Hydatid Disease of the Breast
Gurkan Ozturk, Mehmet Ozturk, Esref Kabalak
The Breast Journal 2010 16;2:204-5
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Breast involvement can be a part of disseminated hydaditosis or present as primary breast hydatid disease. Isolated breast involvement is reported to be rare, accounting for only 0.27% of the localizations of the cyst and 0.3% of the breast masses. Making a diagnosis of a primary breast hydatid cyst prior to surgery is difficult. There were characteristic ring-shaped structures inside the mass; this was attributed to the difference in the density of the walls and the contents of the daughter cysts inside the fluid-filled hydatid cysts. Such an overpenetrated view might be recommended in endemic areas if fine needle aspiration cytology and/or breast ultrasound results were suggestive of hydatid disease. Complete excision of the cyst is recommended for diagnostic pathological evaluation and treatment.
Monday, 15 March 2010
Imaging Features of Bilateral Lupus Mastitis
Imaging Features of Bilateral Lupus Mastitis
Yen-Chi Wang, Chen-Pin Chou, Robin B. Levenson, Pin-Pen Hsieh, Jer-Shyung Huang, Huay-Ben Pan
The Breast Journal 2010 16;2:203-4
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Lupus mastitis is a rare disease. Only a few cases with imaging findings have been reported. Women are affected by lupus mastitis more commonly than men, usually between the ages of 20 and 50 years. Lupus mastitis is known as chronic inflammation of the subcutaneous fat of the breast. The main mammographic finding is prominent coarse calcifications because of subcutaneous fat necrosis. Breast ultrasound may demonstrate hyperechoic foci representing calcifications, ill-defined echogenic areas, or breast masses.
In young female SLE patients showing mastalgia and coarse calcifications on mammography, lupus mastitis should be an important differential diagnosis consideration, as it can be managed medically.
Yen-Chi Wang, Chen-Pin Chou, Robin B. Levenson, Pin-Pen Hsieh, Jer-Shyung Huang, Huay-Ben Pan
The Breast Journal 2010 16;2:203-4
Link to Journal
Lupus mastitis is a rare disease. Only a few cases with imaging findings have been reported. Women are affected by lupus mastitis more commonly than men, usually between the ages of 20 and 50 years. Lupus mastitis is known as chronic inflammation of the subcutaneous fat of the breast. The main mammographic finding is prominent coarse calcifications because of subcutaneous fat necrosis. Breast ultrasound may demonstrate hyperechoic foci representing calcifications, ill-defined echogenic areas, or breast masses.
In young female SLE patients showing mastalgia and coarse calcifications on mammography, lupus mastitis should be an important differential diagnosis consideration, as it can be managed medically.
An Extensive Breast Hematoma Following Stereotactic 9 Gauge Vacuum Assisted Large-Core Biopsy
An Extensive Breast Hematoma Following Stereotactic 9 Gauge Vacuum Assisted Large-Core Biopsy
Lee Pheng Yap, Hannah Rouse, Jennifer Cawson
The Breast 2010 16;2:199-200
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Vacuum assisted large-core biopsy is a widely used procedure for performing biopsy of suspicious breast lesions. However, it seems intuitive that the larger incised area of tissue with larger gauge biopsy devices increases hematoma risk. Whereas better tissue samples are obtained, the risk of bleeding is likely to be increased. Our patient had been on warfarin, although blood tests were in normal range before and after the procedure, and she was elderly and obese which are risk factors for wound hematomas.
Large core devices are unnecessary when smaller gauge needle core biopsy can achieve the diagnosis, at lower cost and morbidity. This case was amenable to 14G core biopsy, which is highly sensitive in most cases, and complications may have been avoided. The lesion type and patient risk factors should be considered and the biopsy procedure tailored to the individual case.
Lee Pheng Yap, Hannah Rouse, Jennifer Cawson
The Breast 2010 16;2:199-200
Link to Journal
Vacuum assisted large-core biopsy is a widely used procedure for performing biopsy of suspicious breast lesions. However, it seems intuitive that the larger incised area of tissue with larger gauge biopsy devices increases hematoma risk. Whereas better tissue samples are obtained, the risk of bleeding is likely to be increased. Our patient had been on warfarin, although blood tests were in normal range before and after the procedure, and she was elderly and obese which are risk factors for wound hematomas.
