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1.
Br J Radiol ; 94(1120): 20200880, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33560894

RESUMO

OBJECTIVES: To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria. METHODS: A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared. RESULTS: Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively. CONCLUSIONS: CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs. ADVANCES IN KNOWLEDGE: In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
2.
Medicine (Baltimore) ; 100(5): e24625, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592915

RESUMO

RATIONALE: Primary breast angiosarcoma (PBA) is a rare and overly aggressive entity and account for less than 1% of all breast cancer cases. PBA had a high rate of delayed preoperative diagnosis due to absent distinctive radiographic characteristics. PATIENT CONCERNS: We report a case of a 47-year-old female patient who had a previous history of luminal cancer in the right breast with mastectomy; the patient complained of asymmetrically diffuse enlarged, accompanying with a painless mass in the left breast 12 years after the mastectomy of her right breast. DIAGNOSES: The tumor mimicked idiopathic granulomatous mastitis on magnetic resonance imaging (MRI) at the first presentation. Contrast-enhanced ultrasound (CEUS) was performed for further lesion characterization and showed heterogeneous rapid hyper enhanced. An ultrasound-guided core needle biopsy was performed, and the pathology report indicated a breast angiosarcoma. INTERVENTIONS: The patient underwent a nipple-sparing simple mastectomy with immediate reconstruction of the left breast. OUTCOMES: After 8 months later, the tumor recurred, CEUS and MRI examination suggested PBA recurrence, then re-excision with implant removal was performed, the patient had a lung metastasis 4 months later eventually died 22 months after diagnosis. LESSONS: It is not easy to diagnose PBA with the radiographic examination. This case's importance is by combining CEUS and MRI to reflect enhanced morphology and hemodynamic characteristics of PBA and help diagnose breast angiosarcomas.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Ultrassonografia Mamária
3.
Radiol Med ; 126(4): 517-526, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33385300

RESUMO

OBJECTIVES: To investigate the role of automated breast volume scanner (ABVS) compared to handheld ultrasound (HHUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the early detection of patients with locally advanced breast cancer who are more likely to reach a complete pathological response (pCR) during neoadjuvant chemotherapy (NAC). METHODS: A single-institution prospective study was performed in patients with histological diagnosis of invasive breast cancer, eligible for NAC, and who were to undergo surgery in our Hospital. Imaging examinations with ABVS, HHUS and CE-MRI were performed at diagnosis (basal time) and after 3 months of chemotherapy (middle time). The tumor size of each lesion was measured at the basal and middle times, and the dimensional variation was reported. Based on this, patients were divided dichotomously by the median value, obtaining "good responders" (goodR) versus "poor responders" (poorR). The results were correlated with the histological assessment (pCR versus No-pCR) with the use of the intergroup comparison of categorical data (Fisher's exact test). RESULT: A total of 21 patients were included; 5 obtained a pCR (23%). Both the ABVS and the CE-MRI found all 5 patients with pCR in the group of goodR (10 patients), while none of the poorR (11 patients) obtained a pCR [correlation was statistically significant (p 0.01)]. In the HHUS, goodR (10 patients) 1 obtained a pCR while in the poorR (11 patients) 4 obtained a pCR [correlation not statistically significant (p 0.31)]. CONCLUSIONS: ABVS could be a useful tool, appearing to be more reliable than HHUS, and as accurate as CE-MRI, in early detection of patients who could reach a pCR after NAC.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Terapia Neoadjuvante , Reconhecimento Automatizado de Padrão , Ultrassonografia Mamária/métodos , Adulto , Mama/anatomia & histologia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Meios de Contraste , Feminino , Humanos , Imageamento Tridimensional , Imagem por Ressonância Magnética/métodos , Tamanho do Órgão , Estudos Prospectivos
4.
Radiologe ; 61(2): 166-169, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33452568

RESUMO

STANDARD RADIOLOGICAL PROCEDURES: Currently, the combination of mammography and sonography is the gold standard in breast diagnostics. If there are any uncertainties, further examinations such as breast magnetic resonance imaging (MRI) and, in studies, computer tomographic procedures can be used. These investigations are carried out separately. METHODICAL INNOVATION: The combination of different imaging techniques in fusion devices promises a significant improvement in breast diagnostics. Advantages of the new imaging technique include the simultaneous acquisition of different image modalities with a fixed breast, which allows better spatial localization of the region of interest (ROI). This can also reduce the time and investigator effort and compensate for the weaknesses of one imaging technique with the strengths of a second imaging technique. The current state of research and the history of the fusion of ultrasound and mammography in breast diagnostics are summarized.


