We aimed to evaluate the findings and results from breast magnetic resonance imaging (MRI) examinations performed for problem-solving purposes due to inconclusive conventional imaging findings.
...Imaging findings, biopsy and follow-up results were retrospectively evaluated for breast MRI performed for problem-solving purposes at our department between January 2011 and December 2016 for cases whose mammography, tomosynthesis, or ultrasonography findings were inconclusive.
Lesions were identified in 414 of 986 problem-solving MRI examinations, and 13.3% of these lesions were diagnosed as malignant. A total of 124 lesions were additionally found by MRI, and 9.7% of these lesions were diagnosed as malignant. MRI produced false-negative results in four cases. In cases whose conventional imaging methods yielded indefinite results, the sensitivity, specificity, negative and positive predictive values of MRI were found to be 96.3%, 83%, 99.3%, and 46.5%, respectively. For the additional lesions identified, the sensitivity, specificity, negative and positive predictive values of MRI were found to be 91.7%, 69%, 98.7%, and 24%, respectively.
Breast MRI is a reliable problem-solving method for excluding malignancy that cannot be confirmed by conventional imaging. In such cases, additional findings from MRI may help identify new cancers that cannot be detected with conventional methods. However, it has moderately low specificity which may cause unnecessary biopsies, follow-ups, and anxiety to patients.
ObjectiveTherapeutic management of ductal carcinoma in situ (DCIS) is heterogeneous among countries worldwide, and some treatment indications are still controversial. To investigate DCIS management ...in different countries; identify both consensual practices and controversial topics; and survey opinions about the future management of DCIS. Materials and MethodsThe Senologic International Society network members participated to an online survey using a questionnaire, between November 2021 and February 2022. ResultsTwenty-two responses from 20 different countries showed that organized breast cancer screening programs were present for 87% participants, and DCIS cases represented 13.7% of all breast cancers. Most participants used the grade classification (100%), the morphological classification (78%) and performed immunohistochemistry assays (73%). In case of conservative treatment, the mean re-excision rate was 10.3% and clear margins of mean 2.5 mm were considered healthy. Radical mastectomy rate was 35.5% with a breast reconstruction rate of 53%. Tumor bed boost indications were heterogeneous, and 73% of participants indicated hormone therapy for hormone-positive DCIS. Surgery and radiotherapy omission for some low-risk DCIS were considered by 73% of participants. Multigene assays were used by 43% of participants. Concerning future changes in DCIS management, participants mostly answered surgical de-escalation (48%), radiotherapy de-escalation (35) and/or active surveillance for some cases (22%). ConclusionThis survey provided an overview of the current practices of DCIS management worldwide. It showed that some areas are rather consensual: incidence increases over time, treatment in young women, pathological classifications, definition of healthy margins, the skin-sparing mastectomy and immediate breast reconstruction. However, some topics are still debated and result in heterogeneous practices, such as evolution in the age of diagnosis, the benefit of de-escalation in low-risk DCIS among elderly women, indications for hormone therapy, radiotherapy omission, or multigene assays. Further evidence is needed to reach consensus on these points, and innovative approaches are still under evaluation in clinical trials. The International Senologic Society, by its members, encourages precision medicine and personalized treatments for DCIS, to avoid overtreatment and overdiagnosis, and provide better healthcare to women with DCIS.
In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer ...were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences.
SIS network members participated in an online survey using a questionnaire (Microsoft
Forms) from June 15
to July 31
, 2020.
Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued.
The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.
Primary hyperparathyroidism (pHPT) caused by a single benign parathyroid adenoma is a common endocrine disorder that is affected by regional differences. Living in different geographical regions ...reveals differences in the laboratory results and pathological findings, but studies on this subject are not sufficient. The article focuses on biochemical and pathological effects of geographical differences in parathyroid adenoma. In addition, the present study seeks to elaborate on treatment methods and effectiveness of screening in geographical area of Bulgaria and Turkey.
In this prospective study, 159 patients were included from 16 centres. Demographic characteristics, symptoms, biochemical markers and pathologic characteristics were analysed and compared between 8 different regions.
Patients from Turkish Black Sea had the highest median serum calcium (Ca) level, whereas patients from Eastern Turkey had the lowest median serum phosphorus (P) level. On the other hand, there was no significant difference between Ca, parathormone (PTH) and P levels according to regions. Patients from Eastern Turkey had the highest adenoma weight, while patients from Bulgaria had the lowest adenoma weight. The weight of adenoma showed statistically significant differences between regions (p < 0.001). There was a correlation between adenoma weight and serum PTH level (p = 0.05) and Ca level (p = 0.035).
This study has provided a deeper insight into the effect of the regional differences upon clinicopathological changing and biochemical values of pHTP patients with adenoma. Awareness of regional differences will assist in biochemical screening and treatment of this patient group.
To examine the mammography and ultrasonography findings of patients who have a final histopathological diagnosis of sclerosing adenosis after breast biopsy, and to evaluate the follow-up results of ...patients who underwent core needle biopsies.
Seventy-six of the 723 patients who underwent breast biopsy in our institution were diagnosed with sclerosing adenosis on histopathological examination. Mammography and ultrasonography findings from these 76 lesions were analyzed retrospectively. Thirty-seven of these lesions were sampled by image-guided core needle biopsy; the remaining lesions were excised surgically. Mammograms and ultrasound images of the lesions were re-evaluated, and the post-biopsy medical records of these patients were evaluated.
