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Radiologic Technology Jan 2022Fibrocystic changes in the breasts are the most common benign breast condition globally, with as many as 50% of women experiencing symptoms during their lifetime. This...
Fibrocystic changes in the breasts are the most common benign breast condition globally, with as many as 50% of women experiencing symptoms during their lifetime. This article explores the types of changes associated with fibrocystic breasts along with signs and symptoms, etiology and possible risk factors, diagnostic techniques, and treatments of fibrocystic breast changes, including lifestyle modifications, cyst drainage, and medications.
Topics: Breast; Breast Neoplasms; Female; Fibrocystic Breast Disease; Humans; Risk Factors
PubMed: 35017277
DOI: No ID Found -
Breast Cancer (Tokyo, Japan) May 2018In 2017, breast cancer became the most commonly diagnosed cancer among women in the US. After lung cancer, breast cancer is the leading cause of cancer-related mortality... (Review)
Review
In 2017, breast cancer became the most commonly diagnosed cancer among women in the US. After lung cancer, breast cancer is the leading cause of cancer-related mortality in women. The breast consists of several components, including milk storage glands, milk ducts made of epithelial cells, adipose tissue, and stromal tissue. Mammographic density (MD) is based on the proportion of stromal, epithelial, and adipose tissue. Women with high MD have more stromal and epithelial cells and less fatty adipose tissue, and are more likely to develop breast cancer in their lifetime compared to women with low MD. Because of this correlation, high MD is an independent risk factor for breast cancer. Further, mammographic screening is less effective in detecting suspicious lesions in dense breast tissue, which can lead to late-stage diagnosis. Molecular differences between dense and non-dense breast tissues explain the underlying biological reasons for why women with dense breasts are at a higher risk for developing breast cancer. The goal of this review is to highlight the current molecular understanding of MD, its association with breast cancer risk, the demographics pertaining to MD, and the environmental factors that modulate MD. Finally, we will review the current legislation regarding the disclosure of MD on a traditional screening mammogram and the supplemental screening options available to women with dense breast tissue.
Topics: Biomarkers, Tumor; Breast; Breast Density; Breast Neoplasms; Early Detection of Cancer; Epithelial Cells; Extracellular Matrix Proteins; Female; Fibroblasts; Humans; Mammography; Risk Factors
PubMed: 29651637
DOI: 10.1007/s12282-018-0857-5 -
Radiology Mar 2023Background The best supplemental breast cancer screening modality in women at average risk or intermediate risk for breast cancer with dense breast and negative... (Meta-Analysis)
Meta-Analysis
Background The best supplemental breast cancer screening modality in women at average risk or intermediate risk for breast cancer with dense breast and negative mammogram remains to be determined. Purpose To conduct systematic review and meta-analysis comparing clinical outcomes of the most common available supplemental screening modalities in women at average risk or intermediate risk for breast cancer in patients with dense breasts and mammography with negative findings. Materials and Methods A comprehensive search was conducted until March 12, 2020, in Medline, Epub Ahead of Print and In-Process and Other Non-Indexed Citations; Embase Classic and Embase; Cochrane Central Register of Controlled Trials; and Cochrane Database of Systematic Reviews, for Randomized Controlled Trials and Prospective Observational Studies. Incremental cancer detection rate (CDR); positive predictive value of recall (PPV1); positive predictive value of biopsies performed (PPV3); and interval CDRs of supplemental imaging modalities, digital breast tomosynthesis, handheld US, automated breast US, and MRI in non-high-risk patients with dense breasts and mammography negative for cancer were reviewed. Data metrics and risk of bias were assessed. Random-effects meta-analysis and two-sided metaregression analyses comparing each imaging modality metrics were performed (PROSPERO; CRD42018080402). Results Twenty-two studies reporting 261 233 screened patients were included. Of 132 166 screened patients with dense breast and mammography negative for cancer who met inclusion criteria, a total of 541 cancers missed at mammography were detected with these supplemental modalities. Metaregression models showed that MRI was superior to other supplemental modalities in CDR (incremental CDR, 1.52 per 1000 screenings; 95% CI: 0.74, 2.33; < .001), including invasive CDR (invasive CDR, 1.31 per 1000 screenings; 95% CI: 0.57, 2.06; < .001), and in situ disease (rate of ductal carcinoma in situ, 1.91 per 1000 screenings; 95% CI: 0.10, 3.72; < .04). No differences in PPV1 and PPV3 were identified. The limited number of studies prevented assessment of interval cancer metrics. Excluding MRI, no statistically significant difference in any metrics were identified among the remaining imaging modalities. Conclusion The pooled data showed that MRI was the best supplemental imaging modality in women at average risk or intermediate risk for breast cancer with dense breasts and mammography negative for cancer. © RSNA, 2023 See also the editorial by Hooley and Butler in this issue.
