Pathomorphological Changes in Mammary Glands of 16 Patients Who Underwent Surgical Aquafilling® Removal: A Single-Center Study.

BACKGROUND Aquafilling® is a soft-tissue filler used in various procedures, including breast plastic surgery. Proponents claim it to be safe and effective without causing serious adverse effects. This study aimed to describe histological changes in breast tissue resulting from potentially harmful effects of Aquafilling®. MATERIAL AND METHODS Tissue samples were collected from 16 patients who underwent surgical removal of Aquafilling®. Histopathological evaluations were performed on hematoxylin and eosin-stained slides, with photographs captured using an Olympus BX 43 light microscope and an XC 30 digital camera at 40×, 100×, and 400× total magnification. RESULTS Inflammatory infiltrates, mainly consisting of macrophages and lymphocytes, were observed in the images. Tissue necrosis was visible in some areas. Fibrosis foci and blood vessels with thickened walls and detached endothelium were identified within mammary adipose tissue. CONCLUSIONS Due to the variety of clinical symptoms and presence of inflammation in all examined women, we recommend histopathological examinations for all cases of Aquafilling® surgical removal. The examination should include information on the extent of inflammation, progression of adipose and muscle tissue damage, and assessment of fibrosis severity. This will help clinicians make informed decisions about Aquafilling® use in patients and improve patient outcomes.

Are contrast enhanced mammography and digital breast tomosynthesis equally effective in diagnosing patients recalled from breast cancer screening?

Purpose: Full-field digital mammography (FFDM) is widely used in breast cancer screening. However, to improve cancer detection rates, new diagnostic tools have been introduced. Contrast enhanced mammography (CEM) and digital breast tomosynthesis (DBT) are used in the diagnostic setting, however their accuracies need to be compared.The aim of the study was to evaluate the diagnostic performance of CEM and DBT in women recalled from breast cancer screening program. Methods: The study included 402 consecutive patients recalled from breast cancer screening program, who were randomized into two groups, to undergo either CEM (202 patients) or DBT (200 patients). All visible lesions were evaluated and each suspicious lesion was histopathologically verified. Results: CEM detected 230 lesions; 119 were classified as benign and 111 as suspicious or malignant, whereas DBT identified 209 lesions; 105 were classified as benign and 104 as suspicious or malignant. In comparison to histopathology, CEM correctly detected cancer in 43 out of 44 cases, and DBT in all 33 cases, while FFDM identified 15 and 18 neoplastic lesions in two groups, respectively. CEM presented with 97% sensitivity, 63% specificity, 70% accuracy, 38% PPV and 99% NPV, while DBT showed 100% sensitivity, 60% specificity, 32%, PPV, 100% NPV and 66% accuracy. The CEM's AUC was 0.97 and DBT's 0.99. The ROC curve analysis proved a significant (p<0.000001) advantage of both CEM and DBT over FFDM, however, there was no significant difference between CEM and DBT diagnostic accuracies (p=0.23). Conclusions: In this randomized, prospective study CEM and DBT show similar diagnostic accuracy.