Rationale And Objectives: Recent ICE3 trial of breast cryoablation for breast cancer demonstrated 98% success rate, similar to breast-conserving surgery. However, ICE3 and other published studies did not differentiate curative from palliative treatment nor define patient-specific treatment objectives. We sought to define treatment success of curative and palliative breast cryoablation for breast cancer in meeting procedure objectives and patient-specific treatment objectives.
View Article and Find Full Text PDFBreast cryoablation for palliative and curative treatment of breast cancer has been performed for decades. Although there is a recent resurgence of interest in breast cryoablation with curative intent for unifocal, hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer, this report highlights the essential role that cryoablation can play in the palliative treatment of multicentric oestrogen and progesterone receptor-negative and human epidermal growth factor receptor 2-negative (triple-negative) breast cancer, meeting the select pretreatment objectives such as breast or nipple pain relief and prevention of tumour erosion through the skin or nipple in patients who have failed or cannot tolerate the standard of care treatment.
View Article and Find Full Text PDFSurgical treatment for breast cancer has evolved from radical mastectomy to modified radical mastectomy to breast-conserving surgery. As the de-escalation of surgical treatment for breast cancer continues, nonsurgical treatment for early-stage breast cancer with favorable ancillary features (low grade, positivity for hormone receptors) is being explored. Of the nonsurgical treatment options, cryoablation has demonstrated the greatest appeal, proven to be effective, safe, well tolerated, and feasible in an outpatient setting with local anesthetic alone.
View Article and Find Full Text PDFThis study aimed to investigate mid-treatment breast tumor ultrasound characteristics that may predict eventual pathologic complete response (pCR) in triple-negative breast cancer; specifically, we examined associations between pCR and two parameters: tumor response pattern and tumor appearance. Ultrasound was performed at mid-treatment, defined as the completion of four cycles of anthracycline-based chemotherapy and before receiving taxane-based chemotherapy. Consensus imaging review was performed while blinded to pathology results (i.
View Article and Find Full Text PDFBreast radiologists are increasingly seeing patients with axillary adenopathy related to COVID-19 vaccination. Vaccination can cause levels I-III axillary as well as cervical lymphadenopathy. Appropriate management of vaccine-related adenopathy may vary depending on clinical context.
View Article and Find Full Text PDFRationale And Objectives: Lack of uniformity in radiology resident education is partially attributable to variable access to subspecialty education. Web-based courses improve standardization, but with growing emphasis on competency based education, more evaluation of their effectiveness is needed. We created a responsive web-based breast imaging curriculum for radiology residents including self-assessment and a satisfaction survey.
View Article and Find Full Text PDFPatients may present to the emergency department with breast complaints due to traumatic or nontraumatic changes in the breast. Benign and malignant breast pathologies may mimic each other both in clinical presentation and imaging appearance. A complex cystic and solid mass seen on ultrasound in a patient with a palpable mass can represent breast cancer, abscess, or hematoma.
View Article and Find Full Text PDFObjective: To review breast cancer incidence in women with ADH diagnosed by CNB and managed nonoperatively.
Background: ADH found on CNB is associated with an upgrade to carcinoma in 10%-50% of women, thus surgical excision remains the standard of care. Safety of nonoperative management is unknown.
Background: Dynamic contrast-enhanced (DCE) MRI is useful for diagnosis and assessment of treatment response in breast cancer. Fast DCE MRI offers a higher sampling rate of contrast enhancement curves in comparison to conventional DCE MRI, potentially characterizing tumor perfusion kinetics more accurately for measurement of functional tumor volume (FTV) as a predictor of treatment response.
Purpose: To investigate FTV by fast DCE MRI as a predictor of neoadjuvant systemic therapy (NAST) response in triple-negative breast cancer (TNBC).
Mammary Paget disease (MPD) comprises 1.45% all male breast cancers, compared with only 0.68% of all female breast cancers.
View Article and Find Full Text PDFPurpose: To determine if tumor necrosis by pretreatment breast MRI and its quantitative imaging characteristics are associated with response to NAST in TNBC.
Methods: This retrospective study included 85 TNBC patients (mean age 51.8 ± 13 years) with MRI before NAST and definitive surgery during 2010-2018.
Purpose: To investigate the value of performing mid-treatment axillary ultrasound (AUS) in triple-negative breast cancer (TNBC) patients who are undergoing neoadjuvant systemic therapy (NAST) by determining the optimal cutoff number of abnormal nodes associated with residual nodal disease on surgical pathology.
Materials And Methods: This sub-study, an interim analysis of an ongoing single-institution clinical trial enrolling patients with stage I-III TNBC, included 106 patients. Number of abnormal nodes at mid-treatment was assessed and recorded by experienced breast radiologists, who empirically categorized lymph nodes using a binary approach of sonographically-normal versus abnormal.
Challenges currently facing breast radiologists, including controversial screening mammography guidelines, radiologist burnout, and the perceived threat posed by artificial intelligence could deter potential candidates from pursuing a career in radiology. However, breast radiologists play a fulfilling role by decreasing the effect of breast cancer through both early detection and direct interaction with patients and interdisciplinary clinical colleagues. While perception is that artificial intelligence will threaten the need for radiologists, it is more likely that it will improve image interpretation and efficiency in workflow, thereby further improving patient care.
View Article and Find Full Text PDFObjective: Different molecular subtypes of triple-negative breast cancer (TNBC) have previously been identified through analysis of gene expression profiles. The luminal androgen receptor (LAR) subtype has been shown to have a lower rate of pathologic complete response to neoadjuvant chemotherapy than other TNBC subtypes. The purpose of this study was to determine if the imaging features of TNBCs differ by AR (androgen receptor) status, which is a surrogate immunohistochemical (IHC) marker for the chemoresistant LAR subtype of TNBC.
View Article and Find Full Text PDFBackground And Purpose: The potential for therapeutic antibody treatment of neurological diseases is limited by poor penetration across the blood-brain barrier. I.c.
View Article and Find Full Text PDFPurpose: Atypical ductal hyperplasia (ADH) found on core biopsy is associated with an upgrade to carcinoma in 10-30 % of women, thus surgical excision remains the standard of care. This study compares the incidence of breast cancer in women with ADH who were observed with those who underwent surgical excision of the ADH site.
Methods: Our departmental, prospectively maintained registry was reviewed to identify patients with ADH diagnosed by core biopsy.
Objective: This article describes the use of sonography for the locoregional staging of breast cancer. Sonography may identify mammographically occult disease within the breast. Sonography of the regional nodal basins, including the axilla, infraclavicular, supraclavicular, and internal mammary regions, can identify nodal metastases, which may upstage disease and have implications for prognosis.
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