scholarly journals Ductal in situ cancer in non-palpable breast lesions

2003 ◽  
Vol 11 (3) ◽  
pp. 220-220
Author(s):  
Dejan Stojiljkovic ◽  
Milan Prekajski ◽  
Momcilo Inic ◽  
Nebojsa Miletic ◽  
Radan Dzodic ◽  
...  
Keyword(s):  
Early Stage ◽  
Basal Membrane ◽  
Needle Aspiration ◽  
Invasive Component ◽  
Significant Difference ◽  
Cancer Types ◽  
Malignant Lesions ◽  
Palpable Breast ◽  
Hospital Registry

Background: Great importance in detecting in situ cancer is in the fact that epithelial layer is deprived of the blood and lymph vessels, so metastases can develop only when basal membrane has been broken. Methods: The paper included 40 operated women in whom preoperatively suspect non-palpable lesion had been verified. Preoperative diagnostics included use of high-resolution mammography, aimed mammography, palpatory examination of surgeon-oncologist, as well as fine-needle aspiration (FNA) biopsy and cytology analysis of the sample. Methodology of the work implied the use of stereotaxic marking, specimen mammography and extempore histopathology analysis. Results: From 40 investigated patients, the breast malignant tissue lesion was diagnosed in 18 patients (45%). Two of these lesions (11.1%) were histopathologically verified as ductal in situ cancer (DCIS) seven (38.9%) as DCIS with present invasive component, and in the remaining nine patients (50%) other cancer types were found. Conclusion: Comparing our results with data from the hospital registry of the Institute of Oncology and Radiology of Serbia (IORS) for 2001, where 1173 patients with the malignant lesions were registered of whom 13 (1.1%) patients with DCIS, we may conclude that there is statistically significant difference in number of detected cancers in this early stage. This further limits surgical intervention to tumorectomy in DCIS, and in DCIS with present invasive component it enables conserving operation in majority of cases. In both cases, disease prognosis is good, what speaks in favor of screening examination and routine application of the most contemporary procedures.

Increse of newly - detected in situ cancers in non-palpable breast lesions

2006 ◽  
Vol 53 (1) ◽  
pp. 73-75
Author(s):  
N. Miletic ◽  
D. Stojiljkovic ◽  
M. Inic ◽  
M. Prekajski ◽  
A. Celebic ◽  
...  
Keyword(s):  
Breast Tissue ◽  
Malignant Disease ◽  
Clinical Stage ◽  
Diagnostic Procedures ◽  
Basal Membrane ◽  
Needle Aspiration ◽  
Screening Mammography ◽  
Significant Difference ◽  
Malignant Lesions

Great importance in detecting cancer in the phase of in situ lays in the fact that the epithelial layer is deprived of blood and lymph vessels, so metastases may develop only when basal membrane has been broken. This paper includes 46 operated women in whom it preoperatively had been verified suspect non-palpable lesion. The preoperative diagnostics included use of high- resolution mammography, aimed mammography, palpatory examination, as well as fine-needle aspiration (FNA), biopsy and cytologic analysis of the sample. The methodology of this work implies the use of stereotaxic marking, specimen mammography and ex-tempore pathohistology analysis. Out of 46 investigated patients in clinical stage T0N0M0, in whom there were no signs of malignant disease, and according to suspect lesion of initial screening mammography, malignant lesions of breast tissue were diagnosed in 19 patients (41%) intraoperatively. Three of these lesions (15,8%) were histopathologically verified as in situ. Comparing our results with data of the Institute of oncology and radiology of Serbia hospital registry (IORS) for the year 2001, from 1173 patients registered with malignant lesions, only 16 ones (1,4%) had in situ cancer, operated on the basis of the suspect mammography of clinical stage T0N0M0. Statistically significant difference was found related to the number of detected cancers in this early phase of the breast malignant disease. This limits surgical intervention to tumorectomy, with preservation of the remaining breast tissue, what brings to healing, justifying in that way, screening examinations and routine application of the most contemporary diagnostic procedures.

