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: Absorbable retaining thread (ART) needle localization utilizes a guiding needle with a thread; this technique was invented to reduce patient discomfort and wire migration. We investigated the feasibility of ultrasound (US)-guided ART needle localization for nonpalpable breast lesions. METHODS: ART needle localization was performed for 26 nonpalpable breast lesions in 26 patients who were scheduled to undergo surgical excision the day after localization. Seventeen breast lesions were initially diagnosed as invasive ductal carcinoma, six as ductal carcinomas in situ, and one as fibrocystic change. The other two cases without an initial pathologic diagnosis had suspicious US features, and excision was planned concomitantly with contralateral breast cancer surgery. The primary outcome was the technical success rate of ART needle localization confirmed by US immediately after the procedure, and the secondary outcomes were the percentage of clear margins on pathology and the complication rate of ART needle localization. RESULTS: The technical success rate of ART needle localization was 96.2% (25 of 26 patients), and the ART was located 1 cm away from the mass in one patient (3.8%). The lesions were successfully removed with clear margins in all 26 patients. No significant complications related to ART needle localization were observed. CONCLUSION: ART needle localization can be an alternative to wire needle localization for nonpalpable breast lesions.
Breast Neoplasms ; Breast ; Carcinoma, Ductal ; Diagnosis ; Humans ; Needles ; Pathology ; Surgery, Computer-Assisted ; Ultrasonography

OBJECTIVE: We wanted to assess the need for surgical excising papillary lesions of the breast that were diagnosed upon sonographically guided 14-gauge core needle biopsy. MATERIALS AND METHODS: Sixty-nine women (age range: 25-74 years, mean age: 51.7 years) with 69 papillary lesions (4.9%) were diagnosed and followed after performing sonographically guided 14-gauge core needle biopsies. Surgical excision was performed for 44 (64%) of 69 papillary lesions, and 25 lesions were followed with imaging studies (range: 6-46 months, mean: 17.9 months). The histologic findings upon core biopsy were compared with the surgical, imaging and follow-up findings. RESULTS: Core needle biopsies of 69 lesions yielded tissue that was classified as benign for 43 lesions, atypical for 18 lesions and malignant for eight lesions. Of the 43 lesions that yielded benign papilloma upon core needle biopsy, one had intraductal papillary carcinoma found upon surgery. An immediate surgical biopsy was recommended for this lesion because of the imaging-histologic discordance. No additional carcinoma was found during the imaging follow-up. Surgical excision was performed for 17 atypical papillary lesions, and this revealed intraductal (n = 6) or invasive (n = 2) papillary carcinoma in 8 (47%) lesions. Of the seven intraductal papillary carcinomas, surgery revealed invasive papillary carcinoma in one (14%). CONCLUSION: Our results suggest that papillary lesions of the breast that are diagnosed as benign upon sonographically guided 14-gauge core needle biopsy can be followed when the results are concordant with the imaging findings.
Adult ; Aged ; Biopsy, Fine-Needle ; Breast/*pathology/surgery ; Breast Neoplasms/*pathology/surgery ; Carcinoma/pathology/surgery ; Female ; Humans ; Middle Aged ; Papilloma, Intraductal/*pathology/surgery ; Retrospective Studies ; *Ultrasonography, Interventional

Adult ; Breast Neoplasms ; diagnosis ; metabolism ; surgery ; Female ; Humans ; Nipples ; pathology ; surgery ; Ultrasonography ; methods

OBJECTIVE: To compare the efficacy and safety between mammotome minimally invasive operation and conventional open excision for benign breast tumor. METHODS: A computer-based online search of Medline, PubMed, Embase, Ovid, Cochrane Library, VIP, Wanfang, CNKI and Chinese Biological Medicine Database was performed, and conference references were manually searched. With the Cochrane Collaboration Guidelines, all randomized controlled trials comparing mammotome minimally invasive operation and conventional open excision were systematically reviewed. The Cochrane Collaboration's RevMan 5.0 software was used for data analysis. RESULTS: A total of 15 studies involving 5256 patients was included. Meta-analyses showed no significant difference in the size of tumor, postoperative hematomas, ecchymosis, ecchymoma and residual disease between mammotome minimally invasive operation and conventional open excision. Mammotome minimally invasive operation was superior to open excision as to the size of incision, intraoperative blood loss, surgical duration, healing time, size of scar, wound infection and breast deformation. CONCLUSION Mammotome minimally invasive surgery is an ideal method for benign breast tumor.
Adult ; Breast Diseases ; pathology ; surgery ; Breast Neoplasms ; pathology ; surgery ; Female ; Fibrocystic Breast Disease ; pathology ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Randomized Controlled Trials as Topic ; Ultrasonography, Interventional ; Vacuum ; Young Adult

