Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 ...Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 and October 2005, 154 biopsies in 152 patients with microcalcifications were performed using the upright-type 11-gauge stereotactic vacuum-assisted biopsy device. Patients in whom this biopsy was diagnosed as carcinoma or a borderline lesion, had a subsequent surgical excision of the lesion. Histopathological and radiological features of the two specimens were then compared with each other. Results: Microcalcification was identified on specimen mammograms and microscopic slides in 97.4% of cases. Of 154 Mammotome biopsies 98 (63.6%) were benign, 51 (33.1%) were malignant, 3 (1.9%) showed atypical hyperplasia, and 2 (1.3%) were indeterminate, respectively. Of the 48 cases that received surgical excision, 6 of 36 ductal carcinomas in situ (16.7%) upstaged to invasive ductal carcinoma and 1 of 2 atypical ductal hyperplasias was upstaged to ductal carcinoma in situ. The positive predictive value of the 11-gauge Mammotome for the diagnosis of invasion in breast cancer was 100%. Linear calcification and pleomorphic calcification linear/segmental distribution was reliable indications of malignancy. The mean follow-up time of the benign lesions was 22 months, and without evidence of lesion growth. Complications included vasovagal reactions (6.3%), bleeding (0.6%) and hematoma (2.6%). Conclusion: The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed.展开更多
<strong>Objective:</strong> To date, few studies have compared the diagnostic performance and visibility of microcalcifications obtained using digital breast tomosynthesis (DBT) with those obtained from fu...<strong>Objective:</strong> To date, few studies have compared the diagnostic performance and visibility of microcalcifications obtained using digital breast tomosynthesis (DBT) with those obtained from full-field digital mammography (FFDM). The visualization and characterization of microcalcifications with DBT remain controversial. The purpose of this study was to compare the visibility of microcalcifications and determine whether DBT exhibits a diagnostic advantage for visualizing microcalcifications over FFDM.<strong> Methods: </strong>We retrospectively reviewed 120 cases including DBT and FFDM imaging (60 histologically verified as breast cancers and 60 as benign microcalcifications or normal). DBT images with a wide scan-angle of 50<span style="white-space:nowrap;"><span style="white-space:nowrap;">°</span></span> and FFDM images were obtained using a flat-panel system (MAMMOMAT Inspiration, Siemens). Images were independently reviewed by four board-certified radiologists and evaluated for the presence of microcalcifications, probability of malignancy (BI-RADS classification), and visibility. <strong>Results:</strong> In predicting the malignancy of detected microcalcifications, no significant difference was found between readers’ areas under the receiver operating characteristic curve for DBT and FFDM (p = 0.068). The visibility scores of detected microcalcifications were 3.74 <span style="white-space:nowrap;"><span style="white-space:nowrap;"><span style="white-space:nowrap;">±</span></span></span> 1.06 for DBT and 3.46 <span style="white-space:nowrap;"><span style="white-space:nowrap;"><span style="white-space:nowrap;">±</span></span></span> 0.93 for FFDM, respectively. The visibility of microcalcifications when using DBT was found to be significantly superior to that of FFDM (p < 0.05). <strong>Conclusion:</strong> Our results suggest that the image quality of DBT with a wide scan-angle is comparable or superior to that obtained with FFDM in terms of both visibility and assessment of microcalcifications.展开更多
A method is proposed to avoid complex computation in finding the region of interest （ROI） in a mammogram. In the method, the true negative region （TNR） definitely containing no microcalcification clusters （MCCs）...A method is proposed to avoid complex computation in finding the region of interest （ROI） in a mammogram. In the method, the true negative region （TNR） definitely containing no microcalcification clusters （MCCs） is screened out, thus obtaining ROIs, The strategy consists of three steps： （1） the mammogram is partitioned into a set of non-overlapping blocks with an equal size, and for each block, five statistical features are computed, （2） negative blocks are screened out by the threshold method through rough analyses, （3） the more accurate analysis is done by the cost-sensitive support vector machine to eliminate the block definitely containing no MCCs, Experimental results on real mammograms show that 81.71% of TNRs can be screened out by the proposed method.展开更多
