Addition of AB US to screening mammography in a generalizable cohort of women with dense breasts increased the cancer detection yield of clinically important cancers, but it also increased the number of false-positive results.

Fat necrosis of the breast is a challenging diagnosis due to the various appearances on mammography, ultrasound, CT, PET-CT, and MRI. Although mammography is more specific, ultrasound is a very important tool in making the diagnosis of fat necrosis. MRI has a wide spectrum of findings for fat necrosis and the appearance is the result of the amount of the inflammatory reaction, the amount of liquefied fat, and the degree of fibrosis. While CT and PET-CT are not first line imaging examinations for the diagnosis of breast cancer or fat necrosis, they are frequently performed in the surveillance and staging of disease. Knowledge of how fat necrosis presents on these additional imaging techniques is important to prevent misinterpretation of the imaging findings. Gross and microscopic appearances of fat necrosis depend on the age of the lesion; the histologic examination of fat necrosis is usually straightforward. Knowledge of the variable appearances of fat necrosis on a vast array of imaging modalities will enhance a radiologist's accuracy in the analysis and interpretation of fat necrosis versus other diagnoses.

Ductal carcinoma in situ (DCIS) is a noninvasive malignancy that is commonly encountered at routine breast imaging. It may be a primary tumor or may be seen in association with other focal higher-grade tumors. Early detection is important because of the large proportion of DCIS that can progress to invasive carcinoma. The extent of DCIS involvement is frequently underestimated at mammography, which can reliably help detect only calcified DCIS; consequently, magnetic resonance (MR) imaging evaluation can alter the course of treatment. Seven biopsy-proved cases of DCIS were evaluated with T2-weighted MR imaging sequences, as well as T1-weighted sequences performed both before and after contrast material administration. The signal intensity and enhancement patterns of the tumors were analyzed, and the findings were correlated with the relevant underlying histopathologic features. Common enhancement patterns of DCIS include clumped linear-ductal enhancement, clumped focal enhancement, and masslike enhancement. The most common enhancement distribution pattern is segmental, followed by focal, diffuse, linear-ductal, and regional patterns. At T2-weighted MR imaging, DCIS is typically isointense relative to breast parenchyma; less commonly, it is hypointense or hyperintense. The use of MR imaging in the evaluation of DCIS is controversial, and many questions remain with regard to treatment and management. However, breast MR imaging can be extremely useful in the preoperative diagnosis and evaluation of DCIS when used in conjunction with other imaging modalities.

No abstract

The demand for highly sonographically visible breast biopsy markers is growing as an increasing number of physicians are using sonography for preoperative localization and single-step intraoperative ultrasound-guided excisional procedures. The objective of this study was to directly compare the sonographic visibility of five commercially available breast biopsy site markers. A single-site prospective comparative study was performed with 25 female participants, each assigned to receive one of five biopsy markers. Postdeployment, 6-week, and 12-week follow-up sonographic images were obtained and a survey was e-mailed to members of the Society of Breast Imaging asking them to grade marker visibility on a 1-to 5-point Likert-type scale. At the time of deployment, the SecurMark (Hologic, Bedford, Massachusetts) was rated with the highest sonographic visibility. At both 6 and 12 weeks after deployment, the HydroMARK (Biopsy Sciences, Clearwater, Florida) was found to be the most visible by sonography. The results can be used by physicians who require highly sonographically visible breast biopsy markers for ultrasound-guided interventional procedures. Further research is needed as biopsy marker manufacturers continue to refine their products.