PURPOSE: To show the results of an audit of screening breast ultrasound (US) in women with negative mammography in a single institution and to analyze US-detected cancers within a year and interval cancers. MATERIALS AND METHODS: During the year of 2006, 1974 women with negative mammography were screened with US in our screening center, and 1727 among them had pathologic results or any follow up breast examinations more than a year. We analyzed the distribution of Breast Imaging Reporting and Data System (BI-RADS) category and the performance outcome through follow up. RESULTS: Among 1727 women (age, 30-76 years, median 49.5 years), 1349 women (78.1%) showed dense breasts on mammography, 762 (44.1%) had previous breast US, and 25 women (1.4%) had a personal history of breast cancers. Test negatives were 94.2% (1.627/1727) [BI-RADS category 1 in 885 (51.2%), 2 in 742 (43.0%)]. The recall rate (=BI-RADS category 3, 4, 5) was 5.8%. Eight cancers were additionally detected with US (yield, 4.6 per 1000). The sensitivity, specificity, and positive predictive value (PPV1, PPV2) were 88.9%, 94.6%, 8.0%, and 28.0%, respectively. Eight of nine true positive cancers were stage I or in-situ cancers. One interval cancer was stage I cancer from BI-RADS category 2. CONCLUSION: Screening US detected 4.6 additional cancers among 1000. The recall rate was 5.8%, which is in lower bound of acceptable range of mammography (5-12%), according to American College of Radiology standard.
Adult ; Aged ; Breast/pathology ; Breast Neoplasms/*diagnosis/*radiography/*ultrasonography ; Female ; Humans ; Mammography/*methods ; Mass Screening/*methods ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography/methods ; *Ultrasonography, Mammary

OBJECTIVE: To compare the diagnostic performance of digital breast tomosynthesis (DBT) and conventional breast ultrasound (US) to characterize breast lesions as benign or malignant. MATERIALS AND METHODS: A total of 332 women, presenting for screening examinations or for breast biopsy between March and June 2012 were recruited to undergo digital mammography (DM), DBT, and breast US examination. Among them, 113 patients with 119 breast lesions depicted on DM were finally included. Three blinded radiologists performed an enriched reader study and reviewed the DBT and US images. Each reader analyzed the lesions in random order, assigned Breast Imaging Reporting and Data System (BI-RADS) descriptors, rated the images for the likelihood of malignancy (%) and made a BI-RADS final assessment. Diagnostic accuracy, as assessed by the area under the receiver operating characteristic curve, sensitivity, and specificity of DBT and US were compared. RESULTS: Among the 119 breast lesions depicted on DM, 75 were malignant and the remaining 44 were benign. The average diagnostic performance for characterizing breast lesions as benign or malignant in terms of area under the curve was 0.899 for DBT and 0.914 for US (p = 0.394). Mean sensitivity (97.3% vs. 98.7%, p = 0.508) and specificity (44.7% vs. 39.4%, p = 0.360) were also not significantly different. CONCLUSION: Digital breast tomosynthesis may provide similar reader lesion characterization performance to that of US for breast lesions depicted on DM.
Adult ; Aged ; Biopsy ; Breast/*pathology ; Breast Neoplasms/*diagnosis/radiography/ultrasonography ; Female ; Humans ; Mammography/*methods ; Middle Aged ; ROC Curve ; Radiographic Image Enhancement/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Mammary/*methods

Women who have been treated for breast cancer are at risk for second breast cancers, such as ipsilateral recurrence or contralateral metachronous breast cancer. As the number of breast cancer survivors increases, interest in patient management and surveillance after treatment has also increased. However, post-treatment surveillance programs for patients with breast cancer have not been firmly established. In this review, we focus on the imaging modalities that have been used in post-treatment surveillance for patients with breast cancer, such as mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography, the effectiveness of each modality for detecting recurrence, and how they can be applied to manage patients.
Breast Neoplasms/*radiography/therapy/*ultrasonography ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Magnetic Resonance Imaging/methods ; Mammography/*methods ; Neoplasm Metastasis/*diagnosis ; Neoplasm Recurrence, Local/*diagnosis ; Positron-Emission Tomography/methods ; Sensitivity and Specificity ; Ultrasonography, Mammary

