Amyloidosis is a rare disease characterized by the formation of pathological protein deposits in organs or tissues. It is typically a systemic disease which can occur in a localized form. Amyloidosis of the breast is uncommon. Common mammographic findings of breast amyloidosis are multiple nodules with or without calcifications. We report a case of primary localized breast amyloidosis presenting suspicious microcalcifications on mammography without associated masses. Mammography in a 72-year-old woman displayed multiple, linearly distributed, irregular and rod-like calcifications in the subareolar area of the left breast. The patient underwent surgical excision under mammo-guided needle localization and the pathology was confirmed to be breast amyloidosis.
Aged ; Amyloidosis/pathology/*ultrasonography ; Breast/pathology ; Breast Diseases/pathology/*ultrasonography ; Calcinosis/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Ultrasonography, Mammary

PURPOSE: Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare, benign condition that can be mistaken as a fibroadenoma on an ultrasound examination or as a low-grade angiosarcoma on a histological examination. The objective of this study was to evaluate the ultrasound features and to present biopsy methods to correctly identify PASH. PATIENTS AND METHODS: We retrospectively reviewed the data of 55 women who were diagnosed with PASH of the breast. Ultrasound features were evaluated according to the Breast Imaging Reporting and Data System (BI-RADS; American College of Radiology). The diagnostic ability of different biopsy methods such as core needle biopsy, vacuum-assisted biopsy and excisional biopsy were analyzed with the final histopathological results of surgical specimens. RESULTS: PASH presented as a circumscribed solid mass, with hypoechoic texture with or without heterogeneity, and a parallel orientation. The features of small, internal cysts or vascular channels and no calcifications can be used to differentiate the lesions from fibroadenomas. A core needle biopsy misdiagnosed PASH in 13 cases out of 28 cases and vacuum-assisted biopsy correctly identified PASH in all 3 cases. CONCLUSION: Ultrasound features of PASH should be noted when performing a biopsy. For inconclusive cases of PASH, an excisional biopsy followed by an initial core biopsy should be performed.
Biopsy/methods ; Breast/*pathology ; Breast Diseases/*diagnosis/pathology/ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia/diagnosis/ultrasonography ; Retrospective Studies ; Stromal Cells/pathology/ultrasonography ; Ultrasonography, Mammary

In this paper, we evaluate the radiological features of pregnancy-associated breast lesions and discuss the difficulties in diagnosis by imaging. We selected patients who were diagnosed with pregnancy-associated breast lesions during the previous 5 years. All patients complained of palpable lesions in the breast and underwent ultrasonographic (US) examination, the first choice for examination of pregnancy-related breast lesions. Any suspicious lesions found by the US were recommended for a US-guided core biopsy, US-guided fine needle aspiration (FNA), or surgery. Various breast lesions were detected during pregnancy and lactation, including breast cancer, mastitis and abscesses, lactating adenoma, galactoceles, lobular hyperplasia, and fibroadenomas. The imaging features of pregnancy-associated breast lesions did not differ from the features of non-pregnancy-associated breast lesions; however, some pregnancy-associated benign lesions had suspicious sonographic features. A US-guided core biopsy was necessary for differentiating benign from malignant. In patients with breast cancer, the cancer was often advanced at the time of diagnosis. In conclusion, various pregnancy-related breast lesions were detected and the imaging of these lesions had variable findings. Breast ultrasound could be an excellent imaging modality for diagnosis and differentiation between benign and malignant lesions. However, when the imaging results are suspicious, a biopsy should be performed to obtain a pathologic diagnosis.
Ultrasonography, Mammary ; Pregnancy Complications/diagnosis/*radiography/surgery ; Pregnancy ; *Mammography ; Humans ; Female ; Breast Neoplasms/pathology/radiography/ultrasonography ; Breast Diseases/pathology/*radiography/ultrasonography ; Breast/pathology/surgery ; Biopsy ; Adult

PURPOSE: The purpose of this study was to describe the breast ultrasonography (US) features and to investigate whether performing a core biopsy is warranted in young women having palpable solid breast masses. METHODS: A total of 76 solid palpable masses in 68 consecutive women (< or =25 years old) underwent tissue diagnosis by percutaneous core biopsy. Two radiologists, who were blinded to the clinical history and histopathology, independently evaluated the US features according to Breast Imaging-Reporting and Data System (BI-RADS) lexicon. The frequency of benign and malignant descriptor terms that were used to characterize the lesions were compared to the final pathology. RESULTS: All 76 palpable solid masses yielded benign pathology. On the US, the shape of the mass was described by radiologists 1 and 2 as oval or round (63.2% and 71.1%), margin as circumscribed (68.4% and 77.6%) and orientation as parallel (85.5% and 90.8%); the frequency of using all three benign descriptors was 61.8% and 68.5%, respectively. Suspicious descriptors were used less frequently by radiologists 1 and 2 including irregular shape (9.2% and 13.1%), non-circumscribed margin (31.6% and 22.4%) and non-parallel orientation (14.5% and 9.2%); the frequency of using all three suspicious descriptors was 9.2% and 11.8%, respectively. CONCLUSION: Despite the variable US features, breast malignancy seems extremely low in 25 years or younger women for palpable breast lesions. Using the BI-RADS lexicon, US accurately predicted benignity in about two thirds of our patients, supporting US surveillance as a safe alternative to invasive tissue sampling in this setting.
Biopsy ; Breast Diseases ; Breast* ; Diagnosis ; Female ; Humans ; Information Systems ; Pathology ; Subject Headings ; Ultrasonography ; Ultrasonography, Mammary ; Young Adult

