A review of current foreign and Russian literature on automated breast ultrasound (ABUS) is presented. The publications were searched in PubMed/MEDLINE and eLibrary databases. Hand-held breast ultrasound and ABUS are discussed, the ABUS technique is described. Addition of ABUS to screening mammography demonstrates increase in detection of early invasive node-negative forms of breast cancer (pT1a-bN0M0). The possible place of ABUS in the screening setting supplemental to mammography in women with dense breasts is considered.
Rationale: A standard algorithm for the assessment of patients with breast trauma does not exist, as such trauma usually does not incur any significant health problems. However, according to existing clinical and work-up data and various radiological signs, posttraumatic abnormalities of the breast can mimic cancer lesions and complicate the differential diagnosis for a radiologist.Aim: To evaluate the potential of digital mammography and breast ultrasound examination in the identification of breast posttraumatic abnormalities and to describe their semiotics.Materials and methods: The study included 150 female patients aged 40 to 86 years (mean±SD, 60±11.9 years) with a history of breast trauma. Digital mammography with tomosynthesis (combined mode) and multiparametric ultrasound were able to identify breast abnormalities in 62 patients. The results of all assessments (n=62) were interpreted according to BI-RADS. Should any confirmation of the abnormalities be necessary, fine needle aspiration biopsy or core-biopsy with stereotaxic or ultrasound control were performed.Results: At mammography, the typical posttraumatic abnormality in the breast was fat necrosis (n=54). It was represented as nodular masses with round (20/34; 58.8%) or oval shape (13/34; 38.2%) and circumscribed margins. In most cases, the masses contained eggshell calcification (27/34; 79.4%). In 35.1% (19/54) of the cases fat necrosis was represented by various calcifications. At ultrasound, fat necrosis could be identified as avascular (40/40; 100%), mostly round (26/40; 65.0%), less frequently oval (12/40; 30.0%), and hypoechoic (19/40; 47.5%) masses with circumscribed margins. Atypical signs of fat necrosis (BIRADS 4) were found in 16.1% (10/62) of the cases, in which 7 (11.2%) core-biopsies with ultrasound control and 3 (4.8%) stereotaxic biopsies were performed. In all the cases, breast fat necrosis was confirmed, with various ratios of fibrous and necrotic fat tissue and lymphoid infiltration.Conclusion: In most cases, standard radiological methods used in the diagnostic algorithm for posttraumatic breast lesions are sufficient for the diagnosis. In uncertain diagnostic cases, morphological verification seems necessary.
The number of women resorting to endoprosthesis replacement of breast is growing from year to year. To date, the most popular and safe method of correcting the shape and size of the breast is augmentation mammoplasty with silicone gel prostheses. Unfortunately, the diagnosis of breast cancer in patients who have had recourse to the augmentation mammoplasty at preclinical stages, is difficult. Most often this is due to the fact that the patient does not undergo preventive examinations. This research exemplifies a comprehensive procedure facilitating diagnostication of a breast cancer in a patient previously subjected to augmentation mammoplasty. A physical examination, a digital and an ultrasound mammography reveals a BI-RADS 5 nodal formation in the patient’s right breast. An ultrasound-guided biopsy of the newly formed tissue over the breast implant is morphologically cross-checked. The diagnosis of breast cancer is thus confirmed histologically.
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