共查询到20条相似文献,搜索用时 11 毫秒
1.
Sun Young Park Eun-Kyung Kim Ki Keun Oh Kyong Sik Lee Byeong-Woo Park 《Korean journal of radiology》2002,3(3):189-193
Objective
To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms.Materials and Methods
Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically-guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography.Results
Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery.Conclusion
In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography. 相似文献2.
Eun Sook Ko Nariya Cho Joo Hee Cha Jeong Seon Park Sun Mi Kim Woo Kyung Moon 《Korean journal of radiology》2007,8(3):206-211
Objective
We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy.Materials and Methods
Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings.Results
Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%).Conclusion
Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings. 相似文献3.
OBJECTIVE: To determine the frequency of imaging-histologic discordance at percutaneous breast biopsy and to evaluate differences in clinical and radiologic findings between pathologically upgraded lesions and non-upgraded lesions. MATERIALS AND METHODS: From February 2000 to June 2005, we reviewed 386 cases that had suspicious imaging findings but yielded benign histology at US-core needle biopsy and that underwent subsequent excisional biopsy. In 74 of 386 cases, the benign histology at core needle biopsy could not provide a satisfactory explanation for the radiologically suspicious lesions. The clinical, radiologic and histologic findings were reviewed for those 74 cases that were classified as the upgrade group and the non-upgrade group after excisional biopsy. RESULTS: The upgrade rate was 17.6% (95% confidence interval, 10.6-27.8%, 13 of 74 cases) revealed upgraded pathology at the subsequent excisional biopsy. Besides the size of masses, there were no statistically significant differences in imaging findings between the upgrade and non-upgrade groups at excisional biopsy. CONCLUSION: This upgrade rate of 17.6% suggests that excisional biopsy or re-biopsy is warranted in those cases presenting imaging-histologic discordance at US-guided core biopsy. 相似文献
4.
5.
Priscilla J. Slanetz MD MPH FACR Shieh-Pei Wu MD Jeffrey B. Mendel MD 《Journal l'Association canadienne des radiologistes》2011,62(4):265-271
Objective
Benign breast masses, such as fibroadenomas, are common, and their management is variable, depending on symptoms and patient concerns. We undertook this study to determine the safety, efficacy, and patient acceptance of percutaneous excision of benign breast masses by using a hand-held vacuum-assisted device.Methods
By using sonographic guidance, percutaneous removal was performed in 40 patients with 42 lesions by using a 9-gauge (n = 13) or 12-gauge (n = 29) probe (ATEC; Suros Surgical). Technical success, procedural complications, and patient experience were recorded at the time of excision and at 48 hours. Clinical, imaging, and/or surgical follow-up was obtained for 39 of 42 lesions (93%). Three of 42 lesions (7%) were lost to follow-up.Results
Of 42 lesions, maximal diameters ranged from 0.6–4.0 cm (mean 1.6 cm), with lesion volumes between 0.05 and 11.2 mL (mean [SD] 1.4 ± 2.1 mL, median 7 mL). The procedure was well tolerated by all patients, and no residual mass was visible in any case at the conclusion of the procedure. All the patients preferred this approach to open surgical biopsy. After percutaneous excision, surgery was performed on 3 of 42 lesions (7%) for atypia (n = 2) or malignancy (n = 1), with a residual mass found only for the malignant case. Of the 26 of 42 lesions (62%) with imaging follow-up, 24 (92%) had no lesion recurrence. Overall, the procedure either completely removed the mass and/or relieved the patient's symptoms of a mass in 36 of 39 lesions (92%) for which clinical, imaging, and/or surgical follow-up was available. Three lesions were lost to follow-up.Conclusion
Ultrasound-guided percutaneous excision of benign breast masses is a safe, effective, and well-tolerated minimally invasive procedure for the diagnosis and removal of benign breast masses. It may serve as an alternative to surgical excision for women with a known benign or probably benign breast mass who desire excision but prefer to avoid surgery or who are poor surgical candidates. 相似文献6.
