Moderate direct band-gap energies and high carrier mobilities of Janus XWSiP2 (X = S, Se, Te) monolayers via first-principles investigation.

Two-dimensional (2D) Janus materials with extraordinary properties are promising candidates for utilization in advanced technologies. In this study, new 2D Janus XWSiP2 (X = S, Se, Te) monolayers were constructed and their properties were systematically analyzed by using first-principles calculations. All three structures of SWSiP2, SeWSiP2, and TeWSiP2 exhibit high energetic stability for the experimental fabrication with negative and high Ecoh values, the elastic constants obey the criteria of Born-Huang, and no imaginary frequency exists in the phonon dispersion spectra. The calculated results from the PBE and HSE06 approaches reveal that the XWSiP2 are semiconductors with moderate direct band-gaps varying from 1.01 eV to 1.06 eV using the PBE method, and 1.39 eV to 1.44 eV using the HSE06 method. In addition, the electronic band structures of the three monolayers are significantly affected by the applied strains. Interestingly, the transitions from a direct to indirect semiconductor are observed for different biaxial strains εb. The transport parameters including the carrier mobility values along the x direction µx and y direction µy were also calculated to study the transport properties of the XWSiP2. The results indicate that the XWSiP2 monolayers not only have high carrier mobilities but also anisotropy in the transport directions for both holes and electrons. Together with the moderate and tunable energy gaps, the XWSiP2 materials are found to be potential candidates for application in the photonic, photovoltaic, optoelectronic, and electronic fields.

Two-dimensional Janus MGeSiP4 (M = Ti, Zr, and Hf) with an indirect band gap and high carrier mobilities: first-principles calculations.

Novel Janus materials have attracted broad interest due to the outstanding properties created by their out-of-plane asymmetry, with increasing theoretical exploration and more reports of successful fabrication in recent years. Here, we construct and explore the crystal structures, stabilities, electronic band structures, and transport properties - including carrier mobilities - of two-dimensional Janus MGeSiP4 (M = Ti, Zr, or Hf) monolayers based on density functional theory calculations. From the cohesive energies, elastic constants, and phonon dispersion calculations, the monolayers are confirmed to exhibit structural stability with high feasibility for experimental synthesis. All the structures are indirect band-gap semiconductors with calculated band-gap energies in the range of 0.77 eV to 1.01 eV at the HSE06 (Heyd-Scuseria-Ernzerhof) level. Interestingly, by applying external biaxial strain, a semiconductor to metal phase transition is observed for the three Janus structures. This suggests potential for promising applications in optoelectronic and electromechanical devices. Notably, the MGeSiP4 monolayers show directionally anisotropic carrier mobility with a high electron mobility of up to 2.72 × 103 cm2 V-1 s-1 for the ZrGeSiP4 monolayer, indicating advantages for applications in electronic devices. Hence, the presented results reveal the novel properties of the 2D Janus MGeSiP4 monolayers and demonstrate their great potential applications in nanoelectronic and/or optoelectronic devices. This investigation could stimulate further theoretical and experimental studies on these excellent materials and motivate further explorations of new members of this 2D Janus family.

Rashba-type spin splitting and transport properties of novel Janus XWGeN2 (X = O, S, Se, Te) monolayers.

We discuss and examine the stability, electronic properties, and transport characteristics of asymmetric monolayers XWGeN2 (X = O, S, Se, Te) using ab initio density functional theory. All four monolayers of quintuple-layer atomic Janus XWGeN2 are predicted to be stable and they are all indirect semiconductors in the ground state. When the spin-orbit coupling (SOC) is included, a large spin splitting at the K point is found in XWGeN2 monolayers, particularly, a giant Rashba-type spin splitting is observed around the Γ point in three structures SWGeN2, SeWGeN2, and TeWGeN2. The Rashba parameters in these structures are directionally isotropic along the high-symmetry directions Γ-K and Γ-M and the Rashba constant αR increases as the X element moves from S to Te. TeWGeN2 has the largest Rashba energy up to 37.4 meV (36.6 meV) in the Γ-K (Γ-M) direction. Via the deformation potential method, we calculate the carrier mobility of all four XWGeN2 monolayers. It is found that the electron mobilities of OWGeN2 and SWGeN2 monolayers exceed 200 cm2 V-1 s-1, which are suitable for applications in nanoelectronic devices.

