RESUMO
Current breast cancer screening relies on mammography, digital breast tomosynthesis and breast ultrasound. In select populations, breast MRI is also of great utility. However, multiple factors limit widespread use of breast MRI for screening. Efforts have been made to increase the availability of breast MRI for screening, in large part due to the increased cancer detection rate of breast MRI compared to mammography. Techniques include shortening standard breast MRI protocols with the potential for accommodating MRI screening in a higher number of patients. This review will explain the role of abbreviated breast MRI and ultrafast breast MRI in breast imaging, and detail how these approaches differ from standard dynamic contrast-enhanced breast MRI. In addition, limitations and advantages of these techniques will also be discussed.
Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Imageamento por Ressonância Magnética , Humanos , Neoplasias da Mama/diagnóstico por imagem , Feminino , Imageamento por Ressonância Magnética/métodos , Detecção Precoce de Câncer/métodos , Mama/diagnóstico por imagem , Meios de Contraste , Mamografia/métodosRESUMO
Breast cancer screening has been highly successful in women in reducing mortality through early detection. In comparison, clinical detection of breast cancer remains the norm in men, and delay in diagnosis is reflected by a persistent survival disparity compared to women despite advances in modern therapy. Male breast cancer presents an interesting dilemma. While mammography is highly sensitive and specific for male breast cancer, routine screening is not justified by the overall low disease incidence. Yet there has been interest in leveraging mammography in targeted screening of men with identifiable risk factors to allow early detection, and early data may support this approach. The purpose of this article is to explore the potential utility of targeted breast cancer screening in men by examining unique clinical and biologic characteristics of male breast cancers that may lend themselves to mammographic detection. We will also discuss available evidence in screening outcomes in men and summarize recent updates in risk management recommendations in Society guidelines.
Assuntos
Neoplasias da Mama Masculina , Neoplasias da Mama , Humanos , Masculino , Feminino , Neoplasias da Mama Masculina/diagnóstico , Detecção Precoce de Câncer , Neoplasias da Mama/diagnóstico , Mamografia , Programas de Rastreamento , Fatores de RiscoRESUMO
Ductal carcinoma in situ (DCIS), breast cancer confined to the milk ducts, is a heterogeneous entity. The question of how and when a case of DCIS will extend beyond the ducts to become invasive breast cancer has implications for both patient prognosis and optimal treatment approaches. The natural history of DCIS has been explored through a variety of methods, from mouse models to biopsy specimen reviews to population-based screening data to modeling studies. This article will review the available evidence regarding progression pathways and will also summarize current trials designed to assess DCIS progression.