The Application of Fine Needle Aspiration Biopsy in the Diagnosis of Axillary Masses

2021 ◽  
pp. 1-7
Author(s):  
Cong-Gai Huang ◽  
Meng-Ze Li ◽  
Shao-Hua Wang ◽  
Xiao-Qin Tang ◽  
Johannes Haybaeck ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Benign Lesions ◽  
Fine Needle ◽  
Significant Difference ◽  
Malignant Lesions ◽  
Axillary Mass

<b><i>Introduction:</i></b> We intend to determine the diagnostic power of fine needle aspiration biopsy (FNAB) for differentiation between malignant and benign lesions on axillary masses and draw the physicians’ attention to the benefits of FNAB cytology in the diagnosis of axillary masses. <b><i>Methods:</i></b> In this study, 1,328 patients with an axillary mass diagnosed by FNAB were retrospectively reviewed. These cases were registered at the affiliated hospital of Southwest Medical University (China), July 2014 to June 2017. Cytological results were verified either by histopathology following surgical resection or clinical follow-up. <b><i>Results:</i></b> Of the 1,328 patients affected by axillary masses, 987 (74.3%) cases were female, and 341 (25.7%) cases were male. The highest incidence of patients was in the age group of 41–50 years (375, 28.2%). There were 1,129 (85.0%) patients with benign lesions and 199 (15.0%) with malignant lesions. Of the 199 malignant lesions cases, 21 cases were lymphomas, 2 cases were accessory breast cancers, and 176 cases were lymph node metastatic tumors. Under lymph node metastases, the most frequent primary tumors were breast cancer (141, 80.1%), followed by lung cancer (21, 11.9%). According to the study, the characters of 1,328 cases showed statistically significant difference (χ<sup>2</sup> = 4.534, <i>p</i> = 0.033), and the incidence of females with axillary mass was significantly higher than that of males. There was a statistically significant difference in the distribution of benign and malignant cases in the patient age groups (χ<sup>2</sup> = 1.129, <i>p</i> = 0.000), and the incidence of patients of 41–50 years of age was significantly higher than that of other patients. The diagnostic accuracy of FNAB in axillary masses was analyzed with the results of 95.98% of sensitivity, 99.56% of specificity, 97.45% of positive predictive value, and 99.29% of negative predictive value. <b><i>Conclusion:</i></b> Our results confirm that FNAB is a valuable initial screening method regarding pathologic diagnosis of axillary mass, in particular with respect to malignancy in 41- to 50-year-old female patients.

scholarly journals Adenocarcinoma in situ and minimally invasive adenocarcinoma in lungs of smokers: image feature differences from those in lungs of non-smokers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haruto Sugawara ◽  
Hirokazu Watanabe ◽  
Akira Kunimatsu ◽  
Osamu Abe ◽  
Shun-ichi Watanabe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ct Images ◽  
Solid Component ◽  
Image Feature ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Invasive Component ◽  
Significant Difference ◽  
Minimally Invasive Adenocarcinoma

Abstract Purpose We aimed to examine the characteristics of imaging findings of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) in the lungs of smokers compared with those of non-smokers. Materials and methods We included seven cases of AIS and 20 cases of MIA in lungs of smokers (pack-years ≥ 20) and the same number of cases of AIS and MIA in lungs of non-smokers (pack-years = 0). We compared the diameter of the entire lesion and solid component measured on computed tomography (CT) images, pathological size and invasive component diameter measured from pathological specimens, and CT values of the entire lesion and ground-glass opacity (GGO) portions between the smoker and non-smoker groups. Results The diameters of AIS and MIA on CT images and pathological specimens of the smoker group were significantly larger than those of the non-smoker group (p = 0.036 and 0.008, respectively), whereas there was no significant difference in the diameter of the solid component on CT images or invasive component of pathological specimens between the two groups. Additionally, mean CT values of the entire lesion and GGO component of the lesions in the smoker group were significantly lower than those in the non-smoker group (p = 0.036 and 0.040, respectively). Conclusion AIS and MIA in smoker’s lung tended to have larger lesion diameter and lower internal CT values compared with lesions in non-smoker’s lung. This study calls an attention on smoking status in CT-based diagnosis for early stage adenocarcinoma.

scholarly journals Cytological Study of Palpable Breast Lump Presenting in Eastern Nepal

2017 ◽  
Vol 1 (1) ◽  
pp. 27-32
Author(s):  
M. Singh ◽  
S.U. Kafle ◽  
K.K. Jha
Keyword(s):  
Benign Lesion ◽  
Significant Proportion ◽  
Needle Aspiration ◽  
Age Group ◽  
Breast Lump ◽  
Pathologic Assessment ◽  
Malignant Lesions ◽  
The Common ◽  
Palpable Breast ◽  
Needle Aspiration Cytology

