PURPOSE: Women with dense breast are known to be at high risk for breast cancer, but their prevalence and number of Korean women are unknown. The current study was to investigate the distribution of mammographic breast density by age of women undergoing screening mammography, and to estimate the prevalence of Korean women with dense breasts, quantitatively. MATERIALS AND METHODS: For obtaining a nationwide representative sample, 6,481 mammograms were collected from 86 screening units participated in the National Cancer Screening Program for breast cancer. Based on the American College of Radiology Breast Imaging Reporting and Data System classification, breast density was evaluated by six breast radiologists, qualitatively. We applied these breast density distributions to age-specific counts of the Korean women population derived to mid-year 2017 to estimate the number of Korean women with dense breasts. RESULTS: Overall, 54.4% (95% confidence interval [CI], 52.9% to 55.8%) of women 40 to 69 years of age had heterogeneously or extremely dense breasts, and this proportion was inversely associated with age. Based on the age distribution of Korean women, we estimated that 6,083,000 women (95% CI, 5,919,600 to 6,245,600) age 40-69 years in Korean have dense breasts. Women aged 40-49 years (n=3,450,000) accounted for 56.7% of this group. CONCLUSION: More than half of Korean women aged 40 and over have dense breasts. To prevent breast cancer effectively and efficiently, it is necessary to develop a new personalized prevention strategy considering her status of breast density.
Age Distribution ; Breast Neoplasms ; Breast ; Classification ; Cross-Sectional Studies ; Early Detection of Cancer ; Female ; Humans ; Information Systems ; Korea ; Mammography ; Mass Screening ; Prevalence

Magnetic resonance imaging (MRI) of the breast is used for various indications. Contrary to computed tomography as a staging tool, breast MRI focuses on the breast parenchyma and axilla. In spite of narrow field of view, many structures such as the anterior portion of the lungs, mediastinum, bony structures and the liver are included which should not be neglected because the abnormalities detected on the above structures may influence the staging and provide a clue to systemic metastasis, which results in the change of treatment strategy. The purpose of this pictorial essay was to review the unexpected extra-mammary findings seen on the preoperative breast MRI.
Adult ; Aged ; Axilla ; Bone Neoplasms/*diagnosis/secondary ; Breast Neoplasms/*diagnosis ; Female ; Humans ; *Incidental Findings ; Liver Neoplasms/*diagnosis ; Lung Neoplasms/*diagnosis ; Magnetic Resonance Imaging/*methods ; Mediastinal Neoplasms/*diagnosis ; Middle Aged ; Tomography, X-Ray Computed

A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.
Acquired Hyperostosis Syndrome* ; Aged ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperostosis ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Osteitis ; Radionuclide Imaging ; Skin Diseases ; Specialization

A 47-year-old Korean woman with right middle lobe lung adenocarcinoma, malignant pleural effusion, and multiple lymph node and bone metastases, after three months of lung cancer diagnosis, presented with a palpable right breast mass. Images of the right breast demonstrated architectural distortion that strongly suggested primary breast cancer. Breast biopsy revealed metastatic lung cancer with a negative result for estrogen receptor (ER), progesterone receptor (PR) and mammaglobin, and a positive result for thyroid transcription factor-1 (TTF-1). We present a case of breast metastasis from a case of lung cancer with an extensive micropapillary component, which was initially misinterpreted as a primary breast cancer due to unusual image findings with architectural distortion.
Adenocarcinoma/drug therapy/*secondary ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biopsy, Needle ; Bone Neoplasms/secondary ; Breast Neoplasms/drug therapy/*secondary ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/*pathology ; Lymphatic Metastasis ; Mammography ; Middle Aged ; Neoplasm Staging ; Tomography, X-Ray Computed ; Ultrasonography, Mammary