Assuntos
Neoplasias da Mama , Ultrassonografia Mamária , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos
5.
Ultrasonics ; 110: 106229, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33091651

RESUMO

Medical ultrasound images are inherently noised with speckle noise, which may interfere with Computer Aided Diagnostics (CAD) tasks, such as automatic segmentation. A compression and speckle de-noising method is proposed and tested on real clinical breast and fetal ultrasound images. The proposed algorithm is based on the optimization of quantization coefficients when applying Wavelet representation on the image, where the optimization is held such that a pre-defined mathematical fidelity criterion with respect to a desired de-speckled image is obtained. The proposed algorithm yields effective speckle reduction whilst preserving the edges in the images, with a reduced computational burden compared to other existing state-of-the-art methods, such as Optimal Bayesian Non-Local Means (OBNLM). In addition, the images are simultaneously compressed to a target bit-rate. The proposed algorithm is evaluated using both objective mathematical fidelity criteria (such as Structural Similarity and Edge Preserve) as well as subjective radiologists tests. The experimental results demonstrate the ability of the proposed method to achieve de-speckled images with compression ratios of approximately 30:1, whilst obtaining competitive subjective as well as objective fidelity measures with respect to the desired de-speckled images.


Assuntos
Algoritmos , Compressão de Dados/métodos , Aumento da Imagem/métodos , Ultrassonografia Mamária , Ultrassonografia Pré-Natal , Feminino , Humanos
6.
Ultrasonics ; 110: 106271, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33166786

RESUMO

Accurate breast mass segmentation of automated breast ultrasound (ABUS) is a great help to breast cancer diagnosis and treatment. However, the lack of clear boundary and significant variation in mass shapes make the automatic segmentation very challenging. In this paper, a novel automatic tumor segmentation method SC-FCN-BLSTM is proposed by incorporating bi-directional long short-term memory (BLSTM) and spatial-channel attention (SC-attention) module into fully convolutional network (FCN). In order to decrease performance degradation caused by ambiguous boundaries and varying tumor sizes, an SC-attention module is designed to integrate both finer-grained spatial information and rich semantic information. Since ABUS is three-dimensional data, utilizing inter-slice context can improve segmentation performance. A BLSTM module with SC-attention is constructed to model the correlation between slices, which employs inter-slice context to assist segmentation for false positive elimination. The proposed method is verified on our private ABUS dataset of 124 patients with 170 volumes, including 3636 2D labeled slices. The Dice similarity coefficient (DSC), Recall, Precision and Hausdorff distance (HD) of the proposed method are 0.8178, 0.8067, 0.8292 and 11.1367. Experimental results demonstrate that the proposed method offered improved segmentation results compared with existing deep learning-based methods.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Redes Neurais de Computação , Reconhecimento Automatizado de Padrão/métodos , Ultrassonografia Mamária/métodos , Algoritmos , Diagnóstico por Computador , Feminino , Humanos
7.
Ultrasonics ; 110: 106300, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33232887

