OBJECTIVE: To improve the performance quality of mammography X-ray system, and to decrease misdiagnoses. METHODS: Quality assurance was tested and controlled from such aspect as measurement of half value layer, beam quality assessment, breast entrance exposure average glandular dose, tube tunsion accuracy and reproducibility, and radiation output. RESULTS: The image contrast, mistiness and noise were optimized. CONCLUSION With the quality assurance of the digital mammography X-ray system, the variations of the performance parameters remain in the range of permission, thus improving the quality of mammography.
Humans ; Image Enhancement ; instrumentation ; Mammography ; instrumentation ; methods ; Quality Control ; Radiographic Image Enhancement ; instrumentation

This article introduces a new testing method for mammographic x-ray equipments. The films placed around the x-ray tube assembly are exposured to find the location of leakage radiation and then the accurate testing for the leakage radiation of the mammographic x-ray equipment is carried out with a radiation dosimeter.
Equipment Design ; Equipment Failure Analysis ; Female ; Humans ; Mammography ; instrumentation ; methods ; Quality Control ; Radiation Dosage ; Radiation Protection ; instrumentation ; methods ; Radiometry ; instrumentation ; methods

Adult ; Biopsy, Needle ; instrumentation ; methods ; Breast Neoplasms ; surgery ; Female ; Humans ; Male ; Mammography ; Mastectomy, Segmental ; methods ; Middle Aged ; Vacuum

OBJECTIVETo evaluate three biopsy methods which are currently used in stereotactic breast biopsy.

METHODSA total of 361 cases of stereotactic breast biopsies were carried out since 2000, including 73 cases of true cut core needle biopsies (ST-CNB), 74 cases of vacuum assisted biopsies (ST-VAB) and 214 cases of excisional biopsies. After medium follow-up time of 18 months (6 to 66 months), the accuracy as well as the clinical benefits of the three stereotactic biopsy procedures were analyzed retrospectively.

RESULTSThe cancer miss rate of stereotactic wire localized excisional biopsy, ST-CNB and ST-VAB is 0, 2.7% and 0 respectively. Under-estimate rate of minimal invasive biopsy was 33% in atypical ductal hyperplasia (ADH) and 53% in ductal carcinoma in situ (DCIS). The minimal invasive procedure is superior to surgical procedure in terms of operation time, breast cosmetic outcome and complications, etc. Furthermore, 69% of the surgeries for suspicious lesion were waived.

CONCLUSIONSStereotactic minimal invasive breast biopsy, especially ST-VAB, is an accurate, safty and convenient diagnosis technique and could be considered as the first line choice for mammographic moderate suspicious breast lesions (BIRADS-4). However, further excisional biopsy is recommended for atypical hyperplasia. Stereotactic excisional biopsy could be directly used for diagnosis of mammographic highly suspicious breast lesions (BIRADS-5).

Biopsy ; methods ; Biopsy, Needle ; instrumentation ; Breast ; pathology ; Breast Diseases ; diagnostic imaging ; pathology ; Female ; Follow-Up Studies ; Humans ; Mammography ; Sensitivity and Specificity

OBJECTIVETo evaluate the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm.

METHODSThe PubMed, the Cochrane Library, CNKI, CBM and Wanfang databases (2003/01/01-2013/04/30) were searched for studies of the diagnostic value of ultrasonography in combination with mammography for breast cancer within 2 cm. The quality of the included studies was evaluated according to QUADAS items. The pooled sensitivity (SEN), pooled specificity (SPE), pooled diagnostic odds ratio (DOR), and area under summary receiver operating characteristic curve (AUC) were calculated using Review Manager 5.2 and Meta-DiSc 1.4 software.

RESULTSNine articles were included in the final analysis. The pooled SEN of ultrasonography, mammography and their combination were 0.75, 0.66, and 0.92, the pooled SPE 0.75, 0.83, and 0.82, the pooled DOR 7.11, 8.67, and 60.82, and the AUC 0.7902, 0.8120, and 0.9469, respectively.

CONCLUSIONThe combination of ultrasonography and mammography can increase the diagnostic accuracy for breast cancer within 2 cm.

Breast Neoplasms ; diagnostic imaging ; pathology ; Early Detection of Cancer ; Female ; Humans ; Mammography ; instrumentation ; methods ; Molybdenum ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Pulsed ; Ultrasonography, Mammary ; methods

