The role of breast scintigraphy in detecting breast masses

127 breast scans were performed on 83 female patients using technetium-99m diphosphonate. 46 out of 48 patients with breast cancer had positive breast scans manifested by a focal increased uptake in 37 patients and a diffuse increased uptake in the remaining 9 patients. Benign breast lesions such as fibrocystic disease, fibroadenoma and fat necrosis may also concentrate the radioactive agent in a focal or a diffuse pattern. So breast scanning is a sensitive though nonspecific modality to detect malignant breast lesions and it is worthwhile performing it on all women referred for bone scan.     

The post therapy breast.

Both systemic and local therapy, for conditions of the breast and unrelated to it, may produce mammographic changes. Some of these are characteristic, such as the pattern of scarring seen in reduction mammoplasty. In many other instances, however, the changes produced overlap features commonly seen in malignancy. A knowledge of the timing, natural history and spectrum of these changes will aid mammographic interpretation.     

The added benefit of digital breast tomosynthesis in second breast cancer detection among treated breast cancer patients

Objectives

We aimed to compare the recall rate (RR) and the cancer detection rate (CDR) of combined full field digital mammography and digital breast tomosynthesis (FFDM?+?DBT) to those of full field digital mammography (FFDM) alone in breast cancer survivors.

The spontaneous disappearance of breast calcification

The spontaneous disappearance of both coarse and fine calcification in the breast was noted in 11 cases who presented either with breast symptoms or to a screening unit. While fine and coarse calcification occur in benign disease, the spontaneous regression of this finding appears not to have been reported previously.     

The supraclavicular recurrence of breast carcinoma

Between January 1970 and December 1978 39 patients with isolated supraclavicular recurrence of breast cancer were referred to the Department of Radiotherapy and Radiobiology, University of Vienna. All patients have had mastectomy as primary treatment. In 46% of the patients a surgical excision of involved lymph node has been performed before irradiation. The median interval between mastectomy and supraclavicular recurrence was 26 months. The cumulative incidence after three years was 75%. 15 patients have shown complete local response during the whole follow-up time. In 38 patients, osseous and/or visceral metastasis were observed after a median interval of eight months. After two years, 87% of the patients presented distant disease. 15 patients suffered on local pain in the supraclavicular region or in the ipsilateral shoulder with lymph oedema of the arm. The median survival after therapy was 18 months. The death rate after three years was 77%. Patients with a recurrence-free interval after mastectomy less than two years had a median survival time of eleven months whereas patients with a recurrence-free interval had 26 months.     

The role of nuclear medicine in breast cancer detection: functional breast imaging

Mammography remains the imaging modality of choice in detection of early, nonpalpable breast cancer. Scintimammography using SPECT, however, may prove to be a very useful adjunct to a nondiagnostic or difficult mammogram. Further prospective studies have to be designed so that the specific clinical applications of this technique are more defined. As with any new imaging procedure, special care to obtain high-quality scintimammographic studies and sufficient training of staff to perform and interpret the imaging are necessary.     

乳腺X线摄影与MRI对致密型乳腺内病变的诊断

目的:比较乳腺X线摄影与MRI对致密型乳腺病变的诊断价值.方法:搜集同时行乳腺X线摄影及MRI检查的致密型乳腺患者185例,所有病例均经病理证实,分别分析两种方法的影像学表现,并与病理对照.结果:185例患者中组织病理学为恶性者80例,良性105例.乳腺X线摄影诊断致密型乳腺恶性病变的敏感度、特异度、阳性预测值及阴性预...     

The role of ultrasound in breast imaging

Sonography has become an important tool for evaluating breast abnormalities, including inflammatory processes, hematomas, ductal ectasia, cysts and solid lesions. This article describes protocols for ultrasound imaging of the breast and the sonographic appearance of common breast conditions, with particular attention to differentiating benign from malignant lesions. Ultrasound's role in interventional breast procedures and radiation therapy planning also are discussed.     

The mammographic breast pattern and oral contraception

The relationship of oral contraceptive usage to breast parenchymal patterns has been studied in 5319 self-selected women presenting to a breast screening unit. Among premenopausal women, 46.1% had taken an oral contraceptive ("the pill") in the past, and 9.5% were still taking the pill. These patients showed a decreased incidence of P2 patterns and an increased incidence of N1 patterns. Of the post-menopausal women, 14.7% had been on the pill. Similar differences of incidence of parenchymal patterns are noted in these women. The significance of these changes is unclear.     

The hidden sentinel node in breast cancer

The purpose of this study was to analyse the occurrence of non-visualisation during preoperative lymphoscintigraphy for sentinel node identification in breast cancer. Preoperative lymphoscintigraphy was performed in 495 clinically node-negative breast cancer patients (501 sentinel node procedures) after injection of technetium-99m nanocolloid. Anterior and prone lateral (hanging breast) planar images were obtained a few minutes and 4 h after injection. The sentinel node was intraoperatively identified with the aid of patent blue dye and a gamma-ray detection probe. A sentinel node was visualised on the 4-h images in 449 of 501 procedures (90%). This visualisation rate improved from 76% to 94% during the study period. Delayed imaging (5-23 h) in 19 patients whose sentinel nodes failed to show, resulted in visualisation in four of them. A repeat injection of radiocolloid in 11 patients revealed a sentinel node in six. In the end, the visualisation rate was 92%. The sentinel node was surgically retrieved in 24 of the remaining 42 patients with non-visualisation (57%). Sentinel nodes that were visualised were tumour-positive in 38% and non-visualised sentinel nodes were involved in 50% (chi2, P=0.17). In a multivariate regression analysis, scintigraphic non-visualisation was independently associated with increased patient age (P<0.001), decreased tracer dose (P<0.001) and increased number of tumour-positive lymph nodes (P=0.013). The use of a sufficient amount of radioactivity (at least 100 MBq) is recommended for lymphatic mapping in breast cancer, especially in elderly women. Delayed imaging and re-injection of the radioactive tracer increase the visualisation rate. The non-visualised sentinel node can be identified intraoperatively in more than half of the patients.     

重视MRI在乳腺疾病中的重要作用

1991年,美国食品药物管理局(FDA)通过决议,认同磁共振成像可以作为乳腺X线成像技术的辅助手段应用于临床。自此,MRI作为一种崭新的乳腺疾病检查方法在全球范围内逐渐得以推广应用。而且,随着这种应用的进一步深入开展,MRI在乳腺疾病的检出和诊断领域中迅速地显示出了无可比拟的独到的优越性!首先,MRI具有极高的组织分辨力,即使对微小病灶也颇为敏感,可以显示其它检查手段不能检出的乳腺疾患。这一优势,在诸多的超声、X线钼靶摄片检查中仅发现1个小的乳腺癌病灶而MRI则显示为多发乳腺癌的病例中得到了充分的证实。人们已不再对临床触…