Idiopathic gigantomastia in a patient on polypharmacy.

Gigantomastia is an uncommon benign condition characterized by massive breast enlargement. It is most often due to hormonal imbalance secondary to puberty or pregnancy, or induced by a pharmacological agent but can also be idiopathic. Herein, we report a rare case of idiopathic gigantomastia in a 46-year-old female on antiepileptic multiple-drug therapy who underwent total bilateral mastectomy to relieve associated pain.

Critical Orientation in the Jungle of Currently Available Methods and Types of Data for Source Attribution of Foodborne Diseases.

With increased interest in source attribution of foodborne pathogens, there is a need to sort and assess the applicability of currently available methods. Herewith we reviewed the most frequently applied methods for source attribution of foodborne diseases, discussing their main strengths and weaknesses to be considered when choosing the most appropriate methods based on the type, quality, and quantity of data available, the research questions to be addressed, and the (epidemiological and microbiological) characteristics of the pathogens in question. A variety of source attribution approaches have been applied in recent years.

Comparative Evaluation of Iodine-125 Radioactive Seed Localization and Wire Localization for Resection of Breast Lesions.

Purpose: Radioactive seed localization (RSL) uses a titanium seed labeled with iodine-125 energy for surgery of nonpalpable breast lesions. RSL facilitates radiology-surgery scheduling and allows for improved oncoplasty compared with wire localization (WL). The purpose of this work was to compare the 2 techniques.

Source attribution of human campylobacteriosis at the point of exposure by combining comparative exposure assessment and subtype comparison based on comparative genomic fingerprinting.

Human campylobacteriosis is a common zoonosis with a significant burden in many countries. Its prevention is difficult because humans can be exposed to Campylobacter through various exposures: foodborne, waterborne or by contact with animals. This study aimed at attributing campylobacteriosis to sources at the point of exposure.

Lupus mastitis as a first manifestation of systemic disease: About two cases with a review of the literature.

Lupus mastitis is an uncommon manifestation of systemic lupus erythematosus (SLE) that affects the subcutaneous fat in the breast, much like lupus panniculitis, but additionally involves the mammary gland. We report on two women for whom lupus mastitis was the initial manifestation of SLE and provide a literature review of 34 additional cases reported in the Anglo-Saxon and French literature since 1971, making this the largest review to date. Lupus mastitis (LM) can manifest clinically as subcutaneous masses that may be painful, or may present cutaneous involvement such as thickening and discolouration.

Is the outcome at surgery different when flat epithelial atypia and lobular neoplasia are found in association at biopsy?

Objective: To assess the impact on the final outcome at surgery of flat epithelial atypia (FEA) when found concomitantly with lobular neoplasia (LN) in biopsy specimens compared with pure biopsy-proven FEA.

Methods: The approval from the institutional review board of the CHUM (Centre Hospitalier Universitaire de Montréal) was obtained. A retrospective review of our database between 2009 and 2013 identified 81 females (mean age 54 years, range 38-90 years) with 81 FEA biopsy-proven lesions.

Breast Biopsies Under Magnetic Resonance Imaging Guidance: Challenges of an Essential but Imperfect Technique.

Magnetic resonance imaging (MRI)-guided breast biopsy is an essential tool of a breast imager; yet, a decade after its introduction, this technique remains challenging and imperfect. This article presents the technique of MRI-guided biopsy, with an emphasis on challenges particular to the technique: technical considerations related to adequate lesion sampling and difficulties in confirming radiologic-pathologic correlation for enhancing lesions. Through clinical vignettes, challenges unique to MRI-guided biopsy are discussed and practical tips are offered.

Breast imaging reporting and data system (BI-RADS) lexicon for breast MRI: interobserver variability in the description and assignment of BI-RADS category.

Purpose: To retrospectively evaluate interobserver variability between breast radiologists when describing abnormal enhancement on breast MR examinations and assigning a BI-RADS category using the Breast Imaging Reporting and Data System (BI-RADS) terminology.

Materials And Methods: Five breast radiologists blinded to patients' medical history and pathologic results retrospectively and independently reviewed 257 abnormal areas of enhancement on breast MRI performed in 173 women. Each radiologist described the focal enhancement using BI-RADS terminology and assigned a final BI-RADS category.

Molecular classification of infiltrating breast cancer: toward personalized therapy.

Breast cancer is a heterogeneous disease, which comprises several molecular and genetic subtypes, each with characteristic clinicobiologic behavior and imaging patterns. Traditional classification of breast cancer is based on the histopathologic features but offers limited prognostic value. Novel molecular characterization of breast cancer with cellular markers has allowed a new classification that offers prognostic value, with predictive categories of disease aggressiveness.

Comparative effectiveness of ACC-deaminase and/or nitrogen-fixing rhizobacteria in promotion of maize (Zea mays L.) growth under lead pollution.

Lead (Pb) pollution is appearing as an alarming threat nowadays. Excessive Pb concentrations in agricultural soils result in minimizing the soil fertility and health which affects the plant growth and leads to decrease in crop production. Plant growth promoting rhizobacteria (PGPR) are beneficial bacteria which can protect the plants against many abiotic stresses, and enhance the growth.

Case 201: glomus tumor of the breast.

History A 55-year-old woman presented to our breast clinic with 1-year history of lancinating pain in the right breast that was exacerbated by blunt pressure and cold temperature. She denied any family history of breast cancer or any personal history of trauma, infection, or surgery of the breast. On clinical examination, exquisite pain was generated by simple light pressure over the upper outer quadrant of the right breast.

