Lesion Size Inaccuracies in Digital Mammography

Lesion Size Inaccuracies in Digital Mammography
Jean R. Paquelet and R. Edward Hendrick
AJR 2010;194:115-118

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We show that some combinations of digital mammography acquisition and display systems can lead to clinically significant over- or underestimation of lesion size in magnification mode. This phenomenon can occur even with acquisition and display systems from the same manufacturer. Thus, the accuracy of lesion size in each magnification mode should be a routine QC acceptance test performed on each digital mammography acquisition–display system combination

Optimal Timing of Breast MRI Examinations for Premenopausal Women Who Do Not Have a Normal Menstrual Cycle

Optimal Timing of Breast MRI Examinations for Premenopausal Women Who Do Not Have a Normal Menstrual Cycle
Richard L. Ellis
AJR 2009;193:1738-1740
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Serum progesterone concentrations corresponding to the follicular phase of a normal menstrual cycle can aid in optimal scheduling of breast MRI examinations for premenopausal women who lack cyclical menses

Preoperative Sonographic Classification of Axillary Lymph Nodes in Patients With Breast Cancer: Node-to-Node Correlation With Surgical Histology and

Preoperative Sonographic Classification of Axillary Lymph Nodes in Patients With Breast Cancer: Node-to-Node Correlation With Surgical Histology and Sentinel Node Biopsy Results
Nariya Cho, Woo Kyung Moon, Wonshik Han, In Ae Park, Jihyoung Cho, and Dong-Young Noh
AJR 2009;193:1731-1737
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Sonographic classification of axillary lymph nodes is effective for predicting the presence of metastases to avoid sentinel node biopsy or to reduce unsuccessful lymphatic mapping during sentinel node biopsy

Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women

Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women
Jennifer A. Harvey, Brandi T. Nicholson, Alexander P. LoRusso, Michael A. Cohen, and Viktor E. Bovbjerg
AJR 2009;193:1723-1730
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Short-term follow-up is a reasonable alternative to biopsy of palpable breast lesions with benign imaging features, particularly for young women with probable fibroadenoma

Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value

Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value
Savannah C. Partridge, Wendy B. DeMartini, Brenda F. Kurland, Peter R. Eby, Steven W. White, and Constance D. Lehman
AJR 2009;193:1716-1722
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DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant le- sions necessitates validation of these findings in larger studies

Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program

Comparison of Digital Mammography and Screen-Film Mammography in Breast Cancer Screening: A Review in the Irish Breast Screening Program
Niamh M. Hambly, Michelle M. McNicholas, Niall Phelan, Gormlaith C. Hargaden, Ann O'Doherty, and Fidelma L. Flanagan
AJR 2009;193:1010-1018
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FFDM resulted in significantly higher cancer detection and recall rates than screen-film mammography in women 50–64 years old. The PPVs of FFDM and screen-film mammography were comparable. The results of this study suggest that FFDM can be safely implemented in breast cancer screening programs

Radioguided Localization of Nonpalpable Breast Cancer Lesions: Randomized Comparison With Wire Localization in Patients Undergoing Conservative Surger

Radioguided Localization of Nonpalpable Breast Cancer Lesions: Randomized Comparison With Wire Localization in Patients Undergoing Conservative Surgery and Sentinel Node Biopsy
Antonio Mariscal Martinez, Montse Sola, Anna Perez de Tudela, Juan Francisco Julian, Manuel Fraile, Sara Vizcaya, and Jaume Fernandez
AJR 2009;193:1001-1009
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The radioguided technique is as effective as the standard wire technique for localization and excision of nonpalpable breast cancer lesions and is somewhat faster and simpler to perform than wire localization

BI-RADS Lesion Characteristics Predict Likelihood of Malignancy in Breast MRI for Masses But Not for Nonmasslike Enhancement

BI-RADS Lesion Characteristics Predict Likelihood of Malignancy in Breast MRI for Masses But Not for Non mass like Enhancement
Robert L. Gutierrez, Wendy B. DeMartini, Peter R. Eby, Brenda F. Kurland, Sue Peacock, and Constance D. Lehman
AJR 2009;193:994-1000
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Combinations of BI-RADS lesion descriptors can predict the probability of malignancy for breast MRI masses but not for NMLE.
If our model is validated, masses with a low probability of malignancy may be eligible for short-interval follow-up rather than biopsy.
Further research focused on predictive features of NMLE is needed

Targeted Ultrasound of the Breast in Women With Abnormal MRI Findings for Whom Biopsy Has Been Recommended

