, fasting serum insulin was associated with a statistically significant increase in risk of BPBD (OR for highest vs. lowest quartile = 1.80; 95% confidence interval, CI, 1.16-2.79; Ptrend = 0.003) as were levels of estradiol (OR for highest vs. lowest tertile = 1.89; 95% CI, 1.26-2.83; Ptrend = 0.02) and CRP (OR for highest vs. lowest quartile = 2.46; 95% CI, 1.59-3.80; Ptrend < 0.001). Baseline adiponectin level was inversely associated with BPBD risk (OR for highest vs. lowest quartile = 0.47; 95% CI, 0.31-0.71; Ptrend < 0.001). These associations persisted after mutual adjustment, but were not observed among users of either estrogen alone or of estrogen plus progestin hormone therapy. Our results indicate that serum levels of estrogen, insulin, CRP, and adiponectin are independent risk factors for BPBD and suggest that the estrogen, insulin, and inflammation pathways are associated with the early stages of breast cancer development.

  1. Adolescent Dietary Vitamin D and Sun Exposure in Relation to Benign Breast Disease

    PubMed Central

    Boeke, Caroline E.; Tamimi, Rulla M.; Berkey, Catherine S.; Colditz, Graham A.; Giovannucci, Edward; Malspeis, Susan; Willett, Walter C.; Frazier, A. Lindsay

    2015-01-01

    Purpose Vitamin D may reduce cell proliferation and tumor growth in breast tissue, and exposure may be most important during adolescence when breast tissue is developing. In the Nurses’ Health Study II, higher recalled adolescent vitamin D intake was associated with a lower risk of benign breast disease (BBD). Our study aim was to assess adolescent vitamin D exposure in relation to BBD in young women. Methods Vitamin D was assessed in 6,593 adolescent girls (9 to 15 years of age at baseline) in the prospective Growing Up Today Study cohort using the mean energy-adjusted intakes from food frequency questionnaires in 1996, 1997, and 1998. In 1999, 5286 girls reported skin color, sunscreen use, tanning bed use, and number of sunburns in the past year, and we used state of residence to assess low vs. high ultraviolet (UV) index. Biopsy-confirmed BBD was reported on questionnaires in 2005, 2007, and 2010 (n=122). Results Dietary vitamin D, tanning behaviors, and other sun exposure variables were not significantly associated with BBD in logistic regression models adjusted for age, family history of breast cancer or BBD, age at menarche, nulliparity, alcohol intake, body mass index, and physical activity. The relative risk for the top (>467 IU/day) vs. bottom (<243 IU/day) quartile of vitamin D intake was 0.76 (95% CI: 0.47, 1.23). Conclusions Sun exposure was not significantly associated with BBD in this prospective cohort study. However, a suggestive inverse association between dietary vitamin D and BBD was observed that merits further study. PMID:26084210

  2. Is there any Correlation between Magnetic Resonance Imaging Features of Breast Lesions of BIRADS Category 4 with Histopathologic Results?

    PubMed Central

    Farghadani, Maryam; Soofi, Ghazale Jamalipoor; Sarrami, Amir Hossein

    2017-01-01

    Background: To evaluate the correlation of magnetic resonance imaging (MRI) features of breast lesions of Breast Imaging Reporting and Database System (BI-RADS) category 4 with histopathologic results. Materials and Methods: In a prospective study between December 2013 and April 2015, patients with suspicious mammographic and/or ultrasound findings referred for Breast MRI were evaluated. Patients with lesions of BI-RADS category 4 were enrolled with a written informed consent. In each patient, mass lesion (ML) or nonmass lesion (NML) was determined, and different characteristics of the lesions were recorded. A follow-up program was taken with mean 3–12 months. Patients who underwent core needle biopsy or open biopsy were summoned. Results: Seventy-eight females aged 24–67 years (mean 43.1 ± 8.8) met the inclusion criteria and had adequate samples for histopathologic study. Twenty-nine (37.2%) patients had ML and 49 (62.8%) patients had NML. Tissue sampling in 63 (80.7%) patients was through core needle biopsy and in 15 (19.2%) patients through surgery. A wide spectrum of benign and malignant pathologic diagnoses was seen. In statistical analysis, none of the MRI features has a significant correlation with any specific histopathologic diagnosis (P = 0.185). However, the relation between the MRI category (ML or NML) and pathology results was significant at level of 0.1 (P = 0.06). Conclusion: This study showed that a wide spectrum of histopathologic results is seen in BI-RADS category 4. However, in this sample volume, none of the MRI features in this BI-RADS category has a significant correlation with any specific histopathologic diagnosis. PMID:28217652

  3. [Effort, accuracy and histology of MR-guided vacuum biopsy of suspicious breast lesions--retrospective evaluation after 389 interventions].

    PubMed

    Fischer, U; Schwethelm, L; Baum, F T; Luftner-Nagel, S; Teubner, J

    2009-08-01

    The aim of this study was to evaluate the effort, accuracy, histological diagnoses and value of MR-guided vacuum biopsy (10-gauge, 9-gauge) as the diagnostic procedure for suspicious breast lesions visible on MRI alone. 389 MR-guided vacuum biopsies of suspicious MRM findings were performed in 365 patients either with a Vacora system (10G, Bard Company) or an ATEC system (9G, Suros Company). The retrospective study included the number of specimens, the table time, the complication rate, and the histopathological results for open biopsy and the findings after follow-up. The study included 341 unilateral unilocular, 12 unilateral bilocular and 12 bilateral unilocular MR-guided vacuum biopsies. In 27 patients (3.9%) the planned intervention was canceled because the lesion could not be reproduced. The average number of specimens was 15.1 (range 4 - 75) with the 10G technique and 14.6 (range 4 - 38) with the 9G technique. The table time was 43.2 min (range 17 - 95 min). Histology revealed concordant benign lesions in 231 cases (59.4%), borderline lesions in 50 cases (12.8%), malignant tumors in 106 cases (DCIS 30 [7.7%], invasive carcinoma 76 [19.5%]), and discordant findings in 2 cases (0.5%). The complication rate was less than 1%. MR-guided vacuum biopsy of the breast is an effective method for the minimally invasive percutaneous evaluation of suspicious breast lesions seen on MRI alone. As a consequence, primary open biopsy can be avoided and the rate of unnecessary surgical interventions reduced. There were no major differences between 10G and 9G vacuum biopsy systems.

  4. Ultrasound-guided vacuum assisted breast biopsy in the assessment of C3 breast lesions by ultrasound-guided fine needle aspiration cytology: results and costs in comparison with surgery.

    PubMed

    Abbate, Francesca; Bacigalupo, Lorenzo; Latronico, Antuono; Trentin, Chiara; Penco, Silvia; Menna, Simona; Viale, Giuseppe; Cassano, Enrico; Bellomi, Massimo

    2009-04-01

    Breast lesions defined C3 at ultrasound (US)-guided fine needle aspiration cytology (FNAC) are probably benign, but exhibit atypias. We evaluate the results of US-guided vacuum assisted breast biopsy (VABB) of these lesions. Patients diagnosed C3 by US-FNAC, submitted to US-VABB and with a minimum follow-up of 36 months or surgery were enrolled. Cost outcome of this diagnostic protocol was evaluated. We evaluated 138 patients with non-palpable C3 lesions. In 2/138 (1.4%) cases VABB results were inadequate. VABB diagnosed: 17/138 (12.3%) malignant and 119/138 (86.2%) benign lesions. In 28/138 cases (20.3%) surgery retrieved 18/28 (64.3%) malignant lesions. One false negative result of VABB was observed. Sensitivity and specificity of VABB resulted 94.4% and 100%. Our diagnostic algorithm estimated a 45% mean decrease of costs using VABB when compared with surgical biopsy of all C3 lesions.

  5. Benign nodal lesions mimicking metastases from pediatric renal neoplasms: a report of the National Wilms' Tumor Study Pathology Center.

    PubMed

    Weeks, D A; Beckwith, J B; Mierau, G W

    1990-12-01

    Regional lymph node status is a key factor in the staging of pediatric renal tumors on the National Wilms' Tumor Study (NWTS). A review of cases entered on the NWTS has uncovered a number of cases where benign lymph node findings were mistaken for metastases. Most frequently, this was due to the presence of complexes of epithelial cells and Tamm-Horsfall protein within nodal sinuses. The epithelial cells were derived from damaged nephrons, usually resulting from obstruction by tumor. Another epithelial pseudometastic lesion, intranodal squamous epithelial cells, was found to originate from metaplastic calyceal urothelium. Benign mesothelial or coelomic inclusions similar to those previously described in pelvic and periaortic lymph nodes of adult females were found in nodes of four patients, including two boys, who are, to our knowledge, the first to be described with this finding. Other sources of confusion included protrusion of lymphoid follicles or germinal centers into nodal sinuses, thick endothelial cells of postcapillary venules mimicking epithelial tubules, nodal megakaryocytes resembling anaplastic nuclear changes, and histiocytic granulomas. Immunocytochemical methods were useful in evaluating some of these phenomena. Recognition of these pseudometastatic lesions is essential in order to avoid unnecessary and potentially hazardous therapeutic intensification.

  6. Benign breast and gynecologic conditions, reproductive and hormonal factors, and risk of thyroid cancer.

    PubMed

    Braganza, Melissa Z; de González, Amy Berrington; Schonfeld, Sara J; Wentzensen, Nicolas; Brenner, Alina V; Kitahara, Cari M

    2014-04-01

    The higher incidence of thyroid cancer in women compared with men suggests an influence of sex steroid hormones in the etiology of this malignancy. We investigated a comprehensive set of potential indicators of lifetime sex steroid hormone exposure in relation to thyroid cancer risk. Using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which enrolled 70,047 women, 50 to 78 years old, we prospectively examined associations of self-reported history of benign breast and gynecologic conditions, reproductive factors, and exogenous sex hormone use with thyroid cancer risk. Multivariable-adjusted HRs and 95% confidence intervals (CI) were calculated in models using age as the time metric. During follow-up (median, 11 years), 127 women were diagnosed with first primary thyroid cancer. Older age at natural menopause (≥55 vs. <50 years; HR, 2.24; 95% CI, 1.20-4.18), greater estimated lifetime number of ovulatory cycles (≥490 vs. <415 cycles; HR, 2.40; 95% CI, 1.33-4.30), greater number of live births (≥5 vs. 1-2; HR, 1.72; 95% CI, 1.05-2.82), and history of uterine fibroids (HR, 1.72; 95% CI, 1.18-2.50) were associated with an increased risk of thyroid cancer. Earlier age at menarche, greater number of reproductive years, history of a tubal ligation, and history of ovarian cysts were nonsignificantly associated with increased thyroid cancer risk. No associations were observed for oral contraceptive use, menopausal hormone therapy, or history of benign breast disease or endometriosis. In general, we found that factors reflecting a greater length of exposure to endogenous hormones, particularly during the reproductive years, were associated with risk of postmenopausal thyroid cancer.

  7. Comparing contrast-enhanced color flow imaging and pathological measures of breast lesion vascularity.

    PubMed

    Forsberg, Flemming; Kuruvilla, Babita; Pascua, Mark B; Chaudhari, Manisha H; Merton, Daniel A; Palazzo, Juan P; Goldberg, Barry B

    2008-09-01

    This study was conducted to compare quantifiable measures of vascularity obtained from contrast-enhanced color flow images of breast lesions to pathologic vascularity measurements. Nineteen patients with solid breast masses received Levovist Injection (10 mL at 300 mg/mL; Berlex Laboratories, Montville, NJ, USA). Color flow images of the mass pre and post contrast were obtained using an HDI 3000 scanner (Philips Medical Systems, Bothell, WA, USA) optimized for clinical scanning on an individual basis. After surgical removal, specimens were sectioned in the same planes as the ultrasound images and stained with an endothelial cell marker (CD31). Microvessel area (MVA) and intratumoral microvessel density (MVD) were determined for vessels 10-19 microm, 20-29 microm, 30-39 microm, 40-49 microm and > or =50 microm in diameter using a microscope and image processing software. From the ultrasound images, the number of color pixels before and after contrast administration relative to the total area of the breast mass was calculated as a first-order measure of fractional tumor vascularity. Vascularity measures were compared using reverse stepwise multiple linear regression analysis. In total, 58 pathology slides (with 8,106 frames) and 185 ultrasound images were analyzed. There was a significant increase in flow visualization pre to post Levovist injection (p = 0.001), but no differences were found between the 11 benign and the eight malignant lesions (p > 0.35). Ultrasound vascularity measurements post contrast correlated significantly with pathology (0.15 < or = r2 < or = 0.46; p < 0.03). The 30-39 microm vessel range contributed most significantly to the MVD relationship (p < 0.001), whereas the MVA was mainly influenced by vessels 20-29 microm (p < 0.004). Precontrast ultrasound only correlated with pathology for relative MVA (r2 = 0.16; p = 0.01). In conclusion, contrast-enhanced color flow imaging provides a noninvasive measure of breast tumor neovascularity

  8. Nurse practitioner-staffed clinic at Virginia Mason improves care and lowers costs for women with benign breast conditions.

    PubMed

    Blackmore, C Craig; Edwards, Jordan W; Searles, Carly; Wechter, Debra; Mecklenburg, Robert; Kaplan, Gary S

    2013-01-01

    The implementation of a breast clinic based on the use of an advanced registered nurse practitioner at Virginia Mason Medical Center in Seattle, Washington, substantially improved care timeliness and efficiency for women with symptomatic benign breast conditions. Women received their final benign diagnosis in an average of four rather than sixteen days, with fewer imaging studies and physician visits, when compared to a control group. Savings to the employer were estimated at $316 per woman, primarily from increased work productivity. Direct care costs decreased an estimated 19 percent, to $213 per woman. By decreasing both direct medical costs and indirect costs such as work absenteeism and presenteeism, the Virginia Mason Breast Clinic has created substantial savings for providers and employers while delivering care that patients rate highly. This model demonstrates the feasibility of achieving higher quality at lower cost through integrated care.

  9. Male breast cancer precursor lesions: analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.

    PubMed

    Doebar, Shusma C; Slaets, Leen; Cardoso, Fatima; Giordano, Sharon H; Bartlett, John Ms; Tryfonidis, Konstantinos; Dijkstra, Nizet H; Schröder, Caroline P; van Asperen, Christi J; Linderholm, Barbro; Benstead, Kim; Dinjens, Winan Nm; van Marion, Ronald; van Diest, Paul J; Martens, John Wm; van Deurzen, Carolien Hm

    2017-04-01

    In men, data regarding breast cancer carcinogenesis are limited. The aim of our study was to describe the presence of precursor lesions adjacent to invasive male breast cancer, in order to increase our understanding of carcinogenesis in these patients. Central pathology review was performed for 1328 male breast cancer patients, registered in the retrospective joint analysis of the International Male Breast Cancer Program, which included the presence and type of breast cancer precursor lesions. In a subset, invasive breast cancer was compared with the adjacent precursor lesion by immunohistochemistry (n=83) or targeted next generation sequencing (n=7). Additionally, we correlated the presence of ductal carcinoma in situ with outcome. A substantial proportion (46.2%) of patients with invasive breast cancer also had an adjacent precursor lesion, mainly ductal carcinoma in situ (97.9%). The presence of lobular carcinoma in situ and columnar cell-like lesions were very low (<1%). In the subset of invasive breast cancer cases with adjacent ductal carcinoma in situ (n=83), a complete concordance was observed between the estrogen receptor, progesterone receptor, and HER2 status of both components. Next generation sequencing on a subset of cases with invasive breast cancer and adjacent ductal carcinoma in situ (n=4) showed identical genomic aberrations, including PIK3CA, GATA3, TP53, and MAP2K4 mutations. Next generation sequencing on a subset of cases with invasive breast cancer and an adjacent columnar cell-like lesion showed genomic concordance in two out of three patients. A multivariate Cox model for survival showed a trend that the presence of ductal carcinoma in situ was associated with a better overall survival, in particular in the Luminal B HER2+ subgroup. In conclusion, ductal carcinoma in situ is the most commonly observed precursor lesion in male breast cancer and its presence seems to be associated with a better outcome, in particular in Luminal B HER2+ cases

  10. An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease.

    PubMed

    Keyzer-Dekker, C M G; van Esch, L; de Vries, J; Ernst, M F; Nieuwenhuijzen, G A P; Roukema, J A; van der Steeg, A F W

    2012-07-01

    Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to women referred after ASM. In addition, the influence of the anxiety as a personality characteristic (trait anxiety) was studied. Between September 2002 and February 2010 we performed a prospective longitudinal study in six Dutch hospitals. Women referred after ASM or with a palpable lump in the breast (PL), who were subsequently diagnosed with BBD, were included. Before diagnosis (at referral) and during follow-up, questionnaires were completed examining trait anxiety (at referral), state anxiety, depressive symptoms (at referral, one, three and 6 months after diagnosis), and QoL (at referral and 12 months). Women referred after ASM (N=363) were compared with women with PL (N=401). A similar state anxiety score was found in both groups, but a lower psychological QoL score at 12 months was seen in the ASM group. In women with not-high trait anxiety those in the ASM group were more anxious with more depressive symptoms at referral, and reported impaired psychological QoL at referral and at 12 months compared with the PL group. No differences were found between ASM and PL in women with high trait anxiety, but this group scored unfavorably on anxiety, depressive symptoms and QoL compared with women with not-high trait anxiety. ASM evokes more anxiety and depressive symptoms and lowered QoL compared with women referred with PL, especially in women who are not prone to anxiety. Women should be fully informed properly about the risks and benefits of breast cancer screening programs. We recommend identifying women at risk of reduced QoL using a psychometric test.

  11. Radio-guided localization of clinically occult breast lesions: current modalities and future directions.

    PubMed

    Aydogan, Fatih; Velidedeoglu, Mehmet; Kilic, Fahrettin; Yilmaz, Halit

    2014-01-01

    The extensive availability of breast cancer screening programs and improvement in diagnostic imaging have led to more frequent detection of suspicious and clinically occult breast lesions. Early detection of tumor is important for breast-conserving treatment. Incomplete excision is a major risk factor for local recurrence. Following precise localization and removing the entire lesion while achieving adequate clear margins is the key factor for successful management of non-palpable breast lesions. For this purpose, several techniques such as wire-guided localization, intra-operative ultrasound guided resection, radio-guided occult lesion localization and radioactive seed localization have been described and applied. In this article, we overview the two commonly used localization techniques, radio-guided occult lesion localization and wire-guided localization, particularly describing their advantages and drawbacks.

  12. State of the art, nomenclature, and points of consensus and controversy concerning benign melanocytic lesions: outcome of an international workshop.

    PubMed

    Barnhill, Raymond L; Cerroni, Lorenzo; Cook, Martin; Elder, David E; Kerl, Helmut; LeBoit, Philip E; McCarthy, Stanley W; Mihm, Martin C; Mooi, Wolter J; Piepkorn, Michael W; Prieto, Victor G; Scolyer, Richard A

    2010-03-01

    The following communication summarizes the proceedings of a one-day International Workshop focusing on the histology of benign melanocytic nevi. Areas of controversy identified in 6 focus sessions were the nomenclature and relationships among common nevi including nevi with halo reactions, traumatized nevi, "dysplastic" nevi, and nevi from particular anatomic sites; developmental biology and frequency of malignant transformation associated with congenital nevi; the characterization and biologic nature of atypical spitzoid neoplasms; the basic definition of particular melanocytic cellular phenotypes, and the nomenclature and biologic nature of many candidate blue nevi, combined nevi, and other controversial lesions such as deep penetrating nevus and pigmented epithelioid melanocytoma. Concentrated data collection and follow-up, molecular characterization, and future consensus Workshops may facilitate the resolution of some of these problems. The Group recommended the description of ambiguous or "borderline" lesions as tumors with indeterminate or uncertain biologic/malignant potential. The participants also advised that such lesions at a minimum should be managed by complete excision with clear surgical margins.

  13. Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures

    PubMed Central

    Kurt, Mevlut; Onal, Ibrahim Koral; Akdogan, Meral; Kekilli, Murat; Arhan, Mehmet; Sayilir, Abdurrahim; Oztas, Erkin; Haznedaroglu, Ibrahim Celalettin

    2010-01-01

    OBJECTIVE: To assess the hemostatic efficacy of the Ankaferd Blood Stopper (ABS, Ankaferd Health Products Ltd, Turkey) hemostatic agent for controlling gastrointestinal bleeding associated with various benign lesions refractory to conventional antihemorrhagic measures. METHODS: The records of all patients who underwent upper and lower endoscopy procedures at the Turkiye Yuksek Ihtisas Teaching and Research Hospital (Ankara, Turkey) between April 2008 and June 2009 were reviewed. Patients in whom ABS was used as a primary or adjuvant hemostatic agent were included in the study. Rates of bleeding control and postprocedural complications were documented. RESULTS: Hemostasis with no immediate complications was achieved in all patients within seconds of endoscopic application of ABS. CONCLUSIONS: ABS may have a role as a primary treatment or as an adjuvant to conventional modalities used to control gastrointestinal bleeding. Prospective controlled studies are needed to help establish its efficacy and, perhaps, offer a comparison with conventional hemostatic interventions. PMID:20559581

  14. Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

    PubMed Central

    Peters, Nicky HGM; Borel Rinkes, Inne HM; Mali, Willem PTM; van den Bosch, Maurice AAJ; Storm, Remmert K; Plaisier, Peter W; de Boer, Erwin; van Overbeeke, Adriaan J; Peeters, Petra HM

    2007-01-01

    Background In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. Methods/Design The MONET – study (MR mammography Of Nonpalpable BrEast Tumors) is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%). The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. Trial registration Study protocol number NCT00302120 PMID:18045470

  15. Computerized Segmentation and Characterization of Breast Lesions in Dynamic Contrast-Enhanced MR Images Using Fuzzy c-Means Clustering and Snake Algorithm

    PubMed Central

    Pang, Yachun; Li, Li; Hu, Wenyong; Peng, Yanxia; Liu, Lizhi; Shao, Yuanzhi

    2012-01-01

    This paper presents a novel two-step approach that incorporates fuzzy c-means (FCMs) clustering and gradient vector flow (GVF) snake algorithm for lesions contour segmentation on breast magnetic resonance imaging (BMRI). Manual delineation of the lesions by expert MR radiologists was taken as a reference standard in evaluating the computerized segmentation approach. The proposed algorithm was also compared with the FCMs clustering based method. With a database of 60 mass-like lesions (22 benign and 38 malignant cases), the proposed method demonstrated sufficiently good segmentation performance. The morphological and texture features were extracted and used to classify the benign and malignant lesions based on the proposed computerized segmentation contour and radiologists' delineation, respectively. Features extracted by the computerized characterization method were employed to differentiate the lesions with an area under the receiver-operating characteristic curve (AUC) of 0.968, in comparison with an AUC of 0.914 based on the features extracted from radiologists' delineation. The proposed method in current study can assist radiologists to delineate and characterize BMRI lesion, such as quantifying morphological and texture features and improving the objectivity and efficiency of BMRI interpretation with a certain clinical value. PMID:22952558

  16. 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

  17. Dairy intakes in older girls and risk of benign breast disease in young women.

    PubMed

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

    2013-04-01

    Previous investigations found high dairy intakes in girls associated with rapid height growth and excess weight gain, which had opposite relationships with benign breast disease (BBD) in young women. We use data from the longitudinal Growing Up Today Study (GUTS) to investigate whether dairy intakes, in older children/adolescents, are associated with BBD risk in young women. GUTS includes 9,039 females, ages 9-15 years in 1996, who completed questionnaires annually through 2001, then in 2003, 2005, 2007, and 2010. Dietary food frequencies (1996-2001) obtained milk, yogurt, and cheese intakes. On 2005-2010 surveys, 7,011 females (18-29 years) reported whether a health care provider ever diagnosed them with BBD (n = 250) and if confirmed by breast biopsy (n = 105). Logistic regression models estimated associations between prevalent biopsy-confirmed BBD and dairy intakes, adjusted for age and energy. Multivariable-adjusted models additionally included menarche age, childhood adiposity, adolescent alcohol consumption, and pregnancy. Further analyses stratified by family history. Age-energy-adjusted models of dairy (milk, yogurt, cheese, total dairy servings, dairy protein, dairy fat) intakes at 14 yr found no significant associations with BBD risk [milk: OR, 0.90/(serving/d); 95% confidence interval (CI), 0.76-1.05; dairy protein: OR, 0.98/(10 g/d); 95% CI, 0.82-1.17). Separate analyses of dairy intakes at 10 yr, intakes before the growth spurt, during the growth spurt, before menses-onset, and after menses-onset provided no significant associations with BBD. Multivariable adjustment, and family history stratification, did not alter the above findings. We conclude that dairy intakes by older girls have no strong relation with BBD risk in young women. Because of small number of cases, it is important to continue follow-up and re-examine later.

  18. 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

  19. Information gaps for patients requiring craniotomy for benign brain lesion: a qualitative study.

    PubMed

    Rozmovits, Linda; Khu, Kathleen Joy; Osman, Soha; Gentili, Fred; Guha, Abhijit; Bernstein, Mark

    2010-01-01

    Doctor-patient communication in the setting of a life-threatening illness poses considerable challenges. This study aimed to determine the information needs of a subset of neurosurgical patients. Qualitative case study methodology was used. Twenty-five semi-structured interviews were conducted with ambulatory adult patients who had undergone surgery for a benign brain tumor, arteriovenous malformation, or unruptured aneurysm. Interviews were digitally audio recorded and transcribed, and the data subjected to thematic analysis. Six overarching themes emerged from the data: (1) the amount of information patients want varies; (2) the type of information needed is not limited to information about treatment options and risks; (3) patients engage in independent information seeking for a variety of reasons; (4) patients consider compassion from their surgeon as important; (5) direct communication with the surgeon post-operatively is very important; and (6) patients' information needs are greatest post-operatively. Many patients felt that the amount and quality of information they received was not sufficient, particularly regarding post-operative recovery and long-term life issues, leading many to do their own research. The findings from this study emphasize the need for improved communication with patients so they can participate meaningfully in choices about their treatment, give a truly informed consent, and effectively participate in their own recovery.