Topics: Female; Humans; Breast Neoplasms; Mammography; Breast Density; Early Detection of Cancer; Breast; Mass Screening; Observational Studies as Topic
PubMed: 36719288
DOI: 10.1148/radiol.221785 -
Plastic and Reconstructive Surgery Nov 2018It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In... (Observational Study)
Observational Study
BACKGROUND
It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In the 1990s, Ted Lockwood taught us the importance of the superficial fascia layers in body contouring procedures he pioneered. These descriptions, however, fail to explain the three-dimensional fascial system in the breast. The authors set out to discover and describe a theory of superficial fascia structures responsible for breast shape.
METHODS
The nature of the superficial fascia system that surrounds the breast and its attachments to the chest were studied in 12 cadaver breast dissections and in clinical cases of both cosmetic and reconstructive breast procedures.
RESULTS
The authors found a three-dimensional, closed system of fascia and fat surrounding the corpus mammae, which attaches to the skin by means of specialized vertical cutaneous ligaments, or Cooper ligaments, and which attaches to the chest wall by means of a three-dimensional zone of adherence at the breast's periphery.
CONCLUSIONS
The breast is shaped by a three-dimensional, fibrofatty fascial system. Two layers of this system surround the corpus mammae and fuse together around it, and anchor it to the chest wall in a structure we have called the circummammary ligament.
Topics: Breast; Cadaver; Dissection; Fascia; Fasciotomy; Female; Humans; Medical Illustration
PubMed: 30511967
DOI: 10.1097/PRS.0000000000004948 -
Journal of Breast Imaging Feb 2023US is a widely available, commonly used, and indispensable imaging modality for breast evaluation. It is often the primary imaging modality for the detection and... (Review)
Review
US is a widely available, commonly used, and indispensable imaging modality for breast evaluation. It is often the primary imaging modality for the detection and diagnosis of breast cancer in low-resource settings. In addition, it is frequently employed as a supplemental screening tool via either whole breast handheld US or automated breast US among women with dense breasts. In recent years, a variety of artificial intelligence systems have been developed to assist radiologists with the detection and diagnosis of breast lesions on US. This article reviews the background and evidence supporting the use of artificial intelligence tools for breast US, describes implementation strategies and impact on clinical workflow, and discusses potential emerging roles and future directions.
Topics: Female; Humans; Artificial Intelligence; Ultrasonography, Mammary; Breast; Breast Neoplasms; Mammography
PubMed: 38416959
DOI: 10.1093/jbi/wbac077 -
FP Essentials Sep 2020Benign breast conditions are heterogenous, with varying clinical presentations. These conditions commonly include nipple discharge, breast pain, palpable masses, common...
Benign breast conditions are heterogenous, with varying clinical presentations. These conditions commonly include nipple discharge, breast pain, palpable masses, common breast lesions, and high-risk breast lesions. Signs and symptoms of these conditions range from pain and abnormal physical examination findings to asymptomatic abnormalities detected on breast imaging. A combination of clinical examination, patient history, and diagnostic studies should be used to make a diagnosis. The primary challenges in addressing new breast symptoms are determination of a clear diagnosis and creation of a management plan, as well as evaluation of future risk of malignancy related to benign diagnoses. Risk assessment can prove difficult in patients of certain racial groups, given the differences in risk attributed to specific benign conditions. This also can prove challenging given the lack of racial diversity in early trials assessing risk in benign breast disease. Many benign breast conditions are diagnosed and managed in the family medicine setting, but some patients may require consultation with a breast subspecialist.
