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Chamming's F, Depetiteville MP, Linck PA, Gaillard AL, Deleau F, Brocard C, Boisserie-Lacroix M. Cancers du sein « ACR 3 ». IMAGERIE DE LA FEMME 2022. [DOI: 10.1016/j.femme.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ultrasonographic features of spontaneous breast tumor infarction. Breast Cancer 2014; 22:596-601. [PMID: 24633469 DOI: 10.1007/s12282-014-0525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of this paper is to evaluate the ultrasonographic features of spontaneous breast tumor infarction. METHODS The pathologic information system database of the Department of Radiology was retrospectively searched. Between 2009 and 2011, nine cases in eight patients were pathologically confirmed as spontaneous breast tumor infarctions. Mammographic images and the ultrasonographic images were acquired. Two other radiologists analyzed the mammographic and ultrasonographic findings. RESULTS Most common features were oval, indistinct, heterogeneously hypoechoic mass with posterior enhancement. All lesions were classified as C4 (suspicious finding) except one case. CONCLUSION Spontaneous breast tumor infarction should be included in the differential diagnoses of hetereogeneously hypoechoic suspicious solid lesions mimicking malignancy.
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Wojcinski S, Stefanidou N, Hillemanns P, Degenhardt F. The biology of malignant breast tumors has an impact on the presentation in ultrasound: an analysis of 315 cases. BMC WOMENS HEALTH 2013; 13:47. [PMID: 24252758 PMCID: PMC3840587 DOI: 10.1186/1472-6874-13-47] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 11/15/2013] [Indexed: 02/13/2023]
Abstract
Background The aim of this study was to evaluate the relation of some ultrasound morphological parameters to biological characteristics in breast carcinoma. Methods Ultrasound data from 315 breast masses were collected. We analyzed the ultrasound features of the tumors according to the ACR BI-RADS®-US classification system stratified by hormone receptor status, HER2 status, histology grade, tumor type (ductal versus lobular), triple-negativity, breast density, tumor size, lymph node involvement and patient’s age. Results We found a variety of ultrasound features that varied between the groups. Invasive lobular tumors were more likely to have an angulated margin (39% versus 22%, p = 0.040) and less likely to show posterior acoustic enhancement (3% versus 16%, p = 0.023) compared to invasive ductal carcinoma. G3 tumors were linked to a higher chance of posterior acoustic enhancement and less shadowing and the margin of G3 tumors was more often described as lobulated or microlobulated compared to G1/G2 tumors (67% versus 46%, p = 0.001). Tumors with an over-expression of HER2 exhibited a higher rate of architectural distortions in the surrounding tissue, but there were no differences regarding the other features. Hormone receptor negative tumors were more likely to exhibit a lobulated or microlobulated margin (67% versus 50%, p = 0.037) and less likely to have an echogenic halo (39% versus 64%, p = 0.001). Furthermore, the posterior acoustic feature was more often described as enhancement (33% versus 13%, p = 0.001) and less often as shadowing (20% versus 47%, p < 0.001) compared to hormone receptor positive tumors. Conclusion Depending on their biological and clinical profile, breast cancers are more or less likely to exhibit the typical criteria for malignancy in ultrasound. Moreover, certain types of breast cancer tend to possess criteria that are usually associated with benign masses. False-negative diagnosis may result in serious consequences for the patient. For the sonographer it is essential to be well aware of potential variations in the ultrasound morphology of breast tumors, as described in this paper.
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Affiliation(s)
- S Wojcinski
- Department for Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
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Yoo JL, Woo OH, Kim YK, Cho KR, Yong HS, Seo BK, Kim A, Kang EY. Can MR Imaging Contribute in Characterizing Well-circumscribed Breast Carcinomas? Radiographics 2010; 30:1689-702. [DOI: 10.1148/rg.306105511] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Matheus VS, Kestelman FP, Canella EDO, Djahjah MCR, Koch HA. Carcinoma medular da mama: correlação anátomo-radiológica. Radiol Bras 2008. [DOI: 10.1590/s0100-39842008000600007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar as características radiológicas do câncer de mama medular em pacientes submetidas a tratamento cirúrgico no Instituto Nacional de Câncer (INCA) - Ministério da Saúde, Rio de Janeiro, RJ, correlacionando os achados com estudo histopatológico. MATERIAIS E MÉTODOS: Foi realizado estudo descritivo retrospectivo de mulheres submetidas a tratamento cirúrgico no INCA, no período de janeiro de 1997 a dezembro de 2006, para identificação das pacientes com carcinoma medular e análise dos achados radiológicos. RESULTADOS: Foram identificadas 21.287 pacientes com diagnóstico de carcinoma neste período, sendo 76 pacientes com diagnóstico de carcinoma medular típico (0,357%). Nessas pacientes selecionadas, a idade média foi de 51,9 anos (32 a 81 anos). Dezenove pacientes apresentavam lesão na mamografia, sendo 17 (89,5%) nódulos e 2 assimetrias focais (10,5%). Entre as pacientes com nódulo, 15 (88,1%) apresentavam alta densidade e 2 eram isodensos (11,9%). Doze pacientes apresentavam achados ultra-sonográficos e, destas, 11 (91,6%) apresentavam nódulos hipoecóicos. Foi observada uma paciente com nódulo anecóico com áreas de degeneração cística. CONCLUSÃO: O nódulo foi o achado radiológico dominante (89,5%), dos quais 88,1% apresentaram nódulos com alta densidade e margens circunscritas. Apesar das características radiológicas de benignidade, um nódulo com alta densidade, sólido, margens circunscritas e crescimento rápido deve ser investigado para confirmar o diagnóstico.