Targeted Ultrasound of the Breast in Women With Abnormal MRI Findings for Whom Biopsy Has Been Recommended
Matthias Meissnitzer, D. David Dershaw, Carol H. Lee, and Elizabeth A.Morris
AJR 2009;193:1025-1029
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The MR characteristics of lesions most likely to be seen with an ultrasound correlate were mass versus non-mass, increasing size, and increased level of suspicion of the lesion. Clip placement and follow-up imaging after ultrasound-guided biopsy that yields benign concordant results should be performed to detect cases in which the presumed ultrasound correlate is inaccurate to detect unsuspected false-negative biopsies

Is Breast MRI Helpful in the Evaluation of Inconclusive Mammographic Findings?

Is Breast MRI Helpful in the Evaluation of Inconclusive Mammographic Findings?
Linda Moy, Kristin Elias, Vashali Patel, Jiyon Lee, James S. Babb, Hildegard K. Toth, and Cecilia L. Mercado
AJR 2009;193:986-993
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We found breast MRI to be a useful adjunctive tool when findings at conventional imaging were equivocal. Strict patient selection criteria should be used because of the high frequency of incidental lesions seen on MR images

Dynamic Contrast-Enhanced MRI of the Breast: Quantitative Method for Kinetic Curve Type Assessment

Dynamic Contrast-Enhanced MRI of the Breast: Quantitative Method for Kinetic Curve Type Assessment
Riham H. El Khouli, Katarzyna J. Macura, Michael A. Jacobs, Tarek H. Khalil, Ihab R. Kamel, Andrew Dwyer, and David A. Bluemke
AJR 2009;193:295-300
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Quantitative assessment of the type of contrast enhancement kinetic curve on breast DCE-MRI resulted in significantly higher diagnostic performance for establishing or excluding malignancy compared with assessment based on the standard qualitative method

Assessment of Breast Lesions With Diffusion-Weighted MRI: Comparing the Use of Different b Values

Assessment of Breast Lesions With Diffusion-Weighted MRI: Comparing the Use of Different b Values
Fernanda Philadelpho Arantes Pereira, Gabriela Martins, Eduardo Figueiredo, Marisa Nassar Aidar Domingues, Romeu Cortes Domingues, Lea Mirian Barbosa da Fonseca, and Emerson Leandro Gasparetto
AJR 2009;193:1030-1035
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http://www.ajronline.org/cgi/content/abstract/193/4/1030

Diffusion-weighted imaging is a potential resource as a coadjutant of MRI in the differentiation between benign and malignant lesions. Such imaging can be performed without a significant increase in examination time, especially because it can be done with lower b values

Characteristics of Probably Benign Breast MRI Lesions

Characteristics of Probably Benign Breast MRI Lesions
Peter R. Eby, Wendy B. DeMartini, Robert L. Gutierrez, Monica H. Saini, Sue Peacock, and Constance D. Lehman
AJR 2009;193:861-867

Indeterminate lesions on high risk screening MRI are the bane of the radiologists life. Some insurance carriers will not pay for 6 month MRI follow up scans of probably benign lesions, so a review and recommendations for management by Connie Lehman and her group in Washington is very welcome.

The characteristics of BI-RADS 3 lesions were highly variable in our population, and the risk of malignancy was low (0.85%).

Assigning foci with 100% persistent enhancement to the BI-RADS 2 category can decrease the frequency of BI-RADS 3 assessment and maintain a likelihood of malignancy in less than 2% of cases

Mammary Fibromatosis

Mammary Fibromatosis
Katrina N. Glazebrook and Carol A. Reynolds
AJR 2009;193:856-860
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Mammary fibromatosis is a rare, benign, non-metastasizing stromal tumor. It presents clinically and radiologically as a palpable, spiculated, and locally invasive tumor that is suspicious for malignancy. MRI is ideal for evaluation of chest wall involvement. Although histologically benign, the tumor is locally aggressive and has significant recurrence rates. On occasion, recurrence may require radical surgery

MRI Follow-Up After Concordant, Histologically Benign Diagnosis of Breast Lesions Sampled by MRI-Guided Biopsy

MRI Follow-Up After Concordant, Histologically Benign Diagnosis of Breast Lesions Sampled by MRI-Guided Biopsy
Jie Li, D. David Dershaw, Carol H. Lee, Jennifer Kaplan, and Elizabeth A. Morris
AJR 2009;193:850-855

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This paper pertains to benign findings at MRI Biopsy when there is disconcordance with imaging findings
Follow-up MRI did not detect missed cancers because of lesion enlargement before 6 months after biopsy; two of four missed cancers were stable. The localizing marker can deploy away from the target despite successful sampling

1H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?