Sclerosing adenosis was the main diagnosis in 41 patients and the complementary diagnosis in 35 patients. Among the first 41 lesions in which sclerosing adenosis was the main diagnosis, there were 18 (44%) mass lesions, 16 (39%) microcalcification clusters, two (5%) lesions with asymmetrical opacity, three (7%) lesions with architectural distortion, and two (5%) lesions with focal acoustical shadowing that was only detected by ultrasonography. No alterations suggesting malignancy were noted during the follow-up examinations of 35 patients who underwent core needle biopsy.
Sclerosing adenosis is a benign proliferative disease of the breast that can be confused with malignancy on clinical, radiological, and even histopathological examination. There is no typical radiological criterion for diagnosis. Core needle biopsy or excisional biopsy can be used, depending on the lesion's characteristics. Core needle biopsy can be the first step in the diagnosis of sclerosing adenosis.
Thyroid hemiagenesis is a rare congenital pathology and it is secondary to a defect which occurs during embryonic development of the thyroid tissue. Usually, diagnosis is incidentally made by imaging ...study of the neck or during diagnosis of a related thyroid gland disease. Absence of the left lobe is observed in near all cases, but involvement of the right lobe has also been reported in the literature, albeit very rare. Although true prevalence is not known, the reported prevalence ranges from 1/1900 to 1/2675. Presence of thyroid nodules, subacute thyroiditis, Hashimoto's thyroiditis and Grave's disease in thyroid hemiagenesis has previously been reported in the literature. Combination of thyroid papillary cancer and thyroid hemiagenesis is rarely reported. In this report, we present the case of papillary cancer in a solitary nodule in a hemiagenetic thyroid gland in a patient with Hashimoto's thyroiditis and treatment modalities thereof.
Predictability of pre-op prognosis on patient with a diagnosis of breast cancer is quite valuable for the choice of both surgical technique and adjuvant therapy. With the aim of evaluation of ...sonoelastography score utility in this respect, correlation of tumoral prognostic factors by sonoelastography score in patients be operated due to breast cancer was analyzed on our study. Pre-op sonoelastography results and tumoral hystopathological properties of 60 patients operated with a diagnosis of breast cancer in 2011 at Adnan Menderes University Faculty of Medicine General Surgery Department were analyzed retrospectively. As an elastography scoring method, “Tsukuba scoring system” was used. Statistically significant differences(
p
< 0,05) were determined between tumor grade and Ki-67 analyzed as prognostic factor with tumors reported as sonoelastography score 4 and score 5, on the other hand there were no statistically significant differences between tumor size, positivity of axillary lymph nodes, significance of lymphovascular invasion, p-53 positivity, CerbB-2 positivity, hormone receptor positivity, tumor hysthologic type and applied surgical technique between tumors reported as elastography score 4 and score 5. (
p
> 0.005). Foresee ability of prognostic factors correlation by sonoelastography score will be guide way for the choice of surgery technique, determination of adjuvant therapy and patient follow-up.
Minimally-invasive parathyroidectomy (MIP) is a surgical procedure that reduces the duration of operation, hospital costs, and hypocalcemia, and shortens the length of hospital stay. This study ...addressed the important procedural details of the radioguided occult lesion localization (ROLL)-MIP technique and evaluated the consequences of the learning curve from a series of patients.
A total of 80 patients who underwent ROLL-MIP for a single parathyroid adenoma were included into this retrospective study. In order to analyze the effect of the learning curve, these subjects were then divided into 2 groups per time period and the operative times were compared. Group A consisted of 22 previously reported patients who served as the control group. Group B consisted of 58 consecutive patients.
Serum calcium and parathyroid hormone (PTH) levels were normalized in all of the patients within 2 days and remained normal during the follow-up period (31 ± 18.5 months). None of the patients who underwent ROLL-guided parathyroidectomy suffered temporary or permanent recurrent laryngeal nerve injuries. Mean operation time (time from incision to excision of the adenoma) was 23 ± 6 min in Group A and 18 ± 7 min in Group B. Mean operative times were significantly shorter in group B.
The success of MIP administered with the ROLL technique in a single adenomatous patient was quite high. This method seems especially valuable in patients with atypically located or small adenomas.
Cavernous Hemangioma in the Breast Aydın, Oğuz Uğur; Soylu, Lütfi; Ercan, Aydan İlkme ...
European journal of breast health,
10/2015, Letnik:
11, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Although the observation of breast vascular tumors is rare, the most common tumor is hemangıoma in the benign group, and these tumors are observed incidentally in lumpectomy or mastectomy specimens ...during histological examinations. They are classified into capillary, cavernous, and venous hemangıomas. Cavernous hemangıoma is the most common subtype. Cavernous hemangıomas are benign vascular tumors, which malformatıon from mature blood vessels. Hemangıomas ın the benıgn group may show a suspicion of ductal carcinoma in situ (DCIS) in mammographic analysis. Ultrasonography (US) and magnetic resonance ımagıng (MRI) are the most useful imaging methods for analyzing the structure of breast vessels. In this case, a 54-year-old female who have any complaint. Scanning mammography (MG) detected the tumor, but physıcal examınatıon and US could not identify the mass. According to the MG analysis, the lesion was evaluated as BIRADS 4b, and the patient underwent excisional biopsy after wire localization. Pathological analysis revealed cavernous hemangıoma.
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