  20. Analysis of 3D Subharmonic Ultrasound Signals from Patients with Known Breast Masses for Lesion Differentiation

    DTIC Science & Technology

    2012-10-01

    AD_____________ Award Number: W81XWH-11-1-0630 TITLE: Analysis of 3D Subharmonic Ultrasound Signals from Patients with Known Breast... Ultrasound Signals from Patients with Known Breast Masses for Lesion Differentiation 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0630 5c...videos were obtained as part of a larger NIH funded clinical trial. The research 15. SUBJECT TERMS Breast Cancer, Ultrasound Imaging, Ultrasound

  1. Differentiation of Benign Pigmented Skin Lesions with the Aid of Computer Image Analysis: A Novel Approach

    PubMed Central

    Choi, Jae Woo; Park, Young Woon; Byun, Sang Young

    2013-01-01

    Background The differential diagnosis of common pigmented skin lesions is important in cosmetic dermatology. The computer aided image analysis would be a potent ancillary diagnostic tool when patients are hesitant to undergo a skin biopsy. Objective We investigated the numerical parameters discriminating each pigmented skin lesion from another with statistical significance. Methods For each of the five magnified digital images containing clinically diagnosed nevus, lentigo and seborrheic keratosis, a total of 23 parameters describing the morphological, color, texture and topological features were calculated with the aid of a self-developed image analysis software. A novel concept of concentricity was proposed, which represents how closely the color segmentation resembles a concentric circle. Results Morphologically, seborrheic keratosis was bigger and spikier than nevus and lentigo. The color histogram revealed that nevus was the darkest and had the widest variation in tone. In the aspect of texture, the surface of the nevus showed the highest contrast and correlation. Finally, the color segmented pattern of the nevus and lentigo was far more concentric than that of seborrheic keratosis. Conclusion We found that the subtle distinctions between nevus, lentigo and seborrheic keratosis, which are likely to be unrecognized by ocular inspection, are well emphasized and detected with the aid of software. PMID:24003278

  2. Glucose transporter-1 (GLUT-1) immunoreactivity in benign, premalignant and malignant lesions of the gallbladder.

    PubMed

    Legan, Mateja; Tevžič, Spela; Tolar, Ana; Luzar, Boštjan; Marolt, Vera Ferlan

    2011-03-01

    GLUT-1 is a transmembrane glucose transport protein that allows the facilitated transport of glucose into cells, normally expressed in tissues which depend mainly on glucose metabolism. Enhanced expression of GLUT-1 can also be found in a large spectrum of carcinomas. This study aimed to investigate GLUT-1 expression in gallbladder tissue: from normal tissue samples, hyperplasias, low-grade and high-grade dysplasias to gallbladder carcinomas. In all, 115 archived samples of gallbladder tissue from 68 patients, presented after cholecystectomy, were immunohistochemically stained for GLUT-1. According to the intensity of GLUT-1 immunoreactivity, samples were divided into negative (stained 0-10% of cells stained), positive with weak to moderate (10-50%) and positive with strong (>50%) GLUT-1 expression. The GLUT-1 immunoreactivity of the samples showed a characteristic increase from premalignant lesions to carcinomas. Normal gallbladder tissue samples did not express GLUT-1 (100%). Weak expression was shown only focally in hyperplasias, but to a greater extent with low-grade dysplasias (20%), high-grade dysplasias (40%) and carcinomas (51.8%). Normal gallbladder tissue is GLUT-1 negative. GLUT-1 expression in carcinoma tissue is significantly higher than in dysplastic lesions. Strong GLUT-1 expression indicates 100% specificity for detecting gallbladder carcinomas. Therefore, GLUT-1 is a candidate as a diagnostic as well as a tissue prognostic marker in gallbladder carcinoma patients.

  3. Excision of Nonpalpable Breast Cancer with Indocyanine Green Fluorescence-Guided Occult Lesion Localization (IFOLL).

    PubMed

    Aydogan, Fatih; Ozben, Volkan; Aytac, Erman; Yilmaz, Halit; Cercel, Ali; Celik, Varol

    2012-02-01

    BACKGROUND: Currently employed techniques for the localization of nonpalpable breast lesions suffer from various limitations. In this paper, we report on 2 patients in order to introduce an alternative technique, indocyanine green fluorescence-guided occult lesion localization (IFOLL), and determine its applicability for the surgical removal of this type of breast lesions. CASE REPORTS: Preoperatively, one of the patients had a needle biopsy-proven diagnosis of breast cancer, and the other one had suspicious findings for malignancy. Lesion localization was performed within 1 h before surgery under ultrasonography control by injecting 2 ml and 0.2 ml of indocyanine green into the lesion and its subcutaneous tissue projection, respectively. During surgery, the site of skin incision and the resection margins were identified by observing the area of indocyanine-derived fluorescence under the guidance of a near-infrared-sensitive camera. In both cases, the breast lesion was correctly localized, and the area of fluorescence corresponded well to the site of the lesions. Subsequent surgical excision was successful with no complications. On histopathologic examination, the surgical margins were found to be clear. CONCLUSION: IFOLL seems to be a technically applicable and clinically acceptable procedure for the removal of nonpalpable breast cancer.

  4. 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

  5. Nodal combined blue nevus and benign nevus cells in multiple axillary sentinel nodes in a patient with breast carcinoma: report of a case.

    PubMed

    Begum, S M K Nahar; Lomme, Michele; Quddus, M Ruhul

    2014-09-01

    Combined blue nevus and benign nevus cells were identified in the same sentinel lymph node. Blue nevus alone was also present in an additional sentinel lymph node in the same axilla in a patient who underwent needle localization, wide local excision, and sentinel lymph node biopsy for her pT1cN1mi(sn)M(na) invasive duct carcinoma of the breast. Of the 4 sentinel lymph nodes, 1 showed micrometastasis and 2 other lymph nodes showed blue nevus involving the capsule and trabeculae of the nodes. The patient had no significant previous clinical history of any skin tumors and had a negative clinical examination for malignant melanoma or pigmented skin lesions after the diagnosis of nodal blue nevus. To our knowledge, this is the first case report of combined blue nevi involving multiple sentinel lymph nodes in the same axilla. An equally interesting finding is the presence of benign nonpigmented nevus cells in continuation with the blue nevus in the same node.

  6. Classification of breast mass lesions using model-based analysis of the characteristic kinetic curve derived from fuzzy c-means clustering.

    PubMed

    Chang, Yeun-Chung; Huang, Yan-Hao; Huang, Chiun-Sheng; Chang, Pei-Kang; Chen, Jeon-Hor; Chang, Ruey-Feng

    2012-04-01

    The purpose of this study is to evaluate the diagnostic efficacy of the representative characteristic kinetic curve of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) extracted by fuzzy c-means (FCM) clustering for the discrimination of benign and malignant breast tumors using a novel computer-aided diagnosis (CAD) system. About the research data set, DCE-MRIs of 132 solid breast masses with definite histopathologic diagnosis (63 benign and 69 malignant) were used in this study. At first, the tumor region was automatically segmented using the region growing method based on the integrated color map formed by the combination of kinetic and area under curve color map. Then, the FCM clustering was used to identify the time-signal curve with the larger initial enhancement inside the segmented region as the representative kinetic curve, and then the parameters of the Tofts pharmacokinetic model for the representative kinetic curve were compared with conventional curve analysis (maximal enhancement, time to peak, uptake rate and washout rate) for each mass. The results were analyzed with a receiver operating characteristic curve and Student's t test to evaluate the classification performance. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the combined model-based parameters of the extracted kinetic curve from FCM clustering were 86.36% (114/132), 85.51% (59/69), 87.30% (55/63), 88.06% (59/67) and 84.62% (55/65), better than those from a conventional curve analysis. The A(Z) value was 0.9154 for Tofts model-based parametric features, better than that for conventional curve analysis (0.8673), for discriminating malignant and benign lesions. In conclusion, model-based analysis of the characteristic kinetic curve of breast mass derived from FCM clustering provides effective lesion classification. This approach has potential in the development of a CAD system for DCE breast MRI.

  7. Benign breast changes and the risk for subsequent breast cancer: an update of the 1985 consensus statement. Cancer Committee of the College of American Pathologists.

    PubMed

    Fitzgibbons, P L; Henson, D E; Hutter, R V

    1998-12-01

    The Cancer Committee of the College of American Pathologists has prepared an update of the consensus statement on premalignant breast lesions and breast cancer risk that was originally published in the Archives of Pathology & Laboratory Medicine in 1986. The objective of this publication is to better define the relative breast cancer risk associated with specific histologic abnormalities by incorporating data derived from recent case-control studies. Explanatory notes are used to document and explain specific risk classifications. In addition to refining the degree of risk associated with individual lesions, such as fibroadenoma and atypical hyperplasia, this update includes a discussion of age-specific breast cancer risk and provides examples that can be used when counseling patients.

  8. 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.

  9. 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

  10. Classification of Benign and Malignant Breast Tumors in Ultrasound Images with Posterior Acoustic Shadowing Using Half-Contour Features.

    PubMed

    Zhou, Zhuhuang; Wu, Shuicai; Chang, King-Jen; Chen, Wei-Ren; Chen, Yung-Sheng; Kuo, Wen-Hung; Lin, Chung-Chih; Tsui, Po-Hsiang

    Posterior acoustic shadowing (PAS) can bias breast tumor segmentation and classification in ultrasound images. In this paper, half-contour features are proposed to classify benign and malignant breast tumors with PAS, considering the fact that the upper half of the tumor contour is less affected by PAS. Adaptive thresholding and disk expansion are employed to detect tumor contours. Based on the detected full contour, the upper half contour is extracted. For breast tumor classification, six quantitative feature parameters are analyzed for both full contours and half contours, including standard deviation of degree (SDD), which is proposed to describe tumor irregularity. Fifty clinical cases (40 with PAS and 10 without PAS) were used. Tumor circularity (TC) and SDD were both effective full- and half-contour parameters in classifying images without PAS. Half-contour TC [74 % accuracy, 72 % sensitivity, 76 % specificity, 0.78 area under the receiver operating characteristic curve (AUC), p > 0.05] significantly improved the classification of breast tumors with PAS compared to that with full-contour TC (54 % accuracy, 56 % sensitivity, 52 % specificity, 0.52 AUC, p > 0.05). Half-contour SDD (72 % accuracy, 76 % sensitivity, 68 % specificity, 0.81 AUC, p < 0.05) improved the classification of breast tumors with PAS compared to that with full-contour SDD (62 % accuracy, 80 % sensitivity, 44 % specificity, 0.61 AUC, p > 0.05). The proposed half-contour TC and SDD may be useful in classifying benign and malignant breast tumors in ultrasound images affected by PAS.

  11. 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. PMID:27630851

  12. 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).

  13. [Functional dysphonia and benign vocal cord lesions in professional voice users].

    PubMed

    de Las Casas Battifora, Rosa Maria; Ramada Rodillac, José Maria

    2012-01-01

    Objetivo: Examinar la frecuencia con que se presentan lesiones orgánicas benignas de las cuerdas vocales (LOB-CV) entre los pacientes diagnosticados de disfonía funcional (DF) y explorar sus asociaciones con el desempeño de un trabajo como usuario profesional de la voz (UPV). Métodos: Estudio realizado en una serie de 132 pacientes diagnosticados de DF. Las LOB-CV se objetivaron mediante fibrolaringoscopia. Se documentaron la ocupación, variables sociodemográficas y factores de riesgo no ocupacionales. Se realizó un análisis descriptivo de la muestra, que se estratificó por las variables de exposición laboral (UPV y no-UPV) y por sexo. Se exploraron las asociaciones bivariadas entre la presencia de LOB-VC y el resto de variables. Se utilizó el paquete estadístico SPSS versión 15. Resultados: Los pacientes fueron principalmente mujeres (58,3%), con una edad media de 48 años (DE±13). Un 40% eran usuarios profesionales de la voz (UPV). El 47% presentaron alguna LOB-CV, siendo la más prevalente los pólipos/nódulos (29%). Los UPV con disfonía funcional presentaron mayor prevalencia de LOB-CV (57%) frente a los no-UPV (40%). Ser UPV se asoció a mayor riesgo de padecer LOB-CV (odds ratio de prevalencia cruda, ORPc=1,48; IC95%=0,74- 2,98), principalmente pólipos/nódulos (ORPc=1,77; IC95%=0,82-3,78) y laringitis crónica (ORPc= 2,31; IC95%=0,37- 14,32), aunque sin alcanzar significación estadística. Fumar se asocio significativamente a mayor riesgo de presentar pólipos/nódulos en todos los pacientes (ORPc=2,95; IC95%=1,33-6,53). Conclusiones: Ser trabajador UPV se asoció a un mayor riesgo de LOB-CV, principalmente pólipos/nódulos de las cuerdas vocales y laringitis crónica. Los servicios de prevención deberían evaluar este riesgo laboral siempre que la voz sea una herramienta de trabajo primaria, con el fin de poder establecer medidas preventivas precoces.

  14. Lower extremity deep venous thrombosis with fatal pulmonary thromboembolism caused by benign pelvic space-occupying lesions--an overview.

    PubMed

    Rosenfeld, Hannah; Byard, Roger W

    2012-05-01

    Venous stasis predisposes to thrombosis. One hundred and sixty cases of fatal pulmonary thromboembolism were reviewed to determine how many cases had deep venous thromboses associated with venous blood flow reduction caused by external pressure from benign pelvic masses. Three cases were identified, representing 2% of cases overall (3/160): a 44-year-old woman with a large uterine leiomyoma (1048 g); a 74-year-old man with prostatomegaly and bladder distension (containing 1 L of urine); and a 70-year-old man with prostatomegaly and bladder distension (containing 3 L of urine). Although a rare cause of fatal deep venous thrombosis and pulmonary thromboembolism, space-occupying pelvic lesions can lead to extrinsic pressure on adjacent veins reducing blood flow and causing stasis and thrombosis. Individuals with large pelvic masses may, therefore, be at increased risk of pulmonary thromboembolism from deep venous thrombosis, particularly in the presence of concurrent risk factors such as immobility, thrombophilias, malignancy, and significant cardiopulmonary disease.

  15. The diagnosis and management of pre-invasive breast disease: Promise of new technologies in understanding pre-invasive breast lesions

    PubMed Central

    Jeffrey, Stefanie S; Pollack, Jonathan R

    2003-01-01

    Array-based comparative genomic hybridization, RNA expression profiling, and proteomic analyses are new molecular technologies used to study breast cancer. Invasive breast cancers were originally evaluated because they provided ample quantities of DNA, RNA, and protein. The application of these technologies to pre-invasive breast lesions is discussed, including methods that facilitate their implementation. Data indicate that atypical ductal hyperplasia and ductal carcinoma in situ are precursor lesions molecularly similar to adjacent invasive breast cancer. It is expected that molecular technologies will identify breast tissue at risk for the development of unfavorable subtypes of invasive breast cancer and reveal strategies for targeted chemoprevention or eradication. PMID:14580250

  16. 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

  17. 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

  18. 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.

  19. 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

    semi-empirical and rigorous mathematical methods for data analysis and image reconstruction, and by technical improvements to instrumentation. Throughout the project, developments in technology and methodology were assessed through appropriate evaluation on human subjects. The nine project partners also applied different measurement techniques to a concerted effort to reliably measure the scattering and absorption properties of normal breast tissue, benign lesions and tumours at various near-infrared wavelengths in vivo non-invasively, during breast surgery, and ex vivo on tissue specimens and biopsy samples. In May 2004, on the successful completion of the OPTIMAMM project, a European workshop entitled `Applied Medical Photonics: from Tissue Characterization to Optical Mammography' was held in Berlin, jointly organized by the OPTIMAMM consortium and by another consortium representing the European network on `Medical Photonics'. At this meeting, all the the OPTIMAMM partners presented summaries of their results obtained during the lifetime of the project. Subsequently, the ten collaborating research groups have prepared a series of papers which focus on the specific results of the consortia and review its overall achievements. This special issue of Physics in Medicine and Biology presents these ten papers (pages 2429-2596), which have been accepted for publication following the usual thorough peer-review process for this journal. The first four papers describe the results of the two parallel clinical assessments of scanning time-domain optical mammography, involving a combined total of about 350 patients. These include descriptions of technical developments and the results of efforts to determine the optical properties of benign lesions and carcinomas. The first two contributions summarize the work performed by collaborating groups based in Berlin. A scanning laser pulse optical mammograph, which records craniocaudal and mediolateral projection images of the compressed

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

    PubMed

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

    2015-08-28

    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.

  2. 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.

  3. Distinguishing Benign from Malignant Pancreatic and Periampullary Lesions Using Combined Use of 1H-NMR Spectroscopy and Gas Chromatography–Mass Spectrometry

    PubMed Central

    McConnell, Yarrow J.; Farshidfar, Farshad; Weljie, Aalim M.; Kopciuk, Karen A.; Dixon, Elijah; Ball, Chad G.; Sutherland, Francis R.; Vogel, Hans J.; Bathe, Oliver F.

    2017-01-01

    Previous work demonstrated that serum metabolomics can distinguish pancreatic cancer from benign disease. However, in the clinic, non-pancreatic periampullary cancers are difficult to distinguish from pancreatic cancer. Therefore, to test the clinical utility of this technology, we determined whether any pancreatic and periampullary adenocarcinoma could be distinguished from benign masses and biliary strictures. Sera from 157 patients with malignant and benign pancreatic and periampullary lesions were analyzed using proton nuclear magnetic resonance (1H-NMR) spectroscopy and gas chromatography–mass spectrometry (GC-MS). Multivariate projection modeling using SIMCA-P+ software in training datasets (n = 80) was used to generate the best models to differentiate disease states. Models were validated in test datasets (n = 77). The final 1H-NMR spectroscopy and GC-MS metabolomic profiles consisted of 14 and 18 compounds, with AUROC values of 0.74 (SE 0.06) and 0.62 (SE 0.08), respectively. The combination of 1H-NMR spectroscopy and GC-MS metabolites did not substantially improve this performance (AUROC 0.66, SE 0.08). In patients with adenocarcinoma, glutamate levels were consistently higher, while glutamine and alanine levels were consistently lower. Pancreatic and periampullary adenocarcinomas can be distinguished from benign lesions. To further enhance the discriminatory power of metabolomics in this setting, it will be important to identify the metabolomic changes that characterize each of the subclasses of this heterogeneous group of cancers. PMID:28098776

  4. A quantitative evaluation of diffusion-weighted MR imaging of focal hepatic lesions by using an optimal b-value for differentiation of malignant and benign tumors

    NASA Astrophysics Data System (ADS)

    Lee, Jae-Seung; Im, In-Chul; Kang, Su-Man; Goo, Eun-Hoe; Kim, Kwang

    2013-12-01

    In this study, we aimed to determine an optimized b-value for the characterization of focal hepatic lesions (malignant and benign tumors) and to perform a quantitative analysis of the results. To achieve this, we obtained diffusion-weighted images (DWIs) from 30 focal hepatic disease patients (liver metastasis: 20 patients, and liver hemangioma: 10 patients) by using a 1.5 T MR system and varying the b-value from 0 through 200. The experimental results revealed that at a b-value of 50, the DWIs of the lesions showed high signal-to-noise ratios (SNRs; SN R liver_meta . = 229.83 ± 19.08, SNR liver_hema . = 241.66 ± 29.02), high contrast-to-noise ratios (CNRs; CN R liver_meta . = 39.66 ± 3.87, C N R liver_hema . = 142.55 ± 12.97) and low signal intensities of the apparent diffusion coefficients (ADCs; ADC liver_meta . = 1.40 × 10-3 ± 0.29, ADC liver_hema . = 2.55 × 10-3 ± 0.92). The focal hepatic lesions were clearly depicted, with DW images and ADC maps corresponding well. Thus, we could present an optimized b-value ( b = 50) for the characterization of focal hepatic lesions. Additionally, the ADC values of liver lesions were found to be useful in differentiating benign from malignant tumors.

  5. [Fine-needle biopsy under echographic control in nonpalpable breast lesions. Technical aspects].

    PubMed

    Klijanienko, J; Vielh, P

    1998-01-01

    Fine-needle biopsy under ultrasound guidance is widely used in the diagnosis of subclinical breast lesions seen on mammograms. This minimally invasive procedure requires little time and is reliable for the diagnosis of lesions in a central or peripheral (axillary extension, upper part of the superomedial quadrant, mammary fold) location, or in small-sized breasts. The procedure is done in real time, allowing reliable verification of the specimen. The cytologic results are available almost immediately. Close collaboration between the radiologist and pathologist is essential.

  6. Innovation in early breast cancer surgery: radio-guided occult lesion localization and sentinel node biopsy.

    PubMed

    Paganelli, G; Veronesi, U

    2002-07-01

    The surgical management of non-palpable breast lesions remains controversial. At the European Institute of Oncology we have introduced a new technique, radio-guided occult lesion localization (ROLL) to replace standard methods and overcome their disadvantages. Regarding axillary dissection, probe-guided biopsy of the sentinel node (SN) is easy to apply, and the whole procedure is associated to a low risk of false negatives. We suggest that the SN technique should be widely adopted to stage the axilla in patients with breast cancer with clinically negative lymph nodes. Large-scale implementation of the sentinel node technique will reduce the cost of treatment as a result of shorter hospitalization times.

  7. Analysis of breast lesions on contrast-enhanced magnetic resonance images using high-dimensional texture features

    NASA Astrophysics Data System (ADS)

    Nagarajan, Mahesh B.; Huber, Markus B.; Schlossbauer, Thomas; Leinsinger, Gerda; Wismueller, Axel

    2010-03-01

    Haralick texture features derived from gray-level co-occurrence matrices (GLCM) were used to classify the character of suspicious breast lesions as benign or malignant on dynamic contrast-enhanced MRI studies. Lesions were identified and annotated by an experienced radiologist on 54 MRI exams of female patients where histopathological reports were available prior to this investigation. GLCMs were then extracted from these 2D regions of interest (ROI) for four principal directions (0°, 45°, 90° & 135°) and used to compute Haralick texture features. A fuzzy k-nearest neighbor (k- NN) classifier was optimized in ten-fold cross-validation for each texture feature and the classification performance was calculated on an independent test set as a function of area under the ROC curve. The lesion ROIs were characterized by texture feature vectors containing the Haralick feature values computed from each directional-GLCM; and the classifier results obtained were compared to a previously used approach where the directional-GLCMs were summed to a nondirectional GLCM which could further yield a set of texture feature values. The impact of varying the inter-pixel distance while generating the GLCMs on the classifier's performance was also investigated. Classifier's AUC was found to significantly increase when the high-dimensional texture feature vector approach was pursued, and when features derived from GLCMs generated using different inter-pixel distances were incorporated into the classification task. These results indicate that lesion character classification accuracy could be improved by retaining the texture features derived from the different directional GLCMs rather than combining these to yield a set of scalar feature values instead.

  8. Radioguided localization of clinically occult breast lesions (ROLL): a pilot study.

    PubMed

    Medina-Franco, Heriberto; Abarca-Pérez, Leonardo; Ulloa-Gómez, José L; Romero, Cecilia

    2007-01-01

    Management of nonpalpable breast lesions requiring pathologic diagnosis has been with wire localization during the last few decades. Recently, radioguided localization (ROLL) became an alternative for this type of lesions. The objective of the present study was to evaluate the feasibility of this technique in a tertiary referral center in Mexico City. Consecutive patients requiring pathologic diagnosis from a nonpalpable breast lesion were included in the present study. On the same day of operation, all patients were injected with particles of human serum albumin. Localization of the lesion was performed in the operation theater with the aid of a hand-held gamma-probe. All lesions were identified in a control x-ray of the surgical specimen. Demographic, clinical, surgical and pathologic data were recorded. Forty patients with a mean age of 56.8 +/- 7.8 years were included. In 39 of the 40 patients (97.5%) the "hot spot" was identified easily. In all patients, the area of maximum radioactivity corresponded to the site of the lesion. Imaging confirmation of the lesion in the surgical specimen was done during the first excision in 37 patients (92.5%). In the remaining cases (7.5%), a wider excision was performed during the same procedure, finding the suspected lesion in all cases. Diagnosis of cancer was made in seven patients, (17.5%). There were no significant surgical complications. Our data suggest that ROLL offer a simple and reliable method to localize occult breast lesions, allowing complete removal of the lesion in 100% of the patients. Because of the small quantity of radioactivity, the procedure is safe for both patients and the medical staff, producing less discomfort in patients than wire localization.

  9. Targeting Premalignant Lesions: Implications for Early Breast Cancer Detection and Intervention

    DTIC Science & Technology

    2016-04-01

    PRINCIPAL INVESTIGATOR: Aman Mann CONTRACTING ORGANIZATION: Sanford Burnham Prebys Medical Discovery Institute La Jolla, CA 92037-1005 REPORT DATE: April...2015 – 31 Mar 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-14-1-0032 Targeting Premalignant Lesions: Implications for Early Breast...identified a peptide CISQ that targets to the stroma in premalignant lesions and binds to cancer-associated fibroblasts (CAFs) in MMTV-PyMT mice

  10. Juvenile papillomatosis of the breast in young male: a case report.

    PubMed

    Sanguinetti, A; Fioriti, L; Brugia, M; Roila, F; Farabi, R; Sidoni, A; Avenia, N

    2011-01-01

    Juvenile papillomatosis of the breast ("Swiss cheese disease'') is a benign localized proliferative condition of the breast which occurs almost exclusively in young adult women. Patients with this lesion often have a family history of breast carcinoma, but rarely carcinoma may coexist with the lesion at the time of diagnosis. We present a case of a young male with juvenile papillomatosis of the breast. The pathology and clinical management of this rare lesion is discussed.

  11. 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

  12. Polymorphisms in estrogen-metabolizing and estrogen receptor genes and the risk of developing breast cancer among a cohort of women with benign breast disease

    PubMed Central

    Gallicchio, Lisa; Berndt, Sonja I; McSorley, Meghan A; Newschaffer, Craig J; Thuita, Lucy W; Argani, Pedram; Hoffman, Sandra C; Helzlsouer, Kathy J

    2006-01-01

    Background A cohort study was conducted to examine the role of genetic polymorphisms in three estrogen metabolizing enzymes (COMT, CYP1A1, CYP1B1) and the two estrogen receptors (ESR1, ESR2) in the progression of benign breast disease (BBD) to breast cancer. Methods Among participants in an ongoing cohort study, 1438 Caucasian women had a breast biopsy for BBD and were successfully genotyped for at least one of the polymorphisms examined in this study. Genotypes were determined using DNA extracted from blood specimens collected in 1989. Incident cases of breast cancer occurring subsequent to BBD diagnosis up to 2003 were identified through cancer registries. Results Among all participants, the ESR2 *5772G allele was associated with a significant decrease in the risk of breast cancer among women with BBD (Odds Ratio (OR) 0.38; 95% Confidence Interval (CI) 0.15, 0.96). Compared to the reference wild-type genotypes, marginally significant associations with the development of breast cancer were observed between carriers of the variant ESR1 – 104062T allele (OR 0.70, 95% CI 0.45, 1.09), the variant ESR2 *38A allele (OR 1.40; 95% CI 0.88, 2.25), and the variant CYP1B1 453Ser allele (OR 1.48, 95% CI 0.95, 2.32). Conclusion The results indicate that specific polymorphisms in the CYP1B1, ESR1, and ESR2 genes may play a role in progression of BBD to breast cancer among Caucasian women. Although additional studies are needed to confirm or refute our findings, these results suggest that genetic markers may aid in the identification of women who are at risk for progression of BBD to cancer. PMID:16808847

  13. Fibroadenoma - breast

    MedlinePlus

    Breast lump - fibroadenoma; Breast lump - noncancerous; Breast lump - benign ... The cause of fibroadenomas is not known. There may be a connection to a problem with genes. Fibroadenoma is the most common benign ...

  14. Comparison between Thin-Slice 3-D Volumetric Ultrasound and Conventional Ultrasound in the Differentiation of Benign and Malignant Thyroid Lesions.

    PubMed

    Li, Wen-Bo; Zhang, Bo; Zhu, Qing-Li; Jiang, Yu-Xin; Sun, Jian; Yang, Meng; Li, Jian-Chu

    2015-12-01

    We explored the efficacy of thin-slice volumetric 3-D ultrasound (3-DUS) in distinguishing between benign and malignant thyroid nodules. A total of 103 thyroid nodules were evaluated prospectively using 3-D gray-scale ultrasonography. The shape, margin, halo and potential capsular invasion of the nodules were compared with the findings of conventional 2-D ultrasound (2-DUS). Of the 103 thyroid nodules, there were 50 pathologically confirmed benign lesions and 53 malignant lesions (51.5%). Shape irregularity, ill-defined margins and capsular invasion provided sensitivities of 90.0%, 47.2% and 39.6% and specificities of 88.0%, 84.0% and 100%, respectively, for the malignant lesions. The diagnosis of thyroid cancer was improved in 3-DUS compared with 2-DUS, with a sensitivity of 88.7%, specificity of 90.0%, positive predictive value of 90.4%, negative predictive value of 88.2% and accuracy of 89.3%. The sensitivity of detection for lesions with capsular invasion increased to 39.6% with 3-DUS, more than twice that of 2-DUS. Three-dimensional US is highly accurate in diagnosing thyroid nodules, particularly those with capsular invasion.