1H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?
Mitsuhiro Tozaki and Eisuke Fukuma
AJR 2009;193:840-849
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The results of an in-vivo study using a 1.5-T MRI unit suggested that careful referencing and optimizing post-acquisition data processing improved the spectral resolution, allowing the few false-positive cases (including lactating women and healthy volunteers) to be distinguished by resonance at 3.28 ppm

1H MRS was useful for characterizing breast lesions measuring 15 mm or larger, and diffusion-weighted imaging was useful for characterizing lesions of any size. However, these two techniques still have potential pitfalls in relation to the diagnosis of non-mass breast lesions

Kinetic Curves of Malignant Lesions Are Not Consistent Across MRI Systems

Kinetic Curves of Malignant Lesions Are Not Consistent Across MRI Systems: Need for Improved Standardization of Breast Dynamic Contrast-Enhanced MRI Acquisition
Sanaz A. Jansen, Akiko Shimauchi, Lindsay Zak, Xiaobing Fan, Abbie M. Wood, Gregory S. Karczmar, and Gillian M. Newstead
AJR 2009;193:832-839
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This paper from Chicago demonstrates that the kinetic curve data on malignant lesions acquired with one system showed significantly lower initial contrast uptake and a different curve shape in comparison with data acquired with the other two systems. Differences in k-space sampling, T1 weighting, and magnetization transfer effects may be explanations for the difference.

Standardization of DCE-MRI is needed for direct comparison

MRI-Detected Suspicious Breast Lesions: Predictive Values of Kinetic Features Measured by Computer-Aided Evaluation

MRI-Detected Suspicious Breast Lesions: Predictive Values of Kinetic Features Measured by Computer-Aided Evaluation
Lilian C. Wang, Wendy B. DeMartini, Savannah C. Partridge, Sue Peacock, and Constance D. Lehman
AJR 2009;193:826-831

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Of Computer Aided Enhancement (CAE) kinetics analyzed, only delayed enhancement categorized by most suspicious type was significantly different between benign and malignant lesions. This supports the American College of Radiology BI-RADS Breast MRI Lexicon recommendation to report the "worst looking" kinetic curve

Invasive Micropapillary Carcinoma of the Breast: Mammographic, Sonographic, and MRI Features

Invasive Micropapillary Carcinoma of the Breast: Mammographic, Sonographic, and MRI Features
Beatriz Adrada, Elsa Arribas, Michael Gilcrease, and Wei Tse Yang
AJR 2009;193:58-63

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The imaging characteristics of invasive micropapillary carcinoma are highly suggestive of malignancy. The lesion is a high-density irregular mass with indistinct margins associated with microcalcifications on mammograms; a solid irregular hypoechoic mass with indistinct margins and frequent axillary nodal involvement on sonograms; and a multifocal mass on MR images. This tumor may necessitate aggressive management

breast, carcinoma, mammography, micropapillary, MRI, neoplasm, pathology, prognosis, sonography

Dermatofibrosarcoma Protuberans of the Breast: Imaging Features and Review of the Literature

Dermatofibrosarcoma Protuberans of the Breast: Imaging Features and Review of the Literature
Su-Ju Lee, Mary C. Mahoney, and Elizabeth Shaughnessy
AJR 2009;193:64-69

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Dermatofibrosarcoma protuberans is an extremely rare malignancy of the breast, with few published reports. This is the largest collection of such cases in a single institution with analysis of the imaging features

Invasive Carcinoma of the Breast Accompanied by Coarse Calcification

Invasive Carcinoma of the Breast Accompanied by Coarse Calcification
Kenichiro Tanaka, Futoshi Akiyama, Noriko Nishikawa, Kiyomi Kimura, Naoya Gomi, Koji Oda, and Takuji Iwase
AJR 2009;193:70-71

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Benign calcifications within a breast mass are not diagnostic of a benign process if the imaging characteristics of the mass are suspicious

Diffusion-Weighted Imaging of Mucinous Carcinoma of the Breast: Evaluation of Apparent Diffusion Coefficient and Signal Intensity

Diffusion-Weighted Imaging of Mucinous Carcinoma of the Breast: Evaluation of Apparent Diffusion Coefficient and Signal Intensity in Correlation With Histologic Findings
Reiko Woodhams, Satoko Kakita, Hirofumi Hata, Keiichi Iwabuchi, Shigeaki Umeoka, Carolyn E. Mountford, and Hiroto Hatabu
AJR 2009;193:260-266

