Use of Ultrasound-Guided Percutaneous Vacuum-Assisted Breast Biopsy for Selected Difficult Indications

Use of Ultrasound-Guided Percutaneous Vacuum-Assisted Breast Biopsy for Selected Difficult Indications
Sylvia H. Heywang-Köbrunner, Anke Heinig, Karin Hellerhoff, Hans Jürgen Holzhausen, Jörg Nährig
The Breast Journal 15;4:348-356

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To assess ultrasound-guided vacuum-assisted biopsy (US-VAB) for selected problem cases and to report experiences with two different biopsy systems. Fifty-one lesions have been biopsied using the Mammotome (n = 24) or the Vacora (n = 27) system.

Main indications: lesion in scarring (n = 5), complex cystic ≥8 mm (n = 7), increase in size (n = 10), architectural distortion (n = 4), uncharacteristic palpable abnormality (2), small size (n = 22), regional microcalcifications (n = 1). Results are verified by surgical excision (n = 10) or follow-up (n = 40). One patient was lost to follow-up. In four of the cases preceding core biopsy was inconclusive. four invasive carcinomas, two ductal carcinoma in situ (DCIS), three papillomas, six fibroadenomas, one adenosis tumor, one hamartoma, 10 complex cysts, 16 benign changes, three fat necroses, two granulomas, three unspecific inflammatory changes are verified.

Surgery confirmed five malignancies, four benign changes, and converted one uncertain diagnosis (architectural distortion) from "inflammatory" to DCIS. Documented removal of all or most of the lesions correctly increased the level of confidence and open surgery could be avoided in 41/51 lesions.

The two systems show different advantages and drawbacks. US-VAB may improve the level of confidence in selected difficult cases. Careful case selection and systematic retrospective correlation of imaging and histology remain crucial

Correlation between Quantified Breast Densities from Digital Mammography and 18F-FDG PET Uptake

Correlation between Quantified Breast Densities from Digital Mammography and 18F-FDG PET Uptake
Paras Lakhani, Andrew D. A. Maidment, Susan P. Weinstein, Justin W. Kung, Abass Alavi
The Breast Journal 15;4:339-347

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To correlate breast density quantified from digital mammograms with mean and maximum standardized uptake values (SUVs) from positron emission tomography (PET). This was a prospective study that included 56 women with a history of suspicion of breast cancer (mean age 49.2 ± 9.3 years), who underwent 18F-fluoro-2-deoxyglucose (FDG)-PET imaging of their breasts as well as digital mammography. A computer thresholding algorithm was applied to the contralateral nonmalignant breasts to quantitatively estimate the breast density on digital mammograms. The breasts were also classified into one of four Breast Imaging Reporting and Data System categories for density.

Comparisons between SUV and breast density were made using linear regression and the Student's t-test. Linear regression of mean SUV versus average breast density showed a positive relationship with a Pearson's correlation coefficient of R2 = 0.83. The quantified breast densities and mean SUVs were significantly greater for mammographically dense than nondense breasts

The average quantified densities and mean SUVs of the breasts were significantly greater for premenopausal than postmenopausal patients

Menopausal status affects the metabolic activity of normal breast tissue, resulting in higher SUVs in pre- versus postmenopausal patients

A Case of Benign Schwannoma of the Breast: Mammographic, Ultrasonographic and Color Doppler Ultrasonographic Findings

A Case of Benign Schwannoma of the Breast: Mammographic, Ultrasonographic and Color Doppler Ultrasonographic Findings
Pinar Balci, Yeliz Takes Pekcevik, Sehnaz Caferova, Tulay Canda, Ali Sevinc, Serdar Saydam
The Breast Journal 15;4:417-418

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Most primary tumors of the breast have an epithelial origin. Nonepithelial tumors arising from indigenous structures in the breast are rare. Schwannoma (neurilemoma) is a benign neoplasm of Schwann cell origin. It can be observed anywhere in the body but the breast is a very unusual site for this tumor.

Schwannoma is a slow growing tumor, usually solitary and it appears as a breast lump having clinical and radiologic characteristics suggestive of benign lesions. Its diagnosis is histologic and its treatment is surgical

Primary Leiomyosarcoma of the Breast

Primary Leiomyosarcoma of the Breast
Bengu Cobanoglu, Muge Sezer, Pervin Karabulut, Sirin Ozer, Ayse Murat
The Breast Journal 15;4:423-425

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Lobulated mass without microcalcification