RESUMO

Breast and thyroid cancers are the two common cancers to affect women worldwide. Ultrasonography (US) is a commonly used non-invasive imaging modality to detect breast and thyroid cancers, but its clinical diagnostic accuracy for these cancers is controversial. Both thyroid and breast cancers share some similar high frequency ultrasound characteristics such as taller-than-wide shape ratio, hypo-echogenicity, and ill-defined margins. This study aims to develop an automatic scheme for classifying thyroid and breast lesions in ultrasound images using deep convolutional neural networks (DCNN). In particular, we propose a generic DCNN architecture with transfer learning and the same architectural parameter settings to train models for thyroid and breast cancers (TNet and BNet) respectively, and test the viability of such a generic approach with ultrasound images collected from clinical practices. In addition, the potentials of the thyroid model in learning the common features and its performance of classifying both breast and thyroid lesions are investigated. A retrospective dataset of 719 thyroid and 672 breast images captured from US machines of different makes between October 2016 and December 2018 is used in this study. Test results show that both TNet and BNet built on the same DCNN architecture have achieved good classification results (86.5% average accuracy for TNet and 89% for BNet). Furthermore, we used TNet to classify breast lesions and the model achieves sensitivity of 86.6% and specificity of 87.1%, indicating its capability in learning features commonly shared by thyroid and breast lesions. We further tested the diagnostic performance of the TNet model against that of three radiologists. The area under curve (AUC) for thyroid nodule classification is 0.861 (95% CI: 0.792-0.929) for the TNet model and 0.757-0.854 (95% CI: 0.658-0.934) for the three radiologists. The AUC for breast cancer classification is 0.875 (95% CI: 0.804-0.947) for the TNet model and 0.698-0.777 (95% CI: 0.593-0.872) for the radiologists, indicating the model's potential in classifying both breast and thyroid cancers with a higher level of accuracy than that of radiologists.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Aprendizado Profundo , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia/métodos , Conjuntos de Dados como Assunto , Diagnóstico Diferencial , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia Mamária
8.
Clin Imaging ; 69: 126-132, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32717540

RESUMO

Idiopathic granulomatous mastitis (IGM), or granulomatous lobular mastitis is a rare, benign, inflammatory condition of the breast, without an identifiable underlying etiology. The clinical and imaging diagnosis of this entity is challenging with the presentation frequently mimicking inflammatory breast carcinoma (IBC). Mammography and breast ultrasound (US) have an important role in its detection, however, biopsy is imperative for histopathological confirmation. We present three cases of biopsy proven IGM, highlighting the variability of the clinical and imaging features,brieflyreview the relevant literature and discuss the challenges associated with its diagnosis and management.


Assuntos
Mastite Granulomatosa , Mastite , Biópsia , Feminino , Mastite Granulomatosa/diagnóstico por imagem , Humanos , Mamografia , Mastite/diagnóstico por imagem , Ultrassonografia Mamária
9.
Radiol Clin North Am ; 59(1): 67-83, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33223001

RESUMO

The sensitivity of mammography is more limited in patients with dense breasts and some patients at higher risk for breast cancer. Patients with intermediate or high risk for breast cancer may begin screening earlier and benefit from supplemental screening techniques beyond standard 2-dimensional mammography. A patient's individual risk factors for developing breast cancer, their breast density, and the evidence supporting specific modalities for a given clinical scenario help to determine the need for supplemental screening and the modality chosen. Additional factors include the availability of supplemental screening techniques at an individual institution, cost, insurance coverage, and state-specific breast density legislation.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Ultrassonografia Mamária/métodos , Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Risco
10.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370954

RESUMO

Type 1 multiple endocrine neoplasia (MEN-1) syndrome is an autosomal dominant disease, associated with germline mutations in the MEN-1 tumour suppressor gene (encoding the menin protein). Recent studies, through a better characterisation of the functions of the menin protein, have started to demonstrate how changes in this protein may be related to breast cancer. We present the case of a patient whose diagnosis of MEN-1 syndrome was made during treatment for a breast tumour-this diagnosis was obtained after finding multiple neoplastic lesions that fitted the MEN-1 syndrome spectrum, during the initial staging and subsequent follow-up of a breast tumour. In line with the growing evidence that links MEN-1 syndrome to breast cancer tumorigenesis, this case report highlights the following question: should we start screening this subset of patients earlier for breast cancer?


Assuntos
Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Neoplasia Endócrina Múltipla Tipo 1/diagnóstico , Proteínas Proto-Oncogênicas/genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Tumor Carcinoide/sangue , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/genética , Tumor Carcinoide/terapia , Carcinoma Ductal de Mama/genética , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Feminino , Aconselhamento Genético , Mutação em Linhagem Germinativa , Humanos , Achados Incidentais , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/terapia , Imagem por Ressonância Magnética , Mamografia , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla Tipo 1/complicações , Neoplasia Endócrina Múltipla Tipo 1/genética , Neoplasia Endócrina Múltipla Tipo 1/terapia , Mutação , Terapia Neoadjuvante/métodos , Estadiamento de Neoplasias , Glândulas Paratireoides/diagnóstico por imagem , Hormônio Paratireóideo/sangue , Neoplasias das Paratireoides/sangue , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/genética , Neoplasias das Paratireoides/terapia , Paratireoidectomia , Pneumonectomia , Radioterapia Adjuvante , Tomografia Computadorizada por Raios X , Ultrassonografia Mamária
11.
Medicine (Baltimore) ; 99(50): e23556, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327307