Hee Jung Shin Hak Hee Kim Sun Mi Kim Dae Bong Kim Ye Ri Lee Mi-Jung Kim Gyungyub Gong 《Korean journal of radiology》2007,8(2):103-110
Objective
We wanted to evaluate the mammographic and sonographic differential features between pure (PT) and mixed tubular carcinoma (MT) of the breast.Materials and Methods
Between January 1998 and May 2004, 17 PTs and 14 MTs were pathologically confirmed at our institution. The preoperative mammography (n = 26) and sonography (n = 28) were analyzed by three radiologists according to BI-RADS.Results
On mammography, a mass was not detected in eight patients with PT and in one patient with MT (57% vs. 8%, respectively, p = 0.021), which was statistically different. The other findings on mammography and sonography showed no statistical differences between the PT and MT, although the numerical values were different. When the lesions were detected mammographically, an irregularly shaped mass with a spiculated margin was more frequently found in the MT than in the PT (100% vs. 83%, respectively, p = 0.353). On sonography, all 28 patients presented with a mass and most lesions showed as not being circumscribed, hypoechoic masses with an echogenic halo. Surrounding tissue changes and posterior shadowing were more frequently found in the MT than in the PT (75% vs. 50%, respectively, p = 0.253, 58% vs. 19%, respectively, p = 1.000). An oval shaped mass was more frequently found in the PT than in the MT (44% vs. 25%, respectively; p = 0.434).Conclusion
PT and MT cannot be precisely differentiated on mammography and sonography. However, the absence of a mass on mammography or the presence of an oval shaped mass would favor the diagnosis of PT. An irregularly shaped mass with surrounding tissue change and posterior shadowing on sonography would favor the diagnosis of MT and also a less favorable prognosis. 相似文献7.
Mi Young Kim Nariya Cho Ann Yi Hye Ryoung Koo Bo La Yun Woo Kyung Moon 《Korean journal of radiology》2013,14(4):559-567
Objective
To evaluate the additional effect of sonoelastography on the radiologist''s ability for distinguishing benign from malignant complex breast masses and to decide whether to perform biopsy by B-mode US.Materials and Methods
One hundred eighteen complex breast masses (15 malignant lesions, 103 benign lesions) were included. Five blinded readers independently assessed the likelihood of the malignancy score from 1 to 5 for two data sets (B-mode ultrasound alone and B-mode ultrasound with sonoelastography). Elasticity scores were categorized as 0, 1, or 2 based on the degree and distribution of strain of the echogenic component within complex masses. The readers were asked to downgrade the likelihood of the malignancy score when an elasticity score of 0 was assigned and to upgrade the likelihood of the malignancy score when an elasticity score of 2 was assigned. The likelihood of the malignancy score was maintained as it was for the lesions with an elasticity score of 1. The Az values, sensitivities, and specificities were compared.Results
The Az value of B-mode ultrasound with sonoelastography (mean, 0.863) was greater than that of B-mode ultrasound alone (mean, 0.731; p = 0.001-0.007) for all authors. The specificity of B-mode ultrasound with sonoelastography (mean, 37.1%) was greater than that of B-mode ultrasound alone (mean, 3.8%; p < 0.001) for all readers. The addition of sonoelastography led to changes in decisions. A mean of 33.6% of benign masses were recommended for follow-up instead of biopsy.Conclusion
For complex breast masses, sonoelastography allows increase in both the accuracy in distinguishing benign from malignant lesions and the specificity in deciding whether to perform biopsy. 相似文献8.
赵媛媛 《航空航天医学杂志》2016,(3):278-279
目的:分析早期乳腺癌保留乳房手术的临床结果。方法抽选2012年2月~2015年3月接收早期乳腺癌患者100例,按先后顺序分成两组(实验组、对照组),对照组患者行临床保留胸大肌疗法,实验组患者行临床保留乳房手术疗法,比对手术结果。结果实验组患者临床术后生活质量和对照组相比,差异性鲜明(P<0.05)。结论临床针对早期乳腺癌患者行保留乳房手术疗法效果明显,可提高患者乳房美观度,改善生活现状,值得使用。 相似文献
9.
Schelfout K Van Goethem M Kersschot E Verslegers I Biltjes I Leyman P Colpaert C Thienpont L Van den Haute J Gillardin JP Tjalma W Buytaert P De Schepper A 《European radiology》2004,14(7):1209-1216
To investigate the use of MRI in preoperative characterization of invasive lobular breast cancer (ILC) and in detection of multifocal/multicentric disease. We retrospectively reviewed T1-weighted FLASH 3D precontrast and postcontrast MR images together with subtraction images of 26 women with histopathologically proven invasive lobular cancer. Two experienced radiologists described tumor patterns of ILC independently. MR findings of unifocal, multifocal, single quadrant and multiquadrant disease were correlated with results of other imaging techniques and compared with histopathological findings as gold standard. Most ILC presented on MRI as a single spiculated/irregular, inhomogeneous mass (pattern 1, n=12) or as a dominant lesion surrounded by multiple small enhancing foci (pattern 2, n=8). Multiple small enhancing foci with interconnecting enhancing strands (pattern 3) and an architectural distortion (pattern 4) were both described in three cases. There was one case of a focal area of inhomogeneous enhancement (pattern 5) and one normal MR examination (pattern 6). Unifocal and multifocal lesions were identified on MRI in four patients with normal conventional imaging. In nine women, multiple additional lesions or more extensive multiquadrant disease were correctly identified only on MRI. MRI may play an important role in the evaluation of patients with ILC, which is often difficult to diagnose on clinical examination and conventional imaging and more likely occur in multiple sites and in both breasts. However, false-negative MR findings do occur in a small percentage of ILC. 相似文献
10.