Aim: To correlate the microcalcifications' characteristics, such as morphology and elemental compositions, with the occurrence of bone metastatic lesions at 5 years from diagnosis. Methods: In this retrospective s...Aim: To correlate the microcalcifications' characteristics, such as morphology and elemental compositions, with the occurrence of bone metastatic lesions at 5 years from diagnosis. Methods: In this retrospective study, we enrolled 70 patients from which we collected one breast biopsy each. From each biopsy, paraffin serial sections were obtained to perform histological classifications, immunohistochemical analyses and Energy Dispersive X-ray evaluation. Results: Microcalcifications analysis showed a significant association between the presence of calcium crystals made of magnesium substituted hydroxyapatite and the development of bone metastasis from 5 years from diagnosis. No significant association was observed by evaluation the morphological appearance of microcalcifications. Immunohistochemical analysis displayed a significant association between the expression of bone morphogenetic proteins 2 and pentraxin-3, two osteoblast induction factors, and the formation of bone metastatic lesions. Conclusion: Results here reported highlighted the possible use of breast microcalcifications as a negative prognostic marker of bone metastatic diseases. In particular, the association between elemental composition of breast microcalcifications and the formation of bone lesions can lay the foundation for the development of new in vivo diagnostic tools based on the analysis of microcalcifications and capable to predict the formation of bone metastasis.展开更多
Purpose: To evaluate the mammographic findings of women treated with accelerated partial breast irradiation (APBI) using single-fraction intraoperative radiotherapy (IORT). Materials/Methods: Women ≥ 40 years of age ...Purpose: To evaluate the mammographic findings of women treated with accelerated partial breast irradiation (APBI) using single-fraction intraoperative radiotherapy (IORT). Materials/Methods: Women ≥ 40 years of age with unifocal invasive or intraductal carcinoma ≤ 2.5 cm on physical examination, mammography, and ultrasound were enrolled on an APBI trial using single fraction IORT. Post-treatment mammographic imaging was obtained at 6 months, 1 year, and then annually. Results: Between 12/02 and 6/04, 17 women underwent IORT at the time of lumpectomy (median age = 60 years;range = 40 - 83). The initial post-IORT mammogram showed increased density at the lumpectomy site in 11 patients (65%), while six patients (35%) had architectural distortion in the area of the irradiated tissue. Fifteen patients (88%) had numerous punctate, benign-appearing calcifications corresponding to the irradiated region. There was focal skin thickening near the incision in 13 patients (76%). At a median of 67 months, architectural distortion had stabilized and the benign-appearing calcifications remained stable in number and character. Eight patients (47%) had mammographic findings consistent with fat necrosis, ranging in size from 0.5 - 4 cm. Conclusions: After lumpectomy and IORT, mammographic changes include increased density and benign appearing calcifications in the irradiated region with focal skin thickening. These changes appear to stabilize over time and are consistent with post-treatment changes. These changes are important to identify in order to characterize benign changes from recurrent tumor.展开更多
基金Supported by a grant from the Sasakawa Foundation (Japan) of Japan China Medical Association
文摘Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 and October 2005, 154 biopsies in 152 patients with microcalcifications were performed using the upright-type 11-gauge stereotactic vacuum-assisted biopsy device. Patients in whom this biopsy was diagnosed as carcinoma or a borderline lesion, had a subsequent surgical excision of the lesion. Histopathological and radiological features of the two specimens were then compared with each other. Results: Microcalcification was identified on specimen mammograms and microscopic slides in 97.4% of cases. Of 154 Mammotome biopsies 98 (63.6%) were benign, 51 (33.1%) were malignant, 3 (1.9%) showed atypical hyperplasia, and 2 (1.3%) were indeterminate, respectively. Of the 48 cases that received surgical excision, 6 of 36 ductal carcinomas in situ (16.7%) upstaged to invasive ductal carcinoma and 1 of 2 atypical ductal hyperplasias was upstaged to ductal carcinoma in situ. The positive predictive value of the 11-gauge Mammotome for the diagnosis of invasion in breast cancer was 100%. Linear calcification and pleomorphic calcification linear/segmental distribution was reliable indications of malignancy. The mean follow-up time of the benign lesions was 22 months, and without evidence of lesion growth. Complications included vasovagal reactions (6.3%), bleeding (0.6%) and hematoma (2.6%). Conclusion: The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed.
