Spectrum of Papillary Lesions of the Breast: Clinical, Imaging, and Pathologic Correlation
Malai Muttarak, Pailin Lerttumnongtum, Benjaporn Chaiwun, and Wilfred C. G. Peh
AJR 2008;191:700-707
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Papillary lesions of the breast are a heterogeneous group of lesions that are difficult to diagnose as benign or malignant. The purpose of this article is to review clinical presentation, imaging features, and pathologic correlation of papillary lesions of the breast and to discuss the prognosis and management of these lesions.
Recognition of the variety of benign and malignant papillary lesions of the breast will facilitate diagnosis and proper management.
Wednesday, 20 August 2008
Pure Ductal Carcinoma in Situ: A Range of MRI Features
Pure Ductal Carcinoma in Situ: A Range of MRI Features
Sughra Raza, Monica Vallejo, Sona A. Chikarmane, and Robyn L. Birdwell
AJR 2008;191:689-699
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Breast MRI plays an important role in the detection of DCIS, which most often appears as non-mass clumped enhancement, in a ductal or segmental distribution, with variable enhancement kinetics.
Sughra Raza, Monica Vallejo, Sona A. Chikarmane, and Robyn L. Birdwell
AJR 2008;191:689-699
Link to Journal
Breast MRI plays an important role in the detection of DCIS, which most often appears as non-mass clumped enhancement, in a ductal or segmental distribution, with variable enhancement kinetics.
Evaluation of MRI Findings After Polyacrylamide Gel Injection for Breast Augmentation
Evaluation of MRI Findings After Polyacrylamide Gel Injection for Breast Augmentation
Chun Ying Lui, Chiu Ming Ho, Po Ping Iu, Wing Yung Cheung, Hon Shing Lam, Ming Shiaw Cheng, and Hin Lun Lawrence Liu
AJR 2008;191:677-688
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Because poly acrylamide gel has a high water content, sagittal and axial T2-weighted are the best sequences to use to detect complications.
Chun Ying Lui, Chiu Ming Ho, Po Ping Iu, Wing Yung Cheung, Hon Shing Lam, Ming Shiaw Cheng, and Hin Lun Lawrence Liu
AJR 2008;191:677-688
Link to Journal
Because poly acrylamide gel has a high water content, sagittal and axial T2-weighted are the best sequences to use to detect complications.
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Juan A. Clavero, Jaume Masia, Jose Larranaga, Josep M. Monill, Gemma Pons, Sahyly Siurana, and Xavier Alomar
AJR 2008;191:670-676
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MDCT provides valuable information before surgery about the arterial anatomy of the inferior abdominal wall. It enables accurate identification of the most suitable dominant perforator vessel and makes surgical perforator flap procedures for breast reconstruction faster and safer.
Juan A. Clavero, Jaume Masia, Jose Larranaga, Josep M. Monill, Gemma Pons, Sahyly Siurana, and Xavier Alomar
AJR 2008;191:670-676
Link to Journal
MDCT provides valuable information before surgery about the arterial anatomy of the inferior abdominal wall. It enables accurate identification of the most suitable dominant perforator vessel and makes surgical perforator flap procedures for breast reconstruction faster and safer.
Role of Breast Sonography in Imaging of Adolescents with Palpable Solid Breast Masses
Role of Breast Sonography in Imaging of Adolescents with Palpable Solid Breast Masses
Aruna Vade, Vaishali S. Lafita, Kathleen A. Ward, Jennifer E. Lim-Dunham, and Davide Bova
AJR 2008;191:659-663
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OBJECTIVE.
The purpose of this study was to assess the role of sonography in the diagnosis and management of palpable solid breast masses in adolescents and to correlate the sonographic findings with the histopathologic findings and clinical outcome.
CONCLUSION.
Sonography was not useful for predicting the histologic diagnosis of all solid benign breast masses in adolescent patients. The Stavros sonographic criteria, however, were useful for predicting benignity in 65% of the breast masses on which histopathologic examination was performed. Tissue biopsy may be performed on solid breast masses that do not meet the criteria for benign masses according to the Stavros sonographic criteria.
