Magnetic Resonance Imaging for Screening of Women at High Risk for Hereditary Breast Cancer

Mokbel, Kefah; Elkak, Abd Elrafea

doi:10.1200/jco.2001.19.21.4184

Cited by 4 publications

(2 citation statements)

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“…In view of the high sensitivity of MRI, the absence of enhancement typical of malignancy in women with papillomas can be reassuring and supportive of conservative management [ 24 ]. However in clinical practice, the high cost, limited expertise and sub-optimal specificity of MRI remain obstacles to its widespread use [ 25 ].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Breast papillomas: current management with a focus on a new diagnostic and therapeutic modality

Sarakbi

Worku

Escobar

et al. 2006

Int Semin Surg Oncol

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Breast papilloma is a term that describes an intraductal papillary configuration of the mammary epithelium on macroscopic or microscopic examination. It includes solitary intraductal papillomas, multiple papillomas, papillomatosis, and juvenile papillomatosis (JP).Recent advances in mammary ductoscopy (MD) have raised new possibilities in the diagnosis and treatment of breast papillomas. This technique represents an important diagnostic adjunct in patients with pathological nipple discharge (PND) by allowing direct visualisation and biopsy of intraductal lesions and guiding duct excision surgery.Treatment of breast papillomas often entails surgical duct excision for symptomatic relief and histopathological examination. Recently, more conservative approach has been adapted. MD-assisted microdochectomy should be considered the procedure of choice for a papilloma-related single duct discharge. Furthermore, there is increasing evidence that MD has the potential to reduce the number of duct excision procedures and minimise the extent of surgical resection. Imaging-guided vacuum-assisted core biopsy can be diagnostic and therapeutic for papillomas seen on mammography and/or ultrasound.Patients with multiple papillomas do have an increased risk of developing cancer and should be kept under annual review with regular mammography (preferably digital mammography) if treated conservatively. Magnetic resonance (MR) can be also used in surveillance in view of its high sensitivity. Because the risk is small, long term and affects both breasts, long-term follow-up is more appropriate than prophylactic mastectomy. Patients who prove to have solitary duct papilloma have insufficient increase in the risk of subsequent malignancy to justify routine follow-up.

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Section: Diagnostic Methodsmentioning

confidence: 99%

Breast papillomas: current management with a focus on a new diagnostic and therapeutic modality

Sarakbi

Worku

Escobar

et al. 2006

Int Semin Surg Oncol

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“…Findings include concealed formations, small luminal structures, or irregular fast growing lesions that cannot be differentiated from invasive malignomas. High costs, limited clinical experience, and suboptimal specificity restrict the use of MRI in this context [19,20,21]. …”

Section: Papillomasmentioning

confidence: 99%

Benign Breast Tumours - Diagnosis and Management

et al. 2018

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With improvements in breast imaging, mammography, ultrasound and minimally invasive interventions, the detection of early breast cancer, non-invasive cancers, lesions of uncertain malignant potential, and benign lesions has increased. However, with the improved diagnostic capabilities comes a substantial risk of false-positive benign lesions and vice versa false-negative malignant lesions. A statement is provided on the manifestation, imaging, and diagnostic verification of isolated benign breast tumours that have a frequent manifestation, in addition to general therapy management recommendations. Histological evaluation of benign breast tumours is the most reliable diagnostic method. According to the S3 guideline and information gained from analysis of the literature, preference is to be given to core biopsy for each type of tumour as the preferred diagnostic method. An indication for open biopsy is also to be established should the tumour increase in size in the follow-up interval, after recurring discrepancies in the vacuum biopsy results, or at the request of the patient. As an alternative, minimally invasive procedures such as therapeutic vacuum biopsy, cryoablation or high-intensity focused ultrasound are also becoming possible alternatives in definitive surgical management. The newer minimally invasive methods show an adequate degree of accuracy and hardly any restrictions in terms of post-interventional cosmetics so that current requirements of extensive breast imaging can be thoroughly met.

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