  15. Metastatic chordoma of the breast: an extremely rare lesion mimicking mucinous cancer.

    PubMed

    Tot, Tibor

    2006-10-01

    Metastases in the breast are rare, with metastatic chordoma being one of the rarest. To our knowledge, only one such case has previously been published in the literature. We report a case of a 74-year-old woman who presented with a palpable lump in her right breast. The lump was mammographically suggestive of mucinous breast cancer because it was a solitary, small, circular, and moderately dense lesion yielding abundant mucoid aspirate. The tumor resembled mucinous carcinoma upon histologic and immunohistochemical examination: it had a mucinous stroma, and the tumor cells strongly expressed epithelial markers. However, the patient had previously undergone surgery for a recurrent sacral chordoma. In addition to the clinical history, the presence of typical physaliferous cells expressing neither estrogen receptors nor cytokeratin 7, but staining positively for S-100 protein, allowed the proper diagnosis. Although extremely rare, metastatic chordoma may represent a challenge in the differential diagnosis of breast lesions. Discriminating metastases of mucin-producing tumors in the breast from primary mucinous carcinomas is important with regard to the striking difference in prognosis of these lesions.

  16. 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

  17. 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.

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

    PubMed

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

    2015-04-21

    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. 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, 0.71, 1.5 and 2.9 mm were representative of breast CT; the average 43 mm slice thickness served to simulate simulated projection images of the breast.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 average physicist observer, however trends

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

    NASA Astrophysics Data System (ADS)

    Chen, L.; Boone, J. M.; Abbey, C. K.; Hargreaves, J.; Bateni, C.; Lindfors, K. K.; Yang, K.; Nosratieh, A.; Hernandez, A.; Gazi, P.

    2015-04-01

    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. 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, 0.71, 1.5 and 2.9 mm were representative of breast CT; the average 43 mm slice thickness served to simulate simulated projection images of the breast. 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 average physicist

  20. Short-term imaging follow-up of patients with concordant benign breast core needle biopsies: is it really worth it?

    PubMed Central

    Adams, Michelle C.; Falcon, Shannon; Mooney, Blaise P.; Laronga, Christine; Chau, Alec; Drukteinis, Jennifer S.

    2014-01-01

    PURPOSE Women with histologically proven concordant benign breast disease are often followed closely after biopsy for a period of two years, and they are considered to be at high-risk for cancer development. Our goal was to evaluate the utility of short-term (six-month) imaging follow-up and determine the incidence of breast cancer development in this population. METHODS Retrospective review of concordant benign breast pathology was performed in 558 patients who underwent multi-modality breast core biopsy. A total of 339 patients (60.7%) with 393 biopsies qualified for the study. The six-, 12-, and 24-month incidence rates of breast cancer development were estimated with 95% confidence intervals (CI), using the exact method binomial proportions. RESULTS No cancer was detected in 285 of 339 patients (84.1%) returning for the six-month follow-up. No cancer was detected in 271 of 339 patients (79.9%) returning for the 12-month follow-up. Among 207 follow-up exams (61.1%) performed at 24 months, three patients were detected to have cancer in the ipsilateral breast (1.45% [95% CI, 0.30%–4.18%]) and two patients were detected to have cancer in the contralateral breast (0.97% [95% CI, 0.12%–3.45%]). Subsequent patient biopsy rate was 30 of 339 (8.85%, [95% CI, 6.05%–12.39%]). Three ipsilateral biopsies occurred as a sole result of the six-month follow-up of 285 patients (1.05%, [95% CI, 0.22%–3.05%]). CONCLUSION Short-term imaging follow-up did not contribute to improved breast cancer detection, as all subsequent cancers were detected on annual mammography. Annual diagnostic mammography after benign breast biopsy may be sufficient. PMID:25205024

  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. A low cost training phantom model for radio-guided localization techniques in occult breast lesions.

    PubMed

    Aydogan, Fatih; Mallory, Melissa Anne; Tukenmez, Mustafa; Sagara, Yasuaki; Ozturk, Erkan; Ince, Yavuz; Celik, Varol; Akca, Tamer; Golshan, Mehra

    2015-09-01

    Radio-guided localization (RGL) for identifying occult breast lesions has been widely accepted as an alternative technique to other localization methods, including those using wire guidance. An appropriate phantom model would be an invaluable tool for practitioners interested in learning the technique of RGL prior to clinical application. The aim of this study was to devise an inexpensive and reproducible training phantom model for RGL. We developed a simple RGL phantom model imitating an occult breast lesion from inexpensive supplies including a pimento olive, a green pea and a turkey breast. The phantom was constructed for a total cost of less than $20 and prepared in approximately 10 min. After the first model's construction, we constructed approximately 25 additional models and demonstrated that the model design was easily reproducible. The RGL phantom is a time- and cost-effective model that accurately simulates the RGL technique for non-palpable breast lesions. Future studies are warranted to further validate this model as an effective teaching tool.

  3. 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

  4. Breast cancer. Part 3: advanced cancer and psychological implications.

    PubMed

    Harmer, Victoria

    This is the last article in this 3-part series on breast cancer. The previous two articles have outlined the principles behind breast awareness and breast health, detailing common benign breast diseases, types of breast cancer and staging, and treatment for breast cancer, including surgery, chemotherapy, radiotherapy and endocrine treatment. The series concludes by giving information on advanced disease, including when a patient presents late with a fungating breast lesion, or if the disease has metastasized from the breast to other organs. Lymphoedema is also described and discussed, and the latter half of this article discusses psychological implications of breast cancer, from diagnosis through the individual treatments.

  5. 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

  6. Artificial neural network in breast lesions from fine-needle aspiration cytology smear.

    PubMed

    Subbaiah, R M; Dey, Pranab; Nijhawan, Raje

    2014-03-01

    Artificial neural networks (ANNs) are applied in engineering and certain medical fields. ANN has immense potential and is rarely been used in breast lesions. In this present study, we attempted to build up a complete robust back propagation ANN model based on cytomorphological data, morphometric data, nuclear densitometric data, and gray level co-occurrence matrix (GLCM) of ductal carcinoma and fibroadenomas of breast cases diagnosed on fine-needle aspiration cytology (FNAC). We selected 52 cases of fibroadenomas and 60 cases of infiltrating ductal carcinoma of breast diagnosed on FNAC by two cytologists. Essential cytological data was quantitated by two independent cytologists (SRM, PD). With the help of Image J software, nuclear morphomeric, densitometric, and GLCM features were measured in all the cases on hematoxylin and eosin-stained smears. With the available data, an ANN model was built up with the help of Neurointelligence software. The network was designed as 41-20-1 (41 input nodes, 20 hidden nodes, 1 output node). The network was trained by the online back propagation algorithm and 500 iterations were done. Learning was adjusted after every iteration. ANN model correctly identified all cases of fibroadenomas and infiltrating carcinomas in the test set. This is one of the first successful composite ANN models of breast carcinomas. This basic model can be used to diagnose the gray zone area of the breast lesions on FNAC. We assume that this model may have far-reaching implications in future.

  7. Imaging breast lesions using the Twente photoacoustic mammoscope: ongoing clinical experience

    NASA Astrophysics Data System (ADS)

    Heijblom, M.; Piras, D.; Xia, W.; van Hespen, J. C. G.; van den Engh, F. M.; Klaase, J. M.; van Leeuwen, T. G.; Steenbergen, W.; Manohar, S.

    2012-02-01

    Current imaging modalities are often not able to detect early stages of breast cancer with high imaging contrast. Visualizing malignancy-associated increased hemoglobin concentrations might improve breast cancer diagnosis. Photoacoustic imaging can visualize hemoglobin in tissue with optical contrast and ultrasound resolution, which makes it potentially ideal for breast imaging. The Twente Photoacoustic Mammoscope (PAM) has been designed specifically for this purpose. Based on a successful pilot study in 2007, a large clinical study using PAM has been started in December 2010. PAM uses a pulsed Q-switched Nd:YAG laser at 1064 nm to illuminate a region of interest on the breast. Photoacoustic signals are detected with a 1MHz, unfocused ultrasound detector array. Three dimensional data are reconstructed using an acoustic backprojection algorithm. Those reconstructed images are compared with conventional imaging and histopathology. In the first phase of the study, the goal was to optimize the visualization of malignancies. We performed sixteen technically acceptable measurements on confined breast malignancies. In the reconstructed volumes of all malignancies, a confined high contrast region could be identified at the expected lesion depth. After ten successful measurements, the illumination area was increased and the fluence was substantially decreased. This caused a further significant increase in PAM lesion contrast.

  8. Benign phyllodes tumor of the breast recurring as a malignant phyllodes tumor and spindle cell metaplastic carcinoma.

    PubMed

    Muller, Kristen E; Tafe, Laura J; de Abreu, Francine B; Peterson, Jason D; Wells, Wendy A; Barth, Richard J; Marotti, Jonathan D

    2015-02-01

    We report a unique case of a 59-year-old woman diagnosed with a benign phyllodes tumor (PT), which recurred twice in the same location over a 7-year period: first as a malignant PT and then as a malignant PT with coexisting spindle cell metaplastic breast carcinoma (MBC). The MBC was differentiated from the malignant PT by expression of cytokeratins (CKs) AE1/AE3, CK MNF-116, CK 5/6, and p63. Somatic mutation analysis using a next-generation sequencing platform revealed a shared mutation in F-box and WD repeat domain containing 7, a tumor suppressor gene that encodes a ubiquitin ligase-associated protein, in the original benign PT and the first recurrent malignant PT. Chromosomal microarray analysis showed shared genetic gains and losses between the malignant PT and MBC. This case highlights the utility of immunohistochemistry to differentiate malignant PT from spindle cell MBC, describes a novel mutation in PT, and demonstrates a biologic relationship between these 2 entities.

  9. 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

  10. Non-mass-like lesions on breast ultrasonography: a systematic review.

    PubMed

    Uematsu, Takayoshi

    2012-10-01

    This article reviews various non-mass-like ultrasonography (US) findings of the breast and the sonographic-pathologic correlation with Doppler techniques, elastography, and MRI. High-resolution US allows for identification of small, clinically occult non-mass-like US findings. Ductal carcinoma in situ and invasive lobular carcinoma usually manifest as a non-mass-like lesion on US. It is useful to classify non-mass-like lesions on US in a similar manner to the classification of non-mass-like enhancement on MRI.

  11. Expression of cyclooxygenase-1 and cyclooxygenase-2, syndecan-1 and connective tissue growth factor in benign and malignant breast tissue from premenopausal women.

    PubMed

    Fahlén, M; Zhang, H; Löfgren, L; Masironi, B; von Schoultz, E; von Schoultz, B; Sahlin, L

    2017-02-21

    Stromal factors have been identified as important for tumorigenesis and metastases of breast cancer. From 49 premenopausal women, samples were collected from benign or malignant tumors and the seemingly normal tissue adjacent to the tumor. The factors studied, with real-time polymerase chain reaction (PCR) and immunohistochemistry, were cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2), syndecan-1 (S-1) and connective tissue growth factor (CTGF). COX-1 and S-1 mRNA levels were higher in the malignant tumors than in normal and benign tissues. The COX-2 mRNA level was lower in the malignant tumor than in the normal tissue, while CTGF mRNA did not differ between the groups. COX-1 immunostaining was higher in stroma from malignant tumors than in benign tissues, whereas COX-2 immunostaining was higher in the malignant tissue. Glandular S-1 immunostaining was lower in malignant tumors compared to benign and normal tissues, and the opposite was found in stroma. Conclusively, mRNA levels of COX-1 and COX-2 were oppositely regulated, with COX-1 being increased in the malignant tumor while COX-2 was decreased. S-1 protein localization switched from glandular to stromal cells in malignant tissues. Thus, these markers are, in premenopausal women, localized and regulated differently in normal/benign breast tissue as compared to the malignant tumor.

  12. Herpes Zoster Lesions on Reconstructed Breast Skin: Rare Objective Proof of Reinervation

    PubMed Central

    Valina, Stephan Wolfgang; Schoeller, Thomas; Ehebruster, Gudrun

    2017-01-01

    Blazed up Herpes zoster lesions have been described in very few patients after free and pedicled flap transfer for reconstructive purpose. Although sensory recovery after flap reconstructions has been studied extensively most studies addressed subjective perceptions of sensation. Objective investigations of spontaneous reinervation of free and pedicled flaps are rare. We would like to present a witnessed herpes zoster infection of a latissimus dorsi skin flap 2 years after breast reconstruction. PMID:28194351

  13. Herpes Zoster Lesions on Reconstructed Breast Skin: Rare Objective Proof of Reinervation.

    PubMed

    Weitgasser, Laurenz; Valina, Stephan Wolfgang; Schoeller, Thomas; Ehebruster, Gudrun

    2017-01-01

    Blazed up Herpes zoster lesions have been described in very few patients after free and pedicled flap transfer for reconstructive purpose. Although sensory recovery after flap reconstructions has been studied extensively most studies addressed subjective perceptions of sensation. Objective investigations of spontaneous reinervation of free and pedicled flaps are rare. We would like to present a witnessed herpes zoster infection of a latissimus dorsi skin flap 2 years after breast reconstruction.

  14. Risk of gynecomastia and breast cancer associated with the use of 5-alpha reductase inhibitors for benign prostatic hyperplasia

    PubMed Central

    Hagberg, Katrina Wilcox; Divan, Hozefa A; Fang, Shona C; Nickel, J Curtis; Jick, Susan S

    2017-01-01

    Background Clinical trial results suggest that 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) may increase the risk of gynecomastia and male breast cancer, but epidemiological studies have been limited. Patients and methods We conducted a cohort study with nested case–control analyses using the UK Clinical Practice Research Datalink. We identified men diagnosed with BPH who were free from Klinefelter syndrome, prostate, genital or urinary cancer, prostatectomy or orchiectomy, or evidence of gynecomastia or breast cancer. Patients entered the cohort at age ≥40 years and at least 3 years after the start of their electronic medical record. We classified exposure as 5ARIs (alone or in combination with alpha blockers [ABs]), AB only, or unexposed to 5ARIs and ABs. Cases were men who had a first-time diagnosis of gynecomastia or breast cancer. Incidence rates and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) in the gynecomastia analysis and crude and adjusted odds ratios (ORs) with 95% CIs in both analyses were calculated. Results Compared to no exposure, gynecomastia risk was elevated for users of 5ARIs (alone or in combination with ABs) in both the cohort (IRR=3.55, 95% CI 3.05–4.14) and case–control analyses (OR=3.31, 95% CI 2.66–4.10), whereas the risk was null for users of AB only. The increased risk of gynecomastia with the use of 5ARIs persisted regardless of the number of prescriptions, exposure timing, and presence or absence of concomitant prescriptions for drugs known to be associated with gynecomastia. The risk was higher for dutasteride than for finasteride. 5ARI users did not have an increased risk of breast cancer compared to unexposed men (OR=1.52, 95% CI 0.61–3.80). Conclusion In men with BPH, 5ARIs significantly increased the risk of gynecomastia, but not breast cancer, compared to AB use and no exposure. PMID:28228662

  15. Sentinel node detection and radioguided occult lesion localization in breast cancer.

    PubMed

    Trifirò, Guiseppe; Lavinia Travaini, Laura; De Cicco, Concetta; Paganelli, Giovanni

    2006-01-01

    Sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 breast cancer patients and represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. In our Institute, Radioguided Occult Lesion Localization is the standard method to locate non-palpable breast lesions and the gamma probes is very effective in assisting intra-operative localization and removal, as in sentinel node biopsy. The rapid spread of sentinel lymph node biopsy has led to its use in clinical settings previously considered contraindications to sentinel lymph node biopsy. In this contest, we evaluated in a large group of patients possible factors affecting sentinel node detection and the reliability of sentinel lymph node biopsy carried out after large excisional breast biopsy. Our data confirm that a previous breast surgery does not prohibit efficient sentinel lymph node localization and sentinel lymph node biopsy can correctly stage the axialla in these patients.

  16. 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

  17. 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. PMID:27429279

  18. Segmentation of Breast Lesions in Ultrasound Images through Multiresolution Analysis Using Undecimated Discrete Wavelet Transform.

    PubMed

    Prabusankarlal, K M; Thirumoorthy, P; Manavalan, R

    2016-11-01

    Earliest detection and diagnosis of breast cancer reduces mortality rate of patients by increasing the treatment options. A novel method for the segmentation of breast ultrasound images is proposed in this work. The proposed method utilizes undecimated discrete wavelet transform to perform multiresolution analysis of the input ultrasound image. As the resolution level increases, although the effect of noise reduces, the details of the image also dilute. The appropriate resolution level, which contains essential details of the tumor, is automatically selected through mean structural similarity. The feature vector for each pixel is constructed by sampling intra-resolution and inter-resolution data of the image. The dimensionality of feature vectors is reduced by using principal components analysis. The reduced set of feature vectors is segmented into two disjoint clusters using spatial regularized fuzzy c-means algorithm. The proposed algorithm is evaluated by using four validation metrics on a breast ultrasound database of 150 images including 90 benign and 60 malignant cases. The algorithm produced significantly better segmentation results (Dice coef = 0.8595, boundary displacement error = 9.796, dvi = 1.744, and global consistency error = 0.1835) than the other three state of the art methods.

  19. Monomorphic Epithelial Proliferations of the Breast: A Possible Precursor Lesion Associated With Ipsilateral Breast Failure After Breast Conserving Therapy in Patients With Negative Lumpectomy Margins

    SciTech Connect

    Goldstein, Neal S.; Kestin, Larry L.; Vicini, Frank A.

    2011-03-01

    Background: It is generally believed that ipsilateral breast failures (IBFs) after breast-conserving therapy (BCT) develop from incompletely eradicated carcinoma. We previously suggested that monomorphic epithelial proliferations (MEPs) in the breast may be a pool of partially transformed clones from which breast carcinomas can arise and that radiation therapy (RT) may also reduce the risk of IBF by eradicating MEPs. We examined salvage mastectomy specimens in patients experiencing an IBF to define the relationship between MEPs and IBFs and an additional potential mechanism for IBF risk reduction by RT. Methods and Materials: The location, number, and distribution of radiation changes and MEPs relative to 51 IBFs were mapped in salvage mastectomy specimens from BCT patients with adequately excised, initial carcinomas (negative lumpectomy margins). Results: All 51 salvage mastectomies had diffuse, late radiation changes. None had active fibrocystic lesions. MEPs were predominantly located in the immediate vicinity of the IBFs. A mean of 39% of MEP cases were located within the IBF, 46% were located within 2 cm of the IBF, and 14% were 2-3 cm from the IBF. Conclusions: MEPs appear to be a pool of partially transformed precursor lesions that can give rise to ductal carcinoma in situ and invasive carcinomas (CAs). Many IBFs may arise from MEPs that reemerge after RT. Radiation may also reduce IBF risk after BCT (including in patients with negative margins) by primarily eradicating MEPs.

  20. Regulation of breast cancer-induced bone lesions by β-catenin protein signaling.

    PubMed

    Chen, Yan; Shi, Heidi Y; Stock, Stuart R; Stern, Paula H; Zhang, Ming

    2011-12-09

    Breast cancer patients have an extremely high rate of bone metastases. Morphological analyses of the bones in most of the patients have revealed the mixed bone lesions, comprising both osteolytic and osteoblastic elements. β-Catenin plays a key role in both embryonic skeletogenesis and postnatal bone regeneration. Although this pathway is also involved in many bone malignancy, such as osteosarcoma and prostate cancer-induced bone metastases, its regulation of breast cancer bone metastases remains unknown. Here, we provide evidence that the β-catenin signaling pathway has a significant impact on the bone lesion phenotype. In this study, we established a novel mouse model of mixed bone lesions using intratibial injection of TM40D-MB cells, a breast cancer cell line that is highly metastatic to bone. We found that both upstream and downstream molecules of the β-catenin pathway are up-regulated in TM40D-MB cells compared with non-bone metastatic TM40D cells. TM40D-MB cells also have a higher T cell factor (TCF) reporter activity than TM40D cells. Inactivation of β-catenin in TM40D-MB cells through expression of a dominant negative TCF4 not only increases osteoclast differentiation in a tumor-bone co-culture system and enhances osteolytic bone destruction in mice, but also inhibits osteoblast differentiation. Surprisingly, although tumor cells overexpressing β-catenin did induce a slight increase of osteoblast differentiation in vitro, these cells display a minimal effect on osteoblastic bone formation in mice. These data collectively demonstrate that β-catenin acts as an important determinant in mixed bone lesions, especially in controlling osteoblastic effect within tumor-harboring bone environment.

  1. The Added Diagnostic Value of Dynamic Contrast-Enhanced MRI at 3.0 T in Nonpalpable Breast Lesions

    PubMed Central

    Merckel, Laura G.; Verkooijen, Helena M.; Peters, Nicky H. G. M.; Mann, Ritse M.; Veldhuis, Wouter B.; Storm, Remmert K.; Weits, Teun; Duvivier, Katya M.; van Dalen, Thijs; Mali, Willem P. Th. M.; Peeters, Petra H. M.; van den Bosch, Maurice A. A. J.

    2014-01-01

    Objective To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading. Materials and Methods We evaluated MRI scans of patients with nonpalpable BI-RADS 3–5 lesions who underwent dynamic contrast-enhanced 3.0 Tesla breast MRI. Initially, MRI scans were read by radiologists in a routine clinical setting. All histologically confirmed index lesions were re-evaluated by two dedicated breast radiologists. Sensitivity and specificity for the three MRI readings were determined, and the diagnostic value of breast MRI in addition to conventional imaging was assessed. Interobserver reliability between the three readings was evaluated. Results MRI examinations of 207 patients were analyzed. Seventy-eight of 207 (37.7%) patients had a malignant lesion, of which 33 (42.3%) patients had pure DCIS and 45 (57.7%) invasive breast cancer. Sensitivity of breast MRI was 66.7% during routine, and 89.3% and 94.7% during expert reading. Specificity was 77.5% in the routine setting, and 61.0% and 33.3% during expert reading. In the routine setting, MRI provided additional diagnostic information over clinical information and conventional imaging, as the Area Under the ROC Curve increased from 0.76 to 0.81. Expert MRI reading was associated with a stronger improvement of the AUC to 0.87. Interobserver reliability between the three MRI readings was fair and moderate. Conclusions 3.0 T breast MRI of nonpalpable breast lesions is of added diagnostic value for the diagnosis of in situ and invasive breast cancer. PMID:24713637

  2. 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

  3. A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease

    PubMed Central

    Mo, Miao; Chen, Jia-jian; Yang, Ben-long; Huang, Xiao-yan; Wu, Jiong

    2017-01-01

    Objectives The current study aims to summarize breast anthropomorphic measurement features in Chinese patients with breast diseases and to investigate their potential correlations with demographic factors. Materials and methods Fifteen breast anthropomorphic parameters of 605 Chinese female patients were collected prospectively. Breast ptosis status was scaled by two methods and breast volume was calculated according to a modified formula of BREAST-V. Results Among 1210 breasts, the average breast volume was 340.0±109.1 ml (91.8–919.2 ml). The distance from the nipple to the inframammary fold was 7.5±1.6 cm in the standing position. The width of the breast base was 14.3±1.4 cm (8.5–23.5 cm). The incidence of breast ptosis was 22.8% (274/1204), of which 37 (23.5%) and 79 (31.7%) women had severe ptosis assessed by different criteria. Increased height (OR[odds ratio] = 1.500, P<0.001), post-menopausal status (OR = 1.463, P = 0.02), increased BMI, breastfeeding for 7–12 months (OR = 1.882, P = 0.008) and more than one year (OR = 2.367, P = 0.001) were risk factors for an increased breast volume. Post-menopausal status (OR = 2.390, P<0.001 and OR = 2.621, P<0.001 for different scales), BMI≥24.7 kg/m2 (OR = 3.149, P<0.001 and OR = 2.495, P = 0.002), breastfeeding for 7–12 months (OR = 4.136, P = 0.004 and OR = 4.010, P = 0.002), and breastfeeding for more than one year (OR = 6.934, P<0.001 and OR = 6.707, P<0.001) were independent risk factors for breast ptosis. Conclusions The current study provides anthropomorphic measurements data of Chinese women with breast diseases, which are useful for cosmetic and reconstructive breast surgery decisions. Post-menopausal status, increased BMI, and breastfeeding for more than six months were independent risk factors for both increased breast volume and breast ptosis. PMID:28192525

  4. 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.

  5. Fine needle aspiration biopsy of cystic benign lymphoepithelial lesion of the parotid gland in patients at risk for the acquired immune deficiency syndrome.

    PubMed

    Finfer, M D; Gallo, L; Perchick, A; Schinella, R A; Burstein, D E

    1990-01-01

    Cystic benign lymphoepithelial lesion (BLL), a previously rare lesion of the parotid gland consisting of marked lymphoid hyperplasia with accompanying squamous-lined cysts, has recently been described in patients with the acquired immune deficiency syndrome (AIDS) or AIDS risk factors. Thirteen fine needle aspiration (FNA) samples of parotid gland masses from patients with AIDS (one case), AIDS risk factors (five cases) or denial of AIDS risk factors (two cases) and a histopathologic diagnosis of BLL were examined. The FNA features that correlated best with the histopathologic findings were (1) a heterogeneous lymphoid population, (2) scattered single and/or clustered foamy macrophages and (3) superficial and/or anucleated squamous cells. Most aspirates showed some combination of these three components. The differential diagnostic considerations, the clinical and radiologic correlations and the relationship of this lesion to HIV infection are discussed. Patients with parotid masses whose aspirates consist of some combination of squamous cells, lymphocytes and foamy macrophages should be questioned for possible AIDS risk factors.

  6. 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

  7. 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

  8. Determining whether excision of all fibroepithelial lesions of the breast is needed to exclude phyllodes tumor: upgrade rate of fibroepithelial lesions of the breast to phyllodes tumor.

    PubMed

    Van Osdol, Andrew D; Landercasper, Jeffrey; Andersen, Jeremiah J; Ellis, Richard L; Gensch, Erin M; Johnson, Jeanne M; De Maiffe, Brooke; Marcou, Kristen A; Al-Hamadani, Mohammed; Vang, Choua A

    2014-10-01

    Fibroepithelial lesions (FELs) are a common histologic finding on core needle biopsy (CNB) of the breast. Fibroepithelial lesions include fibroadenoma and phyllodes tumor, which can be difficult to distinguish with an initial CNB. An institutional experience was reviewed from February 12, 2001, to January 4, 2007, to determine the safety of selective rather than routine excision of FELs and to determine the factors associated with upgrading diagnosis of FELs to phyllodes tumors without definitive phyllodes tumor diagnosis by CNB. Of 313 patients, 261 (83%) with FELs diagnosed by CNB received observation with long-term follow-up (mean, 8 years). Of the observed patients, 3 (1%) were diagnosed with phyllodes tumor on follow-up. Eighteen of 52 patients (35%) who received excision had an upgrade of diagnosis to phyllodes tumor. Sensitivity and specificity of the pathologist's comment of concern for phyllodes tumor on a CNB demonstrating FELs without definitive phyllodes tumor diagnosis were 82% and 93%, respectively. Our policy of selective excision of FELs without definitive phyllodes tumor diagnosis resulted in safe avoidance of many surgical procedures.

  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. Diagnostic power of diffuse reflectance spectroscopy for targeted detection of breast lesions with microcalcifications.

