Publications by authors named "Eva Fallenberg"

Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed.

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Breast ultrasound has been established for many years as an important method in addition to mammography for clarifying breast findings. The goal of the Best Practice Guidelines Part III of the DEGUM breast ultrasound working group is to provide colleagues working in senology with information regarding the specific medical indications for breast ultrasound in addition to the current ultrasound criteria and assessment categories published in part I and the additional and optional sonographic diagnostic methods described in part II. The value of breast ultrasound for specific indications including follow-up, evaluation of breast implants, diagnostic workup of dense breast tissue, diagnostic workup during pregnancy and lactation, and the diagnostic workup of breast findings in men is discussed.

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Article Synopsis
  • A study was done to check how advanced imaging techniques called DWI are used in breast cancer detection and treatment!
  • Even though more research is being published about these techniques, only a small number of doctors currently use them in their practice!
  • The study suggests that more research and teamwork are needed to make these advanced imaging methods a regular part of breast cancer care to help improve diagnosis and treatment!
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Axillary lymphadenopathy (LA) after COVID-19 vaccination is now known to be a common side effect. In these cases, malignancy cannot always be excluded on the basis of morphological imaging criteria.Narrative review for decision-making regarding control and follow-up intervals for axillary LA according to currently published research.

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The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2024 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer.

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Introduction: Each year the interdisciplinary AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer.

Methods: The updated evidence-based treatment recommendations for early and metastatic breast cancer have been released in March 2024.

Results And Conclusion: This paper concisely captures the updated recommendations for early breast cancer chapter by chapter.

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  • A study was conducted to improve the detection of complications in silicone breast implants using advanced MRI techniques, comparing chemical shift encoding (CSE) imaging to traditional double inversion recovery (DIR) imaging.
  • The research involved 71 women and showed that CSE imaging provided clearer images of silicone implants and adjacent tissues, with 96% of patients receiving improved visualization compared to DIR.
  • Results indicated that CSE imaging not only facilitated better detection of implant ruptures but also demonstrated higher contrast-to-noise ratios, suggesting it could be a valuable tool for clinicians in monitoring breast implant integrity.
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Objectives: Achieving a consensus on a definition for different aspects of radiomics workflows to support their translation into clinical usage. Furthermore, to assess the perspective of experts on important challenges for a successful clinical workflow implementation.

Materials And Methods: The consensus was achieved by a multi-stage process.

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Article Synopsis
  • - Pre-therapeutic histologic diagnosis for suspicious breast issues typically uses image-guided biopsies, but patients on anti-coagulation therapy face potential bleeding risks, and there's no standardized management protocol.
  • - A survey conducted among breast health experts revealed that over half believe there’s no standard approach for managing breast biopsies in patients on anti-coagulation or anti-platelet therapy, with differing views on when to discontinue medications.
  • - Experts generally consider breast biopsies safe for patients on aspirin or prophylactic heparin, but there’s hesitation around performing them on other medications like DOACs or phenprocoumon, suggesting a need for further guidelines.
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  • Metastasis-directed therapy has potential benefits for patients with oligometastatic disease (OMD), but breast cancer studies have not yet confirmed these benefits through randomized trials.
  • A study at the Technical University of Munich analyzed 80 patients using F-FDG PET/CT images to better define OMD, revealing that nearly half the time, this imaging method significantly changed the assessment of metastatic disease compared to conventional CT.
  • F-FDG PET/CT discovered additional metastases in a third of cases, highlighting the need for clearer standards in imaging definitions for future research and clinical practices in breast cancer treatment.
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  • The study focuses on the importance of identifying internal mammary lymph node (IMN) metastases in breast cancer patients to optimize treatment strategies like regional lymph node irradiation.
  • Researchers analyzed a total of 297 patients with breast cancer who showed evidence of IMN and/or axillary metastases, assessing tumor contact with internal mammary perforating vessels (IMPV) using advanced MRI techniques.
  • Results indicated a strong correlation between major IMPV contact and the presence of gross IMN involvement, with the predictive accuracy of major IMPV contact surpassing traditional clinical models, suggesting it could be a key risk factor in determining treatment plans.
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  • - Breast MRI is a crucial tool in breast imaging, providing valuable insights for diagnosis and treatment.
  • - Updated recommendations for conducting breast MRI include a useful table that summarizes key points and offers additional detailed commentary.
  • - The "classic" breast MRI can be performed following these updated guidelines, with specific tips for addressing clinical issues like implant rupture and lymph node status.
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The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2023 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer (mBC).

