Interobserver agreement with the new BI-RADS terminology is good and validates the US lexicon. Subcategories 4a, 4b, and 4c are useful in predicting the likelihood of malignancy.
CT and MRI performed similarly; both had lower staging accuracy than in prior single-institution studies. Accuracy of FIGO clinical staging was higher than previously reported. The temporal data suggest that FIGO clinical staging was influenced by CT and MRI findings.
US-guided FNA of axillary lymph nodes in patients with newly diagnosed breast cancer had a sensitivity that increased with increasing size of the primary tumor.
Ultrasound-guided FNA of the axillary lymph nodes is most useful in the preoperative assessment of patients with large tumors (> 2 cm) or lymph nodes that appear abnormal.
Ovarian cancer is the most fatal gynecologic malignancy. Women often present late and though median survival has improved, a majority of women will succumb to their disease. The incidence of ovarian cancer among female-to-male transsexuals is not known. We report only the second case of ovarian cancer in a female-to-male transsexual while on androgen supplementation therapy. Staining of his tumor for androgen receptors showed abundant expression. Androgen supplementation in this population may be associated with an increased risk of both ovarian cancer and of endometrial cancer. Consideration for bilateral salpingo-oophorectomy as part of gender reassignment surgery should be given, especially in this poorly studied group of patients whose overall risk of ovarian cancer remains unknown.
T he term â€oe¿ unicornuate uterus― is a deceptively simple descriptor of a relatively complex set of mtille nan duct anomalies. Accurate classification using hysterosalpingography, sonography, MR imaging, or a combination of the three techniques requires attention to subtle detail because each technique has its own unique set of findings and limitations. Although as sociated anomalies can be broadly identified with all the subtypes, clinical concerns are type-specific. We describe the characteristics of severalof the common subtypesof unicor nuate uterus presenting in the adult, and we thendiscussthe clinical implicationsassoci ated with each subtype.
EmbryologyThe uterus, cervix, and upper two thirds of the vaginaform from fusionand subsequent medial wall resorption of the paired mUlle rian ducts. Variation in this development scheme leads to a variety of congenital mal formations of the uterus. Approximately 15%
Objective. To determine whether sonography can be used to categorize some solid breast masses as probably benign so that biopsy can be deferred. Methods. We prospectively characterized 844 sonographically visible solid breast masses referred for biopsy. Mammographic and sonographic features of the masses were recorded, and all masses were categorized by American College of Radiology Breast Imaging Reporting and Data System classification before biopsy. Of the 844 masses, 148 were categorized as probably benign (Breast Imaging Reporting and Data System category 3). Sonographically guided biopsy (n = 804) or fine-needle aspiration (n = 40) was performed for pathologic correlation. Results. Of the 148 masses that met the sonographic criteria for probably benign masses, there was 1 malignancy, for a negative predictive value of 99.3%. Conclusions. Follow-up can be an acceptable alternative to biopsy for sonographically probably benign solid masses.
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