文摘<strong>Objective:</strong> To date, few studies have compared the diagnostic performance and visibility of microcalcifications obtained using digital breast tomosynthesis (DBT) with those obtained from full-field digital mammography (FFDM). The visualization and characterization of microcalcifications with DBT remain controversial. The purpose of this study was to compare the visibility of microcalcifications and determine whether DBT exhibits a diagnostic advantage for visualizing microcalcifications over FFDM.<strong> Methods: </strong>We retrospectively reviewed 120 cases including DBT and FFDM imaging (60 histologically verified as breast cancers and 60 as benign microcalcifications or normal). DBT images with a wide scan-angle of 50<span style="white-space:nowrap;"><span style="white-space:nowrap;">°</span></span> and FFDM images were obtained using a flat-panel system (MAMMOMAT Inspiration, Siemens). Images were independently reviewed by four board-certified radiologists and evaluated for the presence of microcalcifications, probability of malignancy (BI-RADS classification), and visibility. <strong>Results:</strong> In predicting the malignancy of detected microcalcifications, no significant difference was found between readers’ areas under the receiver operating characteristic curve for DBT and FFDM (p = 0.068). The visibility scores of detected microcalcifications were 3.74 <span style="white-space:nowrap;"><span style="white-space:nowrap;"><span style="white-space:nowrap;">±</span></span></span> 1.06 for DBT and 3.46 <span style="white-space:nowrap;"><span style="white-space:nowrap;"><span style="white-space:nowrap;">±</span></span></span> 0.93 for FFDM, respectively. The visibility of microcalcifications when using DBT was found to be significantly superior to that of FFDM (p < 0.05). <strong>Conclusion:</strong> Our results suggest that the image quality of DBT with a wide scan-angle is comparable or superior to that obtained with FFDM in terms of both visibility and assessment of microcalcifications.
文摘A method is proposed to avoid complex computation in finding the region of interest （ROI） in a mammogram. In the method, the true negative region （TNR） definitely containing no microcalcification clusters （MCCs） is screened out, thus obtaining ROIs, The strategy consists of three steps： （1） the mammogram is partitioned into a set of non-overlapping blocks with an equal size, and for each block, five statistical features are computed, （2） negative blocks are screened out by the threshold method through rough analyses, （3） the more accurate analysis is done by the cost-sensitive support vector machine to eliminate the block definitely containing no MCCs, Experimental results on real mammograms show that 81.71% of TNRs can be screened out by the proposed method.
文摘Aim: To correlate the microcalcifications' characteristics, such as morphology and elemental compositions, with the occurrence of bone metastatic lesions at 5 years from diagnosis. Methods: In this retrospective study, we enrolled 70 patients from which we collected one breast biopsy each. From each biopsy, paraffin serial sections were obtained to perform histological classifications, immunohistochemical analyses and Energy Dispersive X-ray evaluation. Results: Microcalcifications analysis showed a significant association between the presence of calcium crystals made of magnesium substituted hydroxyapatite and the development of bone metastasis from 5 years from diagnosis. No significant association was observed by evaluation the morphological appearance of microcalcifications. Immunohistochemical analysis displayed a significant association between the expression of bone morphogenetic proteins 2 and pentraxin-3, two osteoblast induction factors, and the formation of bone metastatic lesions. Conclusion: Results here reported highlighted the possible use of breast microcalcifications as a negative prognostic marker of bone metastatic diseases. In particular, the association between elemental composition of breast microcalcifications and the formation of bone lesions can lay the foundation for the development of new in vivo diagnostic tools based on the analysis of microcalcifications and capable to predict the formation of bone metastasis.
文摘Purpose: To evaluate the mammographic findings of women treated with accelerated partial breast irradiation (APBI) using single-fraction intraoperative radiotherapy (IORT). Materials/Methods: Women ≥ 40 years of age with unifocal invasive or intraductal carcinoma ≤ 2.5 cm on physical examination, mammography, and ultrasound were enrolled on an APBI trial using single fraction IORT. Post-treatment mammographic imaging was obtained at 6 months, 1 year, and then annually. Results: Between 12/02 and 6/04, 17 women underwent IORT at the time of lumpectomy (median age = 60 years;range = 40 - 83). The initial post-IORT mammogram showed increased density at the lumpectomy site in 11 patients (65%), while six patients (35%) had architectural distortion in the area of the irradiated tissue. Fifteen patients (88%) had numerous punctate, benign-appearing calcifications corresponding to the irradiated region. There was focal skin thickening near the incision in 13 patients (76%). At a median of 67 months, architectural distortion had stabilized and the benign-appearing calcifications remained stable in number and character. Eight patients (47%) had mammographic findings consistent with fat necrosis, ranging in size from 0.5 - 4 cm. Conclusions: After lumpectomy and IORT, mammographic changes include increased density and benign appearing calcifications in the irradiated region with focal skin thickening. These changes appear to stabilize over time and are consistent with post-treatment changes. These changes are important to identify in order to characterize benign changes from recurrent tumor.
