Irregular hypoechoic masses in the breast do not always indicate malignancies. Many benign breast diseases present with irregular hypoechoic masses that can mimic carcinoma on ultrasonography. Some of these diseases such as inflammation and trauma-related breast lesions could be suspected from a patient's symptoms and personal history. Careful ultrasonographic examination and biopsy could help to differentiate these from malignancies.
Abscess/ultrasonography ; Breast Diseases/pathology ; Breast Neoplasms/pathology/*ultrasonography ; Carcinoma/pathology/ultrasonography ; Female ; Fibroadenoma/pathology/ultrasonography ; Fibrocystic Breast Disease/pathology/ultrasonography ; Granulomatous Mastitis/pathology/ultrasonography ; Humans ; Ultrasonography, Mammary

Breast ultrasound and mammography are established procedures for the diagnosis of breast masses while new technology is opening the door for early cancer diagnosis. The limitation of ultrasound and mammography is that they are only based on physical properties. Recently, using a color doppler system, detection of color flow signal and a resistance index that depend on the blood flow and the blood velocity was applied for diagnosis of breast malignancy. Sixty-five patients admitted for breast surgery were studied. The final diagnosis was made by pathology for thirty malignancies and thirty-five benign lesions. The color doppler measurements on the breast lesions were made preoperatively. The following parameter were assessed :flow velocity, color signal grade and resistance index. The results are as follows: 1) Color signals were detected in twenty-four of the thirty malignancies and in seven of thirty-five benign lesions. 2) Malignant lesions showed a significantly higher maximum velocity (mean=12.52 cm/sec vs 6.34 cm/sec). 3) The resistance index values in the malignancies was higher compared to that in the benign lesions (P < 0.01), a cutoff point 0.6 was used. 4) The color signal grade was grade 0 and I in thirty-four cases of the benign breast lesions (97%) and grade II and III in fifteen of the malignant breast lesions (50%). 5) In breast cancer, the color signal was detected more often in large masses above 2 cm is size,but the result was not statistically significant (P > 0.05). Color doppler flow examination is a useful method for evaluation of benign and malignant breast lesions.
Breast Neoplasms* ; Breast* ; Diagnosis* ; Humans ; Mammography ; Pathology ; Ultrasonography

PURPOSE: The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer. METHODS: Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed. RESULTS: Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology. CONCLUSION: We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions.
Breast Neoplasms* ; Breast* ; Humans ; Magnetic Resonance Imaging ; Pathology ; Ultrasonography*

An imaging-guided core needle biopsy has been proven to be reliable and accurate for the diagnosis of both benign and malignant diseases of the breast, and has replaced surgical biopsy. However, the possibility of a false-negative biopsy still remains. Imaging-pathology correlation is of critical importance in imaging-guided breast biopsies to detect such a possible sampling error and avoid a delay in diagnosis. We will review five possible categories and corresponding management after performing an imaging-pathology correlation in a sonography-guided core needle biopsy of a breast lesion, as well as illustrate the selected images for each category in conjunction with the pathologic finding. Radiologists should be familiar with the imaging features of various breast pathologies and be able to appropriately correlate imaging findings with pathologic results after a core needle biopsy.
*Biopsy, Needle ; Breast Neoplasms/*pathology/ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Risk Assessment ; *Ultrasonography, Interventional ; *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

OBJECTIVETo evaluate the impact of lesion size on the detection rate of non-palpable breast malignant lesions and determine whether lesion size should prompt biopsy of non-palpable breast lesions.

METHODSThe study included 816 ultrasonographically detected non-palpable breast lesions. We divided the lesions into five groups based on their largest diameters: ≤0.5cm, 0.6-1.0cm, 1.1-1.5cm, 1.6-2.0 cm, and >2.0 cm. The detection rate of malignancies of different sizes were compared among these lesions, Breast Imaging Reporting and Data System (BI-RADS) category 2-3 lesions, and BI-RADS grades 4-5 lesions. The feasibility of using lesion size as biopsy indicator for BI-RADS category 2-3 non-palpable breast lesion was analyzed using ROC curve.

RESULTSOf these 816 lesions, 100 (12.3%) were found to be malignant lesions. The detection rate of malignancy significantly increased along with the increase of lesion size (P<0.05). When the BI-RADS category was not considered, the frequency of malignancy in the >2.0 cm group was significantly higher than in other groups (P<0.05) The frequencies of malignancy in the 0.6-1.0 cm group, 1.1-1.5 cm group, and 1.6-2.0 cm group were higher than that in ≤0.5 cm group, but the difference was not significant (P>0.05) For BI RADS category 4 and 5 lesions, the frequency of malignancy in >2.0 cm group was higher than in other groups, but significant difference was only seen between >2.0 cm group and ≤0.5 cm group (P<0.05).