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Mucinous carcinoma can be clearly differentiated from other breast tumors on the basis of ADC. The low signal intensity of mucinous carcinoma on diffusion weighted images appears to reflect the presence of mucin and low cellularity. High signal intensity on diffusion-weighted images may reflect the presence of fibrovascular bundles, increased cell density, or a combination of these features

Role of Breast MRI in the Preoperative Evaluation of Patients with Newly Diagnosed Breast Cancer

Role of Breast MRI in the Preoperative Evaluation of Patients with Newly Diagnosed Breast Cancer
Amy M. Schell, Kari Rosenkranz, and Petra J. Lewis
AJR 2009;192:1438-1444

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MRI detected additional suspicious previously unsuspected lesions in 74 patients (37%). Fifty-four of these lesions, in 38 patients (19%), were identified as malignant, of which 41 (76%) were invasive. Retrospective review of the MRI-identified ipsilateral malignant lesions resulted in hypothetical recommendations that would have altered the surgical treatment of 26 of the patients (13%), principally as mastectomy or wider excision.

For patients with a new diagnosis of breast cancer, breast MRI in a mid-sized regional hospital depicts unsuspected malignant lesions in both the ipsilateral and contralateral breasts in proportions consistent with the results of earlier studies at larger institutions. Whether clinical outcome is improved by changes in surgical management consequent to MRI detection of unsuspected malignant lesions remains unproven

Utility of Targeted Sonography for Breast Lesions That Were Suspicious on MRI

Utility of Targeted Sonography for Breast Lesions That Were Suspicious on MRI
Wendy B. DeMartini, Peter R. Eby, Sue Peacock, and Constance D. Lehman
AJR 2009;192:1128-1134

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Targeted sonography detected nearly half (46%) of MRI lesions evaluated, with depiction being most frequent for masses. Sonographically occult lesions had a probability of malignancy (22%), which warrants biopsy despite lack of sonographic detection

Connie Lehman's paper reflects our own experience that we often only find 50% of suspicious masses on 2nd look ultrasound.

Increasing Accuracy of Detection of Breast Cancer with 3-T MRI

Increasing Accuracy of Detection of Breast Cancer with 3-T MRI
Haitham Elsamaloty, Mohamed Salah Elzawawi, Shaden Mohammad, and Nabeel Herial
AJR 2009;192:1142-1148

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MRI at 3 T is more sensitive than mammography and sonography in the detection of breast cancer and the characterization of small lesions (reaching 4 mm) but has lower specificity. Compared with the results of 1-T and 1.5-T MRI in the literature, 3-T MRI has higher sensitivity in the detection of breast cancer with no significant difference in specificity

Patients' Perceptions of Breast MRI: A Single-Center Study

Patients' Perceptions of Breast MRI: A Single-Center Study
Shaheen Zakaria, Kathleen R. Brandt, Amy C. Degnim, and Kristine M. Thomsen
AJR 2009;192:1149-1154

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Most women undergoing breast MRI for cancer staging and screening found it to be a comfortable test and perceived it to have a positive impact on their care. Breast cancer patients perceived the clinical impact of their breast MRI examination to be significantly more positive than when assessed objectively.

A Logistic Regression Model Based on the National Mammography Database Format to Aid Breast Cancer Diagnosis

A Logistic Regression Model Based on the National Mammography Database Format to Aid Breast Cancer Diagnosis
Jagpreet Chhatwal, Oguzhan Alagoz, Mary J. Lindstrom, Charles E. Kahn, Jr., Katherine A. Shaffer, and Elizabeth S. Burnside
AJR 2009;192:1117-1127

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The authors claim that -
"Our logistic regression model can effectively discriminate between benign and malignant breast disease and can identify the most important features associated with breast cancer."

I cannot comment on this paper yet, as I need time to digest it and examine what it has to offer us as practicing mammographers

Atypical Ductal Hyperplasia Diagnosed at Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Mass

Atypical Ductal Hyperplasia Diagnosed at Sonographically Guided 14-Gauge Core Needle Biopsy of Breast Mass
Ji Hyun Youk, Eun-Kyung Kim, and Min Jung Kim
AJR 2009;192:1135-1141

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There conclusions are as follows - ADH diagnosed at sonographically guided 14-gauge core needle biopsy has a high underestimation rate with respect to the results of surgical excision. Surgical excision should be recommended when ADH is diagnosed at sonographically guided 14-gauge core needle biopsy of breast masses.

