Our Radiological Experience on B3 Lesions: Correlation Between Mammographic and MRI Findings With Histologic Definitive Result

Santucci, Domiziana; Faiella, Eliodoro; Calabrese, Alessandro; Favale, Luisa; Zobel, Bruno Beomonte; Felice, Carlo de

doi:10.1016/j.clbc.2019.06.004

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Breast symmetry is often the most di cult to characterize, as it shows great variation between individuals as well as between the left and right breasts of the same individual and even between different breast quadrants. As the primary screening tool for breast cancer, the sensitivity of conventional MG is approximately 70% [23], and the sensitivity decreases with the increase of the quality of breast tissue assessed. Moreover, 76% of cancers are missed in women with dense breast tissue, while the overlap of normal breast tissue can lead to false-positives [24,25].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

Zhang

Cai

Chen

et al. 2021

Preprint

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Objective: To compare multiple breast cancer screening methods for evaluating breast non-mass-like lesions (NMLs) and to investigate the best screening method for breast non-mass-like lesions (NMLs). Methods: This retrospective study examined 253 patients aged 24 to 68 years who were diagnosed with breast NMLs from April 2017 to December 2019. All lesions were evaluated by MG, HHUS, and ABUS to determine BI-RADS classification, underwent pathological examination within six months or at least 2 years of follow-up. The sensitivity, specificity, accuracy, positive predictive values (PPV), and negative predictive values (NPV) of MG, HHUS, and ABUS features in the prediction of malignancy were compared. Independent risk factors for malignancy were assessed using non-conditional logistic regression. Results: MG, HHUS, and ABUS findings significantly differed between benign and malignant breast NML, including internal echo, hyperechoic spot, peripheral blood flow, internal blood flow, catheter change, peripheral change, coronal features of ABUS, and structural distortion, asymmetry, and calcification in MG. ABUS was superior to MG and HHUS in sensitivity, specificity, PPV, NPV, as well as in evaluating the necessity of biopsy and accuracy in identifying malignancy. MG was superior to HHUS in specificity, PPV, and accuracy in evaluating the need for biopsy. HHUS was distinctly superior to MG in sensitivity and NPV in determining malignancy; however, specificity, PPV, and accuracy were similar. Moreover, internal blood flow, calcification, and coronal plane feature were independent risk factors in distinguishing benign and malignant lesions. Conclusions: ABUS was superior to HHUS and MG in evaluating the need for biopsy and differentiating benign and malignant in breast NMLs. Compared to each other, HHUS and MG had their own relative advantages. Internal blood flow, calcification, and coronal plane feature were independent risk factors in identifying benign and malignant lesions.

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Section: Discussionmentioning

confidence: 99%

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

Zhang

Cai

Chen

et al. 2021

Preprint

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“…CCLs are most frequently identified in CNBs performed for mammographically detected calcifications. While the majority of CCLs manifest as grouped amorphous calcifications, fine pleomorphic or punctate calcifications can also be observed [ 2 , 3 , 6 , 8 , 9 , 10 , 32 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. The calcifications associated with CCLs may be indistinguishable from other causes of suspicious calcifications such as ADH or DCIS, necessitating biopsy or excision for diagnosis [ 2 ].…”

Section: Radiologic Findingsmentioning

confidence: 99%

“…The calcifications associated with CCLs may be indistinguishable from other causes of suspicious calcifications such as ADH or DCIS, necessitating biopsy or excision for diagnosis [ 2 ]. Less often FEA may appear as a mammographically detected mass, architectural distortion or asymmetry [ 10 , 41 , 42 , 43 , 44 , 46 , 47 , 49 , 50 ]. Some CCLs may not be detected due to their small size and lack of associated calcifications or other radiologic abnormalities.…”

Section: Radiologic Findingsmentioning

confidence: 99%

“…Although there is a dearth of literature with regards to magnetic resonance imaging (MRI) features in CCLs, findings described include non-mass enhancement (NME) [ 38 , 51 ] and irregular clumped enhancement [ 46 ]. Santucci et al describe a series of 139 patients with histologic borderline (B3) lesions, of which 31 (14.39%) were diagnosed as FEA [ 47 ]. Six patients in this cohort had MRI investigations, including five (83%) with post-contrast mass-like enhancement and one (17%) with segmental enhancement.…”

Section: Radiologic Findingsmentioning

confidence: 99%

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Are Columnar Cell Lesions the Earliest Non-Obligate Precursor in the Low-Grade Breast Neoplasia Pathway?

Strickland

Turashvili

2022

Current Oncology

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Columnar cell lesions (CCLs) of the breast comprise a spectrum of morphologic alterations of the terminal duct lobular unit involving variably dilated and enlarged acini lined by columnar epithelial cells. The World Health Organization currently classifies CCLs without atypia as columnar cell change (CCC) and columnar cell hyperplasia (CCH), whereas flat epithelial atypia (FEA) is a unifying term encompassing both CCC and CCH with cytologic atypia. CCLs have been increasingly recognized in stereotactic core needle biopsies (CNBs) performed for the assessment of calcifications. CCLs are believed to represent the earliest non-obligate precursor of low-grade invasive breast carcinomas as they share molecular alterations and often coexist with entities in the low-grade breast neoplasia pathway. Despite this association, however, the risk of progression of CCLs to invasive breast carcinoma appears low and may not exceed that of concurrent proliferative lesions. As the reported upgrade rates of pure CCL/FEA when identified as the most advanced high-risk lesion on CNB vary widely, the management of FEA diagnosed on CNB remains controversial. This review will include a historical overview of CCLs and will examine histologic diagnostic criteria, molecular alterations, prognosis and issues related to upgrade rates and clinical management.

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“…More recently, Santucci et al [ 34 ], according to these statements, showed that upgrade was often associated with evident contrast-enhanced lesions. In contrast, Amitai et al [ 11 ] found that MRI has low accuracy in differentiating invasive cancer from RS, with positive predictive value of 30%.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Radial Scar: a management dilemma

et al. 2021

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Radial scar (RS) or complex sclerosing lesions (CSL) if > 10 mm is a benign lesion with an increasing incidence of diagnosis (ranging from 0.6 to 3.7%) and represents a challenge both for radiologists and for pathologists. The digital mammography and digital breast tomosynthesis appearances of RS are well documented, according to the literature. On ultrasound, variable aspects can be detected. Magnetic resonance imaging contribution to differential diagnosis with carcinoma is growing. As for the management, a vacuum-assisted biopsy (VAB) with large core is recommended after a percutaneous diagnosis of RS due to potential sampling error. According to the recent International Consensus Conference, a RS/CSL lesion, which is visible on imaging, should undergo therapeutic excision with VAB. Thereafter, surveillance is justified. The aim of this review is to provide a practical guide for the recognition of RS on imaging, illustrating radiological findings according to the most recent literature, and to delineate the management strategies that follow.

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Our Radiological Experience on B3 Lesions: Correlation Between Mammographic and MRI Findings With Histologic Definitive Result

Cited by 9 publications

References 26 publications

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

Comparative study of multiple breast cancer screening methods in the evaluation of breast non-mass-like lesions

Are Columnar Cell Lesions the Earliest Non-Obligate Precursor in the Low-Grade Breast Neoplasia Pathway?

Radial Scar: a management dilemma

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