Breast reconstruction: review of surgical methods and spectrum of imaging findings.

Breast reconstruction after mastectomy is often requested by women with breast cancer who are ineligible for breast-conserving therapy and women with a high genetic risk for breast cancer. Current breast reconstruction techniques are diverse and may involve the use of an autologous tissue flap, a prosthetic implant, or both. Regardless of the technique used, cancer may recur in the reconstructed breast; in addition, in breasts reconstructed with autologous tissue flaps, benign complications such as fat necrosis may occur.

Chronic granulomatous mastitis: Imaging, pathology and management.

Purpose: The aim of this study is to describe the clinical and radiological presentation of chronic granulomatous mastitis.

Material And Methods: We retrospectively reviewed the clinical and radiological data of 11 women with histologically proven chronic granulomatous mastitis (CGM) diagnosed between March 2008 and September 2011.

Results: The diagnosis of CGM is often a challenging one that can mimic infectious and malignant breast conditions.

A plea for the biopsy marker: how, why and why not clipping after breast biopsy?

In the last decade, percutaneous breast biopsies have become a standard for the management of breast diseases. Biopsy clips allow for precise lesion localization, thus minimizing the volume of breast to be resected at the time of surgery. With the development of many imaging techniques (including mammography, sonography, and breast magnetic resonance imaging), one of the challenges of the multidisciplinary became to synthesize all informations obtained from the various imaging procedures.

Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up.

Radiologists who regularly perform breast ultrasonography will likely encounter patients with breast abscesses. Although the traditional approach of surgical incision and drainage is no longer the recommended treatment, there are no clear guidelines for management of this clinical condition. Breast abscesses that develop in the puerperal period generally have a better course than nonpuerperal abscesses, which tend to be associated with longer treatment times and a higher rate of recurrence.

Microcalcifications around a collagen-based breast biopsy marker: complication of biopsy with a percutaneous marking system.

Objective: The purpose of this article is to present the cases of four women who underwent percutaneous breast biopsy with deployment of a titanium metallic marker embedded in a bioresorbable collagen plug. Routine follow-up mammography after benign pathologic results were obtained revealed new fine microcalcifications at the biopsy sites, requiring repeat biopsy. Pathologic examination confirmed the presence of microcalcifications associated with an acidophilic foreign material.

Nonmasslike enhancement at breast MR imaging: the added value of mammography and US for lesion categorization.

Purpose: To determine the value of adding conventional imaging (mammography and ultrasonography [US]) to nonmasslike enhancement (NMLE) analysis with breast magnetic resonance (MR) imaging for predicting malignancy and for building an interpretation model incorporating all imaging modalities.

Materials And Methods: The institutional ethics committees approved the study and granted a waiver of informed consent. In 115 women (mean age, 48.

Second-look targeted studies after breast magnetic resonance imaging: practical tips to improve lesion identification.

Second-look studies, so-called because a re-evaluation of the breast is performed after review of magnetic resonance imaging (MRI) findings, offer the possibility of identifying correlates to MRI-detected lesions that were not previously suspected at mammography or ultrasound, thereby permitting immediate biopsy. To maximize the identification of ultrasound and mammographic correlates to MRI-identified lesions, one must carefully review the initial MRI examination as well as be cognizant of breast normal anatomy and variations in breast position across imaging modalities. We review the steps required for planification and realization of a successful second-look evaluation.

Imaging findings of breast augmentation with injected hydrophilic polyacrylamide gel: patient reports and literature review.

Hydrophilic polyacrylamide gel (PAAG) is a nonresorbable soft tissue filler that has been used as implant material for breast augmentation in some countries, particularly from the Asian continent. Many complications associated with hydrogel use have been reported in the clinical literature including inflammation, persistent mastodynia, formation of multiple lumps, poor cosmetic results, glandular atrophy, and significant spread of hydrogel into the surrounding tissue. Data on long-term toxicity is currently unavailable.

Significant reduction of antibiotic use in the community after a nationwide campaign in France, 2002-2007.

Background: Overuse of antibiotics is the main force driving the emergence and dissemination of bacterial resistance in the community. France consumes more antibiotics and has the highest rate of beta-lactam resistance in Streptococcus pneumoniae than any other European country. In 2001, the government initiated "Keep Antibiotics Working"; the program's main component was a campaign entitled "Les antibiotiques c'est pas automatique" ("Antibiotics are not automatic") launched in 2002.

Management of radial scars found at percutaneous breast biopsy.

Objective: To determine whether percutaneous biopsy can safely differentiate radial scars (RS) that can be followed from those that require excision.

Methods: Retrospective analysis of prospectively collected data regarding 15 986 biopsies was performed at the Centre Hospitalier de l'Université de Montreal between October 1995 and December 2003 and yielded 227 RS. The type of biopsy, number of cores, and mammographic characteristics were recorded.

Breast cancer staging: the role of the radiologist.

The role of the breast radiologist has evolved over the past years, with an increasing involvement in patient care. Improvements in diagnostic technology and surgical techniques allow for better preoperative staging and surgeries with decreased morbidity. This article reviews the elements of investigation that are important to the surgeon and oncologist in optimizing care for the newly diagnosed breast cancer patient, with the 6th edition of the TNM classification of the American Joint Committee on Cancer used as a reference.