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