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Canadian Family Physician Medecin de... Aug 1999To describe an approach to managing women who present with palpable breast lumps. (Review)
Review
OBJECTIVE
To describe an approach to managing women who present with palpable breast lumps.
QUALITY OF EVIDENCE
Databases were searched from 1990 to 1998 using the search terms breast lumps, breast diseases, and breast cysts. Bibliographies of the articles obtained were searched for further relevant titles. Most evidence on management of breast cysts was obtained from cohort studies. Evidence on family physicians' approach to managing breast lumps is based on a review of the 1998 Canadian consensus guidelines and a review of a 1998 consensus guideline by 12 University of Toronto surgical oncologists (U of T guidelines).
MAIN MESSAGE
Family physicians can manage women presenting with breast lumps if they have skill in breast cyst aspiration. Most breast cysts can be cured in minutes, thus avoiding unwarranted anxiety and eliminating unnecessary additional investigations and referrals. Women presenting with solid lesions should be referred to a surgeon.
CONCLUSIONS
Breast cyst aspiration is a simple technique family physicians can use to either cure breast lumps or define appropriate cases for referral.
Topics: Algorithms; Biopsy, Needle; Canada; Decision Trees; Evidence-Based Medicine; Family Practice; Female; Fibrocystic Breast Disease; Humans; Office Visits; Palpation; Practice Guidelines as Topic; Referral and Consultation
PubMed: 10463093
DOI: No ID Found -
Malawi Medical Journal : the Journal of... Mar 2022Hydatid cyst (HC) is a lesion most commonly seen in the liver but can occur in many parts of the body. Breast involvement with HC is extremely rare. It can be isolated...
Hydatid cyst (HC) is a lesion most commonly seen in the liver but can occur in many parts of the body. Breast involvement with HC is extremely rare. It can be isolated or accompanied by other organ involvements. In this report, we present a 46-year-old female with isolated HC located in the right breast. In the ultrasonography and MR images of the patient, the lesion was compatible with the HC, and homogenous dens lesion was shown on mammography. Diagnosis of HC was confirmed pathological. With this study, it was aimed to emphasize the radiological findings of isolated breast HC.
Topics: Female; Humans; Middle Aged; Echinococcosis; Ultrasonography
PubMed: 37265832
DOI: 10.4314/mmj.v34i1.12 -
IEEE Transactions on Ultrasonics,... Mar 2018Short-lag spatial coherence (SLSC) imaging displays the spatial coherence between backscattered ultrasound echoes instead of their signal amplitudes and is more robust...
Short-lag spatial coherence (SLSC) imaging displays the spatial coherence between backscattered ultrasound echoes instead of their signal amplitudes and is more robust to noise and clutter artifacts when compared with traditional delay-and-sum (DAS) B-mode imaging. However, SLSC imaging does not consider the content of images formed with different lags, and thus does not exploit the differences in tissue texture at each short-lag value. Our proposed method improves SLSC imaging by weighting the addition of lag values (i.e., M-weighting) and by applying robust principal component analysis (RPCA) to search for a low-dimensional subspace for projecting coherence images created with different lag values. The RPCA-based projections are considered to be denoised versions of the originals that are then weighted and added across lags to yield a final robust SLSC (R-SLSC) image. Our approach was tested on simulation, phantom, and in vivo liver data. Relative to DAS B-mode images, the mean contrast, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) improvements with R-SLSC images are 21.22 dB, 2.54, and 2.36, respectively, when averaged over simulated, phantom, and in vivo data and over all lags considered, which corresponds to mean improvements of 96.4%, 121.2%, and 120.5%, respectively. When compared with SLSC images, the corresponding mean improvements with R-SLSC images were 7.38 dB, 1.52, and 1.30, respectively (i.e., mean improvements of 14.5%, 50.5%, and 43.2%, respectively). Results show great promise for smoothing out the tissue texture of SLSC images and enhancing anechoic or hypoechoic target visibility at higher lag values, which could be useful in clinical tasks such as breast cyst visualization, liver vessel tracking, and obese patient imaging.
