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The British Journal of Radiology May 2024Early detection of local recurrence has been shown to improve survival. What is unclear is how frequently mammography should be performed, how long surveillance should... (Review)
Review
Early detection of local recurrence has been shown to improve survival. What is unclear is how frequently mammography should be performed, how long surveillance should continue and how the answers to these questions vary with tumour pathology, patients age, and surgery type. Many of these questions are not directly answerable from the current literature. While some of these questions will be answered by the Mammo-50 study, evidence from local recurrence rates, tumour biology, and the lead time of mammography can be used to guide policy. Young age is the strongest predictor of local recurrence and given the short lead time of screening in women under 50, these women require annual mammography. Women over 50 with HER-2 positive and triple negative breast cancer have higher rates of local recurrence after breast conserving surgery than women with luminal cancers. Women with HER-2 positive and triple negative breast cancer also have a higher rate of recurrence in years 1-3 post surgery. Annual mammography in year 1-4 would appear justified. Women over 50 with luminal cancers have low rates of local recurrence and no early peak. Recurrence growth will be low due to tumour biology and hormone therapy. Biennial mammography after year 2 would seem appropriate. Women over 50 following mastectomy have no early peak in contralateral cancers so the frequency should be determined by the lead time of screening. This would suggest 2 yearly mammography for women aged 50-60 while 3 yearly mammography may suffice for women over 60.
Topics: Humans; Female; Mammography; Breast Neoplasms; Neoplasm Recurrence, Local; Middle Aged; Early Detection of Cancer; Aged; Age Factors
PubMed: 38450420
DOI: 10.1093/bjr/tqae043 -
PET Clinics Oct 2023
Topics: Humans; Female; Breast Neoplasms; Mammography; Molecular Imaging
PubMed: 37330407
DOI: 10.1016/j.cpet.2023.05.003 -
Journal of Medical Imaging and... Aug 2019In this pictorial essay, we showcase the imaging and pathological findings of a variety of giant breast lesions. Some lesions such as lipomas and hamartomas contain... (Review)
Review
In this pictorial essay, we showcase the imaging and pathological findings of a variety of giant breast lesions. Some lesions such as lipomas and hamartomas contain fibrous, glandular and lipomatous tissues and can have characteristic mammographic appearances. Other lesions (e.g. simple cysts, fibroepithelial lesions and some malignancies) may be mammographically indistinguishable and ultrasound (US) may be helpful in further characterisation, for example, by demonstrating posterior enhancement with simple cysts, cystic and solid components in papillary lesions, internal septations on haematomas and abscesses, solid homogeneity or heterogeneity in fibroepithelial lesions and increased vascularity in neoplastic, inflammatory or infective lesions. A diagnostic needle biopsy may be performed in some cases; however, with larger and heterogeneous lesions, there is an increased possibility of diagnostic inaccuracy due to limited sampling, such that full excision of the lesion may be advisable to ensure an accurate diagnosis.
Topics: Breast; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Mammography; Ultrasonography, Mammary
PubMed: 31141310
DOI: 10.1111/1754-9485.12899 -
Canadian Association of Radiologists... Feb 2022
Topics: Breast Density; Breast Neoplasms; Canada; Female; Humans; Mammography; Risk
PubMed: 34482760
DOI: 10.1177/08465371211030573 -
PET Clinics Oct 2023Breast cancer detection has a significant impact on population health. Although there are many breast imaging modalities, mammography is the predominant tool for breast... (Review)
Review
Breast cancer detection has a significant impact on population health. Although there are many breast imaging modalities, mammography is the predominant tool for breast cancer screening. The introduction of digital breast tomosynthesis to mammography has contributed to increased cancer detection rates and decreased recall rates. In average-risk women, starting annual screening mammography at age 40 years has demonstrated the highest mortality reduction. In intermediate- and high-risk women as well as in those with dense breasts, additional modalities, including MRI, ultrasound, and molecular breast imaging, can also be considered for adjunct screening to improve the detection of mammographically occult malignancy.
Topics: Female; Humans; Adult; Breast Neoplasms; Mammography; Breast Density; Early Detection of Cancer; Breast
PubMed: 37296043
DOI: 10.1016/j.cpet.2023.04.003 -
European Journal of Radiology Sep 2022
Topics: Breast Neoplasms; Female; Humans; Magnetic Resonance Imaging; Mammography; Retrospective Studies
PubMed: 35667298
DOI: 10.1016/j.ejrad.2022.110362 -
Radiology Oct 2022
Topics: Contrast Media; Humans; Mammography; Perfusion Imaging
PubMed: 36154290
DOI: 10.1148/radiol.221073 -
Radiographics : a Review Publication of... Oct 2023Contrast-enhanced mammography (CEM) involves addition of intravenous iodinated contrast material at digital mammography, thus increasing the ability to detect breast...
