The introduction of systems for automated reading in mammography has been proposed to improve the sensitivity [computer-aided detection (CADe) systems] and, more recently, the specificity [computer-aided diagnosis (CADi) systems] of the test. Only CADe systems have been approved by the U.S. Food and Drug Administration (FDA) and are used in current practice. These systems are still under discussion. Several studies have demonstrated that they are beneficial to inexperienced readers and that, through comparison with the computer, radiologists are led to improve their performance. However, there is still considerable variation among different studies in the level of benefit deriving from CAD. Therefore the role of these systems in clinical practice is still debated, and their real contribution to the overall management of the diagnostic process is not yet clear.
Percutaneous histological VAB with an 11-gauge needle proved to be, as reported in previous studies, a reliable method for diagnosing nonpalpable, mammographically detectable only breast lesions, with an underestimation rate lower than core biopsy and a FN rate similar to that of surgical biopsy, without any significant complications.
Frequently, rare breast neoplasms show low suspicious morphologic and kinetic patterns at MRM, and they are often classified as indeterminate lesions. This is probably due to their high grade of differentiation and their histological features.
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