[Ultrasound follow-up of palpable solid, probably benign breast lesions (BI-RADS category III)]. / Sonographische Verlaufskontrollen bei palpablen soliden, wahrscheinlich gutartigen Brustläsionen (BI-RADS Kategorie III).

PURPOSE: To determine whether palpable non-calcified solid breast masses with benign morphology on ultrasound can be classified as probably benign and whether these lesions fulfill the criteria required for BI-RADS (TM) category III. MATERIALS AND METHODS: This analysis includes 78 patients with 80 palpable non-calcified solid masses that were classified as probably benign at initial sonography. Of 78 patients, 66 had periodic imaging surveillance (2 - 8 years, mean 4.6 years). The remaining 12 patients had a biopsy after initial imaging. RESULTS: In the 64 patients under surveillance, palpable lesions remained stable at follow-up. In 2 patients lesions increased in size during follow-up and no malignancy was diagnosed at subsequent open biopsy. In 19 of the 66 patients, 29 additional nonpalpable lesions of similar morphology were detected on ultrasound. No malignancy was diagnosed in the 12 patients, who had a biopsy after initial imaging. CONCLUSION: Our data suggest that palpable non-calcified solid breast masses with benign morphology on ultrasound can be classified as probably benign (BI-RADS (TM) category III). Biopsy can be averted when lesions remain stable at follow-up.

Stereotactic and ultrasound-guided breast biopsy.

Percutaneous imaging-guided needle biopsy has increasingly become an alternative to surgical biopsy for the histologic assessment of breast lesions. Percutaneous biopsy is faster, less invasive, and less expensive than surgical biopsy. Tissue acquisition is performed with automated core needles or directional vacuum-assisted biopsy probes. Guidance for percutaneous biopsy is usually provided by stereotaxis, ultrasound, and, more recently, under the guidance of MR imaging. Imaging guidance depends on lesion type and the results of diagnostic imaging studies. This article reviews indications, advantages, limitations, and controversial issues in percutaneous imaging-guided biopsy of breast lesions under stereotactic and ultrasound guidance. The potential for new research opportunities and directions is also discussed.

[Electrical impedance scanning in the differentiation of suspicious breast lesions: comparison with mammography, ultrasound and histopathology]. / Elektrische Impedanzmessung in der Abklärung von Brustläsionen: Vergleich mit Mammographie, Sonographie und Histopathologie.

PURPOSE: To assess the value of Electrical Impedance Scanning (EIS) in the differentiation of suspicious breast lesions in comparison to mammography (MG) and ultrasound (US). METHODS: In 95 female patients (median 53.1 ys) 95 suspicious breast lesions (BI-RADS TM III - V) in MG or US underwent targeted EIS (TransScan TS 2000(R); TransScan Medical, Israel; Siemens Elema, Sweden). Histopathologic proof (vacuum-assisted biopsy or surgical biopsy) was obtained in all cases. MG, US and EIS were independently assessed by two radiologists in consensus. Chi-square tests as well as variance-analysis for ROC-statistics were performed. RESULTS: Of 95 lesions, 44 were benign, 51 malignant. Sensitivity, specificity, positive and negative predictive values were, respectively for MG 95.3 %, 23.5 %, 51.3 % and 85.7 %, for US 86.5 %, 44.2 %, 57.1 % and 79.1 %, for EIS 77.3 %, 82.3 %, 79.1 % and 80.8 %. The ROC-analysis revealed a significant greater area under the curve for EIS than for MG and US. The sensitivity for EIS was higher in lesions < 10 mm (n = 26; 100 %) and in invasive cancers (n = 31; 80.6 %). The negative predictive value of EIS was higher in BI-RADS TM-IV-lesions (83.9 %) as well as in dense breast parenchyma on the mammogram (86.7 %). CONCLUSION: EIS shows potential adjunctive value to MG and US in the differentiation of suspicious breast lesions.

[In situ ductal carcinoma of the breast: a diagnostic challenge]. / Das duktale In-situ-Karzinom der Mamma: eine diagnostische Herausforderung.

Ductal carcinoma in situ (DCIS) represents a heterogenous group of lesions nowadays most commonly detected by mammography. The biological behaviour of ductal carcinoma in situ ranges from clinically occult, indolent, essentially benign lesions to precursors of invasive carcinoma. This work gives a review on the natural history of this disorder, and focuses on its imaging features. Stress is laid on the pivotal role of mammography in the management of ductal carcinoma in situ. The recent literature is reviewed.

[Mammography referral center combined with breast cancer center]. / Mammographisches Referenzzentrum im Verbund mit einem Brustkrebszentrum.

Carcinoma of the breast is, with 26.7% of all malignancies, the most commonly diagnosed tumour in women, every eighth female Austrian suffers from this disease. Similar figures are reported from other European countries. Following recommendations of scientific societies like the European School of Mastology (ESOMA) or the British Breast Group, breast diseases should be treated by interdisciplinary teams in dedicated breast centers. Many such institutions exist in Austria and international, but only few of them are organized optimally and fulfill the requirements of an internationally accredited breast cancer centre.