A simple imaging setup based on the principle of coherence-based contrast X-ray imaging with unmonochromatized synchrotron radiation was used for studying mammographic phantom and human breast specimens. The use of unmonochromatized synchrotron radiation simplifies the instrumentation, decreases the cost and makes the procedure simpler and potentially more suitable for clinical applications. The imaging systems consisted of changeable silicon wafer attenuators, a tungsten slit system, a CdWO4 scintillator screen, a CCD (Charge Coupled Device) camera coupled to optical magnification lenses, and a personal computer. In preliminary studies, a spatial resolution test pattern and glass capillary filled with air bubbles were imaged to evaluate the resOolution characteristics and coherence-based contrast enhancement. Both the spatial resolution and image quality of the proposed system were compared with those of a conventional mammography system in order to establish the characteristic advantages of this approach. The images obtained with the proposed system showed a resolution of at least 25micrometer on the test pattern with much better contrast, while the images of the capillary filled with air bubbles revealed coherence-based edge enhancement. This result shows that the coherence-based contrast imaging system, which emphasizes the refraction effect from the edge of materials of different refractive indexes, is applicable to imaging studies in fundamental medicine and biology, although further research works will be required before it can be used for clinical applications.
Breast Diseases/*radiography ; Comparative Study ; Female ; Humans ; Mammography/*instrumentation/*methods ; *Phantoms, Imaging ; Pilot Projects ; Research Support, Non-U.S. Gov't ; *Synchrotrons ; X-Rays

OBJECTIVETo compare the effectiveness of full-field digital mammography (FFDM) and magnetic resonance imaging (MRI) in the detection and diagnosis of breast diseases.

METHODSForty-one patients with 47 breast lesions (20 malignant and 27 benign lesions) underwent preoperative FFDM and MRI, using the pulse sequences including T1WI, T2WI, T2WI/SPIR diffusion-weighted imaging (DWl), and 3D dynamic contrast-enhanced MRI.

RESULTSThe imaging and pathological findings were compared, and the detection rates of the lesions by FFDM and MRI were 97.87% (46/47) and 74.46% (35/47), respectively (P<0.01). The sensitivity of FFDM and MRI was 70.00% (14/20) and 80.00% (16/20) (P>0.05), with specificity of 62.96%(17/27) and 88.89%(24/27) (P<0.05), respectively.

CONCLUSIONMRI is superior to FFDM in the detection and diagnosis of breast diseases.

Adenoma ; diagnosis ; Adult ; Breast Neoplasms ; diagnosis ; Carcinoma, Ductal, Breast ; diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; instrumentation ; methods ; Middle Aged ; Radiographic Image Enhancement ; Sensitivity and Specificity ; Young Adult

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

OBJECTIVETo summarize the morphological features of basal-like subtype of invasive breast carcinoma (BLSIBC), and to look for diagnostic clues for its recognition.

METHODSImmunohistochemistry was performed in 109 cases of invasive ductal carcinoma, with CK5/6, CK14, CK8/ 18, 34betaE12, calponin, p63, CD10, ER, PR and c-erbB-2 monoclonal antibodies. Five subtypes were classified according to immunophenotypes: luminal A subtype (ER+/HER2-), luminal B subtype (ER+/ HER2+), normal breast-like subtype (ER/HER2-), HER2-overexpressing subtype and BLSIBC which was identified with at least one kind of basal-like cytokeratins or markers of myoepithelium and ER/HER2. The microscopic features of basal-like subtype were also analyzed.

RESULTSThe number of luminal A case was 48 (44.0%), luminal B 15 (13.8%), HER2 over-expressing 15 (13.6%), normal breast-like 10 (9.1%), basal-like subtype 19 (17.4%). Besides, the other two cases expressed c-erbB-2 or/and ER plus markers for myoepithelium, thus were excluded from all the five mentioned subtypes. Of the 19 basal-like subtype, CK5/6 was expressed in 16 cases, CK8/18 in 17 cases, CK14 in 11 cases, 34betaE12 in 18 cases, p63 in 5 cases, CD10 in 6 cases, and calponin in 1 case. The diameter of the BLSIBC cases was 1.2-7 cm (averagely 3.9 cm) , and in 6 cases, the tumor diameter was >5 cm. Only one case displayed extensive in situ component, 9 cases were grade 2, and 9 cases were grade 3. Compared to non basal subtype, there were significantly more high grade cases (P <0.01). The morphological features of basal-like subtype were summarized as the followings: pushing margin (13 cases), lymphocytic tissue hyperplasia (18 cases), nest or sheet arrangement (18 cases), nucleus grade 3 and scattered giant or bizarre nuclei (17 cases), syncytial growth (7 cases), and comedo-like necrosis (17 cases). The frequency of these features were significantly more common than non basal subtype (P <0.01).

CONCLUSIONThe morphologic diagnostic features of BLSIBC are pushing margins, lymphocyte infiltration, comedo-like necrosis, gigantic cell and syncytial growth.

Biomarkers, Tumor ; analysis ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma, Basal Cell ; pathology ; Female ; Genes, erbB-2 ; physiology ; Humans ; Immunohistochemistry ; Keratin-5 ; analysis ; Magnetic Resonance Imaging ; Male ; Mammography ; instrumentation ; methods ; Neoplasm Invasiveness ; physiopathology ; Prognosis ; Receptor, Epidermal Growth Factor ; genetics ; Receptor, ErbB-2 ; analysis ; genetics ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis ; Ultrasonography ; methods