RESUMO

Women with nonpalpable breast masses are at a high risk of developing breast cancer (BC) due to misdiagnosis during the follow-up period.A total of 40,334 women were divided into palpable and nonpalpable breast mass groups. We assessed the risk factors for cancer development in patients with nonpalpable breast masses during a 1-year follow-up period.Of the 1335 patients in the nonpalpable breast mass group, we found 50 patients of BC, of which 35 patients accepted surgery and were confirmed with biopsy at the beginning of the study. The remaining 15 (1.1%) were diagnosed with BC during follow-up, and included 10 in situ and 5 invasive carcinomas. Four of the 10 patients in the in situ subgroup, and 2 out of the 5 in the invasive subgroup were overweight (Body mass index > 24 kg/m). Nine in situ BC patients had breast-conserving surgery, 1 had a mastectomy. No patient in the in situ group received chemotherapy or radiotherapy. All 5 patients with invasive disease received 6 cycles of chemotherapy. Only 3 (20%) of the 15 patients with BC had a positive family history. We found 131 BC cases, including BC detected during screening (81) and follow-up (50). The incidence of BC was 240.2 per 100,000 inhabitants.Patients with nonpalpable breast masses require regular follow-up as they have a high risk of cancer occurrence. Regular follow-up can lead to early diagnosis and effective treatment of these early-stage BC patients.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Adolescente , Adulto , Idoso , Doenças Mamárias/diagnóstico , Neoplasias da Mama/diagnóstico , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico por imagem , China , Detecção Precoce de Câncer , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Ultrassonografia Mamária , Adulto Jovem
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2003-2006, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018396

RESUMO

Breast-conserving surgery, also known as lumpectomy, is an early stage breast cancer treatment that aims to spare as much healthy breast tissue as possible. A risk associated with lumpectomy is the presence of cancer positive margins post operation. Surgical navigation has been shown to reduce cancer positive margins but requires manual segmentation of the tumor intraoperatively. In this paper, we propose an end-to-end solution for automatic contouring of breast tumor from intraoperative ultrasound images using two convolutional neural network architectures, the U-Net and residual U-Net. The networks are trained on annotated intraoperative breast ultrasound images and evaluated on the quality of predicted segmentations. This work brings us one step closer to providing surgeons with an automated surgical navigation system that helps reduce cancer-positive margins during lumpectomy.


Assuntos
Neoplasias da Mama , Mastectomia Segmentar , Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Redes Neurais de Computação , Ultrassonografia Mamária
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2051-2054, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018408

RESUMO

Cancer is known to induce significant structural changes to tissue. In most cancers, including breast cancer, such changes yield tissue stiffening. As such, imaging tissue stiffness can be used effectively for cancer diagnosis. One such imaging technique, ultrasound elastography, has emerged with the aim of providing a low-cost imaging modality for effective breast cancer diagnosis. In quasi-static breast ultrasound elastography, the breast is stimulated by ultrasound probe, leading to tissue deformation. The tissue displacement data can be estimated using a pair of acquired ultrasound radiofrequency (RF) data pertaining to pre- and post-deformation states. The data can then be used within a mathematical framework to construct an image of the tissue stiffness distribution. Ultrasound RF data is known to include significant noise which lead to corruption of estimated displacement fields, especially the lateral displacements. In this study, we propose a tissue mechanics-based method aiming at improving the quality of estimated displacement data. We applied the method to RF data acquired from a tissue-mimicking phantom. The results indicated that the method is effective in improving the quality of the displacement data.