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Affiliation(s)
| | | | | | | | - Hilton Augusto Koch
- Universidade Federal do Rio de Janeiro; Pontifícia Universidade Católica do Rio de Janeiro, Brasil
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Sobrino-Mota V, Lagarejos-Bernardo S, Varela-Mezquita B, Castro Y, Segura-González C, Pérez-Milán F. Unusual sonographic findings in a case of atypical medullary inflammatory carcinoma of the breast. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:166-168. [PMID: 18241044 DOI: 10.1002/jcu.20441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the case of a 35-year-old woman who complained of a rapid enlargement of a pre-existing breast mass and yellowish nipple discharge. Clinical examination revealed a firm mass measuring 15 x 10 cm and "peau d'orange" phenomenon. Sonography revealed a well-defined mass with heterogeneous echotexture and hyperechoic trabecular structures that delineated hypoechoic areas, resulting in a honeycomb pattern. The patient underwent a surgical exploration and a biopsy of the mass and of the skin. The histopathologic examination revealed an atypical medullary carcinoma with high mitotic activity.
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Affiliation(s)
- Verónica Sobrino-Mota
- Department of Obstetrics and Gynecology, Gregorio Marañón General University Hospital, 48 28009 Madrid, Spain
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Lorente Ramos RM, del Valle Sanz Y, Alcaraz Mexía MJ, Jareño Dorrego E. [Medullary carcinoma of the breast: a malignant lesion mimicking a benign one]. RADIOLOGIA 2006; 48:165-8. [PMID: 17058639 DOI: 10.1016/s0033-8338(06)73147-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Medullary carcinoma of the breast is an unfrequent type of tumor. We present a case of medullary carcinoma of the breast. The patient presented with a palpable breast mass, corresponding on mammography to an obscured mass, which showed a cystic appearance with thick wall on sonography. We review the radiological findings of this type of tumor which should be considered in the differential diagnosis of lesions with well-circumscribed margins.
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Affiliation(s)
- R M Lorente Ramos
- Servicio de Radiodiagnóstico, Hospital Universitario Santa Cristina, Madrid, España.
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Chen SC, Cheung YC, Su CH, Chen MF, Hwang TL, Hsueh S. Analysis of sonographic features for the differentiation of benign and malignant breast tumors of different sizes. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2004; 23:188-193. [PMID: 14770402 DOI: 10.1002/uog.930] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To analyze the value of various sonographic features in differentiating benign from malignant breast tumors of different sizes to improve the diagnostic accuracy in small lesions. METHODS The sonographic features of 1203 histologically confirmed solid breast lesions were prospectively documented with respect to anteroposterior (AP) diameter/width ratio, shape, margin, echogenicity, echotexture, posterior echo and bilateral refraction sign. The sensitivity, specificity and accuracy of breast ultrasound were calculated for lesions grouped according to size (< or = 1, 1.1-2 and > 2 cm). Univariate and multiple logistic regression analyses including calculation of odds ratios for single sonographic features were used to analyze the significance of the different diagnostic features. RESULTS The accuracy of breast sonography in differentiating between benign and malignant tumors < or = 1, 1.1-2 and > 2 cm in size was 75.6%, 86.4% and 88.4%, respectively. Univariate analysis demonstrated that all sonographic features were significant in tumors > or = 1.1 cm. Shape, margin, echogenicity and echotexture were the significant factors in those tumors < or = 1 cm. Multiple logistic regression analysis demonstrated that margin, shape, posterior echo and echogenicity were the significant factors for differential diagnosis in tumors > 2 cm. Echogenicity, margin, shape, bilateral refraction sign and echotexture were the significant factors for tumors 1.1-2 cm. On multiple regression analysis, margin was the only significant factor for tumors < or = 1 cm. CONCLUSION Tumor margin is the most important sonographic feature in evaluating breast lesions in any size group. With the combination of significant factors and emphasis on specific features according to size of lesion, the diagnostic accuracy of ultrasound for the differential diagnosis of malignant and benign tumors may be improved.
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Affiliation(s)
- S-C Chen
- Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan, Republic of China.