CONCLUSIONSLesion size may influence the detection rate of malignancy of non palpable breast lesions, and can be used as biopsy indicator of non palpable breast lesions in BI-RADS 2,3 category When we use 1.25cm as threshold,the sensitivity and specificity may be satisfying.

OBJECTIVE: The aim of this study is to investigate the effect of tamoxifen on endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer after chemotherapy. METHODS: Fifty-eight tamoxifen-treated postmenopausal breast cancer patients underwent periodically transvaginal ultrasonography twice a year for 2 years and then once a year. We analyzed the correlation between the sonographic endometrial thickness and the duration of tamoxifen therapy. RESULTS: The mean endometrial thickness of breast cancer patients before tamoxifen therapy was 4.68 mm. But the mean endometrial thickness increased to 5.03 mm at 6 months, 5.21 mm at 12 months, after which it slightly declined to 5.13 mm at 18 months. And then it increased to 5.15 mm at 24 months, and 5.24 mm at 36 months. There was a significant increase in endometrial thickness after tamoxifen therapy compared with before tamoxifen therapy (p<0.05). Overall, proliferative endometrium was the most common histopathologic finding (5/14) in tamoxifen-treated postmenopausal women who had endometrial thickness >or=5 mm. No cases of endometrial cancer were detected. CONCLUSION: Significant increase in endometrial thickness with the duration of tamoxifen therapy in postmenopausal tamoxifen-treated patients may be associated with a high risk of endometrial pathologies in these patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Pathology ; Tamoxifen ; Ultrasonography

Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.
Breast/pathology* ; Breast Neoplasms/pathology* ; Diagnosis, Computer-Assisted ; Early Detection of Cancer ; Female ; Humans ; Ultrasonography ; Ultrasonography, Mammary/methods*

OBJECTIVE: We wanted to evaluate the mammographic and sonographic differential features between pure (PT) and mixed tubular carcinoma (MT) of the breast. MATERIALS AND METHODS: Between January 1998 and May 2004, 17 PTs and 14 MTs were pathologically confirmed at our institution. The preoperative mammography (n = 26) and sonography (n = 28) were analyzed by three radiologists according to BI-RADS. RESULTS: On mammography, a mass was not detected in eight patients with PT and in one patient with MT (57% vs. 8%, respectively, p = 0.021), which was statistically different. The other findings on mammography and sonography showed no statistical differences between the PT and MT, although the numerical values were different. When the lesions were detected mammographically, an irregularly shaped mass with a spiculated margin was more frequently found in the MT than in the PT (100% vs. 83%, respectively, p = 0.353). On sonography, all 28 patients presented with a mass and most lesions showed as not being circumscribed, hypoechoic masses with an echogenic halo. Surrounding tissue changes and posterior shadowing were more frequently found in the MT than in the PT (75% vs. 50%, respectively, p = 0.253, 58% vs. 19%, respectively, p = 1.000). An oval shaped mass was more frequently found in the PT than in the MT (44% vs. 25%, respectively; p = 0.434). CONCLUSION: PT and MT cannot be precisely differentiated on mammography and sonography. However, the absence of a mass on mammography or the presence of an oval shaped mass would favor the diagnosis of PT. An irregularly shaped mass with surrounding tissue change and posterior shadowing on sonography would favor the diagnosis of MT and also a less favorable prognosis.
Adenocarcinoma/pathology/*radiography/*ultrasonography ; Adult ; Aged ; Breast Neoplasms/pathology/*radiography/*ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Ultrasonography, Mammary

OBJECTIVE: To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. MATERIALS AND METHODS: Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographicallyguided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. RESULTS: Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. CONCLUSION: In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.
Adenocarcinoma/radiography/secondary/*ultrasonography ; Adult ; Axilla/*pathology ; Biopsy, Needle ; Breast/*pathology ; Breast Neoplasms/pathology/radiography/*ultrasonography ; Carcinoma, Infiltrating Duct/pathology/radiography/*ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/pathology/radiography/*ultrasonography ; Female ; Human ; Lymph Nodes/radiography/*ultrasonography ; Mammography ; Middle Age ; Ultrasonography, Mammary