Breast Ductal Carcinoma in Situ (DCIS): Morphologic and Kinetic MRI Findings

Nadrljanski, Mirjan; Marković, Biljana; Milošević, Zorica

doi:10.5812/iranjradiol.4876

Cited by 11 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In younger age groups, the percentage of women with high density breasts is more than low density ones. As the age Increases, the breast density decreases is correlated with other studies ( 16 , 20 , 23 , 26 , 30 , 31 ) Maximal breast density was observed in the age group 30-50 years old which correlates with their hormonal pattern. Density distribution differences between screening and diagnostic groups may have been due to some other confounding factors, which would affect density; on the other hand, there are theoretically differences between the two groups.…”

Section: Discussionsupporting

confidence: 83%

“…Qualitative methods are observer-base but these methods do not have the limitations that the quantitative methods do, for instance, the tumor volume assessment and estimation from two-dimensional images is possible, because the observer can reconstruct a three-dimensional image of the breast and densities, out of images taken in two different views, in his mind. On the other hand, many common ( 16 , 17 ) and uncommon ( 18 , 19 ) benign and malignant lesions may be presented as dense lesions in mammography images that may be ignored in qualitative methods by the physician when estimating the underlying breast tissue density, but this would not be happened using automated methods. In large or multiple lesion cases, the breast density will be falsely diagnosed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Distribution of Breast Density in Iranian Women and its Association with Breast Cancer Risk Factors

Rahmani

Ahmadinejad

Movahedinia

et al. 2013

Iran Red Cres Med J

View full text Add to dashboard Cite

Background:Breast cancer is one of the most common cancers and the first-leading cause of cancer deaths among women in the world. Indeed, breast cancer is ranked as the first malignancy among Iranian women. Breast density, defined as the percentage of fibro glandular breast tissue in mammographic images, is one of the known risk factors for breast cancer. According to American college of radiology-Breast Imaging Reporting and Data System (ACR-BIRADS), mammographic density is divided into four categories. Studies have shown that increased breast density is associated with significant increase in breast cancer risk. Therefore, it is assumed that breast density should be associated with other breast cancer risk factors.Objectives:The aim of this study was to assess the epidemiologic distribution of breast density of the patients in a referral center in Iran, and to evaluate the association of high breast density and breast cancer risk factors and other factors that may possibly affect the mammographic density according to previous studies.Patients and Methods:In an analytical cross-sectional study, 728 of those who had referred to Imam Khomeini Imaging Center either for diagnostic or screening purposes, participated in the study, after filling out the informed consent form, the survey questionnaire based survey assessing breast cancer risk factors affecting the breast density and related demographic features, was conducted. SPSS 11.5 software and chi-square, t-test and logistic regression tests were used to analyze the data.Results:Most of patients (75%) in categories 2 and 3 of mammographic density had a breast density of 51.9%, however, this amount was less (49.2%) in screening mammograms, while in diagnosing group it was more (51.6%). The Findings showed an increase in age, body mass index (BMI), duration of breast feeding, and also to be menopause e, unemployed and married, younger than 29 years old at first delivery, having children up to 8 and smoking are associated with less breast density. Diagnostic mammograms and symptomatic patients showed denser breasts. But density had no association with oral contraceptives pill (OCP) consumption or hormone replacement therapy or calcium and/or vitamin D consumption, age at menarche and menopause, menstruation cycle phase and family history of breast cancer. Age at the first delivery, menopausal status and parity were independently associated with breast density.Conclusions:Density distribution and risk factors prevalence is different among symptomatic patients and the diagnostic mammograms of the screened persons, hence such information should be considered in the patient managements. In order to consider the effect of marriage and parity on decreasing the breast density, basic consultations should be performed. Smokers and obese women may falsely show low breast density while they may be in high-risk group. In this study no specific phase of menstrual cycle is suggested for mammographic examinations.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Distribution of Breast Density in Iranian Women and its Association with Breast Cancer Risk Factors

Rahmani

Ahmadinejad

Movahedinia

et al. 2013

Iran Red Cres Med J

View full text Add to dashboard Cite

show abstract

“…Although breast MRI is a highly sensitive modality for the detection of breast malignancies, its specificity is relatively low ( 7 , 8 , 21 - 27 ). During the last two decades, substantial research has been done to found the most significant features on breast MRI which may be useful for the diagnosis of breast malignancies ( 14 , 18 , 28 - 35 ).…”

Section: Discussionmentioning

confidence: 99%

Association of Different MRI BIRADS Descriptors with Malignancy in Non Mass-Like Breast Lesions

