The imaging characteristics of cancers in patients under 40 years without proven gene mutations do not differ from their older counterparts, but appear correlated to phenotypic profiles, which have a different distribution in young women compared to the general population.
We report five adolescent girls with secondary breast tumours. All were imaged by US and the imaging findings have been analysed. Four girls had rhabdomyosarcoma as the primary malignant disease and one had leukaemia. US features were variable, but most of the cases showed heterogeneous nodules which were quite different from the usual benign lesions (fibroadenoma, abscess, cyst) encountered at this age. The metastases produced a variety of echo characteristics: masses with well-defined margins, hyperechoic foci and sonolucent or hypoechoic nodules with posterior attenuation or lacking posterior enhancement. One lesion was round and heterogeneous with a hyperechoic centre. These US findings in an adolescent girl suggest the need for fine-needle aspiration. Mammograms, when performed, never revealed microcalcifications and were quite difficult to analyse at this age, due to the dense glandular breast tissue.
Purpose. Triple-negative (TN) breast cancers have high malignancy potential and are often characterized by early systemic relapse. Early detection is vital, but there are few comprehensive imaging reports. Here we describe mammography, ultrasound, and magnetic resonance imaging (MRI) findings of TN breast cancers, investigate the specific features of this subtype, and compare the characteristics of TN breast cancers with those of hormone receptor (HR)-positive/human epidermal growth factor receptor (HER)-2-negative breast cancers. Materials and Methods. From July 2009 to June 2011, mammography and ultrasound findings of 210 patients with pathologically confirmed TN (n ϭ 105) and HR-positive/HER-2-negative breast cancers (n ϭ 105) were retrospectively reviewed from our institutional database. Ultrasound vascularity was notified in 88 cases and elasticity scores were notified in 49 cases overall. Thirty-five patients underwent MRI (22 TN and 13 HR-positive/HER-2-negative). Mammograms, ultrasound, and MRI were reviewed according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon and classification. Results. TN breast cancers were more likely to show round, oval, or lobulated masses with indistinct margins on mammography than HR-positive/HER-2-negative breast cancers. On ultrasound, TN tumors were more likely than HR-positive/ HER-2-negative breast cancers to show circumscribed or microlobulated margins and no posterior acoustic features or posterior enhancement-positive. On MRI, TN cancers exhibited suspicious aspects more often than HR-positive/HER-2-negative cancers, often with rim enhancement-positiveHER-2 (84.6% of masses were classified BI-RADS 5). Conclusion. This study is the first to describe findings on mammography, ultrasound, and MRI for TN breast cancers with a matched HR-positive/HER-2-negative control group. Several distinctive morphological features of these aggressive tumors are identified that can be used for earlier diagnosis and treatment, and ultimately to improve outcomes. The Oncologist 2013;18:802-811 Implications for Practice: Our results suggest that there are correlations between underlying phenotypes and distinctive imaging features for estrogen receptor (ER)-negative/progesterone receptor (PR)-negative/human epidermal growth factor receptor (HER)-negative cancers and ER-positive/EP-positive/HER-negative cancers. The findings show that the triple negative (TN) phenotype has a few characteristic radiological findings: an oval or lobulated mass with circumscribed or microlobulated margins and
A retrospective study of 35 patients with small bowel neoplasms studied by computed tomography (CT) was performed. The tumor detection rate was 80%. Using the findings reported in the literature, an adequate histological diagnosis could be performed in 69% of the cases by CT. Lipomas, leiomyomas, leiomyosarcomas, and carcinoid tumors were well-recognized, but adenocarcinomas and lymphomas were often mistaken one for the other. An accurate preoperative staging was performed in 61% of the cases. CT failed to detect 75% of the invaded lymph nodes, 25% of the liver metastases, and 25% of the tumoral growth beyond the bowel wall. Despite major limitations in preoperative staging, a good detection rate and some features allowing a specific diagnosis advocate using CT along with the barium examination when clinical history suggests a small bowel tumor.
Nipple discharge is a common symptom in breast medicine. It is usually benign in origin (papillomas and galactophore duct ectasia) although it is essential not to miss the risk of an underlying malignant lesion (5%) mostly due to in situ carcinomas. Clinical examination is essential in the management, distinguishing benign "physiological" discharge from discharge suspected of being "pathological" in which further investigations with mammography and ultrasound are required. When the conventional imaging assessment for pathological nipple discharge is normal, breast MRI is gradually replacing galactography although this is still an emerging and invalidated indication. In this context and if the whole imaging assessment is normal, surgery is no longer the only solution for patients, who can now be offered regular monitoring.
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