Aims and objectives
We know that US has the tendency to underestimate the size of breast malignancies (Fig. 1),
particularly in the case of:
lobular tumors
“vertical” lesions (back shadow)
retroareolar lesions
spiculated lesions
non mass-like lesions
lesions with large in situ components.
Back-shadowing is present in 35% of breast cancers,
is not specific for malignancy,
and correlates with the desmoplastic reaction (Fig. 2).
The hyperechoic peritumoral halo may be thick or thin and is due to the tumor infiltration (spiculations) and/or to the desmoplastic reaction and/or to...
Methods and materials
Our study was:
Monocentric (National Cancer Institute)
Prospective
Not randomized
Correlated with MRI
Standard: pathology.
Both nodular and infiltrating lesions were considered,
even if multiple (plurifocal).
Inclusion criteria were the followings:
patients scheduled for breast surgery
BI-RADS 5 and 6 (malignant breast lesions confirmed at preoperative cytology – suspected breast cancer confirmed at postoperative histology)
absence of any contraindication to contrast-enhanced breast MRI
preoperative execution of sonography,
elastography,
and MRI.
Exclusion criteria were the followings:
previous neoadjuvant therapy
breast biopsy in the last 30 days...
Results
We enrolled 22 pts.
not consecutive undergoing radical mastectomy,
quadrantectomy,
or wedge resection.
Two cases were excluded for incompleteness or inadequacy of the preoperative data and one case was excluded because the suspicion of malignancy was not confirmed at final pathology.
The final study group consisted of 23 malignant lesions (1-4/pt.,
mean 1.2) in 19 patients (26-88 years old,
mean 56).
The location was:
10 central
8 retro-parareolar
5 peripheral.
The morphological pattern was:
11 ill-defined,
nodular
9 well-defined,
nodular
3 diffuse.
The histotype was:...
Conclusion
It is known that all imaging modalities may have difficulties in accurately measuring breast cancer (Fig. 24).
A recent article has evaluated the potential application of elastography to measure breast cancer (Fig. 25).
There was no significant advantage of elastography,
although a tendency was apparent.
Elastography had a lower interobserver variability in comparison with US.
This study,
however,
did not considered however MRI and included benign lesions too.
In a small study US was found to slightly,
but non significantly,
undersize breast cancer while elastography...
Personal information
Orlando Catalano,
MD,
Dept of Radiology I,
National Cancer Institute,
Pascale Foundation,
Naples,
Italy
[email protected]
Roberta Fusco,
BiomedicalEngineer,
Dept of Radiology I,
National Cancer Institute,
Pascale Foundation,
Naples,
Italy
MaurizioDi Bonito,MD,
Dept of Pathology,
National Cancer Institute,
Pascale Foundation,
Naples,
Italy
AntonioNunziata,
MD,
Dep of Radiology,
Private Institute,
Naples,
Italy
Vittoria Nunziata,
L'Aquila University,
L'Aquila,
Italy
SalvatoreFilice,MD,
Dept of Radiology I,
National Cancer Institute,
Pascale Foundation,
Naples,
Italy
Antonella Petrillo,MD,
Dept of Radiology I,
National Cancer Institute,
Pascale Foundation,
Naples,
Italy
[email protected]
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