Assuntos
Técnicas de Imagem por Elasticidade , Algoritmos , Feminino , Humanos , Imagens de Fantasmas , Reprodutibilidade dos Testes , Ultrassonografia Mamária
14.
Medicine (Baltimore) ; 99(44): e22929, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126355

RESUMO

RATIONALE: The incidence of pregnancy-associated breast cancer (PABC) is increasing nowadays, and its diagnosis and treatment remain complicated due to the consideration of the fetus. The available data on PABC are primarily derived from case reports since there are ethical restrictions on conducting randomized clinical trials. In the present work, we reported a case of the human epidermal growth factor receptor 2 (HER2)-positive PABC and described the diagnosis and treatment for such type of breast cancer. PATIENT CONCERNS: A 27-year-old patient was admitted to our hospital with the complaints of right breast mass for 3 days, and she was a first-time pregnant woman with a single live intrauterine fetus at 26 + 3 weeks of gestation. Physical examination of the right breast revealed a palpable and hard mass with obscure boundaries (5.0 cm × 4.0 cm) in the upper outer quadrant. Significant axillary lymph nodes (2.0 cm) were also present. DIAGNOSIS: PABC. INTERVENTION: To protect the fetus, breast ultrasonography was used to test her breast mass, a core needle biopsy was adopted to confirm the diagnosis, and abdominal ultrasound and chest X-ray were used to evaluate the metastasis. The patient was scheduled for neoadjuvant therapy using bi-weekly pirarubicin in combination with cyclophosphamide (AC) without anti-HER2 therapy for consideration of the fetus's safety. After 4 cycles of AC, the patient delivered a healthy male infant. After the delivery, all the treatments were carried out according to the standard recommendation for HER2 + breast cancer as non-pregnant patients. OUTCOMES: After the surgery, the disease-free survival for the patient was 12 months until brain metastasis was diagnosed. She was still undergoing second-line anti-HER2 therapy and currently in a stable situation. Besides, the child was also healthy so far. LESSONS: The methods for the diagnosis and treatment of PABC that result in teratogenesis should be avoided to protect the fetus. Mammogram and chest X-ray were safe approaches for the fetus. Moreover, chemotherapy-based on pirarubicin in combination with cyclophosphamide had no risk to the fetus.


Assuntos
Neoplasias da Mama , Ciclofosfamida/administração & dosagem , Doxorrubicina/análogos & derivados , Mastectomia Radical Extensa/métodos , Cuidado Pós-Natal/métodos , Complicações Neoplásicas na Gravidez , Receptor ErbB-2/antagonistas & inibidores , Trastuzumab/administração & dosagem , Adulto , Antineoplásicos/administração & dosagem , Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Doxorrubicina/administração & dosagem , Feminino , Idade Gestacional , Humanos , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/metabolismo , Complicações Neoplásicas na Gravidez/patologia , Complicações Neoplásicas na Gravidez/terapia , Resultado da Gravidez , Ultrassonografia Mamária/métodos
15.
PLoS One ; 15(9): e0239271, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941537

RESUMO

PURPOSE: To evaluate the kinetic patterns of benign and malignant breast lesions using contrast-enhanced digital mammogram (CEDM). METHODS: Women with suspicious breast lesions on mammography or ultrasound were enrolled. Single-view mediolateral oblique (MLO) CEDM of an affected breast was acquired at 2, 3, 4, 7, and 10 min after injection of contrast agent. Three readers visually and semi-quantitatively analyzed the enhancement of suspicious lesions. The kinetic pattern of each lesion was classified as persistent, plateau, or washout over two time intervals, 2-4 min and 2-10 min, by comparing the signal intensity at the first time interval with that at the second. RESULTS: There were 73 malignant and 75 benign lesions in 148 patients (mean age: 52 years). Benign and malignant breast lesions showed the highest signal intensity at 3 min and 2 min, respectively. Average areas under receiver operating characteristic (ROC) curve for diagnostic accuracy based on lesion enhancement at different time points were 0.73 at 2 min, 0.72 at 3 min, 0.69 at 4 min, 0.67 at 7 min, and 0.64 at 10 min. Diagnostic performance was significantly better at 2, 3, and 4 min than at 7 and 10 min (all p < 0.05). A washout kinetic pattern was significantly associated with malignant lesions at 2-4 min and 2-10 min frames according to two of the three readers' interpretations (all p ≤ 0.001). CONCLUSION: Applications of optimal time intervals and kinetic patterns show promise in differentiation of benign and malignant breast lesions on CEDM.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamografia/métodos , Ultrassonografia Mamária/métodos , Adulto , Neoplasias da Mama/epidemiologia , Meios de Contraste/farmacocinética , Feminino , Humanos , Mamografia/normas , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Ultrassonografia Mamária/normas , Ultrassonografia Mamária/estatística & dados numéricos
16.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(3): 116-120, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197296