Nariya Cho Woo Kyung Moon Joo Hee Cha Sun Mi Kim Seung Ja Kim Sin Ho Lee Hye Kyung Chung Kyung Soo Cho In Ae Park Dong-Young Noh 《Korean journal of radiology》2005,6(2):102-109
Objective
To compare the outcomes of 14-gauge automated biopsy and 11-gauge vacuum-assisted biopsy for the sonographically guided core biopsies of breast lesions.Materials and Methods
We retrospectively reviewed all sonographically guided core biopsies performed from January 2002 to February 2004. The sonographically guided core biopsies were performed with using a 14-gauge automated gun on 562 breast lesions or with using an 11-gauge vacuum-assisted device on 417 lesions. The histologic findings were compared with the surgical, imaging and follow-up findings. The histologic underestimation rate, the repeat biopsy rate and the false negative rates were compared between the two groups.Results
A repeat biopsy was performed on 49 benign lesions because of the core biopsy results of the high-risk lesions (n = 24), the imaging-histologic discordance (n = 5), and the imaging findings showing disease progression (n = 20). The total underestimation rates, according to the biopsy device, were 55% (12/22) for the 14-gauge automated gun biopsies and 36% (8/22) for the 11-gauge vacuum-assisted device (p = 0.226). The atypical ductal hyperplasia (ADH) underestimation (i.e., atypical ductal hyperplasia at core biopsy and carcinoma at surgery) was 58% (7/12) for the 14-gauge automated gun biopsies and 20% (1/5) for the 11-gauge vacuum-assisted biopsies. The ductal carcinoma in situ (DCIS) underestimation rate (i.e., ductal carcinoma in situ upon core biopsy and invasive carcinoma found at surgery) was 50% (5/10) for the 14-gauge automated gun biopsies and 41% (7/17) for the 11-gauge vacuum-assisted biopsies. The repeat biopsy rates were 6% (33/562) for the 14-gauge automated gun biopsies and 3.5% (16/417) for the 11-gauge vacuum-assisted biopsies. Only 5 (0.5%) of the 979 core biopsies were believed to have missed the malignant lesions. The false-negative rate was 3% (4 of 128 cancers) for the 14-gauge automated gun biopsies and 1% (1 of 69 cancers) for the 11-gauge vacuum-assisted biopsies.Conclusion
The outcomes of the sonographically guided core biopsies performed with the 11-gauge vacuum-assisted device were better than those outcomes of the biopsies performed with the 14-gauge automated gun in terms of underestimation, rebiopsy and the false negative rate, although these differences were not statistically significant. 相似文献11.
The mammographic and US features of a case of primary tuberculosis of the breast are presented. The differential diagnosis with other benign or malignant conditions of the breast can be difficult with imaging methods due to the variable pattern of presentation of such an inflammatory lesion. 相似文献
12.
Anat Kornecki 《Journal l'Association canadienne des radiologistes》2011,62(1):31-40
Ultrasound (US) has a significant role in diagnostic breast imaging. It is most commonly used as an adjunctive test in characterizing lesions detected by other imaging modalities or by clinical examination. US is recognized as the modality of choice in the evaluation of women who are symptomatic and younger than 30 years of age, pregnant, or lactating. Combined mammography and US appear to have a role in screening high-risk populations. The use of standard Breast Imaging Reporting and Data System US lexicon is helpful in guiding the differentiation between benign and malignant sonographic signs. Biopsy is warranted when benign features are absent or for any feature consistent with malignancy, despite other benign findings. Whole breast and axillary US are useful in assessing tumour extension, multifocality, and the status of axillary lymph nodes. US is the modality of choice for guiding interventional breast procedures. The role of US as a guidance tool for nonoperative breast treatment is being investigated. 相似文献
13.