PURPOSE: Dense breasts have been suggested as a risk factor for breast cancer, but controversy still remains. This study evaluates the association of reproductive and hormonal factors with dense breasts among Korean women. MATERIALS AND METHODS: Using a cross-sectional design, 516 women were recruited and classified for breast density patterns as being either fatty or dense, using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. Univariate and multivariate logistic regression models were used for statistical analysis. RESULTS: In univariate logistic regression, older age, higher body mass index, older age at menarche, and oral contraceptive use were associated with more fatty breasts. On the contrary, longer duration of education, alcohol consumption, lower parity, menopause and use of hormone replacement therapy were associated with dense breasts. After adjustment, age and body mass index were inversely associated with breast density (p-value for trend <0.01, respectively), whereas nulliparous and premenopausal status were positively associated. Compared to women who had > or =2 children, nulliparous women had an 11.8-fold increase of dense breasts (p-value for trend <0.01). Compared to postmenopausal women, premenopausal women had 2.4-fold increase of dense breasts (odds ratio, 2.42; 95% confidence interval, 1.36 to 4.32). CONCLUSION: Young age, lower body mass index, lower parity, and premenopausal status were significantly associated with dense breasts in Korea.
Alcohol Drinking ; Body Mass Index ; Breast ; Breast Neoplasms ; Child ; Cross-Sectional Studies ; Female ; Hormone Replacement Therapy ; Humans ; Information Systems ; Korea ; Logistic Models ; Mammography ; Menarche ; Menopause ; Parity ; Risk Factors

Primary primitive neuroectodermal tumors (PNET) are rare malignant tumors, affecting mostly children and adolescents. Only three cases of primary breast PNETs have been reported in the medical literature, with none in Korea. We present a case of a primary PNET of the breast in a 33-year-old woman, with imaging and immunohistopathology findings.
Adult ; Breast Neoplasms/*diagnosis/pathology ; Female ; Humans ; Immunohistochemistry ; Mammography ; Neuroectodermal Tumors/*diagnosis/pathology ; Positron-Emission Tomography

PURPOSE: to evaluate the serial ultrasonographic findings of experimental intramuscular hemorrhaging to determine if there is a correlation with the pathologic findings. MATERIALS AND METHODS: An uiltrasonography (US) was performed before and immediately after an intramuscular blood injection in nine rabbits. In addition, follow-up US images were obtained at 1, 4, 7, 10, 14, 21, and 28 days after the intramuscular blood injections in seven of the rabbits. The pathologic specimens, compared to the US findings on each date, and consisted of samples of left thigh muscle. RESULTS: A US, performed immediately after a blood injection, showed two patterns; 6 cases of hyperechoic muscle thickening and 3 cases of hyperechoic muscle thickening with extravasation between the epimysium and muscle bundle or within muscle bundle. A follow-up US showed a marked decrease in intramuscular hemorrhaging and microcalcifications, which appeared on the 4th, 7th and 10th day after the blood injection. The pathologic findings revealed several short echogenic lines in the muscular bundles which were hemosiderin. Moreover, a 28 day follow-up US revealed that the normal findings are correlated with the normal gross pathologic findings. CONCLUSION: The US findings of the intramuscular hemorrhaging, for each of the follow-up dates, in comparison to the pathologic findings, revealed a high correlation with the pathologic specimens. Consequently, a US transducer with high resolution can be considered as a helpful technique in the diagnosing and evaluating the follow-up treatment of intramuscular hemorrhaging.
Chronology as Topic ; Follow-Up Studies ; Hemosiderin ; Muscles ; Rabbits ; Tendon Injuries ; Thigh ; Transducers

The paraganglioma is rare neuroendocrine tumor arising from paraganglionic tissue and most cases show characteristic endocrinological symptoms that are caused by catecholamine secretion. We report here on a case of nonfunctioning retroperitoneal paraganglioma that did not show any neuroendocrine symptoms, and this was misdiagnosed as ovarian tumor by ultrasonography and CT.
Female ; Neuroendocrine Tumors ; Ovary* ; Paraganglioma* ; Pheochromocytoma ; Retroperitoneal Space ; Ultrasonography

The paraganglioma is rare neuroendocrine tumor arising from paraganglionic tissue and most cases show characteristic endocrinological symptoms that are caused by catecholamine secretion. We report here on a case of nonfunctioning retroperitoneal paraganglioma that did not show any neuroendocrine symptoms, and this was misdiagnosed as ovarian tumor by ultrasonography and CT.
Female ; Neuroendocrine Tumors ; Ovary* ; Paraganglioma* ; Pheochromocytoma ; Retroperitoneal Space ; Ultrasonography

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