Topics: Algorithms; Female; Humans; Image Interpretation, Computer-Assisted; Liver; Phantoms, Imaging; Principal Component Analysis; Signal-To-Noise Ratio; Ultrasonography
PubMed: 29505405
DOI: 10.1109/TUFFC.2017.2780084 -
Journal of the Korean Society of... May 2023To investigate the incidence, outcomes, and imaging characteristics of clustered microcysts detected on breast US in asymptomatic women, and suggest appropriate...
PURPOSE
To investigate the incidence, outcomes, and imaging characteristics of clustered microcysts detected on breast US in asymptomatic women, and suggest appropriate management guidelines.
MATERIALS AND METHODS
We identified and reviewed the lesions recorded as "clustered microcysts" on breast US performed in asymptomatic women between August 2014 and December 2019. The final diagnosis was based on pathology and imaging follow-up results for at least 12 months.
RESULTS
The incidence was 1.5% and 100 patients with 117 lesions were included. Among 117 lesions, 3 (2.6%), 2 (1.7%), and 112 (95.7%) were malignant, high-risk benign, and benign lesions, respectively. The malignant lesions included two cases of ductal carcinoma in situ and one invasive ductal carcinoma. Two of them were assessed as category 4, showing mammographic suspicious microcalcifications and internal vascularity on Doppler US. The remainder was a false negative case and showed echo pattern change on the 12-month follow-up US.
CONCLUSION
The incidence of clustered microcysts on breast US in asymptomatic women was 1.5% and malignancy rate was 2.6% (3 of 117). Knowledge of outcomes and imaging features of benign and malignant clustered microcysts may be helpful for radiologists, thereby aiding categorization and management recommendations.
PubMed: 37325006
DOI: 10.3348/jksr.2022.0029 -
Radiology Case Reports Oct 2022Male breast lesions are relatively less common. The most encountered malignant lesion in the male breast is ductal adenocarcinoma; and benign lesions are gynecomastia,...
Male breast lesions are relatively less common. The most encountered malignant lesion in the male breast is ductal adenocarcinoma; and benign lesions are gynecomastia, fibrocystic disease, intramammary lymph node, fibroadenoma, lipoma and epidermal inclusion cyst (EIC), respectively [5,6]. To date, there had been published only a few cases of EIC of the male breast in literature [3,5,6]. In this case, we aimed to present a new case of EIC with its clinical, radiological and pathological characteristics in the male breast. It had benign sonographic and magnetic resonance imaging findings but had also malignant imaging findings with diffusion restriction on diffusion-weighted imaging.
PubMed: 36032200
DOI: 10.1016/j.radcr.2022.07.097 -
Clinical Imaging 2016The aim of this study was to test a novel dual-modality imaging system that combines full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in a... (Clinical Trial)
Clinical Trial Comparative Study
PURPOSE
The aim of this study was to test a novel dual-modality imaging system that combines full-field digital mammography (FFDM) and automated breast ultrasound (ABUS) in a single platform. Our Aceso system, named after the Greek goddess of healing, was specifically designed for the early detection of cancer in women with dense breast tissue.
MATERIALS AND METHODS
Aceso was first tested using two industry standards: a Contrast Detail Mammography (CDMAM) phantom as endorsed by European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services was used to assess the FFDM images; and the CIRS 040GSE ultrasound phantom was imaged to evaluate the quality of the ABUS images. In addition, 58 women participated in a clinical trial: 51 were healthy volunteers aged between 40 and 65, while 7 were patients referred by the breast clinic, 6 of whom had biopsy-proven breast cancer.