Introduction Breast lump constitute significant proportion of surgical cases. It is necessary to distinguish between benign and malignant lesions for definite treatment. Fine needle aspiration cytology (FNAC) is widely adopted for the pathologic assessment because of its accuracy and ease of use.Objective The present study was done to find out the frequency of various patterns of breast lesion on FNAC and the common age - group in which the lesions occurs.Methodology This is a four years retrospective study carried out from December 2011 to January 2016. The 553 patients who presented with palpable breast lump, and have underwent FNAC irrespective of age and sex were included in the study. All the datas were collected from the patients record form. FNAC findings were correlated with the data from histopathology records to determine the sensitivity and specificity of FNAC.Results The majority of the patients were female and majority of lump was benign. Fibroadenoma was the most common lesion accounting for 32.18 % of all lesions and most commonly occurring in age group between 21 -30 years. Fibrocystic disease was second common benign lesion accounting for 30.56 also commonly accounting in the age group 21- 30 years. Carcinoma breast was seen in 5.42 % of cases (30/553) occurring most commonly in the female patients above 30 years of age. Most common age group for gynaecomastia in male breast was 11 – 20 years.Conclusion FNAC is a rapid and safe method for diagnosing palpable breast lump into benign and malignant categorizes and thus avoiding unnecessary surgery.Birat Journal of Health Sciences 2016 1(1): 27-32

The evolution of breast cancer screening in the Medicare population: Clinical and economic implications.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1595-1595
Author(s):  
Brigid K. Killelea ◽  
Jessica B. Long ◽  
Xiaomei Ma ◽  
Rong Wang ◽  
Anees B. Chagpar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Early Stage ◽  
Early Period ◽  
Stage At Diagnosis ◽  
Economic Implications ◽  
Medicare Program ◽  
Significant Difference ◽  
The Mean

1595 Background: Breast screening has evolved as newer approaches to mammography, ultrasound, and MRI have diffused into clinical practice. The use of these technologies and their impact on screening-related costs and outcomes remain undefined, particularly among older women. Methods: Using the Surveillance Epidemiology and End Results – Medicare linked database, we identified women aged 66 and older without a diagnosis of breast cancer. We constructed two cohorts (2001 vs. 2006) and followed each for two years. We assessed changes in imaging technology, screening-related costs (defined as costs for screening and subsequent imaging and testing, adjusted to 2009 USD), and stage at diagnosis between the two cohorts. Results: There were 136,845 women in the 2001-2002 (earlier) cohort and 137,733 in the 2006-2007 (later) cohort. The mean age was 76.9 and 77.2 respectively, (p<.001). The proportion of women receiving any screening mammogram was 42.5% in the earlier cohort and 43.4% in the later cohort, (p<.001). The use of digital mammography for screening increased from 2.2% to 15.0%, (p<.001). The use of any computer aided detection (CAD) increased from 3.2% to 29.3% (p<.001). MRI use increased from 0.03% to 0.2%, and ultrasound use from 4.0% to 4.5% (p <.001 for both). Average screening-related cost increased 31%, from $101 to $132 (p<.001). There was no significant difference in early stage at diagnosis over time (58.1% of women were in situ/stage I in early period vs. 57.2% in later period, p=.65). Conclusions: The use of digital mammography and CAD increased substantially between 2001 and 2007, contributing to a 31% increase in screening-related costs for women in the Medicare program. The increased cost of screening and downstream testing must be evaluated in context of an absence of benefit in terms of stage at diagnosis.

scholarly journals Quantitative implications of the updated EARL 2019 PET–CT performance standards

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Andres Kaalep ◽  
Coreline N. Burggraaff ◽  
Simone Pieplenbosch ◽  
Eline E. Verwer ◽  
Terez Sera ◽  
...  
Keyword(s):  
Performance Standards ◽  
Blood Pool ◽  
Volume Of Interest ◽  
Quantitative Metrics ◽  
Pet Ct ◽  
Significant Difference ◽  
Cancer Types ◽  
Malignant Lesions ◽  
The Impact ◽  
Ct Studies

