Ultrasound‐Based Nomogram for Distinguishing Malignant Tumors from Nodular Sclerosing Adenoses in Solid Breast Lesions

Author(s):  
Ting Liang ◽  
Shuzhen Cong ◽  
Zongjian Yi ◽  
Juanjuan Liu ◽  
Chunwang Huang ◽  
...  
1999 ◽  
Vol 17 (7) ◽  
pp. 2020-2020 ◽  
Author(s):  
Christopher Poremba ◽  
Kenneth R. Shroyer ◽  
Michael Frost ◽  
Raihanatou Diallo ◽  
Franz Fogt ◽  
...  

PURPOSE: Telomerase has been detected in a majority of human malignant tumors, making telomerase activity (TA) one key difference between mortal and immortal cells. In this study, we evaluated in blind-trial fashion the association of TA with cytologic and final clinical/pathologic diagnosis in fine-needle aspirates (FNAs) of breast lesions. MATERIALS AND METHODS: In 172 FNAs, including 80 samples that were cytologically malignant, 18 that were atypical but not diagnostic for malignancy, and 74 that were cytologically benign, TA was determined by a modified nonradioactive telomeric repeat amplification protocol (TRAP) assay. Final diagnosis was made by pathologic examination of follow-up surgical material available for all the cytologically malignant samples, a majority of the cytologically atypical samples, and a portion of the cytologically benign samples. RESULTS: TA was detected in 85 of 172 samples. Comparison of the cytologic and histologic diagnoseswith TA showed that 80 of 87 samples from patients with breast cancer were telomerase-positive, resulting in a sensitivity of 92%. TA was found in four of five FNAs from carcinomas that were considered cytologically atypical but not diagnostic for malignancy. Eighty of 85 samples from patients with benign breast lesions were telomerase-negative, revealing a specificity of 94%. The five positive cases in this group were all fibroadenomas with low TA. Among the 18 cases with a cytologic diagnosis of atypia, there was a strong positive relationship between TRAP findings and histologic diagnosis. CONCLUSION: The detection of TA in FNAs of breast lesions is a highly sensitive and specific marker of malignancy and may be used as an adjunct in cases with an equivocal cytologic diagnosis.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Henghui Cheng ◽  
Shouhua Yang ◽  
Zhiling Qu ◽  
Sheng Zhou ◽  
Qiurong Ruan

Aims. DOG1 has proven to be a useful marker of gastrointestinal stromal tumors (GISTs). Recently, DOG1 expression has also been reported in some non-GIST malignant tumors, but the details related to DOG1 expression in breast tissue remain unclear. The aim of this study was to detect the expression of DOG1 in the human breast and to evaluate the feasibility of using DOG1 to discriminate between invasive breast carcinoma and noninvasive breast lesions.Methods and Results. A total of 210 cases, including both invasive and noninvasive breast lesions, were collected to assess DOG1 expression immunohistochemically. DOG1 expression was consistently positive in breast myoepithelial cells (MECs), which was similar to the results obtained for three other MEC markers: calponin, smooth muscle myosin heavy chain (SMMHC), and P63 (P>0.05in all). Importantly, DOG1 was useful in discriminating invasive breast carcinoma from noninvasive breast lesions (P<0.05).Conclusions. DOG1 is a useful marker of breast MECs, and adding DOG1 to the MEC identification panel will provide more sophisticated information when diagnosing uncertain cases in the breast.


2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R Abdullah ◽  
L Abdelmonem ◽  
N Nasry ◽  
M Ayoub