This paper adds to added value to what is the increasingly obvious problem of ADH, and the requirements for surgical biopsy if found at needle biopsy of whatever size. This paper adds validation for the same approach to be used with ultrasound findings as are used with stereotactic biopsy

Probably Benign Breast Masses Diagnosed by Sonography: Is There a Difference in the Cancer Rate According to Palpability?

Probably Benign Breast Masses Diagnosed by Sonography: Is There a Difference in the Cancer Rate According to Palpability?
Jung Hee Shin, Boo-Kyung Han, Eun Young Ko, Yeon Hyeon Choe, and Seok-Jin Nam
AJR 2009;192:187-191

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This Korean paper extends the possible validation of US BIRADS 3 to patients with palpable lesions. These sorts of papers will be useful for the BIRADS committee to review when they produce the next (5th Edition) of BIRADS in the next couple of years

The Many Faces of Fat Necrosis in the Breast

The Many Faces of Fat Necrosis in the Breast
Jorge L. Taboada, Tanya W. Stephens, Savitri Krishnamurthy, Kathleen R. Brandt, and Gary J. Whitman
AJR 2009;192:815-825

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On imaging studies, the appearance of fat necrosis ranges from typically benign to worrisome for malignancy. Mammography is more specific than sonography, and emphasis should be placed on mammography in making the diagnosis of fat necrosis. In selected cases, MRI may be helpful in showing findings consistent with fat necrosis

Digital Mammography-Guided Skin Marking for Sonographically Guided Biopsy of Suspicious Microcalcifications

Digital Mammography-Guided Skin Marking for Sonographically Guided Biopsy of Suspicious Microcalcifications
Nariya Cho and Woo Kyung Moon
AJR 2009;192:132-136

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Digital mammography–guided skin marking can be applied to identify and localize suspicious microcalcifications at breast sonography. This technique has the potential to be an alternative to stereotactic guidance when the stereotactic biopsy is unavailable or unsuccessful

Mucinous Carcinoma of the Breast: MRI Features of Pure and Mixed Forms with Histopathologic Correlation

Mucinous Carcinoma of the Breast: MRI Features of Pure and Mixed Forms with Histopathologic Correlation
Shuichi Monzawa, Masaki Yokokawa, Toshiko Sakuma, Shintaro Takao, Koichi Hirokaga, Keisuke Hanioka, and Shuji Adachi
AJR 2009;192:125-13

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Hypercellular pure mucinous tumors exhibit strong early enhancement and may be difficult to differentiate from mixed mucinous tumors. The distinction between the pure and mixed forms of mucinous carcinoma is important because mixed mucinous carcinoma more frequently undergoes lymph node metastasis and has a poorer prognosis than does pure mucinous carcinoma

Image Registration for Detection and Quantification of Change on Digital Tomosynthesis Mammographic Volumes

Image Registration for Detection and Quantification of Change on Digital Tomosynthesis Mammographic Volumes
Sumedha P. Sinha, Ramkrishnan Narayanan, Bing Ma, Marilyn A. Roubidoux, He Liu, Paul L. Carson
AJR 2009; 192:384-387

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Registration of digital breast tomosynthesis mammographic volumes was achieved with an average error of 1.8 ± 1.4 mm
This will be important when trying to compare change between two studies

Invasive Lobular Carcinoma: Detection with Mammography, Sonography, MRI, and Breast Specific Gamma Imaging

Invasive Lobular Carcinoma: Detection with Mammography, Sonography, MRI, and Breast Specific Gamma Imaging
Rachel F. Brem, Marina Ioffe, Jocelyn A. Rapelyea, Kristen G. Yost, Jean M. Weigert, Margaret L. Bertrand, Lillian H. Stern
AJR 2009; 192:379-383

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BSGI has the highest sensitivity for the detection of invasive lobular carcinoma with a sensitivity of 93%, whereas mammography, sonography, and MRI showed sensitivities of 79%, 68%, and 83%, respectively. BSGI is an effective technique that should be used to evaluate patients with suspected cancer and has a promising role in the diagnosis of invasive lobular carcinoma

NB: Small numbers in retrospective study. However, the technology shows promise

False-Negative Diagnoses at Stereotactic Vacuum-Assisted Needle Breast Biopsy: Long-Term Follow-Up of 1,280 Lesions and Review of the Literature