Abstract Purpose Recently, updated EARL specifications (EARL2) have been developed and announced. This study aims at investigating the impact of the EARL2 specifications on the quantitative reads of clinical PET–CT studies and testing a method to enable the use of the EARL2 standards whilst still generating quantitative reads compliant with current EARL standards (EARL1). Methods Thirteen non-small cell lung cancer (NSCLC) and seventeen lymphoma PET–CT studies were used to derive four image datasets—the first dataset complying with EARL1 specifications and the second reconstructed using parameters as described in EARL2. For the third (EARL2F6) and fourth (EARL2F7) dataset in EARL2, respectively, 6 mm and 7 mm Gaussian post-filtering was applied. We compared the results of quantitative metrics (MATV, SUVmax, SUVpeak, SUVmean, TLG, and tumor-to-liver and tumor-to-blood pool ratios) obtained with these 4 datasets in 55 suspected malignant lesions using three commonly used segmentation/volume of interest (VOI) methods (MAX41, A50P, SUV4). Results We found that with EARL2 MAX41 VOI method, MATV decreases by 22%, TLG remains unchanged and SUV values increase by 23–30% depending on the specific metric used. The EARL2F7 dataset produced quantitative metrics best aligning with EARL1, with no significant differences between most of the datasets (p>0.05). Different VOI methods performed similarly with regard to SUV metrics but differences in MATV as well as TLG were observed. No significant difference between NSCLC and lymphoma cancer types was observed. Conclusions Application of EARL2 standards can result in higher SUVs, reduced MATV and slightly changed TLG values relative to EARL1. Applying a Gaussian filter to PET images reconstructed using EARL2 parameters successfully yielded EARL1 compliant data.

scholarly journals Dynamic telecytopathology of on site rapid cytology diagnoses for pancreatic carcinoma

CytoJournal ◽  
2006 ◽  
Vol 3 ◽  
pp. 27 ◽  
Author(s):  
Burton Kim ◽  
David C Chhieng ◽  
David R Crowe ◽  
Darshana Jhala ◽  
Nirag Jhala ◽  
...  
Keyword(s):  
Pancreatic Carcinoma ◽  
Real Time ◽  
Kappa Statistic ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Kappa Statistics ◽  
Work Time ◽  
Significant Difference ◽  
Malignant Lesions ◽  
The Difference

Background: Diagnosis of pancreatic lesions can be accurately performed by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) with onsite cytopathologists to assess specimen adequacy and to determine a preliminary diagnosis. Considerable time is needed to perform on-site assessments. This takes away work time of cytopathologists and prohibits them from serving remote locations. It is therefore logical to ask if real-time telecytopathology could be used to assess specimen adequacy and if telecytopathology diagnosis has the same level of agreement to the final diagnosis as that of onsite evaluation. In this study, we compare agreement between cytodiagnoses rendered using telecytopathology with onsite and final interpretations. Method: 40 Diff-Quik-stained EUS-FNA were re-evaluated retrospectively (patient ages 31-62, 19:21 male:female, 15 non-malignant lesions, 25 malignant lesions as classified by final diagnosis). Each previously assessed by a cytopathologist and finally reviewed by the same or different cytopathologist. Blinded to the final diagnosis, a resident pathologist re-screened all slides for each case, selected a slide and marked the diagnostic cells most representative of the lesion. Blinded to the diagnosis, one cytopathologist assessed the marked cells through a real time remotely operated telecytopathology system (MedMicroscopy). Diagnosis and time spent were recorded. Kappa statistic was used to compare agreements between telecytopathology vs. original onsite vs. final diagnoses. Results: Time spent for prescreening ranged from 1 to 5 minutes (mean 2.6 +/- 1.3 minutes) and time spent for telecytopathology diagnosis ranged from 2-20 minutes (mean 7.5 +/- 4.5 minutes). Kappa statistics, K, was as follows: telecytopathology versus onsite diagnosis K, 95% CI = 0.65, 0.41-0.88, for telecytopathology versus final K, 95% CI = 0.61, 0.37-0.85 and for onsite diagnosis versus final K, 95% CI = 0.79, 0.61-0.98. There is no significant difference in agreement between onsite and telecytopathology diagnoses. Kappa values for telecytopathology were less than onsite evaluation when compared to the final diagnosis; however, the difference was not statistically significant. Conclusion: This retrospective study demonstrates the potential use of telecytopathology as a valid substitute for onsite evaluation of pancreatic carcinoma by EUS-FNA.