Aruna Vade, Vaishali S. Lafita, Kathleen A. Ward, Jennifer E. Lim-Dunham, and Davide Bova
AJR 2008;191:659-663
Link to Journal
OBJECTIVE.
The purpose of this study was to assess the role of sonography in the diagnosis and management of palpable solid breast masses in adolescents and to correlate the sonographic findings with the histopathologic findings and clinical outcome.
CONCLUSION.
Sonography was not useful for predicting the histologic diagnosis of all solid benign breast masses in adolescent patients. The Stavros sonographic criteria, however, were useful for predicting benignity in 65% of the breast masses on which histopathologic examination was performed. Tissue biopsy may be performed on solid breast masses that do not meet the criteria for benign masses according to the Stavros sonographic criteria.
Application of Sonographic BI-RADS to Synchronous Breast Nodules Detected in Patients with Breast Cancer
Application of Sonographic BI-RADS to Synchronous Breast Nodules Detected in Patients with Breast Cancer
Suk Jung Kim, Eun Young Ko, Jung Hee Shin, Seok Seon Kang, Sung Hee Mun, Boo-Kyung Han, and Eun Yoon Cho
AJR 2008;191:653-658
Link to Journal
OBJECTIVE.
The purpose of this study was to evaluate the applicability of the current BI-RADS for sonography to the assessment of synchronous breast nodules other than the primary malignant tumor in patients with breast cancer.
CONCLUSION.
For assessment of synchronous nodules in breast cancer patients, application of conventional screening sonographic BI-RADS categories may not account for possible increased risk of malignancy in synchronous nodules, especially those in the same quadrant of the breast as the index malignant tumor.
Suk Jung Kim, Eun Young Ko, Jung Hee Shin, Seok Seon Kang, Sung Hee Mun, Boo-Kyung Han, and Eun Yoon Cho
AJR 2008;191:653-658
Link to Journal
OBJECTIVE.
The purpose of this study was to evaluate the applicability of the current BI-RADS for sonography to the assessment of synchronous breast nodules other than the primary malignant tumor in patients with breast cancer.
CONCLUSION.
For assessment of synchronous nodules in breast cancer patients, application of conventional screening sonographic BI-RADS categories may not account for possible increased risk of malignancy in synchronous nodules, especially those in the same quadrant of the breast as the index malignant tumor.
Cortical Morphologic Features of Axillary Lymph Nodes as a Predictor of Metastasis in Breast Cancer: In Vitro Sonographic Study
Cortical Morphologic Features of Axillary Lymph Nodes as a Predictor of Metastasis in Breast Cancer: In Vitro Sonographic Study
Deepak G. Bedi, Rajesh Krishnamurthy, Savitri Krishnamurthy, Beth S. Edeiken, Huong Le-Petross, Bruno D. Fornage, Roland L. Bassett, Jr., and Kelly K. Hunt
AJR 2008;191:646-652
Link to Journal
CONCLUSION.
In breast cancer, axillary lymph nodes can be classified according to cortical morphologic features. Predominantly hyperechoic nodes (types 1–3) can be considered benign. Generalized cortical lobulation (type 4) is uncommonly a false-negative finding, but metastasis, if present, is invariably detected at sentinel node mapping.
The presence of asymmetric focal hypoechoic cortical lobulation (type 5) or a completely hypoechoic node (type 6) should serve as a guideline for universal performance of fine-needle aspiration for preoperative staging of breast cancer. This classification, when verified with larger samples, may serve as a useful clinical guideline if proven with results of in vivo studies.
One of my criticisms of this paper is the absence of mention of the Nottingham Criteria for abnormal lymph nodes requiring biopsy. The original paper was published in 2003 in the British Journal of Cancer, and did not get the publicity it deserved.
Axillary ultrasound is now a routine procedure for patients with cancer, especially important in patients entering neo-adjuvant treatment or trials (such as I-SPY), where the pre-chemo demonstration of positive nodes may be the only evidence of stage 3 disease.
Deepak G. Bedi, Rajesh Krishnamurthy, Savitri Krishnamurthy, Beth S. Edeiken, Huong Le-Petross, Bruno D. Fornage, Roland L. Bassett, Jr., and Kelly K. Hunt
AJR 2008;191:646-652
Link to Journal
CONCLUSION.
