<b>Mammography and Subsequent Whole-Breast Sonography of Nonpalpable Breast Cancers:</b> The Importance of Radiologic Breast Density

Leconte, Isabelle; Féger, C.; Galant, Christine; Berlière, Martine; Berg, Bruno; D’Hoore, William; Maldague, Baudouin

doi:10.2214/ajr.180.6.1801675

Cited by 253 publications

(170 citation statements)

References 13 publications

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“…Although it is not a standard recommendation, many breast radiologists advocate the adjunct use of ultrasonography for such populations. [15][16][17] All six patients with interval disease had aggressive pathologic characteristics (Table 3), which are consistent with the findings of larger reviews involving BRCA mutation carriers. 18 -20 Again, these findings suggest that a shorter interval between breast …”

Section: Discussionsupporting

confidence: 85%

The development of interval breast malignancies in patients with BRCA mutations

Komenaka

Ditkoff²,

Joseph³

et al. 2004

Cancer

146

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BACKGROUNDAt present, there is no consensus regarding how frequently BRCA mutation carriers should be screened for malignancies using breast imaging techniques. An interval malignancy is defined as a malignancy that becomes evident during the period between annual screening mammography scans; the finding of such a malignancy indicates that the malignancy either went undetected by the last breast imaging scan or developed during the interval since that last scan.METHODSThe authors retrospectively reviewed the medical charts of all BRCA mutation carriers who were followed by the genetic counselor at the Columbia‐Presbyterian Comprehensive Breast Center (New York, NY) between September 1995 and September 2002.RESULTSThirteen BRCA mutation carriers elected to undergo close surveillance and thus were followed at our institution. Three of these 13 patients (23%) did not develop breast carcinoma, 4 (31%) developed breast carcinoma that was detected at the time of annual screening, and 6 (46%) developed palpable interval malignancies in less than 12 months. Among the six patients who developed interval malignancies, the mean time between the last screening mammogram and disease presentation was 5.1 months (range, 2–9 months); the average tumor size in this patient subgroup was 1.7 cm (range, 0.8–3 cm). Two of these six patients had ductal carcinoma in situ, whereas the remaining four had invasive breast carcinoma; three patients had positive lymph nodes at presentation. All six patients who developed interval disease exhibited dense breast tissue on the previous mammogram. Focused breast ultrasonography was able to identify the tumor mass in 3 of 4 patients (75%).CONCLUSIONSNearly half of all BRCA‐positive women who chose to undergo close surveillance in the current study developed malignant disease less than a year after exhibiting normal findings on screening mammography. Half of these interval malignancies were positive for lymph node involvement. These results suggest that strong consideration should be given to screening BRCA‐positive women at more frequent intervals and to using additional imaging techniques, such as breast ultrasonography and/or breast magnetic resonance imaging, as a part of this screening. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionsupporting

confidence: 85%

The development of interval breast malignancies in patients with BRCA mutations

Komenaka

Ditkoff²,

Joseph³

et al. 2004

Cancer

146

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“…Parenchymal overlap, which may cause significant obstacles to detect abnormal lesion, is often shown in conventional 2DMMG. In particular, limitations of diagnosis in dense or heterogeneously dense breasts are well known in terms of sensitivity and specificity (Carney et al, 2003;Leconte et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Role of Breast Tomosynthesis in Diagnosis of Breast Cancer for Japanese Women