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Background: Each year the interdisciplinary Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), German Gynecological Oncology Group Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer.

Summary: The updated evidence-based treatment recommendation for early and metastatic breast cancer has been released in March 2023.

Key Messages: This paper concisely captures the updated recommendations for early breast cancer chapter by chapter.

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Background: Contrast-enhanced mammography (CEM) is an imaging method that is able to improve visualization of intramammary tumors after peripheral venous administration of an iodine-containing contrast medium (ICM).

Objectives And Methods: The current significance of CEM is discussed.

Results: Studies were able to show an advantage of CEM in the diagnosis of breast cancer compared to mammography, especially for women with dense breasts.

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Objectives: Quality assurance (QA) of image interpretation plays a key role in screening and diagnostic mammography, maintaining minimum standards and supporting continuous improvement in interpreting images. However, the QA structure across Europe shows considerable variation. The European Society of Breast Imaging (EUSOBI) conducted a survey among the members to collect information on radiologists' preferences regarding QA measures in mammography.

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Axillary lymphadenopathy is a common side effect of COVID-19 vaccination, leading to increased imaging-detected asymptomatic and symptomatic unilateral axillary lymphadenopathy. This has threatened to negatively impact the workflow of breast imaging services, leading to the release of ten recommendations by the European Society of Breast Imaging (EUSOBI) in August 2021. Considering the rapidly changing scenario and data scarcity, these initial recommendations kept a highly conservative approach.

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The heterogeneous group of B3 lesions in the breast harbors lesions with different malignant potential and progression risk. As several studies about B3 lesions have been published since the last Consensus in 2018, the 3rd International Consensus Conference discussed the six most relevant B3 lesions (atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), radial scar (RS), papillary lesions (PL) without atypia, and phyllodes tumors (PT)) and made recommendations for diagnostic and therapeutic approaches. Following a presentation of current data of each B3 lesion, the international and interdisciplinary panel of 33 specialists and key opinion leaders voted on the recommendations for further management after core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB).

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Purpose: To (a) develop a preconditioned water-fat-silicone total field inversion (wfsTFI) algorithm that directly estimates the susceptibility map from complex multi-echo data in the breast in the presence of silicone and to (b) evaluate the performance of wfsTFI for breast quantitative susceptibility mapping (QSM) in silico and in vivo in comparison with formerly proposed methods.

Methods: Numerical simulations and in vivo multi-echo gradient echo breast measurements were performed to compare wfsTFI to a previously proposed field map-based linear total field inversion algorithm (lTFI) with and without the consideration of the chemical shift of silicone in the field map estimation step. Specifically, a simulation based on an in vivo scan and data from five patients were included in the analysis.

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Alongside mammography, breast ultrasound is an important and well-established method in assessment of breast lesions. With the "Best Practice Guideline", the DEGUM Breast Ultrasound (in German, "Mammasonografie") working group, intends to describe the additional and optional application modalities for the diagnostic confirmation of breast findings and to express DEGUM recommendations in this Part II, in addition to the current dignity criteria and assessment categories published in Part I, in order to facilitate the differential diagnosis of ambiguous lesions.The present "Best Practice Guideline" has set itself the goal of meeting the requirements for quality assurance and ensuring quality-controlled performance of breast ultrasound.

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Objectives: There is a clinical need for a non-ionizing, quantitative assessment of breast density, as one of the strongest independent risk factors for breast cancer. This study aims to establish proton density fat fraction (PDFF) as a quantitative biomarker for fat tissue concentration in breast MRI and correlate mean breast PDFF to mammography.

Methods: In this retrospective study, 193 women were routinely subjected to 3-T MRI using a six-echo chemical shift encoding-based water-fat sequence.

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The recommendations of the AGO Breast Committee on the surgical therapy of breast cancer were last updated in March 2022 (www.ago-online.de).

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Introduction: The AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Task Force on Diagnosis and Treatment of Breast Cancer as an interdisciplinary team consists of specialists from gynecological oncology, pathology, diagnostic radiology, medical oncology, and radiation oncology with a special focus on breast cancer.

Methods: The updated evidence-based treatment recommendation 2022 for early breast cancer (EBC) and metastatic breast cancer of the AGO Task Force has been released.

Results And Conclusion: This paper captures the update of EBC.

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The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2022 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer.

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