Large core devices are unnecessary when smaller gauge needle core biopsy can achieve the diagnosis, at lower cost and morbidity. This case was amenable to 14G core biopsy, which is highly sensitive in most cases, and complications may have been avoided. The lesion type and patient risk factors should be considered and the biopsy procedure tailored to the individual case.
True Recurrences and New Primary Tumors Have Different Clinical Features in Invasive Breast Cancer Patients with Ipsilateral Breast Tumor Relapse Afte
True Recurrences and New Primary Tumors Have Different Clinical Features in Invasive Breast Cancer Patients with Ipsilateral Breast Tumor Relapse After Breast-Conserving Treatment
Takashi Yoshida, Hiroyuki Takei, Masafumi Kurosumi, Jun Ninomiya, Yuko Ishikawa, Yuji Hayashi, Katsunori Tozuka, Hanako Oba, Kaori Kawanowa, Kenichi Inoue, Toshio Tabei
The Breast Journal 2010 16;2:127-133
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Ipsilateral breast tumor relapse (IBTR) after breast-conserving treatment (BCT) may represent two distinct types of lesion, including a true recurrence (TR) or a new primary tumor (NPT). The aim of this study was to ascertain the difference between TRs and NPTs and to show the clinical significance of classifying IBTR into these two types of recurrence.
Patients (n = 2,075) with unilateral invasive breast cancer who underwent BCT between 1987 and 2005 at Saitama Cancer Center were analyzed. IBTR was classified into TR and NPT, which was based on all clinical and pathological features of both a primary tumor and IBTR that can be evaluated. IBTR-free survival and the risk factors were analyzed in order to compare the findings for TR and NPT. In addition, the salvage surgical methods for IBTR and overall survival after IBTR were analyzed. Sixty patients with IBTR were classified into 52 with TR and eight with NPT. IBTR-free survival was significantly shorter in the patients with TR than those with NPT. Young age, tumor size, a positive surgical margin, and omission of radiation therapy (RT) were significant risk factors for TR. Omission of RT was the only significant risk factor for NPT. In 27 patients who underwent a repeat lumpectomy for TR, four had a second IBTR.
The overall survival after IBTR was worse in patients with TR than NPT. TR and NPT show quite different clinical features. Classifying IBTR into TR or NPT can therefore help to select the most appropriate treatment for IBTR
Takashi Yoshida, Hiroyuki Takei, Masafumi Kurosumi, Jun Ninomiya, Yuko Ishikawa, Yuji Hayashi, Katsunori Tozuka, Hanako Oba, Kaori Kawanowa, Kenichi Inoue, Toshio Tabei
The Breast Journal 2010 16;2:127-133
Link to Journal
Ipsilateral breast tumor relapse (IBTR) after breast-conserving treatment (BCT) may represent two distinct types of lesion, including a true recurrence (TR) or a new primary tumor (NPT). The aim of this study was to ascertain the difference between TRs and NPTs and to show the clinical significance of classifying IBTR into these two types of recurrence.
Patients (n = 2,075) with unilateral invasive breast cancer who underwent BCT between 1987 and 2005 at Saitama Cancer Center were analyzed. IBTR was classified into TR and NPT, which was based on all clinical and pathological features of both a primary tumor and IBTR that can be evaluated. IBTR-free survival and the risk factors were analyzed in order to compare the findings for TR and NPT. In addition, the salvage surgical methods for IBTR and overall survival after IBTR were analyzed. Sixty patients with IBTR were classified into 52 with TR and eight with NPT. IBTR-free survival was significantly shorter in the patients with TR than those with NPT. Young age, tumor size, a positive surgical margin, and omission of radiation therapy (RT) were significant risk factors for TR. Omission of RT was the only significant risk factor for NPT. In 27 patients who underwent a repeat lumpectomy for TR, four had a second IBTR.