The Chemorepulsive Protein Semaphorin 3A and Perineuronal Net-Mediated Plasticity.

During postnatal development, closure of critical periods coincides with the appearance of extracellular matrix structures, called perineuronal nets (PNN), around various neuronal populations throughout the brain. The absence or presence of PNN strongly correlates with neuronal plasticity. It is not clear how PNN regulate plasticity. The repulsive axon guidance proteins Semaphorin (Sema) 3A and Sema3B are also prominently expressed in the postnatal and adult brain. In the neocortex, Sema3A accumulates in the PNN that form around parvalbumin positive inhibitory interneurons during the closure of critical periods. Sema3A interacts with high-affinity with chondroitin sulfate E, a component of PNN. The localization of Sema3A in PNN and its inhibitory effects on developing neurites are intriguing features and may clarify how PNN mediate structural neural plasticity. In the cerebellum, enhanced neuronal plasticity as a result of an enriched environment correlates with reduced Sema3A expression in PNN. Here, we first review the distribution of Sema3A and Sema3B expression in the rat brain and the biochemical interaction of Sema3A with PNN. Subsequently, we review what is known so far about functional correlates of changes in Sema3A expression in PNN. Finally, we propose a model of how Semaphorins in the PNN may influence local connectivity.

Two-dimensional Janus Si2OX (X = S, Se, Te) monolayers as auxetic semiconductors: theoretical prediction.

The auxetic materials have exotic mechanical properties compared to conventional materials, such as higher indentation resistance, more superior sound absorption performance. Although the auxetic behavior has also been observed in two-dimensional (2D) nanomaterials, to date there has not been much research on auxetic materials in the vertical asymmetric Janus 2D layered structures. In this paper, we explore the mechanical, electronic, and transport characteristics of Janus Si2OX (X = S, Se, Te) monolayers by first-principle calculations. Except for the Si2OTe monolayer, both Si2OS and Si2OSe are found to be stable. Most importantly, both Si2OS and Si2OSe monolayers are predicted to be auxetic semiconductors with a large negative Poisson's ratio. The auxetic behavior is clearly observed in the Janus Si2OS monolayer with an extremely large negative Poisson's ratio of -0.234 in the x axis. At the equilibrium state, both Si2OS and Si2OSe materials exhibit indirect semiconducting characteristics and their band gaps can be easily altered by the mechanical strain. More interestingly, the indirect-direct bandgap phase transitions are observed in both Si2OS and Si2OSe monolayers when the biaxial strains are introduced. Further, the studied Janus structures also exhibit remarkably high electron mobility, particularly along the x direction. Our findings demonstrate that Si2OS and Si2OSe monolayers are new auxetic materials with asymmetric structures and show their great promise in electronic and nanomechanical applications.

Large piezoelectric responses and ultra-high carrier mobility in Janus HfGeZ3H (Z = N, P, As) monolayers: a first-principles study.

