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We report a case of a 58-year-old Caucasian woman affected by papillary thyroid microcarcinoma (PTMC) of the left-lobe of the gland with very small size (Ø 0.3 cm). The characteristics with the Diagnostic Imaging using Ultrasonography, ADF (Advanced Dynamic Flow), and fine-needle-aspiration cytology (FNAC) are discussed, comprising a very small micro-focus of radial shape, with markedly hypoechoic echostructure, irregular margins, supplemented by peripheral vessel formation. It acquires an image which appears similar to a brisk visualization of a dark ink stain in the normal thyroid weave. We call such a pattern “Black Ink” with ultrasonographic image and believe consistent with the infiltrating variant of papillary thyroid microcarcinoma if associated with malignant cytology after FNA.

Background Today, breast cancer is one of the most aggressive cancers in women and new cases continue to increase worldwide. The incidence of this tumor is kept under control especially with surgery. In order to reduce mortality we need to detect this life threatening disease at an earlier stage. For two years, we have conducted a study for the identification and characterization of suspicious breast lesions using a new diagnostic technique applied to ultrasonography and mammography called “PhiΦBreast.” Methods Identification and characterization of category C4-C5 lesions of the breast with high Predictive Positive PPV value, with a new innovative method called “PhiΦBreast” using the Golden Ratio (Phi, or Φ 1.618...) Fibonacci sequence and a Predictive Algorithm, applied to the ultrasonography and mammography with subsequent deepening with cytological examination using fine needle aspiration (FNAC), according to evaluation criteria of the Breast Imaging Report Data System (BI-RADS) and the American College of Radiology (ACR). Usefulness of this research and the use of this new diagnostic tecnique is to detect the breast cancer in early stage. In addition to develop a classification model of the histological type identified in the section areas and the percentage of probability in relation between the golden spiral and Fibonacci sequence. This amazing intuition and research has given contribution to the new Theory of Spiral Cancer. Results With the use of Golden Ratio and Fibonacci sequence, applied to ultrasonography and mammography, we have experimented and developed a diagnostic map with characteristics of high probability of identifying suspicious lesions at an early stage. We examined 987 women, 55 lesions detected with PhiΦBreast pattern were classified according to BI-RADS descriptors for US-imaging, including morphologic features that had a high predictive value for the malignancy (p <0.001). This innovative diagnostic technique has shown a sensitivity of 95%, a specificity of 97%, a positive predictive value of 97%, and negative predictive value of 96%. The discriminating capacity of PhiΦBreast was significantly better than normal ultrasonography (P < 0,05). Furthermore with a predictive algorithm associated with malignant cytology after FNAC, we have classified different types of potentially life threatening cancers for patients. Conclusion PhiΦBreast could be an important new model diagnostic technique to be applied ultrasound and mammography for detection of malignant lesions of category C4-C5. In diagnostic imaging beyond the identification of a lesion and classification according to the BI-RADS category and the evaluation criteria of the ACR is fundamental to recognize predictively the characteristics of a potentially aggressive tumor. Everything mentioned above, reinforces the concept that the early diagnosis is essential because it allows to remove small tumors and therefore capable of producing more limited metastases than the potential of the most voluminous neoplasm. This way, we could plan an effective cure for the patient. This new model (PhiΦBreast) could represent the cornerstone as an important contribution for early diagnosis of breast cancer.

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