    PubMed

    Soares, Jaqueline S; Barman, Ishan; Dingari, Narahara Chari; Volynskaya, Zoya; Liu, Wendy; Klein, Nina; Plecha, Donna; Dasari, Ramachandra R; Fitzmaurice, Maryann

    2013-01-08

    Microcalcifications geographically target the location of abnormalities within the breast and are of critical importance in breast cancer diagnosis. However, despite stereotactic guidance, core needle biopsy fails to retrieve microcalcifications in up to 15% of patients. Here, we introduce an approach based on diffuse reflectance spectroscopy for detection of microcalcifications that focuses on variations in optical absorption stemming from the calcified clusters and the associated cross-linking molecules. In this study, diffuse reflectance spectra are acquired ex vivo from 203 sites in fresh biopsy tissue cores from 23 patients undergoing stereotactic breast needle biopsies. By correlating the spectra with the corresponding radiographic and histologic assessment, we have developed a support vector machine-derived decision algorithm, which shows high diagnostic power (positive predictive value and negative predictive value of 97% and 88%, respectively) for diagnosis of lesions with microcalcifications. We further show that these results are robust and not due to any spurious correlations. We attribute our findings to the presence of proteins (such as elastin), and desmosine and isodesmosine cross-linkers in the microcalcifications. It is important to note that the performance of the diffuse reflectance decision algorithm is comparable to one derived from the corresponding Raman spectra, and the considerably higher intensity of the reflectance signal enables the detection of the targeted lesions in a fraction of the spectral acquisition time. Our findings create a unique landscape for spectroscopic validation of breast core needle biopsy for detection of microcalcifications that can substantially improve the likelihood of an adequate, diagnostic biopsy in the first attempt.

  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. 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

  13. Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors.

    PubMed

    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.

  14. Breast ductoscopy with a 0.55-mm mini-endoscope for direct visualization of intraductal lesions.

    PubMed

    Jacobs, Volker R; Kiechle, Marion; Plattner, Birgit; Fischer, Thorsten; Paepke, Stefan

    2005-01-01

    Standard radiologic examinations of breast duct lesions can give only indirect information. Mini-endoscopy with a breast ductoscope of only 0.55 mm offers direct visualization of the lesion and helps in the decision to perform or avoid exploratory breast tissue resection. We used a LaDuScope (PolyDiagnost, Pfaffenhofen, Germany) with a 0.55- or 0.95-mm outer diameter and a 75-mm working length from October 2003 through July 2004 on 11 women (average age of 48.3 years [range 36-69 years]) with suspicious nipple discharge. The optics have zero-degree direct view, 70-degree field vision, and 3000 or 6000 pixel resolution. Breast ducts and walls could be easily inspected; and irrigation of breast ducts, aspiration, and use of cytology brush were possible under visual control. We had no intraoperative or postoperative complications. The new procedure of mini-ductoscopy is feasible, safe, and helpful as an additional ambulatory diagnostic method for visual inspection of breast ducts. This instrument demonstrates the latest advances of technology and a trend toward less-invasive diagnostics for breast duct lesions.

  15. Computerized Interpretation of Dynamic Breast MRI

    DTIC Science & Technology

    2005-05-01

    malignant and benign lesions. Keywords: Fuzzy c- means , breast cancer, contrast-enhanced MRI, tumor heterogeneity, computer-aided diag- nosis (CAD) 1...applications. tumor response to therapy[3]. Furthermore, breast MRI can In this paper, we present a fast fuzzy c- means (FCM) based be used for quantitative...use of a fuzzy c- means (FCM) algorithm for the assessment of 3-D tumor extent from contrast-enhanced magnetic resonance images (CE-MRI) of the breast

  16. 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.

  17. Pregnancy-like (pseudolactational) hyperplasia: a primary diagnosis in mammographically detected lesions of the breast and its relationship to cystic hypersecretory hyperplasia.

    PubMed

    Shin, S J; Rosen, P P

    2000-12-01

    Pregnancy-like (pseudolactational) hyperplasia (PLH) has long been recognized as an incidental finding in breast biopsies performed for various clinically detected benign and malignant conditions. The histologic features of PLH have been well described, including some instances exhibiting cytologic and structural atypia. The presence of calcifications in these lesions was rarely mentioned and was considered to be of little consequence. More recently, however, calcifications in PLH have become the target of needle localization and needle core biopsies. The authors report 12 instances in which PLH was the primary diagnosis in biopsy specimens obtained for radiographic abnormalities, usually calcifications. Six of 12 procedures (50.0%) were performed for mammographically detected calcifications, four cases for a mass, one for an "abnormal mammogram," and one for galactorrhea. Calcifications were present in PLH in 10 biopsies, in benign terminal ducts in one specimen, and were not identified histologically in the remaining specimen. In most instances, calcifications associated with PLH had smooth round or lobulated contours and distinctive, internal, unevenly spaced laminations. Cystic hypersecretory hyperplasia (CHH) was present in five specimens. In four of the five specimens, CHH merged with PLH (PLH/CHH). Four of 12 specimens (33.3%) showed atypia within foci of PLH/CHH. PLH should be recognized as a primary diagnosis in breast biopsies for mammographically detected abnormalities such as calcifications. Some calcifications associated with PLH have a distinctive histologic appearance, and their recognition can aid in the diagnosis of PLH. Additional cases of PLH/CHH must be studied to ascertain the clinical significance, if any, of this previously undescribed entity. The precancerous significance of PLH/CHH and of PLH with atypia has not been determined. In most instances, surgical excision would be prudent if PLH/ CHH or PLH with atypia is present in a needle core

  18. 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

  19. Nuclear to non-nuclear Pmel17/gp100 expression (HMB45 staining) as a discriminator between benign and malignant melanocytic lesions.

    PubMed

    Rothberg, Bonnie E Gould; Moeder, Christopher B; Kluger, Harriet; Halaban, Ruth; Elder, David E; Murphy, George F; Lazar, Alexander; Prieto, Victor; Duncan, Lynn McDivitt; Rimm, David L

    2008-09-01

    HMB45 is a mouse monoclonal antibody raised against Pmel17/gp100, a melanoma-specific marker, which is routinely used in the diagnosis of primary cutaneous malignant melanoma. The standard expression pattern for a positive HMB45 staining result on immunohistochemistry is based upon the results of chromogenic-based methods. We re-evaluated the patterns of HMB45 staining across the 480-core 'SPORE melanoma progression array' containing lesions representing the spectrum of melanocytic lesions ranging from thin nevus to visceral metastasis using the fluorescence-based staining technique and automated quantitative analysis (AQUA) of the obtained digital images. The methods validated the expected cytoplasmic HMB45 staining pattern in 70/108 malignant lesions and in the epithelial components of nevus specimens. However, the fluorescence-based approach revealed a nuclear gp100 localization present in the dermal component of all nevi that was not seen before. This nuclear localization could not be observed on routine chromogenic stains, because the standard hematoxylin nuclear counterstain overwhelms the weak nuclear HMB45 stain. The thin (0.450+/-0.253) and thick (0.513+/-0.227) nevi had strongly positive mean ln(nuclear/non-nuclear AQUA score ratios), which are significantly higher than those from the group of malignant lesions (P<0.0001). This finding was reproduced on a smaller but independent progression array composed of nevi and melanomas from the Yale Pathology archives (P<0.01). The odds ratio associated with a sample being a nevus was 2.24 (95% CI: 1.87-2.69, P<0.0001) for each 0.1 unit increase of the ln(nuclear/non-nuclear AQUA score ratio) to yield an ROC curve with 0.93 units of area and a simultaneously maximized sensitivity of 0.92 and specificity of 0.80 for distinguishing benign nevi from malignant melanomas. On the basis of this preliminary study, we propose that the ratio of nuclear to non-nuclear HMB45 staining may be useful for diagnostic challenges in

  20. 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

  1. Wavelet-based 3D reconstruction of microcalcification clusters from two mammographic views: new evidence that fractal tumors are malignant and Euclidean tumors are benign.

    PubMed

    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.

  2. Tibial lymphoplasmacytic plaque: a new, illustrative case of a recently and poorly recognized benign lesion in children.

    PubMed

    Moulonguet, Isabelle; Hadj-Rabia, Smaïl; Gounod, Nicolas; Bodemer, Christine; Fraitag, Sylvie

    2012-01-01

    Tibial lymphoplasmacytic plaque (TLP) is a recently recognized clinicopathological entity affecting children and is characterized by a linear, reddish brown plaque on the leg with a dense dermal lymphoplasmacytic infiltrate. No effective treatments are available for this lesion of unknown etiology and its course is chronic. We report a new case in which, for the first time, a causative factor (insect bite) is strongly suspected. The clinical and pathological features of TLP may be misleading for the uninformed dermatologist or pathologist. Therefore, we would like to draw attention to this very distinctive clinicopathological presentation in order to help them recognize it easily and prevent it from being misdiagnosed as an infectious disease or, above all, a cutaneous lymphoma. We will discuss the relationship between TLP and linear acral pseudolymphomatous angiokeratoma of children, a variant of pseudolymphoma localized on acral sites in children which may share some of TLP's histopathological features.

  3. Fine-needle aspiration of gray zone lesions of the breast: fibroadenoma versus ductal carcinoma.

    PubMed

    Jing, Xin; Normolle, Daniel; Michael, Claire W

    2013-09-01

    While breast lesions have characteristic cytological features, some lesions, particularly adenocarcinoma and fibroadenoma, may present with overlapping features causing erroneous diagnoses. The current study aimed to define significant cytomorphologic features predictive of fibroadenoma and adenocarcinoma, respectively. Further, we intended to evaluate the predictive characteristics for differentiation between gray zone lesions and to identify root causes contributing to misdiagnoses. First, direct smears prepared from 14 histology-confirmed fibroadenomas and 14 adenocarcinomas were reviewed and characteristics of commonly encountered morphologic features were assessed. We then retrospectively and blindly reviewed nine cytohistologic discrepant cases using the significant characteristic as a guideline, in order to assess whether these discrepant cases could be correctly categorized. Morphologic characteristics predictive of fibroadenoma included moderate cellularity, large, folded cellular sheets/aggregates, staghorn projections, smooth and round borders, monolayers, honeycomb arrangement, smaller nuclear size, and background bipolar cells. Predictive characteristics of adenocarcinoma included high cellularity, loose cohesive sheets/aggregates, pointed projections, irregular borders, larger nuclear size, irregular nuclear membrane, prominent nucleoli, and single atypical epithelial cells. Retrospective, blind review correctly re-classified seven out of nine cytohistologic discrepant cases, including five false negative cases and two false positive cases. Root causes contributing to the misdiagnoses were large branching sheets of carcinoma mimicking folded sheets of fibroadenoma; fibroblasts mimicking myoepithelial cells; apocrine cells mimicking carcinoma cells; and not recognizing the loose myxoid matrix presenting as soap bubbles in fibroadenoma. In conclusion, this study identified significant characteristics that can assist in achieving accurate diagnosis in a

  4. 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.

  5. 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

    2016-04-15

    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.

  6. 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

  7. 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.

  8. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation.

    PubMed

    Chung, Ellen M; Cube, Regino; Hall, Gregory J; González, Candela; Stocker, J Thomas; Glassman, Leonard M

    2009-01-01

    The spectrum of breast lesions in children and adolescents varies markedly from that for adults, with the former lesions being overwhelmingly benign. A breast mass in a young boy or girl may arise from normal and abnormal breast development. Other causes of masses include infection, trauma, and cyst formation. After onset of puberty, most cases of breast enlargement arise from benign fibroadenoma in girls and gynecomastia in boys. These conditions have specific imaging appearances, although juvenile (often giant) fibroadenoma cannot be distinguished from phyllodes tumor, which can be benign or malignant. In children, both conditions usually appear as well-circumscribed, hypoechoic masses at sonography and show diffuse enhancement except for nonenhancing septations at magnetic resonance imaging. A diagnosis of juvenile papillomatosis (a benign lesion) portends later development of breast cancer, and patients with this condition should be closely monitored. Malignant lesions of the breast in children are rare. The most common malignant lesions are metastases and are usually associated with widespread disease. The most common primary breast malignancy is malignant phyllodes tumor. Primary breast carcinoma is exceedingly rare in the pediatric age group, but its imaging appearance in children is the same as seen in adults and is different from that of almost all benign lesions. In girls, diagnostic interventions may injure the developing breast and cause subsequent disfigurement. Given this risk and the low prevalence of malignant disease in this population, a prudent course should be followed in the diagnosis of breast lesions. Imaging findings are very helpful for selecting patients for further diagnostic procedures. Although malignancy is rare, lesions with suspicious imaging findings or progressive growth should be subjected to cytologic or histologic examination.

  9. 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.

  10. Expression of steroid hormone receptors in benign hepatic tumors. An immunocytochemical study.

    PubMed

    Masood, S; West, A B; Barwick, K W

    1992-12-01

    Many hepatic adenomas have been demonstrated to have a clear relationship with oral contraceptive use, and it is presumed that there may be hormone receptors within the cytoplasm or nucleus of adenoma cells that mediate tumor growth in response to hormonal stimulation. Only a small number of examples of benign hepatic tumors have been analyzed for the presence of estrogen and progesterone receptors, and there has been a lack of consensus with regard to the findings. All previous studies have determined receptor levels by biochemical methods. In a retrospective study, we employed specific monoclonal antibodies against estrogen and progesterone receptors in 10 benign paraffin-embedded hepatic lesions: five examples of hepatic adenoma and five examples of focal nodular hyperplasia. All patients were female, except for one male with adenoma and one male with focal nodular hyperplasia. No patient had received tamoxifen citrate or any other form of hormonal therapy for their hepatic lesion. Positive controls included benign and malignant breast tissue. No positive staining was seen in hepatic adenoma, focal nodular hyperplasia, or normal adjacent liver parenchyma. Intense positive staining was seen in all positive control tissues. This negative result with the use of specific monoclonal antibodies in an established immunohistochemical method for analysis of estrogen and progesterone receptors does not exclude the presence of these receptors in benign hepatic lesions, but does suggest that, if present, they occur in much smaller amounts than in benign and malignant breast tissue. The presence of hormone receptors in benign hepatic tumors deserves further study.

  11. Breast Fibroadenoma With Increased Activity on 68Ga DOTATATE PET/CT.

    PubMed

    Papadakis, Georgios Z; Millo, Corina; Sadowski, Samira M; Karantanas, Apostolos H; Bagci, Ulas; Patronas, Nicholas J

    2017-02-01

    Fibroadenoma is the most common benign breast tumor in women of reproductive age, carrying little to no risk of breast cancer development. We report on a case of a woman with history of neuroendocrine tumor who on follow-up imaging tests underwent whole-body PET/CT study using Ga DOTATATE. The scan showed increased focal activity in the right breast, which was biopsied revealing a fibroadenoma. The presented data suggests cell surface overexpression of somatostatin receptors by this benign breast tumor. Moreover, this finding emphasizes the need for cautious interpretation of Ga DOTATATE-avid breast lesions that could mimic malignancy in neuroendocrine tumor patients.

  12. Second harmonic generation microscopy is a novel technique for differential diagnosis of breast fibroepithelial lesions.

    PubMed

    Tan, Wai Jin; Yan, Jie; Xu, Shuoyu; Thike, Aye Aye; Bay, Boon Huat; Yu, Hanry; Tan, Min-Han; Tan, Puay Hoon

    2015-12-01

    Breast fibroepithelial lesions, including fibroadenomas and phyllodes tumours, are commonly encountered in clinical practice. As histological differences between these two related entities may be subtle, resulting in a challenging differential diagnosis, pathological techniques to assist the differential diagnosis of these two entities are of high interest. An accurate diagnosis at biopsy is important given corresponding implications for clinical decision-making including surgical extent and monitoring. Second harmonic generation (SHG) microscopy is a recently developed optical imaging technique capable of robust, powerful and unbiased label-free direct detection of collagen fibril structure in tissue without the use of antibodies. We constructed tissue microarrays emulating limited materials on biopsy to investigate quantitative collagen signal in fibroepithelial lesions using SHG microscopy. Archived formalin-fixed paraffin-embedded materials of 47 fibroepithelial lesions (14 fibroadenomas and 33 phyllodes tumours) were evaluated. Higher collagen signal on SHG microscopy was observed in fibroadenomas than phyllodes tumours on SHG imaging (p<0.001, area under the curve 0.859). At an automated threshold (2.5 million positive pixels), the sensitivity and specificity of the SHG microscopy for fibroadenoma classification was 71.4% and 84.4%, respectively. To corroborate these findings, we performed immunohistochemistry on tissue array sections using collagen I and III primary antibodies. Both collagen I and III immunohistochemical expressions were also significantly higher in fibroadenomas than in phyllodes tumours (p<0.001). In conclusion, label-free collagen quantitation on SHG microscopy is a novel imaging approach that can aid the differential diagnosis of fibroepithelial lesions.

  13. Image manifold revealing for breast lesion segmentation in DCE-MRI.

    PubMed

    Hu, Liang; Cheng, Zhaoning; Wang, Manning; Song, Zhijian

    2015-01-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is widely used for breast lesion differentiation. Manual segmentation in DCE-MRI is difficult and open to viewer interpretation. In this paper, an automatic segmentation method based on image manifold revealing was introduced to overcome the problems of the currently used method. First, high dimensional datasets were constructed from a dynamic image series. Next, an embedded image manifold was revealed in the feature image by nonlinear dimensionality reduction technique. In the last stage, k-means clustering was performed to obtain final segmentation results. The proposed method was applied in actual clinical cases and compared with the gold standard. Statistical analysis showed that the proposed method achieved an acceptable accuracy, sensitivity, and specificity rates.

  14. Differential marking of excision planes in screened breast lesions by organically coloured gelatins.

    PubMed Central

    Armstrong, J S; Weinzwieg, I P; Davies, J D

    1990-01-01

    Traditionally India ink has been used to mark surgical resection margins, more recently with acetone to aid drying. Alternative methods have been suggested in recent months, including solutions of alcian blue, and Tippex. These methods use one colour only and Tippex is radiodense. Artists' pigments have been used, but their radiodensity makes them unsuitable for the detailed mammograms of the sliced screened specimens. An alternative method was specifically designed for impalpable breast lesions. It is based on coloured gelatins that are painted on to the biopsy specimen before dissection. The markers are radiolucent, quick to set, and do not penetrate the connective tissue. They can be applied to both fresh and fixed tissues, and the cost is about 0.05 pounds a specimen. The system is also suitable for marking other large specimens. Images PMID:2380408

  15. Skin Involvement and Breast Cancer: Are T4B Lesions of All Sizes Created Equal?

    PubMed Central

    Silverman, Diana; Ruth, Karen; Sigurdson, Elin R.; Egleston, Brian L.; Goldstein, Lori J.; Wong, Yu-Ning; Boraas, Marcia; Bleicher, Richard J.

    2014-01-01

    Background Nonmetastatic non-inflammatory invasive breast cancers having skin involvement (SI) are classified as T4b, regardless of size. This study evaluated disease specific survival (DSS) to determine whether size should be considered for these lesions, rather than grouping them all into Stage III. Study Design Surveillance Epidemiology and End Results data linked to Medicare claims were reviewed. SI and nonSI tumors were reclassified using AJCC 7th Edition groupings using tumor size and nodal involvement alone without considering SI (neostage). DSS was adjusted for demographics, histology and treatment using competing risk methods with propensity score-based weighting and bootstrap standard errors. Results Among 924 SI patients diagnosed between 1992 and 2005, tumors were 0.1–2.0, 2.1–5.0, and >5.0 cm in 11.6%, 51.1%, and 37.3% of cases, respectively. There were no nodal metastases in 22.3%, 1–3 positive nodes in 31.7%, 4–9 positive in 28.6% and ≥10 positive in 17.4% of cases. For SI patients, adjusted 5-year DSS was 95.8% [95%CI: 95.6–96.0] for neostage I, declining progressively to 36.4% [95%CI: 33.8–39.2] for neostage IIIC patients. Adjusted 5-year DSS for SI and nonSI tumors (n=66,185) was similar for neostage I, IIA, and IIB, and markedly lower for IIIA and IIIC. Adjusted DSS for SI IIIA was similar to nonSI IIIC. Conclusions Noninflammatory SI breast cancers have widely varied DSS that differs by tumor size and nodal involvement, and therefore should not all be stage III. SI should be subordinate to T and N groupings to classify SI with nonSI lesions having similar prognoses. PMID:25026875

  16. 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

  17. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT.

    PubMed

    Metser, Ur; Even-Sapir, Einat

    2007-05-01

    The use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) in the field of oncology is rapidly evolving; however, (18)F-FDG is not tumor specific. Aside from physiological uptake (18)F-FDG also may accumulate in benign processes. Knowledge of these (18)F-FDG-avid nonmalignant lesions is essential for accurate PET interpretation in oncologic patients to avoid a false-positive interpretation. Through the systematic review of the reports of PET/computed tomography (CT) studies performed in oncologic patients during a 6-month period, we found benign nonphysiological uptake of (18)F-FDG in more than 25% of studies. In half of these, (18)F-FDG uptake was moderate or marked in intensity, similar to that of malignant sites. A total of 73% of benign lesions were inflammatory in nature, with post-traumatic bone and soft-tissue abnormalities (including iatrogenic injury) and benign tumors accounting for the remainder. The differentiation of benign from malignant uptake of (18)F-FDG on PET alone may be particularly challenging as a result of the low anatomical resolution of PET and paucity of anatomical landmarks. Fusion imaging, namely PET/CT, has been shown to improve not only the sensitivity of PET interpretation but also its specificity. Aside from better anatomical localization of lesions on PET/CT, morphological characterization of lesions on CT often may improve the diagnostic accuracy of nonspecific (18)F-FDG uptake. Correlation with CT on fused PET/CT data may obviate the need for further evaluation or biopsy in more than one-third of scintigraphic equivocal lesions. Familiarity with (18)F-FDG-avid nonmalignant lesions also may extend the use of (18)F-FDG-PET imaging beyond the field of oncology. We have tabulated our experience with benign entities associated with increased (18)F-FDG uptake on whole-body PET/CT from 12,000 whole-body (18)F-FDG-PET/CT studies performed during a 4-year period.

  18. A robust region-based active contour model with point classification for ultrasound breast lesion segmentation

    NASA Astrophysics Data System (ADS)

    Liu, Zhihua; Zhang, Lidan; Ren, Haibing; Kim, Ji-Yeun

    2013-02-01

    Lesion segmentation is one of the key technologies for computer-aided diagnosis (CAD) system. In this paper, we propose a robust region-based active contour model (ACM) with point classification to segment high-variant breast lesion in ultrasound images. First, a local signed pressure force (LSPF) function is proposed to classify the contour points into two classes: local low contrast class and local high contrast class. Secondly, we build a sub-model for each class. For low contrast class, the sub-model is built by combining global energy with local energy model to find a global optimal solution. For high contrast class, the sub-model is just the local energy model for its good level set initialization. Our final energy model is built by adding the two sub-models. Finally, the model is minimized and evolves the level set contour to get the segmentation result. We compare our method with other state-of-art methods on a very large ultrasound database and the result shows that our method can achieve better performance.

  19. Early Breast Cancer Precursor Lesions: Lessons Learned from Molecular and Clinical Studies

    PubMed Central

    Sinn, Hans-Peter; Elsawaf, Zeinab; Helmchen, Birgit; Aulmann, Sebastian

    2010-01-01

    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

  20. ROC study of the effect of stereoscopic imaging on assessment of breast lesions.

    PubMed

    Chan, Heang-Ping; Goodsitt, Mitchell M; Helvie, Mark A; Hadjiiski, Lubomir M; Lydick, Justin T; Roubidoux, Marilyn A; Bailey, Janet E; Nees, Alexis; Blane, Caroline E; Sahiner, Berkman

    2005-04-01

    An observer performance study was conducted to evaluate the usefulness of assessing breast lesion characteristics with stereomammography. Stereoscopic image pairs of 158 breast biopsy tissue specimens were acquired with a GE Senographe 2000D full field digital mammography system using a 1.8x magnification geometry. A phantom-shift method equivalent to a stereo shift angle of +/- 3 degrees relative to a central axis perpendicular to the detector was used. For each specimen, two pairs of stereo images were taken at approximately orthogonal orientations. The specimens contained either a mass, microcalcifications, both, or normal tissue. Based on pathological analysis, 39.9% of the specimens were found to contain malignancy. The digital specimen radiographs were displayed on a high resolution MegaScan CRT monitor driven by a DOME stereo display board using in-house developed software. Five MQSA radiologists participated as observers. Each observer read the 316 specimen stereo image pairs in a randomized order. For each case, the observer first read the monoscopic image and entered his/her confidence ratings on the presence of microcalcifications and/or masses, margin status, BI-RADS assessment, and the likelihood of malignancy. The corresponding stereoscopic images were then displayed on the same monitor and were viewed through stereoscopic LCD glasses. The observer was free to change the ratings in every category after stereoscopic reading. The ratings of the observers were analyzed by ROC methodology. For the 5 MQSA radiologists, the average Az value for estimation of the likelihood of malignancy of the lesions improved from 0.70 for monoscopic reading to 0.72 (p=0.04) after stereoscopic reading, and the average Az value for the presence of microcalcifications improved from 0.95 to 0.96 (p=0.02). The Az value for the presence of masses improved from 0.80 to 0.82 after stereoscopic reading, but the difference fell short of statistical significance (p=0.08). The visual

  1. TU-CD-207-02: Quantification of Breast Lesion Compositions Using Low-Dose Spectral Mammography: A Feasibility Study

    SciTech Connect

    Cho, H; Ding, H; Sennung, D; Kumar, N; Molloi, S

    2015-06-15

    Purpose: To investigate the feasibility of measuring breast lesion composition with spectral mammography using physical phantoms and bovine tissue. Methods: Phantom images were acquired with a spectral mammography system with a silicon-strip based photon-counting detector. Plastic water and adipose-equivalent phantoms were used to calibrate the system for dual-energy material decomposition. The calibration phantom was constructed in range of 2–8 cm thickness and water densities in the range of 0% to 100%. A non-linear rational fitting function was used to calibrate the imaging system. The phantom studies were performed with uniform background phantom and non-uniform background phantom. The breast lesion phantoms (2 cm in diameter and 0.5 cm in thickness) were made with water densities ranging from 0 to 100%. The lesion phantoms were placed in different positions and depths on the phantoms to investigate the accuracy of the measurement under various conditions. The plastic water content of the lesion was measured by subtracting the total decomposed plastic water signal from a surrounding 2.5 mm thick border outside the lesion. In addition, bovine tissue samples composed of 80 % lean were imaged as background for the simulated lesion phantoms. Results: The thickness of measured and known water contents was compared. The rootmean-square (RMS) errors in water thickness measurements were 0.01 cm for the uniform background phantom, 0.04 cm for non-uniform background phantom, and 0.03 cm for 80% lean bovine tissue background. Conclusion: The results indicate that the proposed technique using spectral mammography can be used to accurately characterize breast lesion compositions.

  2. Expression and Activation of STAT Transcription Factors in Breast Cancer

    DTIC Science & Technology

    1998-05-08

    several other studies suggest that estrogen given in low doses to relieve menopausal symptoms probably does not increase the incidence of breast cancer...breast cancer. ’It was recently demonstrated that, while .overall STAT DNA-bindinq activity is low in normal breast and benign lesions, it is...adjuvant anticancer treatment, particularly in chronic myelogenous leukemia, maliqnant melanoma, low · grade lymphoma, multiple myeloma, and midgut

  3. [Identification of the primary lesion in a patient with concomitant breast and kidney cancer following fracture of the femur].