Breaking structural symmetry in two-dimensional layered Janus materials can result in enhanced new phenomena and create additional degrees of piezoelectric responses. In this study, we theoretically design a series of Janus monolayers HfGeZ3H (Z = N, P, As) and investigate their structural characteristics, crystal stability, piezoelectric responses, electronic features, and carrier mobility using first-principles calculations. Phonon dispersion analysis confirms that HfGeZ3H monolayers are dynamically stable and their mechanical stability is also confirmed through the Born-Huang criteria. It is demonstrated that while HfGeN3H is a semiconductor with a large bandgap of 3.50 eV, HfGeP3H and HfGeAs3H monolayers have narrower bandgaps being 1.07 and 0.92 eV, respectively. When the spin-orbit coupling is included, large spin-splitting energy is found in the electronic bands of HfGeZ3H. Janus HfGeZ3H monolayers can be treated as piezoelectric semiconductors with the coexistence of both in-plane and out-of-plane piezoelectric responses. In particular, HfGeZ3H monolayers exhibit ultra-high electron mobilities up to 6.40 × 103 cm2 V-1 s-1 (HfGeAs3H), indicating that they have potential for various applications in nanoelectronics.

A first-principles prediction of novel Janus ZrGeZ3H (Z = N, P, and As) monolayers: Raman active modes, piezoelectric responses, electronic properties, and carrier mobility.

In this article, an attempt is made to explore new materials for applications in piezoelectric and electronic devices. Based on density functional theory calculation, we construct three Janus ZrGeZ3H (Z = N, P, and As) monolayers and study their stability, piezoelectricity, Raman response, and carrier mobility. The results from phonon dispersion spectra, ab initio molecular dynamics simulation, and elastic coefficients confirm the structural, thermal, and mechanical stability of these proposed structures. The ZrGeZ3H monolayers are indirect band gap semiconductors with favourable band gap energy of 1.15 and 1.00 eV for the ZrGeP3H and ZrGeAs3H, respectively, from Heyd-Scuseria-Ernzerhof functional method. It is found that the Janus ZrGeZ3H monolayers possess both in-plane and out-of-plane piezoelectric coefficients, revealing that they are potential piezoelectric candidates. In addition, the carrier mobilities of electrons and holes along transport directions are anisotropic. Notably, the ZrGeP3H and ZrGeAs3H monolayers have high electron mobility of 3639.20 and 3408.37 cm2 V-1 s-1, respectively. Our findings suggest the potential application of the Janus ZrGeZ3H monolayers in the piezoelectric and electronic fields.

Association of KCNJ1 variation with change in fasting glucose and new onset diabetes during HCTZ treatment.

Thiazide-induced potassium loss may contribute to new onset diabetes (NOD). KCNJ1 encodes a potassium channel and one study observed that a KCNJ1 single-nucleotide polymorphism (SNP) was associated with changes in fasting glucose (FG) during hydrochlorothiazide (HCTZ) treatment. We used linear regression to test association of KCNJ1 SNPs and haplotypes with FG changes during HCTZ treatment in the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) study. We used logistic regression to test association of KCNJ1 variation with NOD in HCTZ-treated patients from the International Verapamil SR Trandolapril Study (INVEST). Multivariate regression analyses were performed by race/ethnicity with false discovery rate (FDR) correction. In PEAR blacks, a KCNJ1 SNP was associated with increased FG during HCTZ treatment (beta=8.47, P(FDR)=0.009). KCNJ1 SNPs and haplotypes were associated with NOD risk in all INVEST race/ethnic groups (strongest association: odds ratio 2.14 (1.31-3.53), P(FDR)=0.03). Our findings support that KCNJ1 variation is associated with HCTZ-induced dysglycemia and NOD.

Crystal lattice and electronic and transport properties of Janus ZrSiSZ2 (Z = N, P, As) monolayers by first-principles investigations.