Boo-Kyung Han Yeon Hyeon Choe Young-Hyeh Ko Seok-Jin Nam Jung-Hyun Yang 《Korean journal of radiology》2001,2(2):113-116
In Asia, mammography following the injection of foreign materials into the breasts for cosmetic augmentation is frequently seen and diagnosis based on the typical radiologic findings is straightforward.We report the unusual radiologic findings in two patients with foreign body granulomas caused by injected foreign materials and discovered incidentally during screening work up. The mammographic findings were bilateral, hyperdense, spiculated masses, with occasional microcalcification, and at sonography, markedly hypoechoic, spiculated solid masses, located near the pectoralis muscle and partly extending into it, were observed. These radiologic findings mimicked malignancy. 相似文献
14.
目的 探讨CT灌注检查在乳腺疾病诊断中的应用价值. 资料与方法 将22例分为乳腺癌组和乳腺炎症组行CT灌注检查,采用GE AW4.1工作站perfusion 3体部肿瘤灌注软件行图像后处理,得出各组灌注参数值并与正常乳腺组织进行对照分析. 结果 乳腺癌组、乳腺炎症组表面通透性(PS)、血容量(BV)、血流量(BF)平均值均高于正常乳腺组织,其差异具有统计学意义(P<0.05).乳腺炎症组PS、BV平均值高于乳腺癌组,两者差异具有统计学意义(P<0.05).平均通过时间(MTT)值差异均无明显统计学意义(P>0.05).术后瘢痕区PS、BV、BF平均值低于正常乳腺组织. 结论 CT灌注检查可以反映乳腺病变的血流灌注及功能学改变,是诊断乳腺病变可行的辅助检查方法. 相似文献
15.
AIM: To examine the value of US correlation for MRI-detected breast lesions in women with familial risk of breast cancer. METHODS: From an initial dataset of 245 women with positive family history who had breast cancer surveillance involving mammography or MRI between November 1994 and February 2001, 179 subjects with follow-up data were selected. A total of 43 women with 48 MRI-detected lesions underwent further assessment with US. Histopathological correlation was available from 38 breast biopsies performed for 33 women. RESULTS: Sonographic correlates were identified in 32 (66.7%) of the 48 MRI-detected lesions, with cancer present in 11 (34.4%) of these. This compares with 1 (6.3%) cancer found in the 16 lesions without sonographic correlates. Of the 12 malignant lesions, 11 (91.7%) had sonographic correlates whereas 21 (58.3%) of the 36 benign lesions had sonographic correlates. In all 74% of breast biopsies were performed under US guidance compared with 8% under MRI guidance. The proportion of MRI- and US-correlated benign and malignant lesions undergoing US-guided biopsy were 85.7% and 90.9%, respectively. CONCLUSION: The probability of cancer was significantly higher in MRI-detected breast lesions with sonographic correlates compared with those without such correlation. The advantage of convenient biopsy under US guidance as opposed to MRI guidance highlights the value of sonographic assessment of MRI-detected breast lesions. 相似文献
16.
数字化乳腺X线摄影观察年龄和乳腺密度与乳腺良恶性病变的关系 总被引:1,自引:0,他引:1
目的:探讨年龄因素和乳腺X线密度等级与乳腺癌和乳腺良性病变发病风险的相关性。方法:1621例乳腺X线受检者中,62例经手术病理证实为乳腺癌,192例经手术及其它影像手段证实为乳腺良性病变。按受检者年龄将患者分成≤30、31~40、41~50、51~60及≥61岁共5组,按乳腺百分密度分成〈25%、25%~50%、51%~75%及〉75%共4个等级进行统计分析。结果:乳腺密度在各年龄组之间差异有极显著性意义(P〈0.001),随着年龄增长,乳腺密度逐渐减低,在41~50岁和51~60岁两组之间密度变化最显著(Z=-11.7,P〈0.001)。62例乳腺癌在5个年龄组中按从低到高其检出率分别为2.1%、1.1%、3.3%、4.3%和10.9%,在4个密度等级组(从低到高)的检出率分别为17.7%、16.1%、21.0%和45.2%。多元逻辑回归分析结果显示,乳腺癌检出率随着年龄增长呈上升趋势(Waldχ2=40.9,P〈0.001),随乳腺密度增长呈升高趋势(Waldχ2=17.6,P〈0.001);年龄每增长10岁,乳腺癌检出率是前一低年龄段的3.0倍(OR值=3.0);密度每增加1个等级,癌检出率是前一低密度组的1.9倍(OR值=1.9)。乳腺良性病变随年龄增长呈上升趋势,但乳腺密度与良性病变检出率之间无相关性。结论:年龄及乳腺密度均为我国女性乳腺癌的重要危险因素,年龄因素对乳腺癌的影响更大,乳腺密度与乳腺癌发病的风险关系在绝经后的老年女性更突出。 相似文献
17.