    PubMed

    Sato, Yasufumi; Okishiro, Masatsugu; Ishida, Tomo; Morimoto, Yoshihiro; Kusama, Hiroki; Matsusita, Katsunori; Hashimoto, Tadayoshi; Kimura, Kei; Katsura, Yoshiteru; Nitta, Kanae; Kagawa, Yoshinori; Takeno, Atsushi; Sakisaka, Hideki; Nakahira, Shin; Taniguchi, Hirokazu; Egawa, Chiyomi; Takeda, Yutaka; Kato, Takeshi; Tamura, Shigeyuki; Takatsuka, Yuichi; Oku, Kazuko; Goto, Takayoshi; Nagano, Teruaki; Nakatsuka, Shinichi

    2014-11-01

    A 61-year-old woman was diagnosed with breast cancer [T3N3cM0: Stage IIIC, estrogen receptor [ER] (+), progesterone receptor [PgR] (+), human epidermal growth factor receptor 2[HER2] (-)]at the time of initial presentation. Following diagnosis, combined modality therapy including hormone therapy and chemotherapy were initiated, but hemorrhage from the primary lesion and bone metastases were observed. Priority was given to treatment of the breast cancer, and chemotherapy was administered, after which, right mastectomy and axillary lymph node sampling were performed to assess local disease control. In addition, concurrent right kidney enucleation was performed for a renal lesion. The renal neoplasm was diagnosed as T1aN0M0, Stage I. After this intervention, treatment of the breast cancer was continued, but pain of the right femoral region developed, and bone metastasis was diagnosed on close inspection. The bone metastasis was considered to derive from the breast cancer. During hospitalization, the patient fell and broke her right femur. Open reduction and internal fixation was performed immediately, and bone metastasis of kidney cancer was diagnosed via perioperative cytodiagnosis. Pulmonary metastasis, local recurrence, and metastasis to the shoulder blade have been detected. The metastases are considered to derive from the breast cancer, for which treatment has been continued. In the case of concomitant cancers, biopsy for metastatic foci can be considered essential, whenever it can be performed safely.

  4. Label-Free Detection of Breast Masses Using Multiphoton Microscopy

    PubMed Central

    Lu, Jianping; Zhu, Weifeng; Qiu, Jingting; Chen, Jianxin; Xie, Shusen; Zhuo, Shuangmu; Yan, Jun

    2013-01-01

    Histopathology forms the gold standard for the diagnosis of breast cancer. Multiphoton microscopy (MPM) has been proposed to be a potentially powerful adjunct to current histopathological techniques. A label-free imaging based on two- photon excited fluorescence and second-harmonic generation is developed for differentiating normal breast tissues, benign, as well as breast cancer tissues. Human breast biopsies (including human normal breast tissues, benign as well as breast cancer tissues ) that are first imaged (fresh, unfixed, and unstained) with MPM and are then processed for routine H-E histopathology. Our results suggest that the MPM images, obtained from these unprocessed biopsies, can readily distinguish between benign lesions and breast cancers. In the tissues of breast cancers, MPM showed that the tumor cells displayed marked cellular and nuclear pleomorphism. The tumor cells, characterized by irregular size and shape, enlarged nuclei, and increased nuclear-cytoplasmic ratio, infiltrated into disrupted connective tissue, leading to the loss of second-harmonic generation signals. For breast cancer, MPM diagnosis was 100% correct because the tissues of breast cancers did not have second-harmonic generation signals in MPM imaging. On the contrary, in benign breast masses, second-harmonic generation signals could be seen easily in MPM imaging. These observations indicate that MPM could be an important potential tool to provide label-free noninvasive diagnostic impressions that can guide surgeon in biopsy and patient management. PMID:23755295

  5. 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

  6. 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.

  7. Qualitative and quantitative analysis with a novel shear wave speed imaging for differential diagnosis of breast lesions

    PubMed Central

    Yang, Yu-Ping; Xu, Xiao-Hong; Guo, Le-Hang; He, Ya-Ping; Wang, Dan; Liu, Bo-Ji; Zhao, Chong-Ke; Chen, Bao-Ding; Xu, Hui-Xiong

    2017-01-01

    To evaluate the diagnostic performance of a new two-dimensional shear wave speed (SWS) imaging (i.e. Toshiba shear wave elastography, T-SWE) in differential diagnosis of breast lesions. 225 pathologically confirmed breast lesions in 218 patients were subject to conventional ultrasound and T-SWE examinations. The mean, standard deviation and ratio of SWS values (m/s) and elastic modulus (KPa) on T-SWE were computed. Besides, the 2D elastic images were classified into four color patterns. The area under the receiver operating characteristic (AUROC) curve analysis was performed to evaluate the diagnostic performance of T-SWE in differentiation of breast lesions. Compared with other quantitative T-SWE parameters, mean value expressed in KPa had the highest AUROC value (AUROC = 0.943), with corresponding cut-off value of 36.1 KPa, sensitivity of 85.1%, specificity of 96.6%, accuracy of 94.2%, PPV of 87.0%, and NPV of 96.1%. The AUROC of qualitative color patterns in this study obtained the best performance (AUROC = 0.957), while the differences were not significant except for that of Eratio expressed in m/s (AUROC = 0.863) (P = 0.03). In summary, qualitative color patterns of T-SWE obtained the best performance in all parameters, while mean stiffness (36.05 KPa) provided the best diagnostic performance in the quantitative parameters. PMID:28102328

  8. 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.

  9. 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.

  10. Double-blind controlled trial of progesterone vaginal cream treatment for cyclical mastodynia in women with benign breast disease.

    PubMed

    Nappi, C; Affinito, P; Di Carlo, C; Esposito, G; Montemagno, U

    1992-12-01

    The clinical effectiveness and safety of vaginal micronized progesterone treatment in mastodynia were evaluated in a double-blind placebo controlled study. Eighty regularly menstruating women affected by severe cyclical mastodynia were randomly assigned to two groups of 40 patients. One group was treated for 6 cycles from the 19th to the 25th day of the cycle with 4 g of vaginal cream containing 2.5% natural progesterone. The other group was similarly treated with placebo. The treatment was preceded by a control cycle. All patients reported every day their breast pain on a 100 mm visual linear analogue scale (VAS). The response of breast tenderness and nodularity to treatment was assessed by clinical examination. Vaginal progesterone resulted significantly more efficacious than placebo in reducing mean ratings of breast pain on VAS and mean scores of breast tenderness to touch. Success of treatment, defined as reduction greater than 50% of basal mean score of breast pain on VAS, was achieved in the 64.9% of patients treated with progesterone and in the 22.2% of patients receiving placebo (p < 0.01). Conversely, at the end of treatment, the improvement in breast nodularity showed a not statistically significant difference between the two groups. No major side-effects were detected.

  11. Expression of estrogen receptor, progesterone receptor, and Ki67 in normal breast tissue in relation to subsequent risk of breast cancer

    PubMed Central

    Oh, Hannah; Eliassen, A Heather; Wang, Molin; Smith-Warner, Stephanie A; Beck, Andrew H; Schnitt, Stuart J; Collins, Laura C; Connolly, James L; Montaser-Kouhsari, Laleh; Polyak, Kornelia; Tamimi, Rulla M

    2016-01-01

    Although expression of estrogen receptor (ER), progesterone receptor (PR), and cell proliferation marker Ki67 serve as predictive and prognostic factors in breast cancers, little is known about their roles in normal breast tissue. Here in a nested case–control study within the Nurses’ Health Studies (90 cases, 297 controls), we evaluated their expression levels in normal breast epithelium in relation to subsequent breast cancer risk among women with benign breast disease. Tissue microarrays were constructed using cores obtained from benign biopsies containing normal terminal duct lobular units and immunohistochemical stained for these markers. We found PR and Ki67 expression was non-significantly but positively associated with subsequent breast cancer risk, whereas ER expression was non-significantly inversely associated. After stratifying by lesion subtype, Ki67 was significantly associated with higher risk among women with proliferative lesions with atypical hyperplasia. However, given the small sample size, further studies are required to confirm these results. PMID:28111631

  12. Depth-correction algorithm that improves optical quantification of large breast lesions imaged by diffuse optical tomography

    PubMed Central

    Tavakoli, Behnoosh; Zhu, Quing

    2011-01-01

    Optical quantification of large lesions imaged with diffuse optical tomography in reflection geometry is depth dependence due to the exponential decay of photon density waves. We introduce a depth-correction method that incorporates the target depth information provided by coregistered ultrasound. It is based on balancing the weight matrix, using the maximum singular values of the target layers in depth without changing the forward model. The performance of the method is evaluated using phantom targets and 10 clinical cases of larger malignant and benign lesions. The results for the homogenous targets demonstrate that the location error of the reconstructed maximum absorption coefficient is reduced to the range of the reconstruction mesh size for phantom targets. Furthermore, the uniformity of absorption distribution inside the lesions improve about two times and the median of the absorption increases from 60 to 85% of its maximum compared to no depth correction. In addition, nonhomogenous phantoms are characterized more accurately. Clinical examples show a similar trend as the phantom results and demonstrate the utility of the correction method for improving lesion quantification. PMID:21639570

  13. Clinical Data as an Adjunct to Ultrasound Reduces the False-Negative Malignancy Rate in BI-RADS 3 Breast Lesions

    PubMed Central

    Ackermann, S.; Schoenenberger, C.-A.; Zanetti-Dällenbach, R.

    2016-01-01

    Purpose: Ultrasound (US) is a well-established diagnostic procedure for breast examination. We investigated the malignancy rate in solid breast lesions according to their BI-RADS classification with a particular focus on false-negative BI-RADS 3 lesions. We examined whether patient history and clinical findings could provide additional information that would help determine further diagnostic steps in breast lesions. Materials and Methods: We conducted a retrospective study by exploring US BI-RADS in 1469 breast lesions of 1201 patients who underwent minimally invasive breast biopsy (MIBB) from January 2002 to December 2011. Results: The overall sensitivity and specificity of BI-RADS classification was 97.4% and 66.4%, respectively, with a positive (PPV) and negative predictive value (NPV) of 65% and 98%, respectively. In 506 BI-RADS 3 lesions, histology revealed 15 malignancies (2.4% malignancy rate), which corresponds to a false-negative rate (FNR) of 2.6%. Clinical evaluation and patient requests critically influenced the further diagnostic procedure, thereby prevailing over the recommendation given by the BI-RADS 3 classification. Conclusion: Clinical criteria including age, family and personal history, clinical examination, mammography and patient choice ensure adequate diagnostic procedures such as short-term follow-up or MIBB in patients with lesions classified as US-BI-RADS 3. PMID:27689181

  14. Breast implant foreign body reaction mimicking breast cancer recurrence on FDG PET/CT.

    PubMed

    Ulaner, Gary A; D'Andrea, Gabriella; Cody, Hiram S

    2013-06-01

    A woman with bilateral breast cancer treated with bilateral mastectomies, implant reconstructions, chemotherapy, and hormonal therapy underwent FDG PET/CT imaging. Imaging demonstrated sternal, nodal, and lung lesions which were stable or slowly increasing, as well as a parasternal chest wall mass which was enlarging much more rapidly and was excised. Pathology of the chest wall mass demonstrated only benign soft tissue with fat necrosis and foreign body giant cell reaction, without evidence of malignancy or implant rupture. This case demonstrates how a benign FDG-avid foreign body reaction, induced by an intact breast prosthesis, could easily be mistaken for malignancy.

  15. Analysis of 3D Subharmonic Ultrasound Signals from Patients with Known Breast Masses for Lesion Differentiation

    DTIC Science & Technology

    2013-10-01

    kinetics based on temporal data for 4D subharmonic breast ultrasound exams.  Applied these algorithms to an existing data set of contrast enhanced...Mattrey, H. Ojeda- Fournier, K. Wallace, C.L. Chalek, K.E. Thomenius, F. Forsberg. Initial 10 experiences with 4D subharmonic breast Imaging. Ultrasound ...to improve visualization of vascularity using 4D subharmonic breast imaging. Ultrasound Med Biol 2013; 39(5): S27. Scientific presentations: 1

  16. Aluminum concentrations in central and peripheral areas of malignant breast lesions do not differ from those in normal breast tissues

    PubMed Central

    2013-01-01

    Background Aluminum is used in a wide range of applications and is a potential environmental hazard. The known genotoxic effects of aluminum might play a role in the development of breast cancer. However, the data currently available on the subject are not sufficient to establish a causal relationship between aluminum exposure and the augmented risk of developing breast cancer. To achieve maximum sensitivity and specificity in the determination of aluminum levels, we have developed a detection protocol using graphite furnace atomic absorption spectrometry (GFAAS). The objective of the present study was to compare the aluminum levels in the central and peripheral areas of breast carcinomas with those in the adjacent normal breast tissues, and to identify patient and/or tumor characteristics associated with these aluminum levels. Methods A total of 176 patients with breast cancer were included in the study. Samples from the central and peripheral areas of their tumors were obtained, as well as from the surrounding normal breast tissue. Aluminum quantification was performed using GFAAS. Results The average (mean ± SD) aluminum concentrations were as follows: central area, 1.88 ± 3.60 mg/kg; peripheral area, 2.10 ± 5.67 mg/kg; and normal area, 1.68 ± 11.1 mg/kg. Overall and two-by-two comparisons of the aluminum concentrations in these areas indicated no significant differences. We detected a positive relationship between aluminum levels in the peripheral areas of the tumors, age and menopausal status of the patients (P = .02). Conclusions Using a sensitive quantification technique we detected similar aluminum concentrations in the central and peripheral regions of breast tumors, and in normal tissues. In addition, we did not detect significant differences in aluminum concentrations as related to the location of the breast tumor within the breast, or to other relevant tumor features such as stage, size and steroid receptor status. The next

  17. 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

  18. Radial scar lesions of the breast diagnosed by needle core biopsy: analysis of cases containing occult malignancy

    PubMed Central

    Douglas‐Jones, Anthony G; Denson, Jemimah L; Cox, Adam C; Harries, Iwan B; Stevens, Guy

    2007-01-01

    Aim To identify and review cases of false negative needle core biopsy (NCB) in the preoperative investigation of radial scar/complex sclerosing lesion (RS/CSL) lesions—that is, benign NCB from RS/CSL which contained malignancy on excision. Methods and results A total of 11 false negative NCB in RS/CSL lesions from 281 (3.9%) were identified (6 cases: B1, 2 cases: B2 and 3 cases: B3). In 6 of 11 cases a radial scar or stromal sclerosis was seen in NCB. Localisation biopsy showed duct carcinoma in situ in six cases, duct carcinoma in situ with invasive carcinoma in three and invasive carcinoma in two. In all 11 cases, needle tracks were identified as missing the malignant epithelium by a mean of 5 mm (median:4 mm; range:1–20 mm). In 9 of 11 cases, the malignancy was missed by <6 mm. Conclusions Despite evidence of accurate targeting of lesions, the use of NCB instead of fine needle aspiration cytology has not eliminated the problem of false negative biopsy in RS/CSL, and excision is recommended. PMID:16731590

  19. 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.

  20. Endomedullary radiofrequency ablation of metastatic lesion of the right femur 5 years after primary breast carcinoma: a case report.

    PubMed

    Majerović, Mate; Augustin, Goran; Jelincić, Zeljko; Buković, Damir; Burcar, Ivan; Smud, Dubravko; Kekez, Tihomir; Kinda, Emil; Matosević, Petar; Turcić, Josip

    2008-12-01

    Metastatic tumors of the long bones usually present with severe pain refractory to analgesic therapy. Pathologic fractures of the bone may lead to the significant decrease of patient's quality of life and necessitate further surgical therapy. We present 66 year old female with metastatic left breast carcinoma (T2N0M0) diagnosed 5 years before presentation of the metastatic lesion of the right femur causing severe pain in the middle of the right upper leg. Pain persisted after palliative irradiation therapy. We performed radiofrequency ablation of the metastatic lesion of the right femur using R.I.TA. Medical System Generator. This resulted in total necrosis of the tumor mass that caused osteolysis of the internal part of the femoral cortex. First three months after RFA procedure, the pain and tenderness were absent and normal daily activities were performed without restrictions.

  1. Spectral embedding based active contour (SEAC) for lesion segmentation on breast dynamic contrast enhanced magnetic resonance imaging

    PubMed Central

    Agner, Shannon C.; Xu, Jun; Madabhushi, Anant

    2013-01-01

    Purpose: Segmentation of breast lesions on dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) is the first step in lesion diagnosis in a computer-aided diagnosis framework. Because manual segmentation of such lesions is both time consuming and highly susceptible to human error and issues of reproducibility, an automated lesion segmentation method is highly desirable. Traditional automated image segmentation methods such as boundary-based active contour (AC) models require a strong gradient at the lesion boundary. Even when region-based terms are introduced to an AC model, grayscale image intensities often do not allow for clear definition of foreground and background region statistics. Thus, there is a need to find alternative image representations that might provide (1) strong gradients at the margin of the object of interest (OOI); and (2) larger separation between intensity distributions and region statistics for the foreground and background, which are necessary to halt evolution of the AC model upon reaching the border of the OOI. Methods: In this paper, the authors introduce a spectral embedding (SE) based AC (SEAC) for lesion segmentation on breast DCE-MRI. SE, a nonlinear dimensionality reduction scheme, is applied to the DCE time series in a voxelwise fashion to reduce several time point images to a single parametric image where every voxel is characterized by the three dominant eigenvectors. This parametric eigenvector image (PrEIm) representation allows for better capture of image region statistics and stronger gradients for use with a hybrid AC model, which is driven by both boundary and region information. They compare SEAC to ACs that employ fuzzy c-means (FCM) and principal component analysis (PCA) as alternative image representations. Segmentation performance was evaluated by boundary and region metrics as well as comparing lesion classification using morphological features from SEAC, PCA+AC, and FCM+AC. Results: On a cohort of 50

  2. 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

  3. Benign cutaneous Degos' disease.

    PubMed

    Ojeda Cuchillero, R M; Sánchez Regaña, M; Umbert Millet, P

    2003-03-01

    Malignant atrophic papulosis is a rare systemic vaso-occlusive disorder characterized by thrombosis of vessels of the dermis, gastrointestinal tract, central nervous system and, occasionally, other organs. Cutaneous lesions consist of erythematous, dome-shaped papules that develop a central area of necrosis to leave a porcelain-like scar. The most accepted theory of pathogenesis is based on endothelial cell damage. There is no effective treatment of the disease. We describe a 26-year-old man with Degos' disease, a diagnosis based on the clinical and histologic pattern of skin lesions. The good response to antiplatelet therapy and the absence of systemic involvement over 8 years' follow-up is noteworthy. We believe that this case represents the benign form of the disease, typically referred to as benign cutaneous Degos' disease.

  4. 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.

  5. Application of 3D and 2D quantitative shear wave elastography (SWE) to differentiate between benign and malignant breast masses

    PubMed Central

    Tian, Jie; Liu, Qianqi; Wang, Xi; Xing, Ping; Yang, Zhuowen; Wu, Changjun

    2017-01-01

    As breast cancer tissues are stiffer than normal tissues, shear wave elastography (SWE) can locally quantify tissue stiffness and provide histological information. Moreover, tissue stiffness can be observed on three-dimensional (3D) colour-coded elasticity maps. Our objective was to evaluate the diagnostic performances of quantitative features in differentiating breast masses by two-dimensional (2D) and 3D SWE. Two hundred ten consecutive women with 210 breast masses were examined with B-mode ultrasound (US) and SWE. Quantitative features of 3D and 2D SWE were assessed, including elastic modulus standard deviation (ESDE) measured on SWE mode images and ESDU measured on B-mode images, as well as maximum elasticity (Emax). Adding quantitative features to B-mode US improved the diagnostic performance (p < 0.05) and reduced false-positive biopsies (p < 0.0001). The area under the receiver operating characteristic curve (AUC) of 3D SWE was similar to that of 2D SWE for ESDE (p = 0.026) and ESDU (p = 0.159) but inferior to that of 2D SWE for Emax (p = 0.002). Compared with ESDU, ESDE showed a higher AUC on 2D (p = 0.0038) and 3D SWE (p = 0.0057). Our study indicates that quantitative features of 3D and 2D SWE can significantly improve the diagnostic performance of B-mode US, especially 3D SWE ESDE, which shows considerable clinical value. PMID:28106134

  6. Detection and Evaluation of Early Breast Cancer via Magnetic Resonance Imaging: Studies of Mouse Models and Clinical Implementation

    DTIC Science & Technology

    2009-03-01

    Hiroyuki Abe, Robert A. Schmidt, and Gillian M . Newstead. ”Differentiation between benign and malignant breast lesions detected by bilateral dynamic...Gregory S. Karczmar, Hiroyuki Abe, Robert A. Schmidt, Maryellen Giger and Gillian M . Newstead.”DCEMRI of breast lesions: Is kinetic analysis equally...93. 4. Sanaz A. Jansen, Akiko Shimacuhi, Lindsay Zak, Xiaobing Fan, Abbie M . Wood, Gregory Karczmar and Gillian M Newstead. ”Kinetic curves of

  7. Aging changes in the breast

    MedlinePlus

    ... age, a woman's breasts lose fat, tissue, and mammary glands. Many of these changes are due to the ... to their providers about mammograms. Images Female breast Mammary gland References Davidson NE. Breast cancer and benign breast ...

  8. Intraductal location of the sclerosing adenosis of the breast.

    PubMed

    Unal, Bulent; Gur, A Serhat; Bhargava, Rohit; Edington, Howard; Ahrendt, Gretchen; Soran, Atilla

    2009-01-01

    Sclerosing adenosis is a benign breast disease with non-specific images on ultrasound or mammogram. It can mimic infiltrating carcinoma when the above mentioned imaging techniques are used. Herein we present a patient with breast cancer who received neoadjuvant chemotherapy and subsequently underwent mastectomy. Ductoscopy was performed to the mastectomised breast specimen as per the ductoscopy research protocol. Ductoscopy revealed several nodular lesions in the duct with no additional demonstrable intraductal pathology. The lesions were reported as sclerosing adenosis by pathologist. As to our knowledge, this is the first case in literature that demonstrates the use of ductoscopy in diagnosing the sclerosing adenosis in the breast tissue. Ductoscopy and development of ductoscopy guided biopsy techniques may be used as an early diagnostic method for the ductal breast lesions (Fig. 2, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

  9. Molecular Mechanisms of Metastatic Progression in Breast Cancer

    DTIC Science & Technology

    2005-07-31

    15243 Redondo M, Villar E, Torres-Muñoz J, Tellez T, Morell M & Petito CK: Overexpression of clusterin in human breast carcinoma. Am J Pathol 2000...sites. Biochem 2002, 41:282-291. 21. de Silva HV, Stuart WD, Park YB, Mao SJ, Gil CM, Wetterau JR, Busch SJ, Harmony JA: Purification and characterization...reactant proteins in sera and breast lesions of patients with malignant and benign tumors. Electrophoresis 2004, 25:2392-2401. 33. Redondo M, Villar E

  10. A Novel Method Based on Learning Automata for Automatic Lesion Detection in Breast Magnetic Resonance Imaging

    PubMed Central

    Salehi, Leila; Azmi, Reza

    2014-01-01

    Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. In this way, magnetic resonance imaging (MRI) is emerging as a powerful tool for the detection of breast cancer. Breast MRI presently has two major challenges. First, its specificity is relatively poor, and it detects many false positives (FPs). Second, the method involves acquiring several high-resolution image volumes before, during, and after the injection of a contrast agent. The large volume of data makes the task of interpretation by the radiologist both complex and time-consuming. These challenges have led to the development of the computer-aided detection systems to improve the efficiency and accuracy of the interpretation process. Detection of suspicious regions of interests (ROIs) is a critical preprocessing step in dynamic contrast-enhanced (DCE)-MRI data evaluation. In this regard, this paper introduces a new automatic method to detect the suspicious ROIs for breast DCE-MRI based on region growing. The results indicate that the proposed method is thoroughly able to identify suspicious regions (accuracy of 75.39 ± 3.37 on PIDER breast MRI dataset). Furthermore, the FP per image in this method is averagely 7.92, which shows considerable improvement comparing to other methods like ROI hunter. PMID:25298929

  11. Causes of breast lumps (image)

    MedlinePlus

    ... breast lumps are benign (non-cancerous), as in fibroadenoma, a condition that mostly affects women under age ... with the menstrual cycle, whereas a lump from fibroadenoma does not. While most breast lumps are benign, ...

  12. BRCA1-IRIS overexpression promotes and maintains the tumor initiating phenotype: implications for triple negative breast cancer early lesions.

    PubMed

    Sinha, Abhilasha; Paul, Bibbin T; Sullivan, Lisa M; Sims, Hillary; El Bastawisy, Ahmed; Yousef, Hend F; Zekri, Abdel-Rahman N; Bahnassy, Abeer A; ElShamy, Wael M

    2017-02-07

    Tumor-initiating cells (TICs) are cancer cells endowed with self-renewal, multi-lineage differentiation, increased chemo-resistance, and in breast cancers the CD44+/CD24-/ALDH1+ phenotype. Triple negative breast cancers show lack of BRCA1 expression in addition to enhanced basal, epithelial-to-mesenchymal transition (EMT), and TIC phenotypes. BRCA1-IRIS (hereafter IRIS) is an oncogene produced by the alternative usage of the BRCA1 locus. IRIS is involved in induction of replication, transcription of selected oncogenes, and promoting breast cancer cells aggressiveness. Here, we demonstrate that IRIS overexpression (IRISOE) promotes TNBCs through suppressing BRCA1 expression, enhancing basal-biomarkers, EMT-inducers, and stemness-enforcers expression. IRISOE also activates the TIC phenotype in TNBC cells through elevating CD44 and ALDH1 expression/activity and preventing CD24 surface presentation by activating the internalization pathway EGFR→c-Src→cortactin. We show that the intrinsic sensitivity to an anti-CD24 cross-linking antibody-induced cell death in membranous CD24 expressing/luminal A cells could be acquired in cytoplasmic CD24 expressing IRISOE TNBC/TIC cells through IRIS silencing or inactivation. We show that fewer IRISOE TNBC/TICs cells form large tumors composed of TICs, resembling TNBCs early lesions in patients that contain metastatic precursors capable of disseminating and metastasizing at an early stage of the disease. IRIS-inhibitory peptide killed these IRISOE TNBC/TICs, in vivo and prevented their dissemination and metastasis. We propose IRIS inactivation could be pursued to prevent dissemination and metastasis from early TNBC tumor lesions in patients.