From the extending requirements for using innovative materials in advanced technologies, it is necessary to explore new materials for relevant applications. In this work, we design new two-dimensional (2D) Janus ZrSiSZ2 (Z = N, P, As) monolayers and investigate their crystal lattice and dynamic stability by using density functional theory investigations. The two stable structures of ZrSiSP2 and ZrSiSAs2 are then systematically examined for thermal, energetic, and mechanical stability, and electronic and transport properties. The calculation results demonstrate that both the ZrSiSP2 and ZrSiSAs2 monolayers have good thermal stability at room temperature and high energetic/mechanical stabilities for experimental synthesis. The studied structures are found to be in-direct semiconductors. Specifically, with moderate band-gap energies of 1.04 to 1.29 eV for visible light absorption, ZrSiSP2 and ZrSiSAs2 can be considered potential candidates for photovoltaic applications. The applied biaxial strains and external electric fields slightly change the band-gap energies of the monolayers. We also calculate the carrier mobilities for the transport properties based on the deformation potential method. Due to the lower effective masses, the carrier mobilities in the x direction are higher than those in the y direction. The carrier mobilities of the ZrSiSP2 and ZrSiSAs2 monolayers are anisotropic not only in transport directions but also for the electrons and holes. We believe that the results of our work may stimulate further studies to explore more new 2D Janus monolayers with novel properties of the MA2Z4 family materials.

Janus structures of the C 2h polymorph of gallium monochalcogenides: first-principles examination of Ga2XY (X/Y = S, Se, Te) monolayers.

Group III monochalcogenide compounds can exist in different polymorphs, including the conventional D 3h and C 2h phases. Since the bulk form of the C 2h-group III monochalcogenides has been successfully synthesized [Phys. Rev. B: Condens. Matter Mater. Phys. 73 (2006) 235202], prospects for research on their corresponding monolayers have also been opened. In this study, we design and systematically consider a series of Janus structures formed from the two-dimensional C 2h phase of gallium monochalcogenide Ga2XY (X/Y = S, Se, Te) using first-principles simulations. It is demonstrated that the Janus Ga2XY monolayers are structurally stable and energetically favorable. Ga2XY monolayers exhibit high anisotropic mechanical features due to their anisotropic lattice structure. All Janus Ga2XY are indirect semiconductors with energy gap values in the range from 1.93 to 2.67 eV. Due to the asymmetrical structure, we can observe distinct vacuum level differences between the two surfaces of the examined Janus structures. Ga2XY monolayers have high electron mobility and their carrier mobilities are also highly directionally anisotropic. It is worth noting that the Ga2SSe monolayer possesses superior electron mobility, up to 3.22 × 103 cm2 V-1 s-1, making it an excellent candidate for potential applications in nanoelectronics and nanooptoelectronics.

New C 2h phase of group III monochalcogenide monolayers AlX (X = S, Se, and Te) with anisotropic crystal structure: first-principles study.

In this paper, we introduce a new phase of two-dimensional aluminum monochalcogenide, namely C 2h-AlX (X = S, Se, and Te). With the C 2h space group, C 2h-AlX possesses a large unit cell containing 8 atoms. The C 2h phase of AlX monolayers is found to be dynamically and elastically stable based on the evaluation of its phonon dispersions and elastic constants. The anisotropic atomic structure of C 2h-AlX leads to a strong anisotropy in its mechanical properties with Young's modulus and Poisson's ratio strongly dependent on the directions examined in the two-dimensional plane. All three monolayers of C 2h-AlX are found to be direct band gap semiconductors, which are compared with the indirect band gap semiconductors of available D 3h-AlX. Particularly, the transition from direct to indirect band gap is observed in C 2h-AlX when a compressive biaxial strain is applied. Our calculated results indicate that C 2h-AlX exhibits anisotropic optical characteristics and its absorption coefficient is high. Our findings suggest that C 2h-AlX monolayers are suitable for applications in next-generation electro-mechanical and anisotropic opto-electronic nanodevices.

Electronic, optical, and thermoelectric properties of Janus In-based monochalcogenides.