OBJECTIVE: To investigate the value of ultrasound-guided tattooing localization (US-tattoo) using a charcoal suspension for breast lesions. MATERIALS AND METHODS: One hundred sixty-four nonpalpable breast lesions in 134 patients (mean age 47 years; range 30-74 years) were marked with a charcoal suspension under US guidance. The medical records associated with the US-tattoo, the pathology results and the follow-up US results were reviewed. RESULTS: The average size of the localized lesions was 1.0 cm. The procedure time was < 5 minutes (range, 2-10 minutes) per lesion. The US-tattoo was well tolerated in all cases. The only technical difficulty encountered was a needle tip blockage caused by a large charcoal particle (4.9%). The surgeon easily identified the tattoo with the exception one case. In addition, surgery could be safely delayed from one to 57 days after the making US-tattoo. The pathology result was benign in 108 cases, borderline in five, and malignant in 51. The excised specimen was < 4 cm in 76.6% (82/107) of the benign cases (mean; 2.7 cm). The pathologist could identify the mass around the tattoo and was able to make a specific diagnosis in 81.3% (87/107) of benign lesions. The only complication encountered was residual charcoal marking along the incision scar (3.6%). All follow-up US documented the removal of the lesions. CONCLUSION: An US-tattoo for nonpalpable breast lesions is a very simple and accurate method that can help surgeons design and schedule an open biopsy.
Adult ; Aged ; Biopsy, Fine-Needle/methods ; Breast/*pathology/surgery ; Breast Neoplasms/*diagnosis/surgery ; Charcoal/diagnostic use ; Female ; Humans ; Injections, Intralesional ; Middle Aged ; Tattooing/*methods ; *Ultrasonography, Interventional

Breast metastasis from nonmammary malignant neoplasms is uncommon, and it accounts for approximately 2% of all breast tumors. Distant metastasis of thymoma is very rare, and especially to extrathorcic areas. We report a female who had a metastatic thymoma in her breast 20 years after undergoing resection for a non-invasive thymoma. She presented with a palpable mass in her left breast. Mammography and ultrasonogram showed a lobular mass at the anterior glandular portion. Histological examination after surgical excision revealed a metastatic thymoma.
Breast Neoplasms/diagnosis/*secondary/surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Thymoma/diagnosis/*secondary/surgery ; Thymus Neoplasms/diagnosis/*pathology/surgery ; Tomography, X-Ray Computed ; Ultrasonography, Mammary

OBJECTIVE: To evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast. MATERIALS AND METHODS: US-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared. RESULTS: Thirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05). CONCLUSION: US-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography.
Adult ; Aged ; Biopsy, Large-Core Needle/*methods/standards ; Breast/*pathology ; Breast Diseases/pathology/radiography ; Breast Neoplasms/*pathology/surgery/ultrasonography ; Calcinosis/*pathology/ultrasonography ; Carcinoma, Ductal, Breast/*pathology/ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/*pathology/radiography ; Female ; Humans ; Middle Aged ; *Ultrasonography, Interventional/standards ; Young Adult

Image-guided high-intensity focused ultrasound (HIFU) has been used for more than ten years, primarily in the treatment of liver and prostate cancers. HIFU has the advantages of precise cancer ablation and excellent protection of healthy tissue. Breast cancer is a common cancer in women. HIFU therapy, in combination with other therapies, has the potential to improve both oncologic and cosmetic outcomes for breast cancer patients by providing a curative therapy that conserves mammary shape. Currently, HIFU therapy is not commonly used in breast cancer treatment, and efforts to promote the application of HIFU is expected. In this article, we compare different image-guided models for HIFU and reviewed the status, drawbacks, and potential of HIFU therapy for breast cancer.
Breast Neoplasms ; diagnostic imaging ; pathology ; surgery ; Female ; High-Intensity Focused Ultrasound Ablation ; Humans ; Magnetic Resonance Imaging ; methods ; Ultrasonography, Interventional ; methods

OBJECTIVEThe purpose of this study was to describe the X-ray features of the neuroendocrine carcinoma (NEC) of breast to raise the awareness for the disease.

METHODSThe mammography, sonography and clinicopathologic features in a total of 16 cases of pathologically proven breast neuroendocrine carcinoma in Fudan University Cancer Hospital were analyzed retrospectively.

RESULTSAll the 16 patients were women with a mean age of 67.3 years old (ranged from 45 to 75 years old). Twelve patients had palpable masses and the other four patients had outflow from the nipple. Pathological diagnosis included endocrine ductal carcinoma in situ (E-DCIS) in 4 cases, E-DCIS with microinvasion in 5, and invasive solid neuroendocrine carcinoma in 7. On mammography, 9 of 16 cases exhibited round or slightly lobulated masses. Five of the 16 cases exhibited irregular or asymmetric opacities. Two of the 16 cases had negative findings. The borders of the 14 masses detected on mammography were vague in 7, partly unclear in 3 and clear-cut in 4 cases. Malignant microcalcification was not found in all cases. The accuracy rates of preoperative qualitative diagnosis for NEC with mammography and sonography were 68.8% (11/16) and 81.3% (13/16), respectively. Given the application of combined mammography and sonography, the accuracy rates could be improved to 87.5% (14/16).

CONCLUSIONSA round mass and irregular or asymmetric opacities without malignant calcification are the most frequent appearances of mammography in neuroendocrine carcinoma of the breast. Combination of mammography and sonography may be useful to improve the accuracy of diagnosis and early detection of neuroendocrine carcinoma of the breast.

Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; surgery ; Carcinoma, Neuroendocrine ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mammography ; methods ; Middle Aged ; Retrospective Studies ; Ultrasonography, Mammary ; methods