  13. 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

  14. NUCKS overexpression in breast cancer

    PubMed Central

    Drosos, Yiannis; Kouloukoussa, Mirsini; Østvold, Anne Carine; Grundt, Kirsten; Goutas, Nikos; Vlachodimitropoulos, Dimitrios; Havaki, Sophia; Kollia, Panagoula; Kittas, Christos; Marinos, Evangelos; Aleporou-Marinou, Vassiliki

    2009-01-01

    Background NUCKS (Nuclear, Casein Kinase and Cyclin-dependent Kinase Substrate) is a nuclear, DNA-binding and highly phosphorylated protein. A number of reports show that NUCKS is highly expressed on the level of mRNA in several human cancers, including breast cancer. In this work, NUCKS expression on both RNA and protein levels was studied in breast tissue biopsies consisted of invasive carcinomas, intraductal proliferative lesions, benign epithelial proliferations and fibroadenomas, as well as in primary cultures derived from the above biopsies. Specifically, in order to evaluate the level of NUCKS protein in correlation with the histopathological features of breast disease, immunohistochemistry was employed on paraffin sections of breast biopsies of the above types. In addition, NUCKS expression was studied by means of Reverse Transcription PCR (RT-PCR), real-time PCR (qRT-PCR) and Western immunoblot analyses in the primary cell cultures developed from the same biopsies. Results The immunohistochemical Results showed intense NUCKS staining mostly in grade I and II breast carcinomas compared to normal tissues. Furthermore, NUCKS was moderate expressed in benign epithelial proliferations, such as adenosis and sclerosing adenosis, and highly expressed in intraductal lesions, specifically in ductal carcinomas in situ (DCIS). It is worth noting that all the fibroadenoma tissues examined were negative for NUCKS staining. RT-PCR and qRT-PCR showed an increase of NUCKS expression in cells derived from primary cultures of proliferative lesions and cancerous tissues compared to the ones derived from normal breast tissues and fibroadenomas. This increase was also confirmed by Western immunoblot analysis. Although NUCKS is a cell cycle related protein, its expression does not correlate with Ki67 expression, neither in tissue sections nor in primary cell cultures. Conclusion The results show overexpression of the NUCKS protein in a number of non malignant breast lesions and

  15. Bilateral Simultaneous Pseudoangiomatous Stromal Hyperplasia of the Breasts and Axillae: Imaging Findings with Pathological and Clinical Correlation

    PubMed Central

    Ensani, Fereshteh; Omranipour, Ramesh; Abdollahi, Alireza

    2016-01-01

    Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a pathology that is usually diagnosed by accident during pathological examination of other breast lesions. PASH is an uncommon and benign tumoral lesion of the mammary stroma that can be pathologically mistaken for other tumours, such as phyllodes, fibroadenoma, and sometimes even angiosarcoma. We report the case of a 45-year-old woman with complaints of huge bilateral breast enlargement. This is a rare case of PASH presenting with gigantomastia and involving bilateral breasts and axillae simultaneously. Mammography, ultrasonography, and MRI features are illustrated with histopathological correlation. PMID:27867677

  16. 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

  17. Pseudoangiomatous stromal hyperplasia causing massive breast enlargement.

    PubMed

    Bourke, Anita Geraldine; Tiang, Stephen; Harvey, Nathan; McClure, Robert

    2015-10-16

    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.

  18. Computer-Aided Diagnosis of Solid Breast Lesions Using an Ultrasonic Multi-Feature Analysis Procedure

    DTIC Science & Technology

    2011-01-01

    areas. We quantified morphometric features by geometric and fractal analysis of traced lesion boundaries. Although no single parameter can reliably...These include acoustic descriptors (“echogenicity,” “heterogeneity,” “shadowing”) and morphometric descriptors (“area,” “aspect ratio,” “border...quantitative descriptors; some morphometric features (such as border irregularity) also were particularly effective in lesion classification. Our

  19. Efficacy of 'radioguided occult lesion localisation' (ROLL) versus 'wire-guided localisation' (WGL) in breast conserving surgery for non-palpable breast cancer: a randomised controlled multicentre trial.

    PubMed

    Postma, E L; Verkooijen, H M; van Esser, S; Hobbelink, M G; van der Schelling, G P; Koelemij, R; Witkamp, A J; Contant, C; van Diest, P J; Willems, S M; Borel Rinkes, I H M; van den Bosch, M A A J; Mali, W P; van Hillegersberg, R

    2012-11-01

    For the management of non-palpable breast cancer, accurate pre-operative localisation is essential to achieve complete resection with optimal cosmetic results. Radioguided occult lesions localisation (ROLL) uses the radiotracer, injected intra-tumourally for sentinel lymph node identification to guide surgical excision of the primary tumour. In a multicentre randomised controlled trial, we determined if ROLL is superior to the standard of care (i.e. wire-guided localisation, WGL) for preoperative tumour localisation. Women (>18 years.) with histologically proven non-palpable breast cancer and eligible for breast conserving treatment with sentinel node procedure were randomised to ROLL or WGL. Patients allocated to ROLL received an intra-tumoural dose of 120 Mbq technetium-99 m nanocolloid. The tumour was surgically removed, guided by gamma probe detection. In the WGL group, ultrasound- or mammography-guided insertion of a hooked wire provided surgical guidance for excision of the primary tumour. Primary outcome measures were the proportion of complete tumour excisions (i.e. with negative margins), the proportion of patients requiring re-excision and the volume of tissue removed. Data were analysed according to intention-to-treat principle. This study is registered at ClinincalTrials.gov, number NCT00539474. In total, 314 patients with 316 invasive breast cancers were enrolled. Complete tumour removal with negative margins was achieved in 140/162 (86 %) patients in the ROLL group versus 134/152 (88 %) patients in the WGL group (P = 0.644). Re-excision was required in 19/162 (12 %) patients in the ROLL group versus 15/152 (10 %) (P = 0.587) in the WGL group. Specimen volumes in the ROLL arm were significantly larger than those in the WGL arm (71 vs. 64 cm(3), P = 0.017). No significant differences were seen in the duration and difficulty of the radiological and surgical procedures, the success rate of the sentinel node procedure, and cosmetic outcomes. In this first

  20. Regularized Reconstruction of Dynamic Contrast-Enhanced MR Images for Evaluation of Breast Lesions

    DTIC Science & Technology

    2010-09-01

    V. Knopp, E. Weiss, H. P. Sinn, J. Mattern, H. Junkermann, J. Radeleff, A. Magener, G. Brix , S. Delorme, I. Zuna, and G. . Kaick, “Pathophysiologic...basis of contrast enhancement in breast tumors,” J. Mag. Res. Im., vol. 10, no. 3, pp. 260–6, Sept. 1999. [11] P. S. Tofts, G. Brix , D. L. Buckley, J. L

  1. 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

  2. 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

  3. 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

  4. Benign Paroxysmal Positional Vertigo

    MedlinePlus

    ... Questionnaire Home Diseases and Conditions Benign Paroxysmal Positional Vertigo (BPPV) Benign Paroxysmal Positional Vertigo (BPPV) Condition Family HealthMenWomen Share Benign Paroxysmal Positional ...

  5. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature

    PubMed Central

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  6. 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

  7. 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

  8. Pursuing shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS) for concomitant detection of breast lesions and microcalcifications.

    PubMed

    Zheng, Chao; Shao, Wanting; Paidi, Santosh Kumar; Han, Bing; Fu, Tong; Wu, Di; Bi, Lirong; Xu, Weiqing; Fan, Zhimin; Barman, Ishan

    2015-10-28

    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.

  9. Channeling Nanoparticles for Detection and Targeted Treatment of Breast Cancerous Lesions

    DTIC Science & Technology

    2011-10-01

    have also confirmed that non-neoplastic breast epithelial MCF10A cells display basal polarity on filters. This represents a simplified system to study ...is to provide a model to study the use of fluorescent magnetic nano or submicron particles for future detection and treatment applications. In the...PEGylation was successful as indicated by an observed size increase for the PEGylated SMPs relative to the size of the stock SMPs. Zeta potential

  10. Effects of grayscale window/level parameters on breast lesion detectability

    NASA Astrophysics Data System (ADS)

    Johnson, Jeffrey P.; Nafziger, John S.; Krupinski, Elizabeth A.; Lubin, Jeffrey; Roehrig, Hans

    2003-05-01

    The detectability of low-contrast lesions in medical images can be affected significantly by the choice of grayscale window width and level (W/L) for electronic display. Our objective was to measure the effects of various W/L conditions on lesion detectability in simulated and real mammographic images, and then correlate observer performance with predictions of detection thresholds derived from a visual discrimination model (VDM). In the first experiment, detection thresholds were measured in 2AFC trials for five W/L conditions applied to simulated mammographic backgrounds and lesions (i.e., Gaussian "masses" and blurred-disk "microcalcification clusters") using nonmedical observers. In the second experiment, the detectability of real microcalcification clusters in digitized mammograms was evaluated for three W/L conditions in an ROC observer study with mammographers. For the simulated images, there was generally good agreement between model and experimental thresholds and their variations across W/L conditions. Both experimental and model results showed significant reductions in thresholds when W/L processing was applied locally near the lesion. ROC results with digitized mammograms read by radiologists, however, failed to show enhanced detection of microcalcifications using a localized W/L frame, probably due to the nonuniform appearance of parenchymal tissue across the image.

  11. Targeting Premalignant Lesions: Implications for Early Breast Cancer Detection and Intervention

    DTIC Science & Technology

    2015-04-01

    characterized by distinct phenotypic changes that occur in the mammary gland . We proposed to utilize this animal model to probe early stage...of the matrix in the mammary glands containing the early cancer lesions. On further analysis, we determined that CSG peptide co-localizes with

  12. 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

  13. A Retrospective Comparative Study of Image-Guided Excisional Biopsy in High-Risk Non-Palpable Breast Lesions: Predictive Factors for Malignancy

    PubMed Central

    İflazoğlu, Nidal; Üreyen, Orhan; Atahan, Murat Kemal; Meral, Ulvi Mehmet; Sezgin, Gülten; Tarcan, Ercüment

    2015-01-01

    Objective The use of mammography (MM) in breast cancer screening programs has been increasing in recent years. Thus, increasing the number of detected nonpalpable breast cancer patients, through early diagnosis and treatment also increased survival rates. In our study, we wanted to share the factors about imaging-guided exicional biopsies for non-palpable breast lesions in postoperative proven breast carcinoma patients. Materials and Methods The surgical data were reviewed for 83 patients with non-palpabl high-risk breast lesions undergoing imaging-guided surgery in our department between January, 2006 and May, 2011. Histopathologic results and age, ultrasound(US) results, MM image results, BI-RADS categorization, localization of lesion(quadrant) were assessed and factors for predicting malignity were detected. Results Median age was 52 (age range 32–80 years). 29 (34,9%) of patients were malign in histopathologic results. In four patient, re-excision performed because of positive surgical margins. Axillary examination results were normal in 24 (82,7%) of malignant patients. In MM examination; microcalcifications and nodular opasity were diagnosed in 74,6% of patients before surgery. There were no differance about malignity in these groups after surgery (p:0,428). 59% and 32,7% of patients were BI-RADS 4 and 3, respectively. Postoperative diagnosed malignancies in BI-RADS 4 group were significantly higher than BI-RADS 3 group (p:<0,001). Conclusion In our study; we concluded that, preoperative BI-RADS categorization (US and MM) is correlated with histopathologic findings after surgery and imaging-guided breast surgery is effective for diagnosis of early-stage breast carcinoma.

  14. Primary parapharyngeal and skull base synovial sarcoma in a 13-year-old boy with neurofibromatosis radiologically misdiagnosed as a benign lesion.

    PubMed

    Zahir, Shokouh Taghipour; Sharahjin, Naser Sefidrokh; Dadgarnia, Mohammad Hossein

    2013-06-03

    Synovial sarcoma is a rare form of malignant tumour and accounting approximately for 8% of all soft tissue sarcomas. Head and neck synovial sarcomas are uncommon and parapharyngeal space involvement is extremely rare. We report a case of synovial sarcoma in the parapharyngeal space of a 13-year-old boy with a history of neurofibromatosis presented with odynophagia, ptosis and left submandibular mass. The lesion extended from retrostyloid parapharyngeal space to the skull base and foramen jugular superiorly. The first clinical and radiological impressions were carotid jugular related tumours such as schwannoma and paraganglioma.

  15. Reducing breast biopsies by ultrasonographic analysis and a modified self-organizing map

    NASA Astrophysics Data System (ADS)

    Zheng, Yi; Greenleaf, James F.; Gisvold, John J.

    1997-05-01

    Recent studies suggest that visual evaluation of ultrasound images could decrease negative biopsies of breast cancer diagnosis. However, visual evaluation requires highly experienced breast sonographers. The objective of this study is to develop computerized radiologist assistant to reduce breast biopsies needed for evaluating suspected breast cancer. The approach of this study utilizes a neural network and tissue features extracted from digital sonographic breast images. The features include texture parameters of breast images: characteristics of echoes within and around breast lesions, and geometrical information of breast tumors. Clusters containing only benign lesions in the feature space are then identified by a modified self- organizing map. This newly developed neural network objectively segments population distributions of lesions and accurately establishes benign and equivocal regions.t eh method was applied to high quality breast sonograms of a large number of patients collected with a controlled procedure at Mayo Clinic. The study showed that the number of biopsies in this group of women could be decreased by 40 percent to 59 percent with high confidence and that no malignancies would have been included in the nonbiopsied group. The advantages of this approach are that it is robust, simple, and effective and does not require highly experienced sonographers.

  16. Should the hyperechogenic halo around malignant breast lesions be included in the measurement of tumor size?

    PubMed

    Joekel, Judith; Eggemann, Holm; Costa, Serban Dan; Ignatov, Atanas

    2016-04-01

    The estimation of tumor size is important for treatment strategies of breast cancer. The hyperechogenic zone around breast cancer is a recognized criterion for malignancy, but its impact on preoperative tumor size estimations has been poorly investigated. Data of prospectively maintained database of 513 patients with primary breast tumors were analyzed retrospectively. A total of 196 patients with complete datasets including preoperative ultrasound (US) were eligible for analysis. The median age of the patients was 58.5 years (range 33-87). With all of the 196 patients, US has been performed. In 170 of 196 (86.7 %) cases, an echogenic halo was detected. We use two ways to measure tumor size with US: without (US-0) and with (US-1) echogenic halo. Mammography (MG) was used as standard. Tumor size measured by US and MG was compared with the actual histopathological (HP) tumor size. Mean differences between the sizing obtained by US-0, US-1, and MG and the HP sizing were -6.5, -1.5, and -1.8 mm, respectively. All three methods tend to underestimate the tumor size. The US-1 measurement was the closest to the HP size in comparison to the MG and US-0 measurements and the match was higher in tumors <2 cm. The estimated Pearson correlation coefficients (r) were 0.72, 0.68, and 0.61 for US-1, US-0, and MG, respectively. Moreover, the predictive value of US-1 regarding tumor size was not influenced by histological type and grade of the tumor, receptor status, and presence of intraductal component. Estimation of tumor size by US should include the hyperechogenic zone around the tumor.

  17. Design, Implementation, and Characterization of a Dedicated Breast Computed Mammo Tomography System for Enhanced Lesion Imaging

    DTIC Science & Technology

    2007-03-01

    with development of a phantom for this purpose (Figure.7). 9 Figure.7 Schematic of cross phantom with 5mm acrylic spheres arranged in a cross...total of 9 spheres are placed on the sheet (graphic is courtesy of Priti Madhav). Cross phantom studies showed that lesion information may be...measurements of similar Varian devices. A phantom was developed specifically for the measurement of 3D MTF, NPS, and resulting DQE (Figure.9

  18. RET/PTC Rearrangements Are Associated with Elevated Postoperative TSH Levels and Multifocal Lesions in Papillary Thyroid Cancer without Concomitant Thyroid Benign Disease.

    PubMed

    Su, Xuan; He, Caiyun; Ma, Jiangjun; Tang, Tao; Zhang, Xiao; Ye, Zulu; Long, Yakang; Shao, Qiong; Shao, Jianyong; Yang, Ankui

    2016-01-01

    RET/PTC rearrangements, resulting in aberrant activity of the RET protein tyrosine kinase receptor, occur exclusively in papillary thyroid cancer (PTC). In this study, we examined the association between RET/PTC rearrangements and thyroid hormone homeostasis, and explored whether concomitant diseases such as nodular goiter and Hashimoto's thyroiditis influenced this association. A total of 114 patients diagnosed with PTC were enrolled in this study. Thyroid hormone levels, clinicopathological parameters and lifestyle were obtained through medical records and surgical pathology reports. RET/PTC rearrangements were detected using TaqMan RT-PCR and validated by direct sequencing. No RET/PTC rearrangements were detected in benign thyroid tissues. RET/PTC rearrangements were detected in 23.68% (27/114) of PTC tissues. No association between thyroid function, clinicopathological parameters and lifestyle was observed either in total thyroid cancer patients or the subgroup of patients with concomitant disease. In the subgroup of PTC patients without concomitant disease, RET/PTC rearrangement was associated with multifocal cancer (P = 0.018). RET/PTC rearrangement was also correlated with higher TSH levels at one month post-surgery (P = 0.037). Based on likelihood-ratio regression analysis, the RET/PTC-positive PTC cases showed an increased risk of multifocal cancers in the thyroid gland (OR = 5.57, 95% CI, 1.39-22.33). Our findings suggest that concomitant diseases such as nodular goiter and Hashimoto's thyroiditis in PTC may be a confounding factor when examining the effects of RET/PTC rearrangements. Excluding the potential effect of this confounding factor showed that RET/PTC may confer an increased risk for the development of multifocal cancers in the thyroid gland. Aberrantly increased post-operative levels of TSH were also associated with RET/PTC rearrangement. Together, our data provides useful information for the treatment of papillary thyroid cancer.

  19. RET/PTC Rearrangements Are Associated with Elevated Postoperative TSH Levels and Multifocal Lesions in Papillary Thyroid Cancer without Concomitant Thyroid Benign Disease

    PubMed Central

    Su, Xuan; He, Caiyun; Ma, Jiangjun; Tang, Tao; Zhang, Xiao; Ye, Zulu; Long, Yakang; Shao, Qiong

    2016-01-01

    RET/PTC rearrangements, resulting in aberrant activity of the RET protein tyrosine kinase receptor, occur exclusively in papillary thyroid cancer (PTC). In this study, we examined the association between RET/PTC rearrangements and thyroid hormone homeostasis, and explored whether concomitant diseases such as nodular goiter and Hashimoto's thyroiditis influenced this association. A total of 114 patients diagnosed with PTC were enrolled in this study. Thyroid hormone levels, clinicopathological parameters and lifestyle were obtained through medical records and surgical pathology reports. RET/PTC rearrangements were detected using TaqMan RT-PCR and validated by direct sequencing. No RET/PTC rearrangements were detected in benign thyroid tissues. RET/PTC rearrangements were detected in 23.68% (27/114) of PTC tissues. No association between thyroid function, clinicopathological parameters and lifestyle was observed either in total thyroid cancer patients or the subgroup of patients with concomitant disease. In the subgroup of PTC patients without concomitant disease, RET/PTC rearrangement was associated with multifocal cancer (P = 0.018). RET/PTC rearrangement was also correlated with higher TSH levels at one month post-surgery (P = 0.037). Based on likelihood-ratio regression analysis, the RET/PTC-positive PTC cases showed an increased risk of multifocal cancers in the thyroid gland (OR = 5.57, 95% CI, 1.39–22.33). Our findings suggest that concomitant diseases such as nodular goiter and Hashimoto's thyroiditis in PTC may be a confounding factor when examining the effects of RET/PTC rearrangements. Excluding the potential effect of this confounding factor showed that RET/PTC may confer an increased risk for the development of multifocal cancers in the thyroid gland. Aberrantly increased post-operative levels of TSH were also associated with RET/PTC rearrangement. Together, our data provides useful information for the treatment of papillary thyroid cancer. PMID

  20. Skin lesion removal

    MedlinePlus

    ... removal; Basal cell cancer - removal; Actinic keratosis - removal; Wart - removal; Squamous cell - removal; Mole - removal; Nevus - removal; ... can remove: Benign or pre-malignant skin lesions Warts Moles Sunspots Hair Small blood vessels in the ...

  1. Cytodiagnosis of papillary carcinoma of the breast: Report of a case with histological correlation.

    PubMed

    Aggarwal, Deepti; Soin, Navmeet; Kalita, Dipti; Pant, Leela; Kudesia, Madhur; Singh, Sompal

    2014-04-01

    Papillary lesions of the breast pose diagnostic challenges on aspiration cytology due to overlapping features of benign and malignant entities. Accurate cytologic diagnosis of papillary breast carcinoma cannot usually be made pre-operatively. We present the case of an adult female who underwent fine-needle aspiration (FNA) of a left breast lump. FNA smears were highly cellular showing cohesive clusters, complex papillary fragments and few singly dispersed intact cells. The tumor cells had hyperchromatic nuclei, prominent nucleoli and mild nuclear pleomorphism. A cytologic impression of papillary lesion, possibly malignant (in view of high cellularity, complex papillae and single intact cells) was rendered. The lesion proved to be a papillary carcinoma with microscopic foci of stromal invasion on histologic examination. Papillary carcinoma, an uncommon subtype of breast carcinoma, should be considered while evaluating a papillary lesion with complex branching papillae containing delicate fibrovascular cores and singly lying intact atypical cells.

  2. Pink lesions.

    PubMed

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  3. Inhibition of hyaluronan synthesis in breast cancer cells by 4-methylumbelliferone suppresses tumorigenicity in vitro and metastatic lesions of bone in vivo.

    PubMed

    Urakawa, Hiroshi; Nishida, Yoshihiro; Wasa, Junji; Arai, Eisuke; Zhuo, Lisheng; Kimata, Koji; Kozawa, Eiji; Futamura, Naohisa; Ishiguro, Naoki

    2012-01-15

    Hyaluronan (HA) has been shown to play crucial roles in the tumorigenicity of malignant tumors. Previous studies demonstrated that inhibition of HA suppressed the tumorigenicity of various malignant tumors including breast cancer. 4-methylumbelliferone (MU) has been reported to inhibit HA synthesis in several cell types. However, few studies have focused on the effects of HA inhibition in breast cancer cells by MU, nor the effects on bone metastasis. We hypothesized that MU would suppress the progression of bone metastasis via inhibition of HA synthesis. Here, we investigated the effects of MU on HA expression in MDA-MB-231 breast cancer cell line in addition to their tumorigenicity in vitro and in vivo. HAS2 mRNA expression was downregulated after 6 and 24 hr treatment with MU. Quantitative analysis of HA revealed that MU significantly inhibited the intracellular and cell surface HA. MU significantly inhibited cell growth and induced apoptosis as determined by cell proliferation and TUNEL assays, respectively. Phosphorylation of Akt was suppressed after 12 and 24 hr treatment with MU. MU treatment also inhibited cell motility as well as cell invasiveness. MU also inhibited cell growth and motility in murine fibroblast cell line NIH3T3. In vivo, administration of MU inhibited the expansion of osteolytic lesions on soft X-rays in mouse breast cancer xenograft models. HA accumulation in bone metastatic lesions was perturbed peripherally. These data suggest that MU might be a therapeutic candidate for bone metastasis of breast cancer via suppression of HA synthesis and accumulation.

  4. 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

  5. Inframammarial Giant Fibroadenoma Removing and a Nipple-sparing Breast Reconstruction in an Adolescent: A Case Report.

    PubMed

    Ciftci, Ilhan; Sekmenli, Tamer; Ozbek, Seda; Karamese, Mehtap; Ugras, Serdar

    2015-01-01

    Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

  6. Mammary Fat of Breast Cancer: Gene Expression Profiling and Functional Characterization

    PubMed Central

    Chen, Fei; Fu, Ziyi; Yin, Hong; Lu, Xun; Yu, Jing; Lu, Cheng

    2014-01-01

    Mammary fat is the main composition of breast, and is the most probable candidate to affect tumor behavior because the fat produces hormones, growth factors and adipokines, a heterogeneous group of signaling molecules. Gene expression profiling and functional characterization of mammary fat in Chinese women has not been reported. Thus, we collected the mammary fat tissues adjacent to breast tumors from 60 subjects, among which 30 subjects had breast cancer and 30 had benign lesions. We isolated and cultured the stromal vascular cell fraction from mammary fat. The expression of genes related to adipose function (including adipogenesis and secretion) was detected at both the tissue and the cellular level. We also studied mammary fat browning. The results indicated that fat tissue close to malignant and benign lesions exhibited distinctive gene expression profiles and functional characteristics. Although the mammary fat of breast tumors atrophied, it secreted tumor growth stimulatory factors. Browning of mammary fat was observed and browning activity of fat close to malignant breast tumors was greater than that close to benign lesions. Understanding the diversity between these two fat depots may possibly help us improve our understanding of breast cancer pathogenesis and find the key to unlock new anticancer therapies. PMID:25291184

  7. Mammary fat of breast cancer: gene expression profiling and functional characterization.

    PubMed

    Wang, Fengliang; Gao, Sheng; Chen, Fei; Fu, Ziyi; Yin, Hong; Lu, Xun; Yu, Jing; Lu, Cheng

    2014-01-01

    Mammary fat is the main composition of breast, and is the most probable candidate to affect tumor behavior because the fat produces hormones, growth factors and adipokines, a heterogeneous group of signaling molecules. Gene expression profiling and functional characterization of mammary fat in Chinese women has not been reported. Thus, we collected the mammary fat tissues adjacent to breast tumors from 60 subjects, among which 30 subjects had breast cancer and 30 had benign lesions. We isolated and cultured the stromal vascular cell fraction from mammary fat. The expression of genes related to adipose function (including adipogenesis and secretion) was detected at both the tissue and the cellular level. We also studied mammary fat browning. The results indicated that fat tissue close to malignant and benign lesions exhibited distinctive gene expression profiles and functional characteristics. Although the mammary fat of breast tumors atrophied, it secreted tumor growth stimulatory factors. Browning of mammary fat was observed and browning activity of fat close to malignant breast tumors was greater than that close to benign lesions. Understanding the diversity between these two fat depots may possibly help us improve our understanding of breast cancer pathogenesis and find the key to unlock new anticancer therapies.

  8. A cytological and histomorphological case study of an uncommon breast carcinoma: Invasive papillary type.

    PubMed

    Gore, Charusheela R; Panicker, N K; Karve, P P

    2009-01-01

    Pure papillary carcinoma of the breast is a rare tumour affecting elderly postmenopausal women. We report one case in a relatively younger woman presenting with a clinically benign breast lump.The tumour showed extensive apocrine metaplasia. The ease with which abundant material with highly cellular papillary clumps is obtained on fine needle aspirate should be an important consideration favouring papillary carcinoma. The quality and quantity of stroma in papillae rather than the presence or absence of stromal support should also be a guiding criteria for excluding benign papillary lesions.

  9. Radioguided localisation of impalpable breast lesions using 99m-Technetium macroaggregated albumin: Lessons learnt during introduction of a new technique to guide preoperative localisation

    SciTech Connect

    Landman, Joanne; Kulawansa, Sagarika; McCarthy, Michael; Troedson, Russell; Phillips, Michael; Tinning, Jill; Taylor, Donna

    2015-03-15

    Preoperative wire-guided localisation (WGL) of impalpable breast lesions is widely used but can be technically difficult. Risks include wire migration, inaccurate placement, and inadequate surgical margins. Research shows that radioguided occult lesion localisation (ROLL) is quicker, easier, and can improve surgical and cosmetic outcomes. An audited introduction of ROLL was conducted to validate the technique as a feasible alternative to WGL. Fifty patients with single impalpable lesions and biopsy proven malignancy or indeterminate histology underwent WGL followed by intralesional radiopharmaceutical injection of 99m-Technetium macroaggregated albumin. Postprocedural mammography was performed to demonstrate wire position, and scintigraphy to evaluate radiopharmaceutical migration. Lymphoscintigraphy and intraoperative sentinel node biopsy were performed if indicated, followed by lesion localisation and excision using a gamma probe. Specimen imaging was performed, with immediate reexcision for visibly inadequate margins. Accurate localisation was achieved in 86% of patients with ROLL compared to 72% with WGL. All lesions were successfully removed, with clear margins in 71.8% of malignant lesions. Reexcision and intraoperative sentinel node localisation rates were equivalent to preaudit figures for WGL. ROLL was easy to perform and problems were infrequent. Inaccurate radiopharmaceutical placement necessitating WGL occurred in four patients. Minor radiopharmaceutical migration was common, but precluded using ROLL in only two cases. ROLL is effective, simple, inexpensive, and easily learnt; however, preoperative confirmation of correct radiopharmaceutical placement using mammography and the gamma probe is important to help ensure successful lesion removal. Insertion of a backup hookwire is recommended during the initial introduction of ROLL.