RESUMO

El carcinoma sebáceo de mama (CSM) es una neoplasia muy poco frecuente. De acuerdo con la clasificación actual de la OMS, el CSM se define como un carcinoma de la mama en el que sus células presentan diferenciación sebácea en al menos el 50% de las mismas y no existe ninguna relación con las glándulas sebáceas de los anejos de la piel. Acorde con esta definición tan solo encontramos 21 casos descritos en la literatura. Presentamos un nuevo caso de CSM junto a una revisión de características clínicas, anatomopatológicas y terapéuticas de esta rara estirpe tumoral de mama


Sebaceous gland carcinoma (SGC) is an exceedingly rare neoplasm. According to the WHO, SGC is defined as a breast carcinoma in which at least 50% of cells show sebaceous differentiation and there is no relationship with the sebaceous glands of the skin annexes. Only 21 reported cases in the literature fit this definition. We present a new case of this rare breast tumour, as well as a review of its clinical, histological and therapeutic features


Assuntos
Humanos , Feminino , Idoso , Adenocarcinoma Sebáceo/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Imuno-Histoquímica/métodos , Mamografia/métodos , Ultrassonografia Mamária/métodos , Mastectomia/métodos , Diagnóstico Diferencial
17.
Medicine (Baltimore) ; 99(30): e21095, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791685

RESUMO

RATIONALE: Anaplastic large T-cell lymphoma (BI-ALCL) is a rare primitive lymphoma described in women with breast implant prostheses, which has been arousing interest in recent years due to its potentially high social impact. The difficult diagnosis associated with the high and increasing number of prosthetic implants worldwide has led to hypothesize an underestimation of the real impact of the disease among prosthesis-bearing women. The aim of this work is to search for specific radiological signs of disease linked to the chronic inflammatory pathogenetic mechanism. PATIENT CONCERNS: This work describes a case of BI-ALCL in an American woman with no personal or family history of cancer, who underwent breast augmentation for esthetic purposes at our Institute. After about 10 years of relative well-being, the patient returned to our Institute with clear evidence of breast asymmetry due to the increase in volume of the right breast which had progressively become larger over a period of 6 months. There was no evidence of palpable axillary lymph nodes or other noteworthy signs. DIAGNOSIS: The ultrasound and magnetic resonance (MR) tests indicated the presence of seroma with amorphous material in the exudate which was confirmed by indirect signs, visible in right breast mammography. Due to suspected cold seroma, an ultrasound-guided needle aspiration was performed for the cytological analysis of the effusion which highlighted the presence of a number of large-sized atypical cells with an irregular nucleus with CD30 immunoreactivity, leucocyte common antigen (CD45) compatible with the BI-ALCL diagnosis. INTERVENTIONS: In our case, a capsulectomy was performed because the disease was limited inside the capsule and periprosthetic seroma. The final histological examination confirmed the stage. LESSONS: The patient is being monitored and shows no signs of recurrence of disease >24 months after surgery. CONCLUSION: A diagnosis of BI-ALCL can be reached using new radiological indicators, such as fibrin, which is clearly visible by MR in the form of nonvascularized debris of amorphous material hypointense in all sequences, free flowing or adhered to the external surface of the prosthesis.


Assuntos
Implantes de Mama/efeitos adversos , Linfoma Anaplásico de Células Grandes/diagnóstico por imagem , Biópsia por Agulha , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/patologia , Imagem por Ressonância Magnética , Mamografia , Pessoa de Meia-Idade , Seroma/diagnóstico por imagem , Ultrassonografia Mamária
18.
Zhonghua Yi Xue Za Zhi ; 100(30): 2367-2371, 2020 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-32791813

