Malignancy Upgrade Rates of Radial Sclerosing Lesions at Breast Cancer Screening

Yan, Pamela; DeMello, Linda; Baird, Grayson L.; Lourenço, Ana P.

doi:10.1148/rycan.2021210036

Cited by 11 publications

(8 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If it is evident on clinical imaging, it typically appears on mammography as a stellate lesion with radiolucent center and radiating spicules along with architectural distortion with or without associated calcifications [2,7,42]. Tomosynthesis facilitates the recognition of RS on mammogram [46]. On ultrasound, the lesion may appear as parenchymal distortion and/or a hypoechoic mass [47].…”

Section: Radiological Featuresmentioning

confidence: 99%

Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

Elfgen,

Leo,

Kubik-Huch

et al. 2023

Virchows Arch

View full text Add to dashboard Cite

The heterogeneous group of B3 lesions in the breast harbors lesions with different malignant potential and progression risk. As several studies about B3 lesions have been published since the last Consensus in 2018, the 3rd International Consensus Conference discussed the six most relevant B3 lesions (atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), radial scar (RS), papillary lesions (PL) without atypia, and phyllodes tumors (PT)) and made recommendations for diagnostic and therapeutic approaches. Following a presentation of current data of each B3 lesion, the international and interdisciplinary panel of 33 specialists and key opinion leaders voted on the recommendations for further management after core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB). In case of B3 lesion diagnosis on CNB, OE was recommended in ADH and PT, whereas in the other B3 lesions, vacuum-assisted excision was considered an equivalent alternative to OE. In ADH, most panelists (76%) recommended an open excision (OE) after diagnosis on VAB, whereas observation after a complete VAB-removal on imaging was accepted by 34%. In LN, the majority of the panel (90%) preferred observation following complete VAB-removal. Results were similar in RS (82%), PL (100%), and FEA (100%). In benign PT, a slim majority (55%) also recommended an observation after a complete VAB-removal. VAB with subsequent active surveillance can replace an open surgical intervention for most B3 lesions (RS, FEA, PL, PT, and LN). Compared to previous recommendations, there is an increasing trend to a de-escalating strategy in classical LN. Due to the higher risk of upgrade into malignancy, OE remains the preferred approach after the diagnosis of ADH.

show abstract

Section: Radiological Featuresmentioning

confidence: 99%

Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

Elfgen,

Leo,

Kubik-Huch

et al. 2023

Virchows Arch

View full text Add to dashboard Cite

show abstract

“…SA is an IDC-mimicking benign proliferative breast lesion, which is usually asymptomatic or only palpated with a mass. In previous studies, it has been confirmed that SA can imitate IDC clinically, radiologically, and pathologically, so it is necessary to distinguish between SA and IDC ( 1 – 5 , 7 ). As a convenient, affordable, and radiation-free imaging examination, the US is a most widely used breast screening technique.…”

Section: Discussionmentioning

confidence: 93%

“…As the most common breast cancer, IDC may coexist with SA, making it difficult to distinguish between them ( 6 ). However, surgical resection is the main treatment for IDC due to its invasiveness and metastasis, whereas follow-up procedures are performed for SA ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

An ultrasound-based radiomics model to distinguish between sclerosing adenosis and invasive ductal carcinoma

Huang

Nong²,

Tang³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

ObjectivesWe aimed to develop an ultrasound-based radiomics model to distinguish between sclerosing adenosis (SA) and invasive ductal carcinoma (IDC) to avoid misdiagnosis and unnecessary biopsies.MethodsFrom January 2020 to March 2022, 345 cases of SA or IDC that were pathologically confirmed were included in the study. All participants underwent pre-surgical ultrasound (US), from which clinical information and ultrasound images were collected. The patients from the study population were randomly divided into a training cohort (n = 208) and a validation cohort (n = 137). The US images were imported into MaZda software (Version 4.2.6.0) to delineate the region of interest (ROI) and extract features. Intragroup correlation coefficient (ICC) was used to evaluate the consistency of the extracted features. The least absolute shrinkage and selection operator (LASSO) logistic regression and cross-validation were performed to obtain the radiomics score of the features. Based on univariate and multivariate logistic regression analyses, a model was developed. 56 cases from April 2022 to December 2022 were included for independent validation of the model. The diagnostic performance of the model and the radiomics scores were evaluated by performing the receiver operating characteristic (ROC) analysis. The calibration curve and decision curve analysis (DCA) were used for calibration and evaluation. Leave-One-Out Cross-Validation (LOOCV) was used for the stability of the model.ResultsThree predictors were selected to develop the model, including radiomics score, palpable mass and BI-RADS. In the training cohort, validation cohort and independent validation cohort, AUC of the model and radiomics score were 0.978 and 0.907, 0.946 and 0.886, 0.951 and 0.779, respectively. The model showed a statistically significant difference compared with the radiomics score (p<0.05). The Kappa value of the model was 0.79 based on LOOCV. The Brier score, calibration curve, and DCA showed the model had a good calibration and clinical usefulness.ConclusionsThe model based on radiomics, ultrasonic features, and clinical manifestations can be used to distinguish SA from IDC, which showed good stability and diagnostic performance. The model can be considered a potential candidate diagnostic tool for breast lesions and can contribute to effective clinical diagnosis.

show abstract

“…8 ). 특히 최근 디지털 토모신테시스 영상의 보급으로 유방촬영술에서 발견되는 방사상 반흔을 포함한 고위험 병변 진단이 빈번해지고, 초음파 또는 MRI 검사를 통해 우연히 발견되는 작은 크기의 고위험병변이 많이 발견되어, 불필요한 수술을 막기 위해서는 의사들 간의 충분한 의견을 통한 환자의 적절한 치료 수립이 중요하다( 33 34 35 ). 그러나 다른 양성 질환과는 달리 양성 일치의 소견을 보이더라도 악성 위험도 증가로 인하여 수술적 재생검 또는 절제를 시행하기도 한다( 36 ).…”

Section: 영상 유도하 유방 조직검사 후 결과의 해석unclassified

Interpretation of Image-Guided Biopsy Results and Assessment

Chang

2023

J Korean Soc Radiol

View full text Add to dashboard Cite

영상 유도하 유방 조직검사의 성공 여부는 조직검사를 시행하는 당시의 정확한 판단에 근거한 조직검사 유도방식, 기구 선택, 적절한 술기에 의하여 상당 부분 결정되지만, 불충분한 또는 부정확한 검체 채취에 의한 위음성 또는 조직학적 저평가의 한계가 있을 수 있다. 이러한 이유로 영상-병리 합당성 판정을 포함한 조직검사 이후의 적절한 처치와 대응이 매우 중요하다. 조직검사 시 정확한 검체 획득이 이루어지지 않아 암 병변임에도 불구하고, 비특이적인 양성 병변의 병리 결과가 나오는 경우, 영상과 병리 간의 결과 일치 및 불일치 여부를 확인함으로써, 암을 놓치는 일을 막을 수 있다. 이 종설의 목적은 영상 유도하 유방 조직검사 후 결과의 정확한 해석을 위하여 구체적으로 고려할 사항들을 알아보고, 어떻게 적절한 평가를 할 수 있는지 알아보고자 한다.

show abstract

Malignancy Upgrade Rates of Radial Sclerosing Lesions at Breast Cancer Screening

Cited by 11 publications

References 36 publications

Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

Third International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions)

An ultrasound-based radiomics model to distinguish between sclerosing adenosis and invasive ductal carcinoma

Interpretation of Image-Guided Biopsy Results and Assessment

Contact Info

Product

Resources

About