Topics: Breast; Breast Neoplasms; Humans; Physical Examination; Risk Assessment
PubMed: 32902242
DOI: No ID Found -
Seminars in Ultrasound, CT, and MR Feb 2018Although dense breast tissue is a normal and routine finding on screening mammography, dense breast tissue is associated with an independent increased risk for breast... (Review)
Review
Although dense breast tissue is a normal and routine finding on screening mammography, dense breast tissue is associated with an independent increased risk for breast cancer. It is well known that screening mammography has a decreased sensitivity for cancer detection in women with dense breasts. Over the past decade, there has been increased interest generated among patients, physicians, and legislators regarding how best to screen dense-breasted women culminating in 2009 with the passage of a breast density notification law in Connecticut. Since that time, over half the United States has passed similar notification laws. Despite this, controversy remains as to the optimal supplemental screening modality to complement mammography as each imaging modality (digital breast tomosynthesis, whole breast ultrasound, magnetic resonance imaging, contrast-enhanced mammography, and molecular breast imaging) has variable benefits and limitations.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography
PubMed: 29317035
DOI: 10.1053/j.sult.2017.08.001 -
Clinical Obstetrics and Gynecology Jun 1982
Topics: Adult; Breast; Breast Neoplasms; Female; Fever; Fibrocystic Breast Disease; Humans; Middle Aged; Thermography
PubMed: 7105516
DOI: 10.1097/00003081-198206000-00023 -
Clinical Breast Cancer Aug 2022In the United States, Europe, and Asia, a consensus has been reached that there is a higher risk of breast cancer in high density breasts. However, there are some...
BACKGROUND
In the United States, Europe, and Asia, a consensus has been reached that there is a higher risk of breast cancer in high density breasts. However, there are some contrary reports that suggest the absence of an association between breast composition and breast cancer subtype; thus, there is conflicting evidence. The purpose of this study was to investigate trends in the incidence of breast cancer subtypes according to breast composition and analyze the survival rates in Japanese women.
PATIENTS AND METHODS
Between 2007 and 2008, 1258 Japanese patients with invasive breast cancer who underwent mammography and obtained a pathological diagnosis in our institution were included in the study. We compared cancer subtypes with breast composition types (dense and non-dense breast), and classified them based on initial mammography findings. Information on 5- and 10-year survival rates was collected by chart review for patients with dense and nondense breasts. Statistical analysis was performed using the Pearson's chi-square test for breast composition and cancer subtype. The effect of breast composition on mortality was examined using a multivariate Cox proportional hazards model, and adjusted hazard ratios were calculated.
RESULTS
No significant difference was found between breast cancer subtype and breast composition (P = .08). Five-year (log-rank test, P = .09) and 10-year (log-rank test, P = .31) survival rates were not significantly different between breast composition types.
CONCLUSION
There was no significant association between breast composition and cancer subtypes. There was also no significant difference in the prognosis between patients with and without dense breasts.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Prognosis
PubMed: 35581133
DOI: 10.1016/j.clbc.2022.04.005 -
Radiologic Technology 2013Breast calcifications are a common mammographic finding, present on 86% of images. Although usually benign, they also can be malignant. Characteristics such as their... (Review)
Review
Breast calcifications are a common mammographic finding, present on 86% of images. Although usually benign, they also can be malignant. Characteristics such as their size, shape, number, distribution pattern, location, density, and other findings help determine their pathology. The American College of Radiology's BI-RADS assessment categories and Appropriateness Criteria guidelines help radiologists and other physicians determine appropriate action when calcifications are discovered. This article reviews breast anatomy, the classification of calcifications, malignant vs benign characteristics, imaging techniques for calcifications, and biopsy procedures.
Topics: Biopsy; Breast; Breast Diseases; Calcinosis; Diagnosis, Computer-Assisted; Female; Humans; Magnetic Resonance Imaging; Mammography; Molecular Imaging; Therapeutic Irrigation; Ultrasonography, Mammary
PubMed: 23547207
DOI: No ID Found