RESULTS
The CDMAM tests showed that the FFDM results were "acceptable" but fell short of "achievable" which was attributed to the low dose used. The ABUS images had good depth penetration (80 mm) and adequate axial resolution (0.5 mm), but the lateral resolution of 2 mm was judged to be too coarse. In a 42-year-old volunteer with extremely dense breast tissue, the ABUS modality detected a lesion (a benign cyst) that was mammographically occult in the FFDM image. For a 73-year-old patient with fatty breasts, a malignant lesion was successfully detected and co-registered in the FFDM and ABUS images. On average, each woman spent less than 11 min in the acquisition room.
CONCLUSIONS
While there is room for improvement in the quality of both the FFDM and ABUS images, Aceso has demonstrated its ability to acquire clinically meaningful images for a range of women with varying breast densities and, therefore, has potential as a screening device.
Topics: Adult; Aged; Breast; Breast Neoplasms; Equipment Design; Female; Healthy Volunteers; Humans; Mammography; Middle Aged; Phantoms, Imaging; Ultrasonography, Mammary
PubMed: 27133694
DOI: 10.1016/j.clinimag.2015.11.024 -
Journal of Clinical Oncology : Official... Aug 2021Tumor mutational profiling is increasingly performed in patients with advanced cancer. We determined the extent to which germline mutation profiling guides therapy...
PURPOSE
Tumor mutational profiling is increasingly performed in patients with advanced cancer. We determined the extent to which germline mutation profiling guides therapy selection in patients with advanced cancer.
METHODS
Patients with cancer undergoing tumor genomic profiling were prospectively consented for germline cancer predisposition gene analysis (2015-2019). In patients harboring germline likely pathogenic or pathogenic (LP/P) alterations, therapeutic actionability was classified using a precision oncology knowledge base. Patients with metastatic or recurrent cancer receiving germline genotype-directed therapy were determined.
RESULTS
Among 11,947 patients across > 50 malignancies, 17% (n = 2,037) harbored a germline LP/P variant. By oncology knowledge base classification, 9% (n = 1042) had an LP/P variant in a gene with therapeutic implications (4% level 1; 4% level 3B; < 1% level 4). variants accounted for 42% of therapeutically actionable findings, followed by (13%), (12%), mismatch repair genes (11%), and (5%). When limited to the 9,079 patients with metastatic or recurrent cancer, 8% (n = 710) harbored level 1 or 3B genetic findings and 3.2% (n = 289) received germline genotype-directed therapy. Germline genotype-directed therapy was received by 61% and 18% of metastatic cancer patients with level 1 and level 3B findings, respectively, and by 54% of , 75% of mismatch repair, 43% of , 35% of , 24% of , and 19% of carriers. Of patients receiving a poly(ADP-ribose) polymerase inhibitor, 45% (84 of 188) had tumors other than breast or ovarian cancer, wherein the drug, at time of delivery, was delivered in an investigational setting.
CONCLUSION
In a pan-cancer analysis, 8% of patients with advanced cancer harbored a germline variant with therapeutic actionability with 40% of these patients receiving germline genotype-directed treatment. Germline sequence analysis is additive to tumor sequence analysis for therapy selection and should be considered for all patients with advanced cancer.
Topics: Female; Genetic Predisposition to Disease; Germ-Line Mutation; Humans; Male; Middle Aged; Neoplasms; Prospective Studies
PubMed: 34133209
DOI: 10.1200/JCO.20.03661 -
Eye (London, England) May 2022To investigate the results of partial lamellar sclerouvectomy (PLSU) for anteriorly located uveal tumours. (Review)
Review
OBJECTIVES
To investigate the results of partial lamellar sclerouvectomy (PLSU) for anteriorly located uveal tumours.
METHODS
We reviewed the tumour features, histopathologic findings, complications, visual acuity outcomes, eye preservation, metastasis, and mortality data of 56 cases with uveal tumours who underwent PLSU between February 1999 and February 2019.