目的:探讨乳腺良恶性病变磁共振弥散成像与分子生物学之间的相关性。材料和方法:对36例原发性乳腺癌和12例良性乳腺病变患者术前行乳腺弥散成像(DWI),测定良恶性病变弥散系数(ADC)值,术后标本行免疫组织化学染色测定癌细胞CerbB-2、PCNA、P53的表达情况,并分析与磁共振弥散系数值的相关性。结果:34例乳腺癌及12例良性乳腺病变完成弥散成像。恶性肿瘤组ADC值(0.778±0.169)×10-3mm2/s明显小于良性病变ADC值(1.801±0.429)×10-3mm2/s(P<0.05,b=1000s/mm2)。ADC值与PCNA、P53表达呈负相关(r=-0.634,-0.493,P<0.05)。结论:乳腺良恶性病变的ADC值有显著性差异,乳腺癌的ADC值与分子生物学之间存在一定相关性。 相似文献
18.
Chae Yeon Lyou Nariya Cho Sun Mi Kim Mijung Jang Jeong-Seon Park Seung Yon Baek Woo Kyung Moon 《Korean journal of radiology》2011,12(1):34-43
Objective
To evaluate the accuracy of a computer-aided evaluation program (CAE) of breast MRI for the assessment of residual tumor extent and response monitoring in breast cancer patients receiving neoadjuvant chemotherapy.Materials and Methods
Fifty-seven patients with breast cancers who underwent neoadjuvant chemotherapy before surgery and dynamic contrast enhanced MRI before and after chemotherapy were included as part of this study. For the assessment of residual tumor extent after completion of chemotherapy, the mean tumor diameters measured by radiologists and CAE were compared to those on histopathology using a paired student t-test. Moreover, the agreement between unidimensional (1D) measurement by radiologist and histopathological size or 1D measurement by CAE and histopathological size was assessed using the Bland-Altman method. For chemotherapy monitoring, we evaluated tumor response through the change in the 1D diameter by a radiologist and CAE and three-dimensional (3D) volumetric change by CAE based on Response Evaluation Criteria in Solid Tumors (RECIST). Agreement between the 1D response by the radiologist versus the 1D response by CAE as well as by the 3D response by CAE were evaluated using weighted kappa (k) statistics.Results
For the assessment of residual tumor extent after chemotherapy, the mean tumor diameter measured by radiologists (2.0 ± 1.7 cm) was significantly smaller than the mean histological diameter (2.6 ± 2.3 cm) (p = 0.01), whereas, no significant difference was found between the CAE measurements (mean = 2.2 ± 2.0 cm) and histological diameter (p = 0.19). The mean difference between the 1D measurement by the radiologist and histopathology was 0.6 cm (95% confidence interval: -3.0, 4.3), whereas the difference between CAE and histopathology was 0.4 cm (95% confidence interval: -3.9, 4.7). For the monitoring of response to chemotherapy, the 1D measurement by the radiologist and CAE showed a fair agreement (k = 0.358), while the 1D measurement by the radiologist and 3D measurement by CAE showed poor agreement (k = 0.106).Conclusion
CAE for breast MRI is sufficiently accurate for the assessment of residual tumor extent in breast cancer patients receiving neoadjuvant chemotherapy. However, for the assessment of response to chemotherapy, the assessment by the radiologist and CAE showed a fair to poor agreement. 相似文献19.
We report a 59-year-old woman presenting with a 2-month history of occasional bloody discharge from her right nipple and a palpable right breast mass on self-examination. The mammography revealed heterogeneously dense fibroglandular stromas of bilateral breasts, a lobulated mass in her right breast associated with faint pleomorphic microcalcifications, and, in addition, very faint focal granular microcalcifications in the left breast. Breast ultrasound revealed a lobulated and heterogeneous hypoechoic tumor with irregular margins at the right breast and a well-circumscribed tumor with heterogeneous echotexture at the left breast. 相似文献
20.
Ji Hye Lee Sung Hun Kim Bong Joo Kang Ah Won Lee Byung Joo Song 《Korean journal of radiology》2010,11(5):522-527