Contrast-enhanced mammography (CEM) involves addition of intravenous iodinated contrast material at digital mammography, thus increasing the ability to detect breast cancer owing to tumor contrast enhancement. After image acquisition, interpretation includes careful assessment of the technique, artifacts, and pitfalls and reporting with a standard lexicon category and appropriate follow-up recommendations. Artifacts and pitfalls that may cause image misinterpretation should be detected and distinguished from pathologic conditions. Different artifacts apparent on CEM images are usually caused during image acquisition and include CEM-specific and contrast agent-related artifacts, apart from the typical digital mammography artifacts. The pitfalls are related to technical and diagnostic difficulties. One disadvantage of CEM that MRI does not have is a technical factor related to a mammography technique that consists of blind spots that may not be included in the imaging field of mammography views, including the axilla, medial region of the breast, or areas close to the breast wall. Normal breast tissue enhancement called is also present at CEM and may affect interpretation performance. Diagnostic pitfalls are caused by minimally enhancing lesions, such as invasive lobular carcinomas and mucinous carcinomas, which are difficult to detect with CEM, resulting in false-negative findings. Benign lesions can show enhancement at CEM and represent false-positive lesions that should also be recognized. The authors discuss image interpretation of CEM studies and focus on the artifacts and pitfalls that may be encountered. RSNA, 2023 Quiz questions for this article are available in the supplemental material.
Topics: Humans; Female; Artifacts; Mammography; Breast Neoplasms; Breast; Contrast Media; Magnetic Resonance Imaging
PubMed: 37792595
DOI: 10.1148/rg.230021 -
International Journal of Occupational... Oct 2022Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose...
OBJECTIVES
Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose ionizing radiation (IR) has been recognized as a breast cancer risk factor. The aim of our study was to investigate association between lifetime low dose ionizing radiation (LDIR) and MD.
MATERIAL AND METHODS
A cross-sectional study included 467 women aged 40-60 years who underwent screening mammography in Łódź, Poland. The digital mammography examination of the breasts included both craniocaudal and mediolateral oblique views. The volumetric breast density (VBD) (%) and fibrograndular tissue volume (FG) (cm) were determined based on the analysis of mammographic image ("for processing") using Volpara Imaging Software. The exposure to IR was estimated for each individual, based on the data from interviews about diagnostic or therapeutic medical procedures performed in the area of the neck, chest, abdomen and spine, which involved X-rays and γ rays and the data about the doses derived from literature. Linear and logistic regression were fitted with VBD and FG as the outcomes and organ breast dose, effective dose and number of mammographies as the determinants, adjusted for major confounders.
RESULTS
The analyses showed no association between VBD or FG and the breast organ dose or the effective dose. The only significant finding observed concerned the association between the number of mammographies and the FG volume with β coefficient: 0.028 (95% CI: 0.012-0.043), and predicted mean FG volume >13.4 cm3 among the women with >3 mammographies when compared to those with none.
CONCLUSIONS
This study does not, in general, provide support for the positive association between LDIR and MD. The weak association of the FG volume with the number of mammographies warrants further verification in larger independent studies. Int J Occup Med Environ Health. 2022;35(5):635-49.
Topics: Breast Density; Breast Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Female; Humans; Mammography; Radiation, Ionizing
PubMed: 35913368
DOI: 10.13075/ijomeh.1896.01916 -
Journal of Ultrasound Jun 2023The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer.
METHODS
Comprehensive searches of PubMed, Scopus and EMBASE from 2008 to 2021 were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of MMG and US. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference.
RESULTS
Analysis of the studies revealed that the overall validity estimates of MMG and US in detecting breast cancer were as follows: pooled sensitivity per-patient were 0.82 (95% CI 0.76-0.87) and 0.83 (95% CI 0.71-0.91) respectively, The pooled specificities for detection of breast cancer using MMG, and US were 0.84 (95% CI 0.73-0.92) and 0.84 (95% CI 0.74-0.91) respectively. AUC of MMG, and US were 0.8933 and 0.8310 respectively. Pooled sensitivity and specificity per-lesion was 76% (95% CI 0.62-0.86) and 82% (95% CI 0.66-0.91) for MMG and 94% (95% CI 0.87-0.97) and 84% (95% CI 0.74-0.91) for US.
CONCLUSIONS
The meta-analysis found that, US and MMG has similar diagnostic performance in detecting breast cancer on per-patient basis after corrected threshold effect. However, on a per-lesion basis US was found to have a better diagnostic accuracy than MMG.
Topics: Female; Humans; Breast Neoplasms; Mammography; Ultrasonography, Mammary; Ultrasonography; Sensitivity and Specificity
PubMed: 36696046
DOI: 10.1007/s40477-022-00755-3