  10. Signal enhancement ratio (SER) quantified from breast DCE-MRI and breast cancer risk

    NASA Astrophysics Data System (ADS)

    Wu, Shandong; Kurland, Brenda F.; Berg, Wendie A.; Zuley, Margarita L.; Jankowitz, Rachel C.; Sumkin, Jules; Gur, David

    2015-03-01

    Breast magnetic resonance imaging (MRI) is recommended as an adjunct to mammography for women who are considered at elevated risk of developing breast cancer. As a key component of breast MRI, dynamic contrast-enhanced MRI (DCE-MRI) uses a contrast agent to provide high intensity contrast between breast tissues, making it sensitive to tissue composition and vascularity. Breast DCE-MRI characterizes certain physiologic properties of breast tissue that are potentially related to breast cancer risk. Studies have shown that increased background parenchymal enhancement (BPE), which is the contrast enhancement occurring in normal cancer-unaffected breast tissues in post-contrast sequences, predicts increased breast cancer risk. Signal enhancement ratio (SER) computed from pre-contrast and post-contrast sequences in DCE-MRI measures change in signal intensity due to contrast uptake over time and is a measure of contrast enhancement kinetics. SER quantified in breast tumor has been shown potential as a biomarker for characterizing tumor response to treatments. In this work we investigated the relationship between quantitative measures of SER and breast cancer risk. A pilot retrospective case-control study was performed using a cohort of 102 women, consisting of 51 women who had diagnosed with unilateral breast cancer and 51 matched controls (by age and MRI date) with a unilateral biopsy-proven benign lesion. SER was quantified using fully-automated computerized algorithms and three SER-derived quantitative volume measures were compared between the cancer cases and controls using logistic regression analysis. Our preliminary results showed that SER is associated with breast cancer risk, after adjustment for the Breast Imaging Reporting and Data System (BI-RADS)-based mammographic breast density measures. This pilot study indicated that SER has potential for use as a risk factor for breast cancer risk assessment in women at elevated risk of developing breast cancer.

  11. Precursor lesions of mucinous carcinoma of the breast: analysis of 130 cases.

    PubMed

    Kryvenko, Oleksandr N; Chitale, Dhananjay A; Yoon, Jiyoon; Arias-Stella, Javier; Meier, Frederick A; Lee, Min W

    2013-07-01

    Mucinous mammary carcinoma (MC) is a tumor type with relatively favorable prognosis. Unlike the circumstances surrounding conventional invasive duct carcinoma, data are limited regarding precursor lesions for MC. This study characterizes patterns of mucinous ductal carcinoma in situ (DCIS) as a precursor lesion for MC. All slides from 130 cases of MC encountered between 2000 and 2011 at Henry Ford Hospital, Detroit, MI were reviewed to subclassify MC, identify DCIS, and explore transition patterns from DCIS to MC. Calponin, p63, chromogranin, synaptophysin, CD56, and MIB-1 immunostaining analyses were performed in 65 cases. Among 106 cases of pure (71 type A, 35 type B) and 24 cases of mixed MC, DCIS appeared in 88 (68%) specimens, with all but 4 showing luminal mucin accumulation. Dominant patterns of mucinous DCIS were cribriform/solid (66), cribriform and papillary (7), papillary (5), micropapillary (3), and flat (3). Fifty-seven (68%) cases of mucinous DCIS demonstrated transitions from DCIS to MC. Luminal mucinous distention, focal flattening and attenuation of the epithelium, and disruption of the duct wall resulting in a mucocele-like extravasation of malignant epithelia with escaping mucin was a transition pattern seen with all architectures of DCIS and in all types of MC. This was the only pattern of transition to type A MC. The epithelial outpouching, formation of a cleft with accumulation of mucin around the epithelium, and transition into mucin pools with floating tumor cell clusters was the second transition pattern that went from cribriform/solid DCIS to type B and mixed MC. DCIS preceding aggressive phenotypes of MC (type B and mixed) more often had a cribriform/solid architecture, higher nuclear grade, and higher Ki-67-labeling index (all P<0.05). In summary, mucinous DCIS is a precursor to MC with distinctive features that link patterns of DCIS with aggressive MC phenotypes. The 2 observed transitions between mucinous DCIS and MC suggest that

  12. In vivo breast sound-speed imaging with ultrasound tomography

    SciTech Connect

    Huang, Lianjie; Li, Cuiping; Duric, Neb; Littrup, Peter

    2009-01-01

    We discuss a bent-ray ultrasound tomography algorithm with total-variation (TV) regularization. We have applied this algorithm to 61 in vivo breast datasets collected with our in-house clinical prototype for imaging sound-speed distributions in the breast. Our analysis showed that TV regularization could preserve sharper lesion edges than the classic Tikhonov regularization. Furthermore, the image quality of our TV bent-ray sound-speed tomograms was superior to that of the straight-ray counterparts for all types of breasts within BI-RADS density categories 1-4. For all four breast types from fatty to dense, the improvements for average sharpness (in the unit of (m{center_dot} s) {sup -1}) of lesion edges in our TV bent-ray tomograms are between 2.1 to 3.4 fold compared to the straight ray tomograms. Reconstructed sound-speed tomograms illustrated that our algorithm could successfully image fatty and glandular tissues within the breast. We calculated the mean sound-speed values for fatty tissue and breast parenchyma as 1422 {+-} 9 mls (mean{+-} SD) and1487 {+-} 21 mls, respectively. Based on 32 lesions in a cohort of 61 patients, we also found that the mean sound-speed for malignant breast lesions (1548{+-}17 mls) was higher, on average, than that of benign ones (1513{+-}27 mls) (one-sided pbreast density (, and therefore, breast cancer risk), as well as detect and help differentiate breast lesions. Finally, our sound-speed tomograms may also be a useful tool to monitor clinical response of breast cancer patients to neo-adjuvant chemotherapy.

  13. Effects of visual fixation cues on the detectability of simulated breast lesions

    NASA Astrophysics Data System (ADS)

    Nafziger, John S.; Johnson, Jeffrey P.; Lubin, Jeffrey

    2005-04-01

    A discrepancy exists between two studies that investigated psychophysical detection of simulated lesions (e.g. gaussians or designer nodules) embedded in filtered noise images (Johnson et al, 2002; Burgess et al, 2003). Johnson et al, 2002 identified a significant difference in the slope of the contrast detail plots (CD plots) as the presentation methodology in a 2AFC task was changed from the unlike background (unpaired) to identical backgrounds (paired). In comparable experiments, Burgess et al, 2003 challenged the results by finding no difference between the slopes (both positive) of the CD plots when using paired backgrounds or unpaired backgrounds. We found that a significant difference between the two studies, namely the presence of a circular fixation cue was responsible for the discrepancy. The detection noise due to positional uncertainty was sufficient to reduce subject's threshold for small target diameters. This effect was amplified in the paired background, switching the CD plot from a negative slope (without fixation) to a positive slope (with fixation). The effect was less dramatic with the unpaired backgrounds, however intra-observer variability seemed to be reduced with fixation cues. These results significantly reduce the discrepancies in C-D characteristics between the two studies.

  14. Diagnosing breast cancer by using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Haka, Abigail S.; Shafer-Peltier, Karen E.; Fitzmaurice, Maryann; Crowe, Joseph; Dasari, Ramachandra R.; Feld, Michael S.

    2005-08-01

    We employ Raman spectroscopy to diagnose benign and malignant lesions in human breast tissue based on chemical composition. In this study, 130 Raman spectra are acquired from ex vivo samples of human breast tissue (normal, fibrocystic change, fibroadenoma, and infiltrating carcinoma) from 58 patients. Data are fit by using a linear combination model in which nine basis spectra represent the morphologic and chemical features of breast tissue. The resulting fit coefficients provide insight into the chemical/morphological makeup of the tissue and are used to develop diagnostic algorithms. The fit coefficients for fat and collagen are the key parameters in the resulting diagnostic algorithm, which classifies samples according to their specific pathological diagnoses, attaining 94% sensitivity and 96% specificity for distinguishing cancerous tissues from normal and benign tissues. The excellent results demonstrate that Raman spectroscopy has the potential to be applied in vivo to accurately classify breast lesions, thereby reducing the number of excisional breast biopsies that are performed. Author contributions: M.F., J.C., R.R.D., and M.S.F. designed research; A.S.H. and K.E.S.-P. performed research; A.S.H. and M.F. analyzed data; and A.S.H. wrote the paper.This paper was submitted directly (Track II) to the PNAS office.Abbreviations: DEH, ductal epithelial hyperplasia; ROC, receiver operating characteristic; N/C, nuclear-to-cytoplasm.

  15. Benign Papillomas Without Atypia Diagnosed on Core Needle Biopsy: Experience From a Single Institution and Proposed Criteria for Excision

    PubMed Central

    Nayak, Anupma; Carkaci, Selin; Gilcrease, Michael Z.; Liu, Ping; Middleton, Lavinia P.; Bassett, Roland L.; Zhang, Jinxia; Zhang, Hong; Coyne, Robin L.; Bevers, Therese B.; Sneige, Nour; Huo, Lei

    2015-01-01

    The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. We describe the clinicopathologic features of 80 patients with such lesions in our institution, with an upgrade rate to malignancy of 3.8%. A multidisciplinary approach to select patients for surgical excision is recommended. Background The management of benign papilloma (BP) without atypia identified on breast core needle biopsy (CNB) is controversial. In this study, we determined the upgrade rate to malignancy for BPs without atypia diagnosed on CNB and whether there are factors associated with upgrade. Methods Through our pathology database search, we studied 80 BPs without atypia identified on CNB from 80 patients from 1997 to 2010, including 30 lesions that had undergone excision and 50 lesions that had undergone ≥ 2 years of radiologic follow-up. Associations between surgery or upgrade to malignancy and clinical, radiologic, and pathologic features were analyzed. Results Mass lesions, lesions sampled by ultrasound-guided CNB, and palpable lesions were associated with surgical excision. All 3 upgraded cases were mass lesions sampled by ultrasound-guided CNB. None of the lesions with radiologic follow-up only were upgraded to malignancy. The overall upgrade rate was 3.8%. None of the clinical, radiologic, or histologic features were predictive of upgrade. Conclusion Because the majority of patients can be safely managed with radiologic surveillance, a selective approach for surgical excision is recommended. Our proposed criteria for excision include pathologic/radiologic discordance or sampling by ultrasound-guided CNB without vacuum assistance when the patient is symptomatic or lesion size is ≥ 1.5 cm. PMID:24119786

  16. Development and Application of a Suite of 4-D Virtual Breast Phantoms for Optimization and Evaluation of Breast Imaging Systems

    PubMed Central

    Lin, Yuan; Ikejimba, Lynda C.; Ghate, Sujata V.; Dobbins, James T.; Segars, William P.

    2014-01-01

    Mammography is currently the most widely utilized tool for detection and diagnosis of breast cancer. However, in women with dense breast tissue, tissue overlap may obscure lesions. Digital breast tomosynthesis can reduce tissue overlap. Furthermore, imaging with contrast enhancement can provide additional functional information about lesions, such as morphology and kinetics, which in turn may improve lesion identification and characterization. The performance of these imaging techniques is strongly dependent on the structural composition of the breast, which varies significantly among patients. Therefore, imaging system and imaging technique optimization should take patient variability into consideration. Furthermore, optimization of imaging techniques that employ contrast agents should include the temporally varying breast composition with respect to the contrast agent uptake kinetics. To these ends, we have developed a suite of 4-D virtual breast phantoms, which are incorporated with the kinetics of contrast agent propagation in different tissues and can realistically model normal breast parenchyma as well as benign and malignant lesions. This development presents a new approach in performing simulation studies using truly anthropomorphic models. To demonstrate the utility of the proposed 4-D phantoms, we present a simplified example study to compare the performance of 14 imaging paradigms qualitatively and quantitatively. PMID:24691118

  17. Comedo-DCIS is a precursor lesion for basal-like breast carcinoma: identification of a novel p63/Her2/neu expressing subgroup

    PubMed Central

    Shekhar, Malathy P.V.; Kato, Ikuko; Nangia-Makker, Pratima; Tait, Larry

    2013-01-01

    Basal breast cancer comprises ~15% of invasive ductal breast cancers, and presents as high-grade lesions with aggressive clinical behavior. Basal breast carcinomas express p63 and cytokeratin 5 (CK5) antigens characteristic of the myoepithelial lineage, and typically lack Her2/neu and hormone receptor expression. However, there is limited data about the precursor lesions from which they emerge. Here we wished to determine whether comedo-ductal carcinoma in situ (comedo-DCIS), a high-risk in situ breast lesion, serve as precursors for basal-like breast cancer. To determine this link, p63, CK5, Her2/neu, epidermal growth factor receptor (EGFR), estrogen receptor (ER) and progesterone receptor (PgR) expression were analyzed by immunohistochemistry in 17 clinical comedo- and 12 noncomedo-DCIS cases, and in tumors derived from unfractionated and CK5-overexpressing subpopulation (MCF10DCIS.com-CK5high) of MCF10DCIS.com cells, a model representative of clinical comedo-DCIS. p63 and Her2/neu coexpression was analyzed by immunofluorescence double labeling. A novel p63/CK5/Her2/neu expressing subpopulation of cells that are ER−/PgR−/EGFR− were identified in the myoepithelial and luminal areas of clinical comedo-DCIS and tumors derived from unfractionated MCF10DCIS.com and MCF10DCIS.com-CK5high cells. These data suggest that p63 and Her2/neu expressors may share a common precursor intermediate. P63, but not Her2/neu, expression was significantly associated (P = 0.038) with microinvasion/recurrence of clinical comedo-DCIS, and simultaneous expression of p63 and Her2/neu was marginally associated (P = 0.067) with comedo-DCIS. These data suggest that p63/Her2/neu expressing precursor intermediate in comedo-DCIS may provide a cellular basis for emergence of p63+/Her2/neu- or p63+/Her2/neu+ basal-like breast cancer, and that p63/Her2/neu coexpression may serve as biomarkers for identification of this subgroup of basal-like breast cancers. PMID:23548208

  18. Synergy in combining findings from mammography and ultrasonography in detecting malignancy in women with higher density breasts and lesions over 2 cm in Albania

    PubMed Central

    Shahini, Albana

    2017-01-01

    Aim of the study To provide evidence of the synergy of combining findings from mammography (MM) and ultrasonography (US) in detecting malignancy in women with high-density breasts. Material and methods A total of 245 women were screened for breast cancer using both mammography and ultrasonography at the American Hospital in Tirana during 2013–2014. The data was used to identify possible benefits in detecting malignancy, by combining the findings of MM and US and confirming them with those of the biopsy. Data on age, breast density, BI-RADS classification, and biopsy confirmations were collected and analysed. Results Out of the 245 women, 36 biopsies were taken (17 for women classified BI-RADS 4 and 5; 19 for women with BI-RADS 3 that had grown in size from the previous examination). The accuracy in detecting malignancy for low-density-breast women was 90% for MM, 70% for US, and 90% for combined. For high-density breasts, the accuracy was 65% for MM, 79% for US, and 82% for combined findings. Multivariate analysis indicates that high-density-breast women who have a malignant finding in at least one of the examinations (MM or US) are 24 times more likely (p = 0.039) to have a positive finding in biopsy for malignancy. The odds increased 32 times for lesions over 2 cm (p = 0.056). Conclusions Our study results indicate additional benefits of combining findings from MM and US for high-density-breast women. Further study is warranted in a larger population and for different kinds of cancer. PMID:28239286

  19. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    SciTech Connect

    Williams, Alex C; Hitt, Austin N; Voisin, Sophie; Tourassi, Georgia

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  20. Imaging and Histopathologic Features of BI-RADS 3 Lesions Upgraded during Imaging Surveillance.

    PubMed

    Michaels, Aya; Chung, Chris SungWon; Birdwell, Robyn L; Frost, Elisabeth P; Giess, Catherine S

    2017-01-01

    To evaluate imaging and histopathologic differences between screen-detected benign and malignant upgraded lesions initially assessed as BI-RADS 3 at diagnostic evaluation. An IRB approved retrospective review of the mammography data base from January 1, 2004 to December 31, 2008 identified 1,188 (1.07%) of 110,776 screening examinations assessed as BI-RADS 3 following diagnostic evaluation at our academic center (staffed by breast specialists) or our outpatient center (staffed by general radiologists), 1,017 with at least 24 months follow-up or biopsy. Sixty (5.9%) BI-RADS 3 lesions were upgraded to BI-RADS 4 or 5 during imaging surveillance (study population). Prospective reports, patient demographics, and clinical outcomes were abstracted from the longitudinal medical record. Mean patient age was 54.1 years (range 35-85). Lesions consisted of 7 masses, 12 focal asymmetries and 41 calcifications. Fifteen (25%) of 60 lesions upgraded from initial BI-RADS 3 assessment were malignant (1.47% of total; 15/1,017 BI-RADS 3 studies). Malignancy rates by upgraded lesion type showed no significant difference: Thirty-three (73.3%) of 45 benign upgraded lesions were calcifications compared to 8 (53.3%) of 15 malignant upgraded lesions (p = 0.202). Twelve (26.7%) of 45 benign upgraded lesions were masses or focal asymmetries, compared to 7 (46.7%) of 15 upgraded malignant lesions (p = 0.202). Six (85.7%) of 7 malignant upgraded masses/focal asymmetries had no US correlate at initial BI-RADS 3 assessment compared to 7 (58.3%) of 12 benign upgraded masses/focal asymmetries (p = 0.33). Breast-imaging specialists interpreted 21 studies, 3 (14.3%) malignant; general radiologists interpreted 39 studies, 12 (30.8%) malignant (p = 0.218). There was no significant difference in malignancy rate among different types of upgraded mammographic lesions, nor depending on subspecialty interpretation versus nonsubspecialist interpretation. Although calcifications made up a majority of upgraded

  1. Human papillomavirus in oral lesions.

    PubMed

    González, Joaquín V; Gutiérrez, Rafael A; Keszler, Alicia; Colacino, Maria del Carmen; Alonio, Lidia V; Teyssie, Angelica R; Picconi, Maria Alejandra

    2007-01-01

    Growing evidence suggests a role for human papillomavirus (HPV) in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases); the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell samples from normal oral mucosa were used as controls. HPV detection and typing were performed by polymerase chain reaction (PCR) using primers MY09, 11, combined with RFLP or alternatively PCR using primers GP5+, 6+ combined with dot blot hybridization. HPV was detected in 91.0% of HPV- associated benign lesions, 14.3% of non-HPV associated benign lesions, 51.5% of preneoplasias and 60.0% of cancers. No control sample tested HPV positive. In benign HPV- associated lesions, 30.0% of HPV positive samples harbored high-risk types, while in preneoplastic lesions the value rose to 59.9%. In cancer lesions, HPV detection in verrucous carcinoma was 88.9% and in squamous cell carcinoma 43.8%, with high-risk type rates of 75.5% and 85.6%, respectively. The high HPV frequency detected in preneoplastic and neoplastic lesions supports an HPV etiological role in at least a subset of oral cancers.

  2. Oral benign fibrous histiocytoma: two case reports

    PubMed Central

    2009-01-01

    Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported. PMID:20066060

  3. Recent results from clinical trials using SERMs to reduce the risk of breast cancer.

    PubMed

    Vogel, Victor G

    2006-11-01

    Selective estrogen receptor modulators (SERMs) are used for the treatment of invasive breast cancer. Chemoprevention is the use of specific natural or synthetic chemical agents to reverse, suppress, or prevent the progression of premalignant lesions to invasive carcinoma. The finding of a decrease in contralateral breast cancer incidence following tamoxifen administration for adjuvant therapy led to its use in breast cancer prevention. Four large trials have used tamoxifen, the prototypical SERM, as a breast cancer chemopreventive agent with differing results. In the National Surgical Adjuvant Breast and Bowel Project's (NSABP) Breast Cancer Prevention Trial (BCPT), tamoxifen reduced the risk of invasive breast cancer by 49%. Tamoxifen also reduced the incidence of benign breast disease as well as the number of breast biopsies in the treated women. Three other randomized prevention trials comparing tamoxifen with placebo have been reported and show a reduction in breast cancer incidence of 38%. Serum levels of estrone sulfate and testosterone are significantly associated with breast cancer risk, and estradiol appears to be more strongly associated with breast cancer in high-risk women. Raloxifene is comparable to tamoxifen in its ability to reduce the risk of breast cancer in postmenopausal, high-risk women and has fewer side effects, as shown in the study of tamoxifen and raloxifene. Several ongoing and planned studies will evaluate the ability of aromatase inhibitors to reduce the risk of breast cancer in women at increased risk.

  4. Varicosity of a single breast: a rare entity.

    PubMed

    Jain, Vinod; Misra, Samir; Jaiswal, Vaibhav; Singh, Saumya

    2014-09-19

    Varicosity of the breasts is a rare clinical entity that may lead to symptoms such as prominent vascular markings over the breasts and may be painless; in long-standing cases it can lead to recurrent bleeding episodes. Bilateral venous affection in the breasts has been described in the literature; however, unilateral affection is a rarely documented phenomenon. Since vascular affliction of a single breast is rare and there is inherent difficulty in obtaining a histopathological diagnosis against a background of suspicion of malignancy, it is always challenging to provide optimal management to the patient. We are reporting a rare case of a 42-year-old, postmenopausal Indian woman with a long-standing history of unilateral varicosity of the left breast, who was treated successfully with a simple mastectomy; postoperative histopathology was consistent with benign vascular lesion, that is, angiomatosis.

  5. The Journey of Elastography: Background, Current Status, and Future Possibilities in Breast Cancer Diagnosis.

    PubMed

    Faruk, Tasnuva; Islam, Md Kafiul; Arefin, Sams; Haq, Md Zahurul

    2015-10-01

    Elastography is a promising way to assess tissue differences regarding stiffness or elasticity for what was historically assessed manually by palpation. Combined with conventional imaging modalities (eg, ultrasonography [US]), elastography can potentially evaluate the stiffness of a breast lesion and consequently help to detect malignant breast tumor from benign ones. Recent studies show that ultrasonographic elastography (USE) provides higher image quality compared with conventional B-mode US or mammography during breast cancer diagnosis, which eventually helps to reduce false-positive results (ie, increased specificity) and therefore is useful in avoiding breast biopsy. This article reviews the basics of elastography technique, classifications, diagnosis results obtained from clinical studies to date for differentiating malignant breast tumors from benign lesions, and its future possibilities. In addition, this article generalizes different elastography methods, modes, and associated imaging modalities in a simpler way and attempts to identify misconceptions and confusion related to existing elastography techniques. It also makes an effort to identify the gaps of information that need to be filled so that interested researchers can get an overall idea of elastography-based methods in a convenient way to carry out their research on breast elastography for prospective future applications, eg, breast cancer diagnosis or even in intraoperative breast tumor localization.

  6. Does flat epithelial atypia have rounder nuclei than columnar cell change/hyperplasia? A morphometric approach to columnar cell lesions of the breast.

    PubMed

    Yamashita, Yoshiko; Ichihara, Shu; Moritani, Suzuko; Yoon, Han-Seung; Yamaguchi, Masahiro

    2016-06-01

    Columnar cell lesions of the breast encompass columnar cell change/hyperplasia (CCC/CCH) and flat epithelial atypia (FEA). These have attracted researchers because emerging data suggest that FEA may represent the earliest histologically detectable non-obligate precursor of breast cancer. However, it is occasionally difficult to distinguish FEA from CCC/CCH because of similar histology. Although the nuclei of FEA are frequently described as relatively round compared with those of CCC/CCH, there are few morphometric studies to support this statement. The aim of this study was to provide objective data as to the nuclear shape in columnar cell lesions. As a shape descriptor, we adopted ellipticity that is defined by the formula 2b/2a, where a is the length of the long axis of the ellipse and b is the length of the short axis. Contrary to circularity, ellipticity reflects the overall configuration of an ellipse irrespective of surface irregularity. Our image analysis included generating whole slide images, extracting glandular cell nuclei, measuring nuclear ellipticity, and superimposing graded colors based on execution of results on the captured images. A total of 7917 nuclei extracted from 22 FEA images and 5010 nuclei extracted from 13 CCC/CCH images were analyzed. There was a significant difference in nuclear roundness between FEA and CCC/CCH with mean ellipticity values of 0.723 and 0.679, respectively (p < 0.001, Welch's t test). Furthermore, FEA with malignancy had significantly rounder nuclei than FEA without malignancy (p < 0.001). Our preliminary results suggest that nuclear ellipticity is a key parameter in reproducibly classifying columnar cell lesions of the breast.

  7. Adenolipoma of the Breast: A Clinicoradiological Entity and Pathologist’s Dilemma!

    PubMed Central

    Selvakumar, Veda Padama Priya

    2016-01-01

    Breast hamartomas are benign lesions composed of variety of normal breast components arranged in disorganized manner. These are rare and classified as adenolipoma, fibrolipoma, adenofibrolipoma, etc. Clinically these present as painless well-circumscribed, mobile lumps of breast. Incidence and etiology remain obscure due to its rarity. These have been described in women in their 40’s or 50’s. Mammographically they appear non homogenous mass with circumscribed fatty masses. Histologically they appear as circumscribed masses with variable amount of fat, fibrous and glandular tissue. Here we are presenting adenolipoma in 29-year-old woman with review of literature. PMID:27504390

  8. Outcome of initially only magnetic resonance mammography-detected findings with and without correlate at second-look sonography: distribution according to patient history of breast cancer and lesion size.

    PubMed

    Linda, Anna; Zuiani, Chiara; Londero, Viviana; Bazzocchi, Massimo

    2008-02-01

    The purpose of the study was to evaluate the outcome of initially only magnetic resonance mammography (MRM)-detected breast lesions as a function of radiologic features, history of breast cancer and lesion size. We evaluated core needle biopsy (CNB) (148) and follow-up (25) results of 173 initially only MRM-detected lesions-142 with and 31 without "second-look" correlate, as a function of (1) radiologic features (sonographic correlate, MRI BI-RADS category); (2) history of breast cancer; (3) MRM indication in case of history of breast neoplasm; (4) side and size of synchronous cancer; (5) lesion diameter. (1) Overall malignancy rate was 28.3% (49/173); significantly higher among lesions with a sonographic correlate (46/142), than among those without (3/31) (p=0.014). Frequencies of malignancy for MRI BI-RADS categories 2, 3, 4 and 5, were 0% (0/1), 5.4% (4/73), 26.1% (17/65) and 82.3% (28/34), respectively. (2) Malignancy rate was significantly higher in case of history of breast carcinoma (40/118 versus 9/55; p=0.027); in particular, of 42 MRI BI-RADS category 3 lesions in women with history of breast cancer and of 31 in patients without history, 3 (7%) and 1 (3%) proved to be malignant, respectively (non-significant). (3) Malignancy was more frequent when MRM was performed for pre-operative assessment than for follow-up (30/78 versus 10/40; non-significant). (4) Malignancy rate increased in presence of ipsilateral (19/35 versus 11/43; p=0.018), large (cut-off 6 mm: 30/75 versus 0/3, non-significant; 11 mm: 28/61 versus 2/17, p=0.011; 16 mm: 24/48 versus 6/30, p=0.015; 21 mm: 14/21 versus 16/57, p=0.004) primary tumors. (5) The frequency of malignancy was significantly higher in lesions equal to or larger than 6, 11 and 16 mm, compared with smaller lesions (6 mm: 45/136 versus 4/37, p=0.007; 11 mm: 21/51 versus 28/122, p=0.025; 16 mm: 12/24 versus 37/149, p=0.021). Radiologic features, history of breast cancer and large diameter are associated with high likelihood

  9. Myofibroblastoma of the Breast

    PubMed Central

    Aytaç, Hüseyin Özgür; Bolat, Filiz Aka; Canpolat, Tuba; Pourbagher, Ayşin

    2015-01-01

    This study aimed presenting a case of a 64-year-old woman with a rare diagnosis of myofibroblastoma (MFB). MFB is one of the rare, benign, spindle-like stromal tumors arising from the connective tissue of the breast. MFBs are often confused with fibroadenomas and hamartomas because of their benign characteristic appearance on breast imaging and are diagnosed after excisional biopsies. Their differential diagnosis with malignant neoplasia of the breast is important because of their wide morphological spectrum. Our case also demonstrated a breast mass with benign imaging characteristics and a needle core biopsy revealing a benign, spindle-like stromal tumor. The pathological examination performed after the excision of the lump demonstrated a collagenous-/fibrous-type MFB. This case report emphasizes the rare but important place of MFB variants of the breast in the differential diagnosis of breast mass.