Takamoto¹,

Tsunoda²,

Kikuchi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Introduction: Mammography is the most basic modality in breast cancer imaging. However, the overlap of breast tissue depicted on conventional two-dimensional mammography (2DMMG) may create significant obstacles to detecting abnormalities, especially in dense or heterogeneously dense breasts. In three-dimensional digital breast tomosynthesis (3DBT), tomographic images of the breast are reconstructed from multiple projections acquired at different angles. It has reported that this technology allows the generation of 3D data, therefore overcoming the limitations of conventional 2DMMG for Western women. We assessed the detectability of lesions by conventional 2DMMG and 3DBT in diagnosis of breast cancer for Japanese women. Methods: The subjects were 195 breasts of 99 patients (median age of 48 years, range 34~82 years) that had been pathologically diagnosed with breast cancer from December 20, 2010 through March 31, 2011. Both conventional 2DMMG and 3DBT imaging were performed for all patients. Detectability of lesions was assessed based on differences in category class. Results: Of the affected breasts, 77 (75.5%) had lesions assigned to the same categories by 2DMMG and 3DBT. For 24 (23.5%) lesions, the category increased in 3DBT indicating improvement in diagnostic performance compared to 2DMMG. 3DBT improved diagnostic sensitivity for patients with mass, focal asymmetric density (FAD), and architectural distortion. However, 3DBT was not statistically superior in diagnosis of the presence or absence of calcification. Conclusions: In this study, 3DBT was superior in diagnosing lesions in form of mass, FAD, and/or architectural distortion. 3DBT is a novel technique that may provide a breakthrough in solving the difficulties of diagnosis caused by parenchyma overlap for Japanese women.

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“…However, the detection rate of breast cancer varies widely from *45% in the case of extremely dense breasts and small preinvasive tumors up to *97% in the case of fatty breasts and bigger invasive tumors. [16][17][18] The examination, as such, can be uncomfortable or even painful, and the images obtained still require specialist interpretation and confirmation with biopsy in the case of suspected malignancy. Statistically significant difference between the total sums of true and false results: P < 1.268E-51.…”

Section: Discussionmentioning

confidence: 99%

“…The US detection rate of breast cancer also varies from *43% in the case of nonpalpable tumors up to *94% in the case of larger invasive changes. [16][17][18] However, a US examination cannot detect calcifications and still requires specialist interpretation of the images as well as confirmation with biopsy in the case of suspected malignancy. Combined use of both mammography and US imaging increases the breast pathology detection rate but can be costly and timeconsuming.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Organ Electrodermal Diagnostics in Detection of Breast Pathology: A Multicenter, Randomized, Double-Blinded Clinical Study

Szopinski¹,

Rayne

2017

Medical Acupuncture

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Objective: Pathology of an internal organ/body part causes corresponding skin areas-organ projection areas/ acupuncture points-to rectify applied electrical currents (a diode phenomenon) once the resistance ''breakthrough effect'' has been induced in these specific, and sometimes remote, skin zones. The aim of this study was to estimate the diagnostic accuracy-as well as the scope of utilization-for detection of breast pathology of organ electrodermal diagnostics (OED), which utilizes this electrophysiologic phenomenon. Materials and Methods: A multicenter randomized, double-blinded comparative study of OED results and clinical diagnoses, as the criteria standards, was done on 400 female volunteers, with a mean age of 39 (standard deviation: 9 years), at three academic breast clinics. Participants were divided into 7 groups: (1) a control group; (2) a cancer-survivor group; (3) a breast-fibroadenoma group; (4) a mastitis group; (5) a breastabscess group; (6) a preinvasive breast-cancer group; and (7) an invasive breast-cancer group. Results: The OED overall detection rate was 88.8%, the sensitivity rate was 92.7%, and the specificity rate was 76.5%. The predictive value for positive OED results equaled 92.4% and, for negative OED results, equaled 77.3%. However, both sensitivity and specificity rates varied among specific groups. The highest sensitivity rates were shown by OED in groups with serious pathologies, such as invasive cancer (94.2%), preinvasive cancer (90.0%), breast abscess (94.4%), and mastitis (95.9%). The OED results correlated with the intensity of the pathologic process within breasts but were not affected by either the type or the etiology of the disease.Conclusions: OED appears to be a reliable method for detecting breast pathology; this method might also estimate the intensity of a breast pathologic process but cannot explain the cause of the disease directly.

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Mammography and Subsequent Whole-Breast Sonography of Nonpalpable Breast Cancers: The Importance of Radiologic Breast Density

Abstract: Sonography is a useful adjunct after mammography for the detection of nonpalpable breast cancer, particularly in the dense breast.

Cited by 253 publications

References 13 publications

The development of interval breast malignancies in patients with BRCA mutations

The development of interval breast malignancies in patients with BRCA mutations

Role of Breast Tomosynthesis in Diagnosis of Breast Cancer for Japanese Women

Usefulness of Organ Electrodermal Diagnostics in Detection of Breast Pathology: A Multicenter, Randomized, Double-Blinded Clinical Study

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