Abstract Background Breast cancer in women is a major public health problem throughout the world, being the second most common cancer worldwide. Sonomammography has been always recommended as the basic breast imaging modality for early detection and diagnosis of breast cancer. Some malignant tumors have been missed, specially in dense breasts, and high false-negative rate have been reported. Contrast enhanced spectral mammography is a new modality, used to depict the tumor vascularity and neoangiogenesis; a classic sign of malignant tumors. Aim of Work The purpose of this study is to determine the added value of dual energy contrast mammography to sono-mammography in the assessment of suspicious breast lesions. Patients and Methods 36 patients were included in the study, referred from outpatient clinics in private settings and from Demerdash Hospitals. Contrast enhanced spectral mammography CESM was performed by using a digital mammography unit (Seno DS; GE, Buc, France) that had been adapted to obtain two images for each view: a low-energy image (below the k edge of iodine, 33.2 keV) and a high-energy image (above the k edge of iodine) at 45 to 49 kVp. Results: CEDM versus sonomammography shows p (0.021) value less than 0.05. Also the area under the ROC curve was higher for MX+CEDM (94.4%) than that was for sonomammography (63.8%) compared to pathology analysis with 100% sensitivity, 88.2 % specificity, 90.48 %PPV and 100 % NPV in diagnosis of suspicious lesions. Conclusion The diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma has proven to be superior to sonomammography alone. CEDM had a better diagnostic accuracy mainly due to improved positive and negative predictive values (Positive predictive value about 90.48, negative predictive value 100). The role of CEDM in detection of multifocal / multicentric carcinomas with particular interest for the assessment of the extent of disease specially in dense breasts is appreciated.


2018 ◽  
Vol 8 (6) ◽  
pp. 8-14
Author(s):  
Huong Tran Thi Song ◽  
Yen Vo Thi Kim ◽  
Quan Nguyen Phuoc Bao

Breast tumor is common in women. Benign tumors account for 80%, malignant tumors account for 20%. Breast cancer is the most common and deadly cancer among women, including Vietnam. Elastography, evaluates the stiffness of the tissue, helps to distinguish soft or hard tumors, which can help distinguish benign or malignant. Benign lesions tend to be softer than malignant lesions. There are two types of elastography: SE (Strain Elastography) and Shear Ware Elastography (SWE). In examining breast lesions, the maligne tumor tends to be stronger and the higher the velocity. Studies have shown that the SWE features should be combined with 2D ultrasound to complement the BIRADS classification. Elastography is a new technique that has emerged in the past few years, promising good diagnostic prospects, more and more research and application of elastography in diagnostics breast lesions. Breast elastogarphy, survey of hardness of breast cancer showed 4 times higher than that of benign tumor and 7 folds of normal breast tissue.


2017 ◽  
pp. 23-29
Author(s):  
Thi Kim Yen Vo ◽  
Phuoc Bao Quan Nguyen ◽  
Thanh Thao Nguyen

Objective: To describe the sonographic characteristics of the focal breasst lesions using Acoustic Radiation Force Impulse Imaging (ARFI), and to evaluate the role of ARFI technique in combination with 2D Ultrasound in diagnosing focal breast lesions. Methods: 2D Ultrasound and ARFI Elastography were caried out in 52 patients who have focal lesions of breast. Images of 2D Ultrasound were classified according to ACR 2013. ARFI Elastography was performed by 2 techniques: “Virtual Touch HD tissue imaging” in order to image of strain distribution and “Virtual Touch HD Tissue quantification imaging” to measure the shear wave velocity (SWV) in the tissue. Strain distribution was classified according to Ako Itoh scale. SWV were measured in 4 positions: internal the lesion (SWVi), boundary zone (SWVb), glandular tissue and fatty tissue next to lesion (SWg and SWf). According to the results of pathology, we determine and compare the value between 2D Ultrasound plus ARFI elastography and 2D Ultrasound alone. Results: 52 patients with breast focal lesions: 22 malignant tumors and 30 benign tumors. Mean Ako Itoh scale of benign tumors were 2.19 ± 1.13 and malignant tumors were 4.72 ± 0.55; the cut-off value was between E3 và E4. SWVi, SWVb, SWVf, SWVg of benign tumors were lower than malignant tumors with cut-off values were 3.32 m/s; 6.01m/s; 1.08m/s; 2.37m/s, respectively. 2D Ultrasound plus ARFI Elastography: Se 100%, Sp 90%, PPV 88%, NPV 100%, Acc 94.2% (p<0.001, K = 0.884). Conclutions: In addition to the morphologic characteristics of breast lesions, ARFI provides information about lesion’s tissue elasticity, which can be a useful tool to differentitate malignant lesions from benign ones. Key words: elastography, focal breast lesions, Acoustic Radiation Force Impulse Imaging


Author(s):  
Manvir S. Tevatia ◽  
Prabhashankar Mishra ◽  
Ajay K. Baranwal ◽  
Prachi B. Nichat ◽  
Divya Shelly ◽  
...  