  10. Multi-probe-based resonance-frequency electrical impedance spectroscopy for detection of suspicious breast lesions: improving performance using partial ROC optimization

    NASA Astrophysics Data System (ADS)

    Lederman, Dror; Zheng, Bin; Wang, Xingwei; Wang, Xiao Hui; Gur, David

    2011-03-01

    We have developed a multi-probe resonance-frequency electrical impedance spectroscope (REIS) system to detect breast abnormalities. Based on assessing asymmetry in REIS signals acquired between left and right breasts, we developed several machine learning classifiers to classify younger women (i.e., under 50YO) into two groups of having high and low risk for developing breast cancer. In this study, we investigated a new method to optimize performance based on the area under a selected partial receiver operating characteristic (ROC) curve when optimizing an artificial neural network (ANN), and tested whether it could improve classification performance. From an ongoing prospective study, we selected a dataset of 174 cases for whom we have both REIS signals and diagnostic status verification. The dataset includes 66 "positive" cases recommended for biopsy due to detection of highly suspicious breast lesions and 108 "negative" cases determined by imaging based examinations. A set of REIS-based feature differences, extracted from the two breasts using a mirror-matched approach, was computed and constituted an initial feature pool. Using a leave-one-case-out cross-validation method, we applied a genetic algorithm (GA) to train the ANN with an optimal subset of features. Two optimization criteria were separately used in GA optimization, namely the area under the entire ROC curve (AUC) and the partial area under the ROC curve, up to a predetermined threshold (i.e., 90% specificity). The results showed that although the ANN optimized using the entire AUC yielded higher overall performance (AUC = 0.83 versus 0.76), the ANN optimized using the partial ROC area criterion achieved substantially higher operational performance (i.e., increasing sensitivity level from 28% to 48% at 95% specificity and/ or from 48% to 58% at 90% specificity).

  11. An MMP13-Selective Inhibitor Delays Primary Tumor Growth and the Onset of Tumor-Associated Osteolytic Lesions in Experimental Models of Breast Cancer

    PubMed Central

    Shah, Manisha; Huang, Dexing; Blick, Tony; Connor, Andrea; Reiter, Lawrence A.; Hardink, Joel R.; Lynch, Conor C.; Waltham, Mark; Thompson, Erik W.

    2012-01-01

    We investigated the effects of the matrix metalloproteinase 13 (MMP13)-selective inhibitor, 5-(4-{4-[4-(4-fluorophenyl)-1,3-oxazol-2-yl]phenoxy}phenoxy)-5-(2-methoxyethyl) pyrimidine-2,4,6(1H,3H,5H)-trione (Cmpd-1), on the primary tumor growth and breast cancer-associated bone remodeling using xenograft and syngeneic mouse models. We used human breast cancer MDA-MB-231 cells inoculated into the mammary fat pad and left ventricle of BALB/c Nu/Nu mice, respectively, and spontaneously metastasizing 4T1.2-Luc mouse mammary cells inoculated into mammary fat pad of BALB/c mice. In a prevention setting, treatment with Cmpd-1 markedly delayed the growth of primary tumors in both models, and reduced the onset and severity of osteolytic lesions in the MDA-MB-231 intracardiac model. Intervention treatment with Cmpd-1 on established MDA-MB-231 primary tumors also significantly inhibited subsequent growth. In contrast, no effects of Cmpd-1 were observed on soft organ metastatic burden following intracardiac or mammary fat pad inoculations of MDA-MB-231 and 4T1.2-Luc cells respectively. MMP13 immunostaining of clinical primary breast tumors and experimental mice tumors revealed intra-tumoral and stromal expression in most tumors, and vasculature expression in all. MMP13 was also detected in osteoblasts in clinical samples of breast-to-bone metastases. The data suggest that MMP13-selective inhibitors, which lack musculoskeletal side effects, may have therapeutic potential both in primary breast cancer and cancer-induced bone osteolysis. PMID:22253746

  12. Stereotactic vacuum-assisted biopsies on a digital breast 3D-tomosynthesis system.

    PubMed

    Viala, Juliette; Gignier, Pierre; Perret, Baudouin; Hovasse, Claudie; Hovasse, Denis; Chancelier-Galan, Marie-Dominique; Bornet, Gregoire; Hamrouni, Adel; Lasry, Jean-Louis; Convard, Jean-Paul

    2013-01-01

    The purpose of this study was to describe our operating process and to report results of 118 stereotactic vacuum-assisted biopsies performed on a digital breast 3D-tomosynthesis system. From October 2009 to December 2010, 118 stereotactic vacuum assisted biopsies have been performed on a digital breast 3D-tomosynthesis system. Informed consent was obtained for all patients. A total of 106 patients had a lesion, six had two lesions. Sixty-one lesions were clusters of micro-calcifications, 54 were masses and three were architectural distortions. Patients were in lateral decubitus position to allow shortest skin-target approach (or sitting). Specific compression paddle, adapted on the system, performed, and graduated, allowing localization in X-Y. Tomosynthesis views define the depth of lesion. Graduated Coaxial localization kit determines the beginning of the biopsy window. Biopsies were performed with an ATEC-Suros, 9 Gauge handpiece. All biopsies, except one, have reached the lesions. Five hemorrhages were incurred in the process, but no interruption was needed. Eight breast hematomas, were all spontaneously resolved. One was an infection. About 40% of patients had a skin ecchymosis. Processing is fast, easy, and requires lower irradiation dose than with classical stereotactic biopsies. Histology analysis reported 45 benign clusters of micro-calcifications, 16 malignant clusters of micro-calcifications, 24 benign masses, and 33 malignant masses. Of 13 malignant lesions, digital 2D-mammography failed to detect eight lesions and underestimated the classification of five lesions. Digital breast 3D-tomosynthesis depicts malignant lesions not visualized on digital 2D-mammography. Development of tomosynthesis biopsy unit integrated to stereotactic system will permit histology analysis for suspicious lesions.

  13. SPARC (osteonectin) in breast tumors of different histologic types and its role in the outcome of invasive ductal carcinoma.

    PubMed

    Hsiao, Yi-Hsuan; Lien, Huang-Chun; Hwa, Hsiao-Lin; Kuo, Wen-Hung; Chang, King-Jen; Hsieh, Fon-Jou

    2010-01-01

    The purpose of this study was to characterize the immunohistochemical distribution of secreted protein acidic and rich in cystein (SPARC) in benign and malignant breast tumors of different histologic types and define its association with the outcome of invasive ductal carcinoma (IDC) patients. A total of 286 samples of benign and malignant breast lesions between 1994 and 2005 were retrieved from National Taiwan University Hospital. Up to 11 years clinical follow-up data were available for 185 patients with IDC. Immunohistochemistry staining with SPARC was performed in tissue microarray or whole section. The association of expression of SPARC and cumulative overall survival of IDC patients were analyzed using Kaplan-Meier survival analysis and Cox regression analysis. Secreted protein acidic and rich in cystein was not expressed in benign breast phylloides and all benign breast tumors, while expressed in 17.2% of IDC, 85% of metaplastic carcinoma of the breast (MCB), and all malignant breast phylloides. Secreted protein acidic and rich in cystein was strongly expressed in mesenchymal components of MCB and expression levels in epithelial components were variable. The correlation of positive expression of SPARC and poor long-term survival in IDC is significant (p = 0.004). Individuals with positive SPARC expression had 2.34 times higher hazard of death compared with those with negative SPARC expression after adjusting for factors including positive lymph node, TNM tumor stage, estrogen receptor, and progesterone receptor. Secreted protein acidic and rich in cystein may be useful as a prognostic indicator for IDC.

  14. Design of a phased array for the generation of adaptive radiation force along a path surrounding a breast lesion for dynamic ultrasound elastography imaging.

    PubMed

    Ekeom, Didace; Hadj Henni, Anis; Cloutier, Guy

    2013-03-01

    This work demonstrates, with numerical simulations, the potential of an octagonal probe for the generation of radiation forces in a set of points following a path surrounding a breast lesion in the context of dynamic ultrasound elastography imaging. Because of the in-going wave adaptive focusing strategy, the proposed method is adapted to induce shear wave fronts to interact optimally with complex lesions. Transducer elements were based on 1-3 piezocomposite material. Three-dimensional simulations combining the finite element method and boundary element method with periodic boundary conditions in the elevation direction were used to predict acoustic wave radiation in a targeted region of interest. The coupling factor of the piezocomposite material and the radiated power of the transducer were optimized. The transducer's electrical impedance was targeted to 50 Ω. The probe was simulated by assembling the designed transducer elements to build an octagonal phased-array with 256 elements on each edge (for a total of 2048 elements). The central frequency is 4.54 MHz; simulated transducer elements are able to deliver enough power and can generate the radiation force with a relatively low level of voltage excitation. Using dynamic transmitter beamforming techniques, the radiation force along a path and resulting acoustic pattern in the breast were simulated assuming a linear isotropic medium. Magnitude and orientation of the acoustic intensity (radiation force) at any point of a generation path could be controlled for the case of an example representing a heterogeneous medium with an embedded soft mechanical inclusion.

  15. Expression of Axl and its prognostic significance in human breast cancer

    PubMed Central

    Jin, Gaoyuan; Wang, Zhenzhen; Wang, Jianguang; Zhang, Like; Chen, Yanbin; Yuan, Pengfei; Liu, Dechun

    2017-01-01

    Breast cancer is the most common malignant cancer and second leading cause of cancer-related death among women, and its prevalence continues to increase. Axl overexpression has been identified in the many types of human cancer, and it has been demonstrated to participate in signaling pathways related to carcinogenesis and cancer development. In the present study, Axl expression was examined by performing immunohistochemical staining in 60 breast cancer tumors and 40 benign breast lesions (25 mammary dysplasia and 15 breast fibroadenoma). In total, 34 (56.67%) cancer tissues and 13 (32.5%) benign breast lesions were classified as exhibiting high levels of Axl expression, indicating a significant association between malignancy and high Axl expression. High Axl expression was also associated with estrogen receptor (ER) positivity (P=0.028), progesterone receptor (PR) positivity (P=0.007), and poor tumor differentiation (P=0.033). No significant associations were observed between Axl expression and age, tumor size, lymph node metastasis, tumor node metastasis staging, human epidermal growth factor receptor 2 and Ki67 antigen. The Kaplan-Meier survival analysis and Cox proportional hazard model both demonstrated that there was no statistical difference between Axl expression and breast cancer prognosis. However, it remains unclear whether the expression of Axl is correlated with the prognosis of luminal type breast cancer patients. PMID:28356938

  16. 8-Oxo-7,8-dihydro-2′-deoxyguanosine and other lesions along the coding strand of the exon 5 of the tumour suppressor gene P53 in a breast cancer case-control study

    PubMed Central

    Brancato, Beniamino; Munnia, Armelle; Cellai, Filippo; Ceni, Elisabetta; Mello, Tommaso; Bianchi, Simonetta; Catarzi, Sandra; Risso, Gabriella G.; Galli, Andrea; Peluso, Marco E.M.

    2016-01-01

    The next-generation sequencing studies of breast cancer have reported that the tumour suppressor P53 (TP53) gene is mutated in more than 40% of the tumours. We studied the levels of oxidative lesions, including 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG), along the coding strand of the exon 5 in breast cancer patients as well as in a reactive oxygen species (ROS)-attacked breast cancer cell line using the ligation-mediated polymerase chain reaction technique. We detected a significant ‘in vitro’ generation of 8-oxodG between the codons 163 and 175, corresponding to a TP53 region with high mutation prevalence, after treatment with xanthine plus xanthine oxidase, a ROS-generating system. Then, we evaluated the occurrence of oxidative lesions in the DNA-binding domain of the TP53 in the core needle biopsies of 113 of women undergoing breast investigation for diagnostic purpose. An increment of oxidative damage at the −G− residues into the codons 163 and 175 was found in the cancer cases as compared to the controls. We found significant associations with the pathological stage and the histological grade of tumours. As the major news of this study, this largest analysis of genomic footprinting of oxidative lesions at the TP53 sequence level to date provided a first roadmap describing the signatures of oxidative lesions in human breast cancer. Our results provide evidence that the generation of oxidative lesions at single nucleotide resolution is not an event highly stochastic, but causes a characteristic pattern of DNA lesions at the site of mutations in the TP53, suggesting causal relationship between oxidative DNA adducts and breast cancer. PMID:27260513

  17. Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous excision.

    PubMed

    Grady, Ian; Gorsuch, Heidi; Wilburn-Bailey, Shelly

    2008-01-01

    Surgical as well as conservative treatment has been described for fibroadenomas. Both have disadvantages. A minimally invasive treatment, ultrasound-guided, vacuum-assisted percutaneous excision has been shown to facilitate the removal of all imaged evidence of benign breast lesions, including fibroadenomas up to 3 cm in diameter. This study is performed to assess the long-term outcome of ultrasound-guided percutaneous excision as a minimally invasive treatment for fibroadenomas. A retrospective review of 69 consecutive fibroadenomas treated with ultrasound-guided percutaneous excision between May, 2001 and December, 2005 was carried out. All these lesions underwent percutaneous excision of all imaged lesion evidence. Clinical and sonographic follow-up was recommended for all patients every 6 months. Initial size, location, and patient age were recorded for each treated lesion. Of 69 lesions treated, 52 were available for follow-up. The median follow-up period was 22 months, with a range of 7 to 59 months. At 6 months, there were no fibroadenoma recurrences. Follow-up sonography demonstrated recurrences in 13 lesions distributed across eight patients. The overall recurrence rate was 15% (8/52) with an actuarial recurrence rate of 33% at 59 months. All of the recurrences were in lesions which were larger than 2 cm in size at initial presentation. Our data suggest that the mechanism of recurrence is the regrowth of retained lesion fragments too small to be detected by ultrasound--not the incomplete excision of all imaged lesion evidence. Despite successful percutaneous excision, fibroadenomas do recur. Lesions smaller than 2 cm in size, so treated, do not need additional therapy or surveillance. Fibroadenomas larger than 2 cm are prone to recurrence and require additional treatment.

  18. Optical mammography: bilateral breast symmetry in hemoglobin saturation maps

    NASA Astrophysics Data System (ADS)

    Anderson, Pamela G.; Sassaroli, Angelo; Kainerstorfer, Jana M.; Krishnamurthy, Nishanth; Kalli, Sirishma; Makim, Shital S.; Graham, Roger A.; Fantini, Sergio

    2016-10-01

    We present a study of the bilateral symmetry of human breast hemoglobin saturation maps measured with a broadband optical mammography instrument. We have imaged 21 patients with unilateral breast cancer, 32 patients with unilateral benign lesions, and 27 healthy patients. An image registration process was applied to the bilateral hemoglobin saturation (SO2) images by assigning each pixel to the low, middle, or high range of SO2 values, where the thresholds for the categories were the 15th and 85th percentiles of the individual saturation range. The Dice coefficient, which is a measure of similarity, was calculated for each patient's pair of right and left breast SO2 images. The invasive cancer patients were found to have an average Dice coefficient value of 0.55±0.07, which was significantly lower than the benign and healthy groups (0.61±0.11 and 0.62±0.12, respectively). Although differences were seen in a group analysis, the healthy patient Dice coefficients spanned a wide range, limiting the diagnostic capabilities of this SO2 symmetry analysis on an individual basis. Our results suggest that for assessing the SO2 contrast of breast lesions, it may be better to select a reference tissue in the ipsilateral rather than the contralateral breast.

  19. Optical mammography: bilateral breast symmetry in hemoglobin saturation maps

    PubMed Central

    Anderson, Pamela G.; Sassaroli, Angelo; Kainerstorfer, Jana M.; Krishnamurthy, Nishanth; Kalli, Sirishma; Makim, Shital S.; Graham, Roger A.; Fantini, Sergio

    2016-01-01

    Abstract. We present a study of the bilateral symmetry of human breast hemoglobin saturation maps measured with a broadband optical mammography instrument. We have imaged 21 patients with unilateral breast cancer, 32 patients with unilateral benign lesions, and 27 healthy patients. An image registration process was applied to the bilateral hemoglobin saturation (SO2) images by assigning each pixel to the low, middle, or high range of SO2 values, where the thresholds for the categories were the 15th and 85th percentiles of the individual saturation range. The Dice coefficient, which is a measure of similarity, was calculated for each patient’s pair of right and left breast SO2 images. The invasive cancer patients were found to have an average Dice coefficient value of 0.55±0.07, which was significantly lower than the benign and healthy groups (0.61±0.11 and 0.62±0.12, respectively). Although differences were seen in a group analysis, the healthy patient Dice coefficients spanned a wide range, limiting the diagnostic capabilities of this SO2 symmetry analysis on an individual basis. Our results suggest that for assessing the SO2 contrast of breast lesions, it may be better to select a reference tissue in the ipsilateral rather than the contralateral breast. PMID:26849841

  20. [Benign metastasizing pulmonary leiomyomatosis. A report of 3 cases].

    PubMed

    Pifarré, R; Izquierdo, J; Calatrava, A; Martínez, C; Ruiz, J; Morera, J

    1999-12-01

    The benign metastasizing leiomyoma is an uncommon variety of leiomyoma, tumor derived from smooth muscular tissue. The benign metastasizing leiomyoma affects a middle age women, with antecedents of uterine leiomyoma, the pulmonary lesions appeared as a multiple nodules, without systemic affectation. We present three cases of benign metastasizing leiomyoma that de diagnosis was made for biopsy by thoracotomy; and in one case the markers from estrogens' receivers were positive.

  1. Aberrant DNA methylation of cancer-related genes in giant breast fibroadenoma: a case report

    PubMed Central

    2011-01-01

    Introduction Giant fibroadenoma is an uncommon variant of benign breast lesions. Aberrant methylation of CpG islands in promoter regions is known to be involved in the silencing of genes (for example, tumor-suppressor genes) and appears to be an early event in the etiology of breast carcinogenesis. Only hypermethylation of p16INK4a has been reported in non-giant breast fibroadenoma. In this particular case, there are no previously published data on epigenetic alterations in giant fibroadenomas. Our previous results, based on the analysis of 49 cancer-related CpG islands have confirmed that the aberrant methylation is specific to malignant breast tumors and that it is completely absent in normal breast tissue and breast fibroadenomas. Case presentation A 13-year-old Hispanic girl was referred after she had noted a progressive development of a mass in her left breast. On physical examination, a 10 × 10 cm lump was detected and axillary lymph nodes were not enlarged. After surgical removal the lump was diagnosed as a giant fibroadenoma. Because of the high growth rate of this benign tumor, we decided to analyze the methylation status of 49 CpG islands related to cell growth control. We have identified the methylation of five cancer-related CpG islands in the giant fibroadenoma tissue: ESR1, MGMT, WT-1, BRCA2 and CD44. Conclusion In this case report we show for the first time the methylation analysis of a giant fibroadenoma. The detection of methylation of these five cancer-related regions indicates substantial epigenomic differences with non-giant fibroadenomas. Epigenetic alterations could explain the higher growth rate of this tumor. Our data contribute to the growing knowledge of aberrant methylation in breast diseases. In this particular case, there exist no previous data regarding the role of methylation in giant fibroadenomas, considered by definition as a benign breast lesion. PMID:22011321

  2. Computerized self-assessment of automated lesion segmentation in breast ultrasound: implication for CADx applied to findings in the axilla

    NASA Astrophysics Data System (ADS)

    Drukker, K.; Giger, M. L.

    2008-03-01

    We developed a self-assessment method in which the CADx system provided a confidence level for its lesion segmentations. The self-assessment was performed by a fuzzy-inference system based on 4 computer-extracted features of the computer-segmented lesions in a leave-one-case-out evaluation protocol. In instances where the initial segmentation received a low assessment rating, lesions were re-segmented using the same segmentation method but based on a user-defined region-of-interest. A total of 542 cases with 1133 lesions were collected in this study, and we focused here on the 97 normal lymph nodes in this dataset since these pose challenges for automated segmentation due to their inhomogeneous appearance. The percentage of all lesions with satisfactory segmentation (i.e., normalized overlap with the radiologist-delineated lesion >=0.3) was 85%. For normal lymph nodes, however, this percentage was only 36%. Of the lymph nodes, 53 received a low confidence rating (<0.3) for their initial segmentation. When those lymph nodes were re-segmented, the percentage with a satisfactory segmentation improved to 80.0%. Computerassessed confidence levels demonstrated potential to 1) help radiologists decide whether to use or disregard CADx output, and 2) provide a guide for improvement of lesion segmentation.

  3. Raman spectroscopic sensing of carbonate intercalation in breast microcalcifications at stereotactic biopsy

    NASA Astrophysics Data System (ADS)

    Sathyavathi, R.; Saha, Anushree; Soares, Jaqueline S.; Spegazzini, Nicolas; McGee, Sasha; Rao Dasari, Ramachandra; Fitzmaurice, Maryann; Barman, Ishan

    2015-04-01

    Microcalcifications are an early mammographic sign of breast cancer and frequent target for stereotactic biopsy. Despite their indisputable value, microcalcifications, particularly of the type II variety that are comprised of calcium hydroxyapatite deposits, remain one of the least understood disease markers. Here we employed Raman spectroscopy to elucidate the relationship between pathogenicity of breast lesions in fresh biopsy cores and composition of type II microcalcifications. Using a chemometric model of chemical-morphological constituents, acquired Raman spectra were translated to characterize chemical makeup of the lesions. We find that increase in carbonate intercalation in the hydroxyapatite lattice can be reliably employed to differentiate benign from malignant lesions, with algorithms based only on carbonate and cytoplasmic protein content exhibiting excellent negative predictive value (93-98%). Our findings highlight the importance of calcium carbonate, an underrated constituent of microcalcifications, as a spectroscopic marker in breast pathology evaluation and pave the way for improved biopsy guidance.

  4. Juvenile fibroadenoma and granular cell tumor of the breast in an adolescent.

    PubMed

    Marshall, Andre P; Spottswood, Stephanie E; Grau, Ana M; Jackson, Gretchen Purcell

    2012-10-01

    We describe a case of a 15-year-old girl who presented with 2 painful masses in her right breast. Ultrasound confirmed the presence of 2 lesions, both of which appeared noncharacteristic for fibroadenomas. Both lesions were surgically resected. One was found to be a fibroadenoma and the other a granular cell tumor, both benign upon further histologic evaluation. Breast masses are rare in the pediatric population. The finding of a concurrent fibroadenoma and granular cell tumor is unique and has not been previously reported. Granular cell tumors of the breast are relatively uncommon. Often, they are mistaken for a breast malignancy. The concerning clinical and radiographic findings in this patient warranted operative excision.

  5. Estimation and imaging of breast lesions using a two-layer tissue structure by ultrasound-guided optical tomography

    PubMed Central

    Xu, Yan; Zhu, Quing

    2015-01-01

    Abstract. A new two-step estimation and imaging method is developed for a two-layer breast tissue structure consisting of a breast tissue layer and a chest wall underneath. First, a smaller probe with shorter distance source-detector pairs was used to collect the reflected light mainly from the breast tissue layer. Then, a larger probe with 9×14 source-detector pairs and a centrally located ultrasound transducer was used to collect reflected light from the two-layer tissue structure. The data collected from the smaller probe were used to estimate breast tissue optical properties. With more accurate estimation of the average breast tissue properties, the second layer properties can be assessed from data obtained from the larger probe. Using this approach, the unknown variables have been reduced from four to two and the estimated bulk tissue optical properties are more accurate and robust. In addition, a two-step reconstruction using a genetic algorithm and conjugate gradient method is implemented to simultaneously reconstruct the absorption and reduced scattering maps of targets inside a two-layer tissue structure. Simulations and phantom experiments have been performed to validate the new reconstruction method, and a clinical example is given to demonstrate the feasibility of this approach. PMID:26046722

  6. Percutaneous ablation of benign bone tumors.

    PubMed

    Welch, Brian T; Welch, Timothy J

    2011-09-01

    Percutaneous image-guided ablation has become a standard of practice and one of the primary modalities for treatment of benign bone tumors. Ablation is most commonly used to treat osteoid osteomas but may also be used in the treatment of chondroblastomas, osteoblastomas, and giant cell tumors. Percutaneous image-guided ablation of benign bone tumors carries a high success rate (>90% in case series) and results in decreased morbidity, mortality, and expense compared with traditional surgical methods. The ablation technique most often applied to benign bone lesions is radiofrequency ablation. Because the ablation technique has been extensively applied to osteoid osteomas and because of the uncommon nature of other benign bone tumors, we will primarily focus this discussion on the percutaneous ablation of osteoid osteomas.

  7. Imaging features of benign adrenal cysts.

    PubMed

    Sanal, Hatice Tuba; Kocaoglu, Murat; Yildirim, Duzgun; Bulakbasi, Nail; Guvenc, Inanc; Tayfun, Cem; Ucoz, Taner

    2006-12-01

    Benign adrenal gland cysts (BACs) are rare lesions with a variable histological spectrum and may mimic not only each other but also malignant ones. We aimed to review imaging features of BACs which can be helpful in distinguishing each entity and determining the subsequent appropriate management.

  8. Association between bilateral asymmetry of kinetic features computed from the DCE-MRI images and breast cancer

    NASA Astrophysics Data System (ADS)

    Yang, Qian; Li, Lihua; Zhang, Juan; Zhang, Chengjie; Zheng, Bin

    2013-03-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of breast yields high sensitivity but relatively lower specificity. To improve diagnostic accuracy of DCE-MRI, we investigated the association between bilateral asymmetry of kinetic features computed from the left and right breasts and breast cancer detection with the hypothesis that due to the growth of angiogenesis associated with malignant lesions, the average dynamic contrast enhancement computed from the breasts depicting malignant lesions should be higher than negative or benign breasts. To test this hypothesis, we assembled a database involving 130 DCE-MRI examinations including 81 malignant and 49 benign cases. We developed a computerized scheme that automatically segments breast areas depicted on MR images and computes kinetic features related to the bilateral asymmetry of contrast enhancement ratio between two breasts. An artificial neural network (ANN) was then used to classify between malignant and benign cases. To identify the optimal approach to compute the bilateral kinetic feature asymmetry, we tested 4 different thresholds to select the enhanced pixels (voxels) from DCE-MRI images and compute the kinetic features. Using the optimal threshold, the ANN had a classification performance measured by the area under the ROC curve of AUC=0.79+/-0.04. The positive and negative predictive values were 0.75 and 0.67, respectively. The study suggested that the bilateral asymmetry of kinetic features or contrast enhancement of breast background tissue could provide valuable supplementary information to distinguish between the malignant and benign cases, which can be fused into existing computer-aided detection schemes to improve classification performance.

  9. Carbohydrate antigens in nipple aspirate fluid predict the presence of atypia and cancer in women requiring diagnostic breast biopsy

    PubMed Central

    2010-01-01

    Background The goal of this prospective study was to determine (a) concentrations of the carbohydrate biomarkers Thomsen Friedenreich (TF) antigen and its precursor, Tn antigen, in nipple discharge (ND) collected from women requiring biopsy because of a suspicious breast lesion; and (b) if concentration levels predicted pathologic diagnosis. Methods Adult women requirin