Data from an integrated cancer prevention center screening for multiple cancer types.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13069-e13069
Author(s):  
Ezra Bernstein ◽  
Ofer Isakov ◽  
Lior Galazan ◽  
Ari Leshno ◽  
Meital Shaked ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pap Smear ◽  
Oral Surgery ◽  
Early Stage ◽  
Clinical Indication ◽  
Multiple Cancer ◽  
Free Psa ◽  
Cancer Types ◽  
Malignant Lesions ◽  
Prevention Center

e13069 Background: Cancer is the second leading cause of death globally, and was responsible for ~9.6 million deaths in 2018. Importantly, between 30–50% of cancers can be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies. Methods: We present the results of 15758 adults who came to our clinic between 2006 and 2018. Patients were counseled on reducing risk factors and screened for early detection of 11 of the most common cancer types. Patients were examined by specialists in internal medicine, surgery, plastic surgery, OBGYN, urology, oncology, oral surgery, gastroenterology, and others. Women underwent vaginal US, pap smear, mammography (40yr) and US/MRI of the breast with a clinical indication. Men underwent PSA/free PSA ( > 40yr). LDCT for moderate smokers. Colonoscopy was recommended to all subjects ( > 40yr). Results: A total of 7900 (50.1%) men and 7857 women (49.9%) mean age 46.9±11.3 years were screened. A total of 418 (2.7%) malignant lesions were detected in patients who had been screened, 245 (1.6%) of which were detected through our screening: skin 66 (0.4%), prostate 30 (0.2%), thyroid 28 (0.2%), breast 28 (0.2%), colorectal 19 (0.1%), urinary 13 (0.08%), lung 11 (0.07%), cervical 11 (0.07%), other/unknown 9 (0.06%), hematologic 8 (0.05%), ovarian 5 (0.03%), uterine 5 (0.03%), pancreas 3 (0.02%), testicular 3 (0.02%), oropharyngeal 2 (0.01%), hepatobiliary 2 (0.01%), stomach 1 (0.01%), larynx 1 (0.01%). A total of 17 (0.1%) malignant lesions were missed: breast 3 (0.02%), colorectal 3 (0.02%), skin 2 (0.01%), thyroid 2 (0.01%), hematologic 2 (0.01%), pancreas 2 (0.01%), kidney 1 (0.01%), lung 1 (0.01%), brain 1 (0.01%). A total of 147 (0.9%) malignant lesions developed > 1year after a visit. Only forty-nine of the cancer patients (12.5%) died after 18.9±17.8 months at a mean age of 66.5±12.2 years. Significantly, better than the expected cancer mortality in general. First-degree family member with cancer (HR = 1.46) and advanced age (HR = 21.8) was associated with increased cancer risk (P < 0.05). Conclusions: One stop shop cancer screening, in the setting of a multidisciplinary outpatient clinic is feasible, can detect cancer at an early stage, and can significantly improve survival.

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

1997 ◽  
Vol 36 (08) ◽  
pp. 282-288 ◽  
Author(s):  
T. Atasever ◽  
A. Özdemir ◽  
I. Öznur ◽  
N. I. Karabacak ◽  
N. Gökçora ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Lower Sensitivity ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Combined Use ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
Benign Breast Lesions ◽  
Palpable Breast ◽  
Metastatic Sites

Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

TO SEPARATELY ASSESS THE DIAGNOSTIC POTENTIAL OF TVS & MRI IN THE TERMS OF SENSITIVITY AND SPECIFICITY BY CORRELATING THE IMAGING FINDINGS WITH HISTOPATHOLOGY

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Suraj Mathur
Keyword(s):  
Transvaginal Ultrasound ◽  
High Sensitivity ◽  
Imaging Evaluation ◽  
Medical College ◽  
Conventional Mri ◽  
Diagnostic Potential ◽  
Adc Mapping ◽  
Malignant Lesions ◽  
Sensitivity Specificity

This prospective study was done in the Department of Radio diagnosis Govt. Medical College, Kozhikode. A total of 65 patients who were referred to our department with clinical suspicion of endometrial lesions and incidentally detected endometrial lesions on ultrasonography underwent transvaginal ultrasound and subsequent Imaging evaluation of pelvis MRI has very high sensitivity (95%) and specificity (98%) and is almost as accurate (97%) as histopathology in differentiating benign from malignant lesions. Addition of DWI with ADC mapping to conventional MRI increases its accuracy even more. However there is inherent limitation to MRI in detecting carcinoma in situ and micrometastasis. Keywords: TVS, MRI, Sensitivity, Specificity, Histopathology.

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