Hypothesis: Core needle biopsy is a useful diagnostic tool in differentiating phyllodes tumor from fibroadenoma. Design: The radiology database was queried for patients who underwent core needle biopsies of fibroepithelial lesions that raised the possibility of phyllodes tumor. These diagnoses were then compared with the final pathological diagnoses after surgical excision. Setting: The data were gathered from the Comprehensive Breast Center, Columbia Presbyterian Medical Center, a tertiary care, university-based medical center.

Benign and malignant papillary lesions of the breast can be reliably diagnosed at SDVAB when the SDVAB results correlate with the imaging findings. However, the extent of malignant papillary disease may be underestimated at SDVAB; in our study, invasive carcinoma was later discovered in 25% of patients with this diagnosis.

Purpose-To investigate the use of advanced ultrasonic imaging to quantitatively evaluate normaltissue toxicity in breast-cancer radiation treatment.Methods and Materials-Eighteen breast cancer patients who received radiation treatment were enrolled in an IRB-approved clinical study. Radiotherapy involved a radiation dose of 50.0-50.4 Gy delivered to the entire breast, followed by an electron boost of 10.0-16.0 Gy delivered to the tumor bed. Patients were scanned with ultrasound during follow-up that ranged from 6 to 94 months (median 22 months) post radiotherapy. Conventional ultrasound images and radio-frequency (RF) echo signals were acquired from treated and untreated breasts. Three ultrasound parameters: skin thickness, Pearson coefficient, and spectral midband fit were computed from RF signals to measure radiation-induced changes in dermis, hypodermis and subcutaneous tissue, respectively. Ultrasound parameter values of the treated breast were compared to those of the untreated breast. Ultrasound findings were compared with clinical assessment using RTOG late-toxicity scores.Results-Significant changes were observed in ultrasonic parameter values of the treated versus untreated breasts. Average skin thickness increased by 26.9%, from 2.05 ± 0.22 mm to 2.61 ± 0.52 mm, Pearson correlation coefficient decreased by 31.5%, from 0.41 ± 0.07 to 0.28 ± 0.05, midband fit increased by 91.6%, from −0.92 ± 7.35 dB to 0.87 ± 6.70 dB. Ultrasound evaluations were consistent with RTOG scores.Conclusions-Quantitative ultrasound provides a noninvasive, objective means of assessing radiation-induced changes to the skin and subcutaneous tissue. This imaging tool will become increasingly valuable as we continue to improve radiation therapy technique.

The advantages of imaging the chest with digital storage phosphor radiography (SR) may be nullified by its spatial resolution, which is lower than that of conventional film radiography (FR). To test the reader detection performance with the two modalities under clinical conditions, the authors compared 140-kVp isoexposure SR (system resolution: 0.2 mm, 10 bits) and FR images of a variety of chest abnormalities proved by computed tomography (CT) (157 patients, 244 abnormalities, 5,652 observations, six readers). In all tests, SR was as good as or better than FR (P less than .05). In overall detection, indicated by the average area of receiver operating characteristics, SR and FR were equivalent. SR was superior for mediastinal lesions and for pulmonary opacities greater than 2 cm in diameter. For all other types of pulmonary lesions and pleural abnormalities, SR and FR were equivalent. Currently available commercial SR systems can replace film radiographic systems in the detection of a wide variety of chest lesions. SR is likely to enable better visualization than FR in the detection of mediastinal and large pulmonary abnormalities.

A series of 100 consecutive occult mammographic abnormalities were localized with a curved-end retractable wire system. A true-positive rate of 24% and a failure rate of 4% for initial excision were found. The pitfalls and advantages of this new needle-wire breast localizer are presented.