Inspired by the successfully experimental synthesis of Janus structures recently, we systematically study the electronic, optical, and electronic transport properties of Janus monolayers In2XY(X/Y= S, Se, Te withX≠Y) in the presence of a biaxial strain and electric field using density functional theory. Monolayers In2XYare dynamically and thermally stable at room temperature. At equilibrium, both In2STe and In2SeTe are direct semiconductors while In2SSe exhibits an indirect semiconducting behavior. The strain significantly alters the electronic structure of In2XYand their photocatalytic activity. Besides, the indirect-direct gap transitions can be found due to applied strain. The effect of the electric field on optical properties of In2XYis negligible. Meanwhile, the optical absorbance intensity of the Janus In2XYmonolayers is remarkably increased by compressive strain. Also, In2XYmonolayers exhibit very low lattice thermal conductivities resulting in a high figure of meritZT, which makes them potential candidates for room-temperature thermoelectric materials.

Spin-orbit coupling effect on electronic, optical, and thermoelectric properties of Janus Ga2SSe.

In this paper, we investigate the electronic, optical, and thermoelectric properties of Ga2SSe monolayer by using density functional theory. Via analysis of the phonon spectrum and ab initio molecular dynamics simulations, Ga2SSe is confirmed to be stable at room temperature. Our calculations demonstrate that Ga2SSe exhibits indirect semiconductor characteristics and the spin-orbit coupling (SOC) effect has slightly reduced its band gap. Besides, the band gap of Ga2SSe depends tightly on the biaxial strain. When the SOC effect is included, small spin-orbit splitting energy of 90 meV has been found in the valence band. However, the spin-orbit splitting energy dramatically changes in the presence of biaxial strain. Ga2SSe exhibits high optical absorption intensity in the near-ultraviolet region, up to 8.444 × 104 cm-1, which is needed for applications in optoelectronic devices. By using the Boltzmann transport equations, the electronic transport coefficients of Ga2SSe are comprehensively investigated. Our calculations reveal that Ga2SSe exhibits a very low lattice thermal conductivity and high figure of merit ZT and we can enhance its ZT by temperature. Our findings provide further insight into the physical properties of Ga2SSe as well as point to prospects for its application in next-generation high-performance devices.

Curcumin inhibits COPD-like airway inflammation and lung cancer progression in mice.

Recent studies have demonstrated that K-ras mutations in lung epithelial cells elicit inflammation that promotes carcinogenesis in mice (intrinsic inflammation). The finding that patients with chronic obstructive pulmonary disease (COPD), an inflammatory disease of the lung, have an increased risk of lung cancer after controlling for smoking suggests a further link between lung cancer and extrinsic inflammation. Besides exposure to cigarette smoke, it is thought that airway inflammation in COPD is caused by bacterial colonization, particularly with non-typeable Hemophilus influenzae (NTHi). Previously, we have shown that NTHi-induced COPD-like airway inflammation promotes lung cancer in an airway conditional K-ras-induced mouse model. To further test the role of inflammation in cancer promotion, we administered the natural anti-inflammatory agent, curcumin, 1% in diet before and during weekly NTHi exposure. This significantly reduced the number of visible lung tumors in the absence of NTHi exposure by 85% and in the presence of NTHi exposures by 53%. Mechanistically, curcumin markedly suppressed NTHi-induced increased levels of the neutrophil chemoattractant keratinocyte-derived chemokine by 80% and neutrophils by 87% in bronchoalveolar lavage fluid. In vitro studies of murine K-ras-induced lung adenocarcinoma cell lines (LKR-10 and LKR-13) indicated direct anti-tumoral effects of curcumin by reducing cell viability, colony formation and inducing apoptosis. We conclude that curcumin suppresses the progression of K-ras-induced lung cancer in mice by inhibiting intrinsic and extrinsic inflammation and by direct anti-tumoral effects. These findings suggest that curcumin could be used to protract the premalignant phase and inhibit lung cancer progression in high-risk COPD patients.

A waterborne outbreak of hepatitis E virus transmission in southwestern Vietnam.