RESUMO

Objective: To analyze the screening results of breast cancer in rural women in Fujian Province from 2015 to 2018, and to explore the screening mode of breast cancer. Methods: Breast cancer screening was provided for 35-64 years old rural women in Fujian province. Color Doppler ultrasound was used as the primary screening method. Suspected patients were referred to mammography. Color Doppler ultrasound and breast X -ray 4-5 grade were diagnosed by pathology. Results: The incidence of breast cancer from 2015 to 2018 was 56.96/10 million, 94.41/10 million, 71.61/10 million, and 73.05/10 million, respectively. And the peak age of breast cancer was (46-55) years. From 2015 to 2018, the proportion of cancer in situ showed an overall upward trend. The sensitivity of color Doppler ultrasound was 79.06%, and the sensitivity of mammography for those diagnosed abnormally by ultrasound was 91.88%. Conclusion: Breast cancer screening for women of the right age is an important measure to raise the rate of early diagnosis and early treatment and reduce the mortality of breast cancer. Screening mode based on breast ultrasound is the most suitable technology. We need to further expand the coverage of screening, improve the screening system and process, and ensure the health of women.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Adulto , Feminino , Humanos , Mamografia , Programas de Rastreamento , Pessoa de Meia-Idade , Ultrassonografia Mamária
19.
Rev. chil. obstet. ginecol. (En línea) ; 85(4): 376-382, ago. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1138635

RESUMO

RESUMEN El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral unilateral, de crecimiento rápido e indolora. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 12 cm de diámetro en la mama de una niña de 13 años. Se realiza estudio radiológico e histológico de la lesión siendo categorizada como un fibroadenoma gigante juvenil por lo que se realiza tumorectomía completa con remodelación mamaria posterior. A los dos meses de seguimiento, la paciente se encuentra sin signos de recidiva, con buena situación general y a la espera de cirugía de remodelación mamaria.


ABSTRACT Juvenile giant fibroadenoma is a benign breast tumor and a rare variant of fibroadenomas. The clinical presentation is usually a painless, fast growing, unilateral tumor mass. In this article we present the case of a giant juvenile fibroadenoma of 12 cm in diameter in the breast of a 13-year-old girl. A radiological and histological study of the lesion was carried out and it was categorized as a juvenile giant fibroadenoma, so a complete lumpectomy with posterior breast remodeling was performed. After two months of follow-up, the patient is without signs of recurrence, in good general condition and waiting for the breast remodeling surgery.


Assuntos
Humanos , Feminino , Adolescente , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Fibroadenoma/cirurgia , Fibroadenoma/diagnóstico por imagem , Neoplasias da Mama/patologia , Imagem por Ressonância Magnética , Ultrassonografia Mamária , Fibroadenoma/patologia
20.
Tumori ; 106(5): 378-387, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32623975

RESUMO

INTRODUCTION: Breast cancer is one of the most frequently occurring cancers during pregnancy and its incidence is increasing. Many studies have shown poor outcomes, the causes of which remain unclear. OBJECTIVES: To analyze radiologic characteristics, histology, and prognosis factors of breast cancer during pregnancy. METHODS: A total of 42 patients with breast cancer diagnosed during pregnancy (BCP) were matched with 84 patients with breast cancer of similar age who were not pregnant. Sensitivity of radiology, tumor characteristics, prognosis factors, disease-free survival, and overall survival were analyzed. RESULTS: The sensitivity of breast ultrasound was higher than that of mammography for both groups. Ultrasound sensitivity for cancer was 95.7% in patients with BCP versus 98% in the not pregnant group, with non-statistically significant differences. Mammography sensitivity for cancer was 56.5% in patients with BCP versus 61% in the not pregnant group, with non-statistically significant differences. The stage at diagnosis according to the TNM staging system was significantly higher in patients with BCP with stage IV cancer: 16.7% in patients with BCP versus 3.7% in the not pregnant group (p = 0.03). No statistically significant differences were observed in histologic grade, Ki-67 index, or molecular subtype. Disease-free survival and overall survival were significantly lower in patients with BCP (p = 0.002 and p = 0.04). Multivariate analysis showed no difference when adjusting for stage and surrogate molecular subtype. CONCLUSION: Breast ultrasound shows a high sensitivity to detect breast cancer during pregnancy. BCP is diagnosed at a higher stage than in nonpregnant women. In our series, patients with BCP had poorer outcomes than the not pregnant group. These results were not observed when adjusting for stage.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/diagnóstico , Prognóstico , Adulto , Neoplasias da Mama/complicações , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Humanos , Mamografia , Estadiamento de Neoplasias , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/patologia , Taxa de Sobrevida , Ultrassonografia Mamária
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