Inflammatory pseudotumor, also known as inflammatory myofibroblastic tumor and plasma cell granuloma, is an uncommon low-grade lesion composed of spindle cells admixed with mature plasma cells and other inflammatory cells, such as histiocytes, lymphocytes, and eosinophils. Here, we describe the mammographic and ultrasonographic findings of a case of an inflammatory pseudotumor of the breast in a 60-year-old woman. With the suspicion of malignancy, core needle biopsy and surgical excision confirmed the mass as being an inflammatory pseudotumor of the breast.
Biopsy ; Breast Diseases/pathology/*radiography/*ultrasonography ; Diagnosis, Differential ; Female ; Granuloma, Plasma Cell/pathology/*radiography/*ultrasonography ; Humans ; Mammography ; Middle Aged ; Ultrasonography, Mammary

Cholesterol granuloma of the breast is a rare, benign disease. Here, we present the unique ultrasonographic findings of breast cholesterol granuloma manifesting as an intracystic mass. The findings of this case report may help expand existing knowledge regarding differential diagnosis of intracystic breast masses, which are found on ultrasonographic examination.
Biopsy, Needle ; Breast Diseases/pathology/surgery/*ultrasonography ; *Cholesterol ; Diagnosis, Differential ; Female ; Granuloma, Foreign-Body/pathology/surgery/*ultrasonography ; Humans ; Mammography ; Middle Aged ; *Ultrasonography, Mammary

The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infiltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm.
Adult ; Aged ; Aged, 80 and over ; Breast Diseases/*diagnosis/pathology ; Breast Neoplasms/diagnosis/pathology/secondary ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Tomography, X-Ray Computed ; Ultrasonography, Mammary

OBJECTIVETo investigate the value of ultrasonographic grading with high-frequency probes in differentiating benign and malignant breast tumors.

METHODSSixty-four women (mean age 44.5-/+13.7 years) with 79 breast tumors underwent high-frequency ultrasonography to examine the tumor number, size, aspect ratio, shape, boundaries, encapsulation, pseudopod, internal and rear echoes, calcifications, blood perfusion, abnormality lymph nodes in the axilla. The tumors were graded based on these findings using a 10-point grading system.

RESULTSBetween the 46 women with benign tumors and 18 with malignant tumors, no significant differences were found in the mean tumor number (1.5-/+1.3 vs 1.1-/+0.3, P>0.05) or size (55.0-/+19.2 mm vs 19.8-/+8.3 mm, P>0.05), but the mean age (41.4-/+12.4 years vs 52.4-/+14.1 years) and ultrasonographic grade (2.8-/+2.2 vs 7.3-/+1.7, P<0.05) differed significantly. The ultrasonographic grade of the breast tumors showed an obvious correlation to the nature of the tumors (r=0.695, P<0.001).

CONCLUSIONGrading of breast tumors with high-frequency ultrasonography helps evaluate the nature of the tumors, and a higher score suggests increased probability of malignancy.

Adult ; Aged ; Breast Diseases ; diagnostic imaging ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neoplasm Grading ; Ultrasonography, Mammary ; methods ; Young Adult

OBJECTIVETo evaluate MRI in diagnosing breast lesions which need biopsy.

METHODSOne hundred and eight patients were admitted to hospital for biopsies due to one hundred and sixteen suspicious lesions detected in their breasts. These lesions were detected by physical examination, mammography or ultrasonography. They were also administrated MRI examination before biopsy. The sensitivity and specificity of each diagnostic method were obtained and the radiologic-pathologic correlation was meanwhile calculated.

RESULTSSeventy (60.3%) breast lesions were diagnosed malignancy. The sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of ultrasonography were 83.3%, 62.0%, 74.1%, 74.3% and 73.8%. Such data of mammography were 86.8%, 68.1%, 78.0%, 75.4% and 82.1%. And those of MRI were 97.1%, 73.9%, 87.9%, 85.0% and 94.4%.

CONCLUSIONMRI is superior to ultrasonography and mammography in diagnosing breast lesions, especially for the nonpalpable lesions.

Adult ; Aged ; Breast Diseases ; diagnosis ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography, Mammary

OBJECTIVETo evaluate fine needle localized biopsy under mammography-guiding and skin incision selection by hookwire under ultrasound-guiding for patients with breast microcalcification.

METHODSBreast microcalcification of 178 patients treated from May 2000 to November 2006 were resected after localized with fine needle under X-ray mammography-guiding. Among them, 62 patients received the selection of hookwire under ultrasound-guiding.

RESULTSBreast cancer was detected in 58 patients (32.6%). Among them, 32 (55.1%) cases were carcinoma in situ, 11 (19.0%) intraductal carcinoma with early infiltration, 15 (25.9%) infiltrative ductal carcinoma, and 4 infiltrative ductal carcinoma with lymph node metastasis. The overall 5-year survival rate was 100%. Compared with that in needle guided group, the acceptable rate of cosmetic results was higher in hookwire group (P = 0.022).

CONCLUSIONSFor breast microcalcification, mammography guided needle biopsy with ultrasound selected skin incision is an effective and accurate diagnostic method.

Adult ; Aged ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Diseases ; pathology ; Breast Neoplasms ; pathology ; Calcinosis ; diagnosis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Mammography ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity ; Stereotaxic Techniques ; Ultrasonography, Mammary