A hepatitis outbreak affecting primarily adults occurred in southwestern Vietnam, along the Hau river bordering Cambodia, in June and July 1994. One month after the outbreak, sera and epidemiologic information were collected from 150 subjects: 50 patient cases, 50 matched, healthy community controls, and 50 geographic controls living 50 km upriver. The prevalence of immunoglobulin G (IgG) to hepatitis E virus (HEV) was significantly (P < 0.001) higher (76%) among cases than among the matched (38%) and geographic (38%) control populations. Immunoglobulin M to HEV was detected by enzyme-linked immunosorbent assay and Western blot in 16% of sera collected from patients one month after the outbreak. Hepatitis E virus RNA was detected with the polymerase chain reaction in 6% of sera from patients; RNA was not detected in either control group. These results indicate that HEV was the etiologic agent responsible for the outbreak. Children were under-represented among clinical cases. River water served as the principal source for drinking and bathing among most (96%) of the case and control study populations. Boiling of drinking water was negatively associated (P < 0.05) with IgG anti-HEV seropositivity. Unusually heavy rainfall likely contributed to conditions that favored the outbreak. This is the first recognized outbreak of epidemic HEV transmission in Indo-China.

Additional effects of bisphenol A and paraben on the induction of calbindin-D(9K) and progesterone receptor via an estrogen receptor pathway in rat pituitary GH3 cells.

There are concerns about the combined estrogenic effects of chemicals since mixtures of these chemicals exist in our environment. This study investigated potential additional interactions between bisphenol A (BPA) and isobutylparaben (IBP), which are major xenoestrogens used in the manufacture of plastics, cosmetics, drugs, and other products. The combined effects of these two chemicals were analyzed by measuring the expression of calbindin-D(9k) (CaBP-9k) in rat pituitary cancer GH3 cells. GH3 cells were treated with single and combination doses of both chemicals (BPA single doses: 10(-7), 10(-6) and 10(-5) M; IBP single doses: 10(-7), 10(-6) and 10(-5) M, and each of the BPA and IBP doses combined). Prior to treatment, cells were temporarily transfected with a plasmid containing an ERE-luciferase reporter gene. Luciferase activity was measured as an indicator of ER activation by 17ß-estradiol (E2), BPA, and IBP. BPA (10(-5) M) combined with IBP (10(-7) M and 10(-6) M) induced a significant increase in the luciferase activity. Twenty-four hours after treatment, dose-dependent effects were observed in both single and combined dose groups, and several combination doses induced significant increases in the expression of CaBP-9k and progesterone receptor (PR) at both transcriptional and translational levels. Pre-treatment with ICI 182,780, a pure estrogen antagonist, significantly reversed BPA- and IBP-induced CaBP-9k and PR upregulation in GH3 cells. Taken together, these results indicate that BPA and IBP may have additionally increased estrogenic potency via an estrogen receptor-mediated pathway.

Biological effect of irradiated chitosan on plants in vitro.

For degradation of chitosan, chitosan with an 80% degree of deacetylation and a weight-average molecular mass (Mw) of approx. 48 kDa was irradiated with gamma-rays at doses up to 200 kGy in a 10% (w/v) solution. The Mw of chitosan was reduced from 48 to 9.1 kDa by irradiation. The characteristics of irradiated chitosan were analysed by using Fourier-transform IR spectroscopy and an elemental analyser. The amino group was found to be stable, whereas the C-O-C group decreased with increase in the dose. The product of chitosan irradiated at 100 kGy with an Mw of approx. 16 kDa showed the strongest growth promotion effect on plants in vitro. For shoot culture, supplementation with irradiated chitosan increased the fresh biomass of shoot clusters (7.2-17.0%) as well as the shoot multiplication rate (17.9-69.0%) for Chrysanthemum morifolium (florist's chrysanthemum), Limonium latifolium (limonium or sea-lavender), Eustoma grandiflorum (lisianthus, tulip gentian or Texas bluebell) and Fragaria ananassa (modern garden strawberry). The optimum concentrations of irradiated chitosan were found to be approx. 70-100 mg/l for chrysanthemum, 50-100 mg/l for lisianthus and 30-100 mg/l for limonium. For the plantlet culture, the optimum concentrations were found to be approx. 100 mg/l for chrysanthemum, 30 mg/l for lisianthus, 40 mg/l for limonium and 50 mg/l for strawberry. Supplementation with optimum concentrations of irradiated chitosan resulted in a significant increase in the fresh biomass (68.1% for chrysanthemum, 48.5% for lisianthus, 53.6% for limonium and 26.4% for strawberry), shoot height (19.4% for chrysanthemum, 16.5% for lisianthus, 33.9% for limonium and 25.9% for strawberry) and root length (40.6% for chrysanthemum, 66.9% for lisianthus, 23.4% for limonium and 22.6% for strawberry). In addition, treatment with irradiated chitosan enhanced the activity of chitosanase in treated plants and also improved the survival ratio and growth of the transferred plantlets acclimatized for 10-30 days under greenhouse conditions.

