Background: The aim of this study was to demonstrate the feasibility of performing multidetector computed tomography (MDCT) with a dedicated protocol for locoregional staging in breast cancer patients. Methods: This prospective single-center study included newly diagnosed breast cancer patients submitted to contrast-enhanced chest MDCT and breast magnetic resonance imaging (MRI). MDCT was performed in prone position and using subtraction techniques. Fleiss’ Kappa coefficient (K) and intraclass correlation coefficient (ICC) were used to assess agreement between MRI, MDCT, and pathology, when available. Results: Thirty-three patients were included (mean age: 47 years). Breast MRI and MDCT showed at least substantial agreement for evaluation of tumor extension (k = 0.674), presence of multifocality (k = 0.669), multicentricity (k = 0.857), nipple invasion (k = 1.000), skin invasion (k = 0.872), and suspicious level I axillary lymph nodes (k = 0.613). MDCT showed higher number of suspicious axillary lymph nodes than MRI, especially on levels II and III. Both methods had similar correlation with tumor size (MRI ICC: 0.807; p = 0.008 vs. MDCT ICC: 0.750; p = 0.020) and T staging (k = 0.699) on pathology. Conclusions: MDCT with dedicated breast protocol is feasible and showed substantial agreement with MRI features in stage II or III breast cancer patients. This method could potentially allow one-step locoregional and systemic staging, reducing costs and improving logistics for these patients.

Pleomorphic adenoma (PA) is a common tumor of the salivary gland, but rarely occurs in the breast. PA of the breast is a benign tumor that usually presents as a periareolar nodule. Core-needle biopsies may yield misdiagnosis with complex fibroadenoma, phyllodes tumor and metaplastic breast cancer due to the mixture of stromal and epithelial elements. We present a case of PA of the breast suspected after core-needle biopsy, but confirmed after surgical excision. The importance to make a correct diagnosis consists in avoid extensive unnecessary surgery, such as mastectomy, since PA can be treated with local surgical resection.

AGV. Computed tomography-guided biopsy of breast lesions: a viable option for selected cases.

A implantação da tela de Vicryl após quadrantectomia, proposta pela primeira vez em 2003, é uma técnica simples, sendo menos dispendiosa do que outros biomateriais implantáveis. Entretanto, o acompanhamento pós-operatório pode ser difícil, uma vez que a tela implantada compromete a avaliação do parênquima mamário adjacente, tanto na mamografia quanto na ultrassonografia. A ressonância magnética pode ser utilizada se houver achados duvidosos no exame físico, na mamografia ou na ultrassonografia. No entanto, existem poucos relatos na literatura sobre os aspectos de imagem da tela absorvível implantada na mama. As imagens apresentadas neste caso mostram a apresentação típica de um granuloma de corpo estranho associado à tela de Vicryl. Radiologistas e cirurgiões devem estar cientes desses aspectos de imagem para evitar diagnósticos incorretos e exames adicionais desnecessários. ABSTRACTThe Vicryl mesh implantation after lumpectomy, which was first proposed in 2003, is a simple technique, less expensive than other proposed implantable biomaterials. However, the postoperative follow-up may be difficult, since the implanted mesh impairs the evaluation of surrounding breast parenchyma at both mammography and ultrasound. Magnetic resonance imaging can be used as a problem-solving tool if there are equivocal findings at physical exam, mammography, or ultrasound. Nevertheless, there are only few reports in literature about the imaging aspects of implanted absorbable mesh in the breast. The images presented in this case show the typical presentation of a foreign body granuloma associated with the Vicryl mesh. Breast radiologists and surgeons should be aware of these imaging aspects to avoid misdiagnosis and unnecessary additional exams.

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