False-Negative Diagnoses at Stereotactic Vacuum-Assisted Needle Breast Biopsy: Long-Term Follow-Up of 1,280 Lesions and Review of the Literature
Roger J. Jackman, Francis A. Marzoni, Jr., Jarrett Rosenberg
AJR 2009; 192:341–351

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The purpose of this study was to determine retrospectively the frequency and causes of false-negative diagnoses of lesions evaluated with percutaneous stereotactic biopsy performed with vacuum-assisted probes with the patient prone on a biopsy table.
False-negative findings at stereotactic biopsy were least common with 11-gauge probes and were similar in frequency for calcifications and masses

NB: Comparisons only made between 14G and 11G needles

Detection of Breast Cancer with Full-Field Digital Mammography and Computer-Aided Detection

Detection of Breast Cancer with Full-Field Digital Mammography and Computer-Aided Detection
Juliette S. The, Kathy J. Schilling, Jeffrey W. Hoffmeister, Euvondia Friedmann, Ryan McGinni and Richard G. Holcomb
AJR 2009; 192:337–340

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CAD with FFDM showed a high sensitivity in identifying cancers manifesting as calcifications and masses. Sensitivity was maintained in cancers with lower mammographic sensitivity, including invasive lobular carcinomas and small neoplasms (1–20 mm). CAD with FFDM should be effective in assisting radiologists with earlier detection of breast cancer. Future studies are needed to assess CAD accuracy in larger populations

Original Research. Predictors of Radiologists' Perceived Risk of Malpractice Lawsuits in Breast Imaging

Predictors of Radiologists' Perceived Risk of Malpractice Lawsuits in Breast Imaging
John F. Dick, III, Thomas H. Gallagher, R. James Brenner, Joyce P. Yi, Lisa M. Reisch, Linn Abraham, Diana L. Miglioretti, Patricia A. Carney, Gary R. Cutter, Joann G. Elmore
AJR 2009; 192:327–333

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Radiologists working in breast imaging substantially overestimate their risk of a future malpractice lawsuit. Radiologists with higher risk perceptions show more negative reactions to uncertainty in a clinical setting. Understanding that their actual risk of malpractice lawsuits may be substantially lower than anticipated may help reduce radiologists' fears and alleviate the manpower shortage in mammography. Programs to address the shortage of breast imagers could be targeted toward radiologists with heightened malpractice lawsuit concerns

Frequency and Upgrade Rates of Atypical Ductal Hyperplasia Diagnosed at Stereotactic Vacuum-Assisted Breast Biopsy: 9-Versus 11-Gauge

Frequency and Upgrade Rates of Atypical Ductal Hyperplasia Diagnosed at Stereotactic Vacuum-Assisted Breast Biopsy: 9-Versus 11-Gauge
Peter R. Eby, Jennifer E. Ochsner, Wendy B. DeMartini, Kimberly H. Allison, Sue Peacock, and Constance D. Lehman
AJR 2009;192:229-234

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Compared with an 11-gauge vacuum-assisted breast biopsy device, the use of a larger 9-gauge vacuum-assisted breast biopsy needle does not decrease the upgrade rate of ADH. Our frequency of ADH at vacuum-assisted breast biopsy is higher than any previously reported and may reflect regional differences in the incidence of breast cancer or practice patterns of the pathologist

Sonographic Surveillance for the Detection of Contralateral Metachronous Breast Cancer in an Asian Population

Sonographic Surveillance for the Detection of Contralateral Metachronous Breast Cancer in an Asian Population
Min Jung Kim, Eun-Kyung Kim, Jin Young Kwak, Byeong-Woo Park, Seung-Il Kim, Joohyuk Sohn, and Ki Keun Oh
AJR 2009;192:221-228

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With a false-negative rate of only 0.06% and a PPV of 41.0% for the biopsy recommendation rate, our results suggest that annual sonography could be a useful adjunctive tool to mammography for the detection of metachronous contralateral cancers

Timed Efficiency of Interpretation of Digital and Film-Screen Screening Mammograms

Timed Efficiency of Interpretation of Digital and Film-Screen Screening Mammograms
Tamara Miner Haygood, Jihong Wang, E. Neely Atkinson, Deanna Lane, Tanya W. Stephens, Parul Patel, and Gary J. Whitman
AJR 2009;192:216-220

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In screening mammography interpretation, digital mammograms take longer to read than film-screen mammograms, independent of other variables. Exclusive use of digital comparison studies may not cause interpretation times to drop enough to approach the interpretation time required for film-screen mammograms