Metallic clip deployment during stereotactic breast biopsy: retrospective analysis.

PURPOSE: To determine the visibility of presumably excised lesions on screen-film mammograms obtained after biopsy and to determine the accuracy of clip deployment on the basis of measurements obtained on routine pre- and postbiopsy mammograms. MATERIALS AND METHODS: One hundred eleven cases of core-needle biopsy with clip deployment were reviewed. In each, the type of lesion, lesion location, and biopsy approach were recorded. Pre- and postbiopsy images were reviewed, and the distance between the clip and biopsy site was measured. Postbiopsy images were reviewed to determine whether the targeted lesion remained visible. RESULTS: In 62 (56%) cases, the clip was located within 5 mm of the target on postbiopsy images (craniocaudal and mediolateral), while in 18 (16%), the clip was within 6-10 mm on one projection. However, 31 (28%) clips were more than 1 cm from the target on at least one postbiopsy image. Of the 111 cases, 39 (35%) were malignant or atypical and required excision. Of these, 18 (46%) had clips at least 1 cm from the targeted lesion on at least one projection. CONCLUSION: Metallic clips placed during core-needle breast biopsy are intended to mark the biopsy site when the visible lesion is excised, in case additional biopsy is required. The data suggest that the position of metallic clips placed during stereotactic core-needle biopsy may differ substantially from the location of the biopsy site. Postbiopsy mammography should be performed in two orthogonal planes to document clip position relative to the biopsy site.

Negative predictive value of sonography with mammography in patients with palpable breast lesions.

OBJECTIVE: This study was performed to determine the negative predictive value of sonography with mammography in evaluating palpable breast lesions. MATERIALS AND METHODS: Four hundred twenty patients with 455 palpable breast lesions were retrospectively identified from our mammography database as having negative mammographic and sonographic results. For patients diagnosed with breast cancer, images and medical records were reviewed to determine whether the palpable lesion evaluated on sonography and mammography corresponded to the patient's breast cancer. On the basis of the number of breast cancers that correlated to the palpable areas imaged, the negative predictive value of sonography with mammography was determined. RESULTS: Sixty-two of the 420 patients in the study group were already diagnosed with breast carcinoma, and eight new carcinomas were diagnosed during the study period. Only one of six ipsilateral cancers corresponded to a palpable lesion that had a negative imaging evaluation. This lesion was diagnosed as an invasive lobular cancer, hard and fixed at physical examination. Imaging and clinical follow-up of the remaining patients showed no abnormality at the sites of previously investigated palpable abnormalities. The mean imaging follow-up was 25 months. The negative predictive value of sonography and mammography in the setting of a palpable lesion was 99.8%. CONCLUSION: The negative predictive value of sonography with mammography is high, and together these imaging modalities can be reassuring if follow-up is planned when the physical examination is not highly suspicious. However, if the physical examination is suspicious, biopsy should not be delayed.