Cowden syndrome is an uncommon, autosomal dominant disease which is characterized by multiple hamartomas of the skin, mucous membrane, brain, breast, thyroid, and gastrointestinal tract. The diagnosis of Cowden syndrome implicates an increased risk of developing breast cancer. We report a case of a 22-year-old woman with Cowden syndrome that presented as breast cancer with concomitant bilateral exuberant benign masses in both breasts.
Arteriovenous Malformations/radiography ; Breast Neoplasms/*complications/*diagnosis/ultrasonography ; DNA/analysis ; DNA Mutational Analysis ; Diagnosis, Differential ; Female ; Hamartoma Syndrome, Multiple/*complications/*diagnosis/genetics/ultrasonography ; Humans ; PTEN Phosphohydrolase/genetics ; Thyroid Neoplasms/radiography ; Tomography, X-Ray Computed ; Young Adult

No abstract available.
Adult ; Breast Neoplasms/diagnosis ; Carcinoma, Hepatocellular/diagnosis ; Eosinophilia/*diagnosis/radiography ; Eosinophils/immunology/metabolism ; Female ; Humans ; Liver Abscess/*radiography/ultrasonography ; Liver Neoplasms/diagnosis ; Male ; Middle Aged

Sonography is an attractive supplement to mammography in breast cancer screening because it is relatively inexpensive, requires no contrast-medium injection, is well tolerated by patients, and is widely available for equipment as compared with MRI. Sonography has been especially valuable for women with mammographically dense breast because it has consistently been able to detect a substantial number of cancers at an early stage. Despite these findings, breast sonography has known limitations as a screening tool; operator-dependence, the shortage of skilled operators, the inability to detect microcalcifications, and substantially higher false-positive rates than mammography. Further study of screening sonography is still ongoing and is expected to help establish the role of screening sonography.
Biopsy ; Breast Neoplasms/pathology/radiography/*ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Mass Screening ; Observer Variation ; Predictive Value of Tests ; *Ultrasonography, Mammary

Antigens, CD20 ; metabolism ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lymphoma ; diagnosis ; diagnostic imaging ; metabolism ; Middle Aged ; Positron-Emission Tomography ; Radiography ; Ultrasonography

Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient's mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.
Adult ; Breast Neoplasms/drug therapy/radiography/*secondary/ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*pathology ; Ultrasonography, Mammary

OBJECTIVE: To compare the accuracy of ultrasonic elastography(UE) with molybdenum X-ray photography(MX-rP) in their ability to differentiate benign and malignant breast lesions. METHODS: Eighty-three females with 101 lesions in the breast were prospectively studied. Pathologic outcome was used as the golden diagnosis criterion. The sensitivity, specificity, accuracy, Youden index, positive and negative predictive values of UE for diagnosing breast diseases were compared. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of UE. RESULTS: Sensitivity of UE was 87.06%, specificities, accuracy, and Youden index were 93.05%, 91.08%, and 83.30%, respectively. The positive and negative predictive values were 94.36% and 80.10%. Those of MX-rP were 72.40%, 83.33%, 80.19%, 87.74%, 89.55%, and 63.52%, respectively. The positive and negative-likelihood ratio for UE was 12.41(95%CI, 5.90 to 26.88) and 0.14(95%CI, 0.06 to 0.30); and those for MX-rP, the values were 4.34(95%CI, 1.63 to 11.42) and 0.33(95%CI, 0.19 to 0.63), respectively. Area under ROC in ultrasonic elastography was 0.954(95%CI, 0.912 to 0.996). CONCLUSION UE has better diagnostic value than MX-rP in breast masses.
Adolescent ; Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; Diagnosis, Differential ; Elasticity Imaging Techniques ; Female ; Humans ; Middle Aged ; Molybdenum ; Radiography ; methods ; Ultrasonography, Mammary ; methods ; Young Adult

Some breast neoplasms are classified as primary neuroendocrine carcinomas because they are positive for neuroendocrine markers. Although neuroendocrine carcinomas can originate from various organs of the body, primary neuroendocrine carcinomas of the breast are extremely rare. The diagnosis of primary neuroendocrine carcinoma of the breast can only be made if nonmammary sites are confidently excluded or if an in situ component can be found. Here we report a primary large-cell neuroendocrine carcinoma (LCNL) involving the left breast. Breast ultrasonography revealed a lobulated, heterogeneous, low-echoic mass in the left breast, and the lesion ap-peared as a well-defined, highly-enhancing mass on a chest computed tomography scan. Ultrasound-guided core needle biopsy was performed on the mass, and primary LCNC was confirmed by histopathologic examination.
Adult ; Breast Neoplasms/*diagnosis/pathology/ultrasonography ; Carcinoma, Large Cell/*diagnosis/pathology/radiography ; Carcinoma, Neuroendocrine/*diagnosis/pathology/radiography ; Diagnosis, Differential ; Female ; Humans ; Tomography, X-Ray Computed