RESULTS
The mean largest tumour base diameters were 5.8 × 3.4 mm and the mean tumour thickness was 3.3 mm. Histopathologically, 30 (53.6%) eyes had malignant melanoma, 13 (23.2%) had nevus, 5 (8.9%) had iris stromal cyst, 4 (7.1%) had melanocytoma, 2 (3.6%) had Fuchs' adenoma, 1 (1.8%) had iris pigment epithelial cyst, and 1 (1.8%) had invasive breast cancer metastasis. The most common postoperative complications included cataract in 21 (37.5%) eyes, vitreous haemorrhage in 15 (26.8%), scleral thinning in 10 (17.9%), and hyphema in 6 (10.7%). At a mean follow-up of 40.4 (range: 10-201) months, tumour recurrence was observed in 2/30 (6.7%) eyes with melanoma and 1/5 (20.0%) eye with iris stromal cyst. Eyes with recurrent melanoma were treated with enucleation. Liver metastasis developed in only 1 (3.3%) melanoma case. All patients were alive at the end of follow-up.
CONCLUSIONS
PLSU is a successful treatment method for many anteriorly located uveal tumours. In our series, the overall tumour recurrence and globe salvage rates were 5.4% and 96.4% respectively. Among melanoma cases, the metastasis rate was 3.3% and survival rate was 100%.
Topics: Cysts; Eye Enucleation; Humans; Iris Diseases; Melanoma; Neoplasm Recurrence, Local; Retrospective Studies; Skin Neoplasms; Treatment Outcome; Uveal Neoplasms; Melanoma, Cutaneous Malignant
PubMed: 33941875
DOI: 10.1038/s41433-021-01545-7 -
Cureus Jun 2019Simple benign breast cysts are commonly diagnosed in female breasts and may present as palpable masses. However, they are extremely uncommon in the male breast and are...
Simple benign breast cysts are commonly diagnosed in female breasts and may present as palpable masses. However, they are extremely uncommon in the male breast and are rarely reported in the literature. Here, we report a case of a simple benign cyst of the breast in a relatively healthy 37-year-old man. The patient initially presented with a palpable 2-3 mm tender left breast lump. Further evaluation with mammography and ultrasound revealed a mass most consistent with a simple benign cyst. However, considering the rarity of breast cysts in males, the lesion was biopsied to rule out malignancy. Pathology results from ultrasound-guided core needle biopsy demonstrated fibro-adipose tissue with a benign cyst lined by foamy cells with apocrine features, consistent with a diagnosis of a benign epithelial cyst and concordant with the radiological findings. To our knowledge, this is the youngest case of a benign breast cyst in a male that has been reported in the literature. In this case report, we discuss the typical features and presentation of breast cysts in males, associated imaging findings on mammography and ultrasound, and the necessity for pathological confirmation with biopsy in this population.
PubMed: 31404321
DOI: 10.7759/cureus.4814 -
JPMA. the Journal of the Pakistan... Jul 2023Hydatid cysts are mainly found in the liver and lungs. Only few cases have been reported in the breast and majority of these cases have been diagnosed post 15... (Review)
Review
Hydatid cysts are mainly found in the liver and lungs. Only few cases have been reported in the breast and majority of these cases have been diagnosed post 15 operatively. We report a case of hydatid cyst of the breast diagnosed pre-operatively by fine needle aspiration and cytology (FNAC), without any complication. A 50 years old female presented with a slowly growing mobile lump in the left breast for 3 years. Mammography showed a circumscribed opacity in left breast. High resolution ultrasound displayed a unilocular cyst with some echogenic specks settling to the gravity dependent portion. An aspiration was planned and, as the cyst volume decreased, membranes appeared within the residual fluid and started settling down. Cytology of aspirated fluid revealed a hydatid cyst. Hydatid cysts in the breast are rare but possible, particularly in endemic regions. Clinical and radiological aspects of hydatid disease along with review of literature are presented in this paper.
Topics: Female; Humans; Middle Aged; Echinococcosis; Breast; Biopsy, Fine-Needle; Diagnosis, Differential; Cysts
PubMed: 37469075
DOI: 10.47391/JPMA.7085