Gity¹,

Moghadam²,

Jalali³

et al. 2014

Iran Red Crescent Med J

View full text Add to dashboard Cite

Background:Several studies on the diagnostic efficacy of MRI has not real consensus for the accuracy of MRI characteristics in non mass like breast lesions, and the number of malignant lesions in different studies is insufficient.Objectives:In this study we aimed to analyze the diagnostic role of MRI BIRADS features for diagnosis of malignancy in non mass like breast lesions.Patients and Methods:All patients with positive findings (BIRADS 3, 4, 5), which had either biopsy proved pathology or follow-up MRI data at least for 12 months were included in the study. Finally, 213 breasts MRI that showed non mass like enhancing lesions among our patients were assessed in study. One experienced breast radiologist who was unaware of any clinical information or the histopathologic diagnosis evaluated all images retrospectively. The morphologic parameters evaluated consisted of distribution modifiers and pattern of internal enhancement. The kinetic enhancement parameters were assessed as showing washout, plateau, or persistent patterns. In the enhancement kinetic analysis, thew most worrisome curve type in each lesion was considered for interpretation, if it was more than 2% enhancement. We have evaluated the visual findings by comparison of the signal intensity on the first and third dynamic series. Data for the study were extracted from the breast MRI database and analyzed using SPSS version 16 statistical software.Results:Totally 188 patients had 213 non mass like lesions. Mean age of the patients was 44.9 ± 8.3 years (24-63). Totally 46 of lesions were malignant (21.6%). The most common BIRADS score was 4 (116; 54.5%). The most prevalent feature of distribution, internal enhancement and curve type were focal (59.2%), clumped (27.2%) and washout (34.3%). Distribution of different subgroups of MR BIRADS features was different among benign and malignant lesions (All Pvalues < 0.05). Regarding association with malignancy, odds ratio of lesions with segmental or ductal linear distribution was 3.4 (95% CI = 1.7-6.8), Clumped, Reticular and Dendritic internal enhancement was 2.5 (95% CI = 1.3-5) and wash out curve type was 5.4 (95% CI = 2.7-10.9). Sensitivity of higher MR BIRADS (4,5) for diagnosis of malignancy was 100%. Specificity of segmental or ductal linear distribution in diagnosis of malignancy was 81%. Specificity of BIRADS 5 for diagnosis of malignancy was 98%. In a multivariate logistic regression analysis for diagnosis of malignancy in which distribution, internal enhancement and curve type were considered as independent variables, distribution and curve type remained significant in the model while the internal enhancement showed a borderline P-value.Conclusions:Although in our study washout pattern was the most powerful indicator for malignant pathology in non mass like enhancing lesions, more studies with larger sample size needs in this regard.

show abstract

“…As the radiological appearance of breast lesions are similar to fibro glandular breast tissue, many common ( 8 , 9 ) and uncommon ( 10 , 11 ) benign and malignant lesions may present as dense lesions in mammography that affect mammographic density sensitivity in predicting risk of malignancy. One limitation of automated methods in estimating underlying breast density is that such lesions are not ignored and semi-automated methods, in which the radiologist specifies lesions, seem more precise.…”

Section: Backgrtoundmentioning

confidence: 99%

Association of Mammographic Density with Pathologic Findings

Ahmadinejad¹,

Movahedinia²,

Movahedinia³

et al. 2013

Iran Red Crescent Med J

View full text Add to dashboard Cite

BackgroundBreast cancer is one of the most common cancers in the world and is the first cause of death due to cancer among women. Mammography is the best screening method and mammographic density, which determines the percentage of fibro glandular tissue of breast, is one of the strongest risk factors of breast cancer. Because benign and malignant lesions may present as dense lesions in mammography so it is necessary to take a core biopsy of any suspicious lesions to evaluate pathologic findings.ObjectivesThe aim of this study was to assess the association between mammographic density and histopathological findings in Iranian population. Moreover, we assessed the correlation between mammographic density and protein expression profile. We indeed, determined the accuracy and positive predictive value and negative predictive value of mammographic reports in our center.Patients and MethodThis study is a cross-sectional study carried out among 131 eligible women who had referred to imaging center for mammographic examination and had been advised to take biopsy of breast tissue. All participants of the study had filled out the informed consent. Pathologic review was performed blinded to the density status. Patients were divided into low density breast tissue group (ACR density group 1-2) and high density breast tissue group (ACR 3, 4) and data was compared between these two groups. Statistical analysis performed using SPSS for windows, version 11.5. We used chi-square, t-test, and logistic regression test for analysis and Odds Ratio calculated where indicated.ResultsIn patients with high breast densities, malignant cases (61.2%) were significantly more in comparison to patients with low breast densities (37.3%) (P= 0.007, OR=2.66 95% CI=1.29-5.49). After adjusting for age, density was associated with malignancy in age groups <46 years (P=0.007), and 46-60 years (P=0.024) but not in age group >60yrs (P=0.559). Adjusting for menopausal status, density showed association with malignancy in both pre-menopause (P=0.041) and menopause (P=0.010) patients. Using logistic regression test, only age and density showed independent association with risk of breast cancer. No association was found between density and protein profile expression. Mammographic method has a false negative percent of 10.3% for negative BI-RADS group and a Positive Predictive Value (PPV) of 69.6% for positive BI-RADS group. PPVs for BI-RADS 4a, 4b, 4c and 5 were 16%, 87.5%, 84.6%, and 91.5% respectively. NPVs for BI-RADS 1, 2 and 3 were 66.7%, 95.8% and 90.0% respectively.ConclusionsIn this study we found that increasing in mammographic density is associated with an increase in malignant pathology reports. Expression of ER, PR and HER-2 receptors didn't show association with density. Our mammographic reports had a sensitivity of 94.1% and a specificity of 55.6%, which shows that our mammography is an acceptable method for screening breast cancer in this center.

show abstract

Breast Ductal Carcinoma in Situ (DCIS): Morphologic and Kinetic MRI Findings

Cited by 11 publications

References 14 publications

Distribution of Breast Density in Iranian Women and its Association with Breast Cancer Risk Factors

Distribution of Breast Density in Iranian Women and its Association with Breast Cancer Risk Factors

Association of Different MRI BIRADS Descriptors with Malignancy in Non Mass-Like Breast Lesions

Association of Mammographic Density with Pathologic Findings

Contact Info

Product

Resources

About