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Xu R, Feiner H, Li P, Yee H, Inghirami G, Delgado Y, Perle MA. Differential amplification and overexpression of HER-2/neu, p53, MIB1, and estrogen receptor/progesterone receptor among medullary carcinoma, atypical medullary carcinoma, and high-grade invasive ductal carcinoma of breast. Arch Pathol Lab Med 2003; 127:1458-64. [PMID: 14567723 DOI: 10.5858/2003-127-1458-daaoon] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Medullary carcinoma (MC) is a special type of breast cancer that has a better prognosis than atypical medullary carcinoma (AMC) and high-grade invasive ductal carcinoma (HGIDC) with prominent lymphocytic infiltrates. What accounts for the different clinical courses of these carcinomas, despite their similar histology, is unknown. To address this issue, we performed a comparative study of amplification and overexpression of HER-2/neu and expression of several other important biochemical markers (p53, MIB1, and estrogen receptor [ER]/progesterone receptor [PR]) in these 3 cancer groups. OBJECTIVE To evaluate HER-2/neu, p53, MIB1, and ER/PR as markers in the differential diagnosis of MC, AMC, and HGIDC.Design.-Nine cases of MC, 13 cases of AMC, and 16 cases of HGIDC with prominent lymphocytic infiltrates were identified according to strict histologic criteria. All tests were performed on formalin-fixed, paraffin-embedded archival tissues. HER-2/neu gene amplification was examined by fluorescence in situ hybridization using PathVysion HER-2 DNA probes. Expression of HER-2/neu, p53, MIB1, and ER/PR was detected by immunohistochemistry. chi2 and Student t tests were applied for statistical analyses. RESULTS None of 9 cases of MC examined had either amplification or overexpression of HER-2/neu (0%). In contrast, HER-2/neu amplification was observed in AMC (46%, P <.025) and HGIDC (56%, P <.005). All 3 categories of tumors had similar percentages of expression of p53 (78% of MC, 77% of AMC, and 69% of HGIDC) and MIB1 (89% of MC, 92% of AMC, and 94% of HGIDC). Immunostaining for ER/PR was rarely positive in either MC or AMC, and there were no significant differences of expression of ER/PR between these 2 lesions (P >.05). However, the expression rate of ER/PR (31%/44%) in HGIDC is higher than in both MC (P =.05) and AMC (P =.01). CONCLUSIONS Medullary carcinoma of breast is distinct from AMC and HGIDC with prominent lymphocytic infiltrates in amplification and overexpression of HER-2/neu. This difference may account for its different clinical and biological behavior, and may potentially aid in diagnosis and management of these groups of patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Breast Neoplasms/genetics
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Medullary/genetics
- Diagnosis, Differential
- Gene Amplification/genetics
- Gene Expression Regulation, Neoplastic/genetics
- Genes, erbB-2
- Genes, p53
- Humans
- Ki-67 Antigen/biosynthesis
- Ki-67 Antigen/genetics
- Lymphocytes, Tumor-Infiltrating/pathology
- Middle Aged
- Receptor, ErbB-2/biosynthesis
- Receptor, ErbB-2/genetics
- Receptors, Estrogen/biosynthesis
- Receptors, Estrogen/genetics
- Receptors, Progesterone/biosynthesis
- Receptors, Progesterone/genetics
- Tumor Suppressor Protein p53/biosynthesis
- Tumor Suppressor Protein p53/genetics
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Affiliation(s)
- Ruliang Xu
- Department of Pathology, Mount Sinai School of Medicine of New York University, New York, NY, USA
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Yilmaz E, Lebe B, Balci P, Sal S, Canda T. Comparison of mammographic and sonographic findings in typical and atypical medullary carcinomas of the breast. Clin Radiol 2002; 57:640-5. [PMID: 12096865 DOI: 10.1053/crad.2001.0902] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The aim of this study was to describe the contribution of mammographic and sonographic findings to the discrimination of typical and atypical histopathologic groups of medullary carcinomas of the breast. MATERIALS AND METHODS Imaging findings were retrospectively assessed in 33 women with medullary carcinomas (15 typical medullary carcinomas and 18 atypical medullary carcinomas) identified during pre-operative mammography. Twenty-nine of these women also had ultrasound and these findings were reviewed. RESULTS Mammography showed a well circumscribed mass in 10 of the 15 (67%) typical medullary carcinomas and in four of the 17 (24%) atypical medullary carcinomas (P < 0.02). One small tumour in a woman with atypical medullary carcinoma was missed on mammography and was shown only on sonography. Sonographically, an irregular margin surrounding the whole mass or part of it was seen in three out of 14 (21%) patients with typical medullary carcinoma and in nine out of 15 (60%) patients with atypical medullary carcinomas (P < 0.05). Posterior acoustic shadowing was more often observed in the typical medullary carcinoma group than in atypical medullary carcinoma and the difference was found to be statistically significant (P < 0.05). None of the other mammographic and sonographic findings were sufficiently characteristic to allow for a differentiation between two groups. CONCLUSION When typical medullary carcinomas were compared with atypical medullary carcinomas according to imaging features, they tended to be well circumscribed masses on both mammography and sonography, and a posterior acoustic shadow was not found on sonography. However, the imaging findings in these two subgroups often resembled each other and histopathology will always be required to confirm the diagnosis.
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Affiliation(s)
- E Yilmaz
- Department of Radiology, Dokuz Eylül University Hospital, Izmir, Turkey.
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Medullary Carcinoma of the Breast: Sonographic Features Distinguishing it from Fibroadenoma. J Med Ultrasound 2002. [DOI: 10.1016/s0929-6441(09)60035-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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