The overall survival after IBTR was worse in patients with TR than NPT. TR and NPT show quite different clinical features. Classifying IBTR into TR or NPT can therefore help to select the most appropriate treatment for IBTR
In Newly Diagnosed Breast Cancer, Screening MRI of the Contralateral Breast Detects Mammographically Occult Cancer, Even in Elderly Women: The Mayo Cl
In Newly Diagnosed Breast Cancer, Screening MRI of the Contralateral Breast Detects Mammographically Occult Cancer, Even in Elderly Women: The Mayo Clinic in Florida Experience
Johnny Ray Bernard Jr, Laura A. Vallow, Elizabeth R. DePeri, Rebecca B. McNeil, Deborah G. Feigel, Surabhi Amar, Steven J. Buskirk, Edith A. Perez
The Breast Journal 2010 16;2:118-126
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The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution.
MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors.
A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016).
We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis
Johnny Ray Bernard Jr, Laura A. Vallow, Elizabeth R. DePeri, Rebecca B. McNeil, Deborah G. Feigel, Surabhi Amar, Steven J. Buskirk, Edith A. Perez
The Breast Journal 2010 16;2:118-126
Link to Journal
The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution.
MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors.
A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016).
We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis
Routine Breast MRI as a Screening Modality for Occult Contralateral Breast Cancer: Where Do We Draw the Line?
Routine Breast MRI as a Screening Modality for Occult Contralateral Breast Cancer: Where Do We Draw the Line?
Christine Dauphine, Iraj Khalkhali
The Breast Journal 2010 16;2:115-117
Link to Journal
It is clear that there is some benefit to performing MRI in breast cancer patients, looking for contralateral cancers. But at what cost? The results of the analyses by Bernard et al. suggest that selective use is possible. We hope that further studies are undertaken to include minority patients, larger numbers overall, and to continue looking at predictive factors to help determine where MRI would be the most useful
Christine Dauphine, Iraj Khalkhali
The Breast Journal 2010 16;2:115-117
Link to Journal
It is clear that there is some benefit to performing MRI in breast cancer patients, looking for contralateral cancers. But at what cost? The results of the analyses by Bernard et al. suggest that selective use is possible. We hope that further studies are undertaken to include minority patients, larger numbers overall, and to continue looking at predictive factors to help determine where MRI would be the most useful
Interstitial Laser Therapy of Breast Fibroadenomas With 6 and 8 Year Follow-Up
Interstitial Laser Therapy of Breast Fibroadenomas With 6 and 8 Year Follow-Up
K. Dowlatshahi, S. Wadhwani, R. Alvarado, C. Valadez, J. Dieschbourg
The Breast Journal 2010 16;1:73-76
Link to Journal
Fibroadenomas are non-cancerous breast tumors commonly seen in teenagers but also found in women at the time of first mammogram. They have distinct physical findings and imaging features but the definitive diagnosis is made by ultrasound or stereotactic guided needle biopsy.
Treatment options are observation or surgical removal. Recently, removal by ultrasound-guided technique has been reported. Alternatively, the tumor may be ablated within the breast by cold (cryotherapy) or by heat (laser, radiofrequency, focused ultrasound and microwave).
In this paper the laser treatment in two patients, one with bilateral fibroadenomas, with 6 and 8 year follow-up is presented.
The is a minimally invasive image-guided laser treatment of breast fibroadenoma and long term follow-up in two patients; one with single and the other with multiple bilateral tumors. The treatment is an office-based procedure given under local anesthesia with minimal pain and discomfort. It is esthetically superior to lumpectomy
K. Dowlatshahi, S. Wadhwani, R. Alvarado, C. Valadez, J. Dieschbourg
The Breast Journal 2010 16;1:73-76
Link to Journal
Fibroadenomas are non-cancerous breast tumors commonly seen in teenagers but also found in women at the time of first mammogram. They have distinct physical findings and imaging features but the definitive diagnosis is made by ultrasound or stereotactic guided needle biopsy.
Treatment options are observation or surgical removal. Recently, removal by ultrasound-guided technique has been reported. Alternatively, the tumor may be ablated within the breast by cold (cryotherapy) or by heat (laser, radiofrequency, focused ultrasound and microwave).
In this paper the laser treatment in two patients, one with bilateral fibroadenomas, with 6 and 8 year follow-up is presented.
The is a minimally invasive image-guided laser treatment of breast fibroadenoma and long term follow-up in two patients; one with single and the other with multiple bilateral tumors. The treatment is an office-based procedure given under local anesthesia with minimal pain and discomfort. It is esthetically superior to lumpectomy
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