In breast cancer, axillary lymph nodes can be classified according to cortical morphologic features. Predominantly hyperechoic nodes (types 1–3) can be considered benign. Generalized cortical lobulation (type 4) is uncommonly a false-negative finding, but metastasis, if present, is invariably detected at sentinel node mapping.
The presence of asymmetric focal hypoechoic cortical lobulation (type 5) or a completely hypoechoic node (type 6) should serve as a guideline for universal performance of fine-needle aspiration for preoperative staging of breast cancer. This classification, when verified with larger samples, may serve as a useful clinical guideline if proven with results of in vivo studies.
One of my criticisms of this paper is the absence of mention of the Nottingham Criteria for abnormal lymph nodes requiring biopsy. The original paper was published in 2003 in the British Journal of Cancer, and did not get the publicity it deserved.
Axillary ultrasound is now a routine procedure for patients with cancer, especially important in patients entering neo-adjuvant treatment or trials (such as I-SPY), where the pre-chemo demonstration of positive nodes may be the only evidence of stage 3 disease.
Radiologic Features of Polyacrylamide Gel Mammoplasty
Radiologic Features of Polyacrylamide Gel Mammoplasty
Sze Yiun Teo and Shih-chang Wang
AJR 2008;191:89-95
Link to Journal
Although polyacrylamide gel implants may mimic conventional implants on both sonography and MRI in women who do not have complications from mammoplasty, polyacrylamide gel implants have some distinguishing features.
The imaging appearance of polyacrylamide gel implants is related to the technique of injection and whether there are any associated complications. The implants are usually in a retroglandular location. Mammography, sonography, and MRI can be used to evaluate short-term complications, although MRI appears to be the most sensitive. Common short-term complications include extravasation of polyacrylamide gel and secondary infection, which may be related to lactation.
The long-term complications of polyacrylamide gel mammoplasty are unknown. Knowledge of the appearances of polyacrylamide gel implants in women with and those without complications from mammoplasty is useful in the radiologic evaluation of such patients.
Sze Yiun Teo and Shih-chang Wang
AJR 2008;191:89-95
Link to Journal
Although polyacrylamide gel implants may mimic conventional implants on both sonography and MRI in women who do not have complications from mammoplasty, polyacrylamide gel implants have some distinguishing features.
The imaging appearance of polyacrylamide gel implants is related to the technique of injection and whether there are any associated complications. The implants are usually in a retroglandular location. Mammography, sonography, and MRI can be used to evaluate short-term complications, although MRI appears to be the most sensitive. Common short-term complications include extravasation of polyacrylamide gel and secondary infection, which may be related to lactation.
The long-term complications of polyacrylamide gel mammoplasty are unknown. Knowledge of the appearances of polyacrylamide gel implants in women with and those without complications from mammoplasty is useful in the radiologic evaluation of such patients.
Image Quality of Digital Direct Flat-Panel Mammography Versus an Analog Screen-Film Technique Using a Low-Contrast Phantom
Image Quality of Digital Direct Flat-Panel Mammography Versus an Analog Screen-Film Technique Using a Low-Contrast Phantom
Kathrin Barbara Krug, Hartmut Stutzer, Rene Schroder, Julia Boecker, Jorg Poggenborg, and Klaus Lackner
AJR 2008;191:80-88
Link to Journal
RESULTS. The digital monitor technique generally scored better than digital film viewing and analog readings. The McNemar test for multiple paired comparisons mostly yielded a p value of <>
CONCLUSION. Digital flat-panel mammography is superior to the analog screen-film method for the detection of simulated opacities.
Kathrin Barbara Krug, Hartmut Stutzer, Rene Schroder, Julia Boecker, Jorg Poggenborg, and Klaus Lackner
AJR 2008;191:80-88
Link to Journal
RESULTS. The digital monitor technique generally scored better than digital film viewing and analog readings. The McNemar test for multiple paired comparisons mostly yielded a p value of <>
CONCLUSION. Digital flat-panel mammography is superior to the analog screen-film method for the detection of simulated opacities.
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