Abstract Overview Mesenchymal tumors of the breast are rare. Few epithelial tumors also have mesenchymal components. It is crucial to identify these as per histogenesis. This can be facilitated by markers of epithelial–mesenchymal transition (EMT) Objectives The aim of this study was to categorize the breast lesions with mesenchymal morphology and to study EMT on immunohistochemistry (IHC). Materials and Methods This is a retrospective study of 5-year duration from January 2015 to December 2019. Inclusion criteria: all breast lesions showing mesenchymal/nonepithelial morphology, complete or partial, on histology. Exclusion criteria: Mammary carcinomas without any mesenchymal/nonepithelial morphology, fibroadenomas, and lymphomas. Demographics, clinical, gross examination, histology, and IHC findings of selected cases were reviewed and recorded. Three additional markers p53, E-cadherin, and β-catenin were performed. Statistical Analysis Used Frequency calculation for each variable (IHC). Results Thirteen (2.5%) out of total 510 breast specimens showed mesenchymal histology. Of these, five (38.5%) were metaplastic breast carcinomas (MBC), four (31%) were phyllodes tumor (PT), and one (7.7%) case each of malignant peripheral nerve sheath tumor, primary stromal sarcoma of breast, pseudoangiomatous stromal hyperplasia, and myofibroblastoma. Loss of E-cadherin was seen in 4/5 (80%) MBCs and was retained in ductal component of PTs. p53 was not expressed in any of the tumors except 3/5 (60%) MBCs. β-Catenin was aberrant in all MBCs. Conclusions Primary breast tumors with mesenchymal morphology present a spectrum ranging from benign mesenchymal, fibroepithelial neoplasms to malignant tumors of mesenchymal and epithelial origin. Loss of E-cadherin, expression of p53, and aberrant expression of β-catenin are suggestive of EMT and molecular heterogeneity of MBCs.


2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions.Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months.Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions.Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.


2020 ◽  
Vol 2 (4) ◽  
pp. 285-292
Author(s):  
Hassan ALgarsh ◽  
◽  
Hana Abusaida ◽  
Fairouz Torjman ◽  
◽  
...  

Introduction: This experimental study gauged the value of argyrophilic nucleolar organizer region (AgNOR) staining as a possible technique for the estimation of cell kinetics in conventional histology sections, in benign and malignant breast lesions. Methods: With a silver staining technique and immunohistochemistry, we associated the numbers of AgNORs and Ki67 scores in 30 breast carcinomas and 10 benign breast lesions. Results: The mean values of Ag NORs silver stain dots count for normal, benign, grade II and III were 1.28±0.17, 2.83±0.68, 5.23±0.87 and 7.32±0.92, respectively. There was a statistically significant difference (p≤0.001) was noticed between the all individual groups, among the normal and breast lesion as well as among the GII and GIII. Immunohistochemical Results of Ki-67 protein exhibited homogenous golden-brown color in control case and a positive brown granules or diffuse dark brown color in the nuclei of both benign and malignant cases under the 400X magnify examined under the light microscope. Discussion: AgNOR counts performed on routine formalin-fixed paraffin sections could provide substantial kinetic evidence. Additionally, the difference in AgNOR counts between benign and malignant tumors is such that they may be of diagnostic worth.


2012 ◽  
Vol 20 (1-2) ◽  
pp. 12-14 ◽  
Author(s):  
Smaroula Divani ◽  
Angeliki Giovani

Background: HPV infection is the most commonly distributed sexually transmitted disease. Human papillomavirus has also been linked to malignant tumors of many human organs. The presence of viral DNA in breast cancer cells is controversial. The aim of the present study was to investigate the presence of HPV-DNA in a group of Greek women with breast carcinoma. Methods: Liquid cytology specimens from 35 malignant breast cases and 35 cases with benign breast lesions were investigated by PCR (clinical arrays technique). In addition, in situ hybridization was performed on all HPV positive cases. Results: HPV-DNA was detected in 17.14% of the carcinoma cases and HPV16 DNA was present in 83.3% of them. All benign breast lesions were negative for HPV-DNA. Conclusion: Our report confirmed the presence of HPV in breast cancer cells while the most prevalent type was HPV16. More studies are necessary in order to elucidate the pathogenesis of HPV and a possible way of prevention of some breast cancers.


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