Clinical and Imaging Features Associated With Malignant Focal Nonmass Enhancement on Breast MRI.

Introduction: Focal non-mass enhancement (NME) is a common breast MRI finding with limited data to guide management. This study aimed to assess clinical and imaging features of malignant BI-RADS 4 focal NME.

Methods: This IRB-approved, retrospective study included breast MRI exams between August 1, 2013 and September 1, 2022 yielding BI-RADS 4 focal NME lesions that underwent core biopsy or excision with available pathology result or demonstrated decrease or resolution during follow-up MRI or at least 2 years of MRI stability.

MixTURE: L1-Norm-Based Mixed Second-Order Continuity in Strain Tensor Ultrasound Elastography.

Energy-based displacement tracking of ultrasound images can be implemented by optimizing a cost function consisting of a data term, a mechanical congruency term, and first- and second-order continuity terms. This approach recently provided a promising solution to two-dimensional axial and lateral displacement tracking in ultrasound strain elastography. However, the associated second-order regularizer only considers the unmixed second derivatives and disregards the mixed derivatives, thereby providing suboptimal noise suppression and limiting possibilities for total strain tensor imaging.

Clinical Outcomes of Benign Concordant MRI-Guided Breast Biopsies.

Introduction: MRI-guided biopsy is the standard of care for breast imaging findings seen only by MRI. Although a non-zero false-negative rate of MRI-guided breast biopsy has been reported by multiple studies, there are varied practice patterns for imaging follow-up after a benign concordant MRI guided biopsy. This study assessed the outcomes of benign concordant MRI-guided biopsies at a single institution.

Patient Utilization of Weekend and Evening Appointments for Screening Mammography: An 8-Year Observational Cohort Study.

Objective: To characterize the patient population using weekend and evening appointments for screening mammography versus standard appointment times across four outpatient facilities in our academic health system.

Methods: In this institutional review board-approved retrospective cohort study, there were 203,101 screening mammograms from 67,323 patients who had a screening mammogram performed at outpatient centers at a multisite academic institution from January 1, 2015, to December 31, 2022. Screening appointments were defined as "standard appointment time" (between 8 am and 5 pm on Monday through Friday) or "weekend or evening appointment time" (scheduled after 5 pm on Monday through Friday or at any time on a Saturday or Sunday).

Circumscribed Masses on Breast MRI: Can MRI Features Guide Management?

Objective: Management of circumscribed breast masses seen on MRI is largely extrapolated from mammography and US data with limited MRI-specific data available. This study aimed to assess clinical and MRI imaging features of malignant circumscribed breast masses.

Methods: In this IRB-approved retrospective study, breast MRIs performed between April 1, 2008, and August 30, 2020, containing circumscribed masses, excluding multiple bilateral circumscribed masses, were reviewed.

Spatial Coherence Approaches to Distinguish Suspicious Mass Contents in Fundamental and Harmonic Breast Ultrasound Images.

When compared to fundamental B-mode imaging, coherence-based beamforming, and harmonic imaging are independently known to reduce acoustic clutter, distinguish solid from fluid content in indeterminate breast masses, and thereby reduce unnecessary biopsies during a breast cancer diagnosis. However, a systematic investigation of independent and combined coherence beamforming and harmonic imaging approaches is necessary for the clinical deployment of the most optimal approach. Therefore, we compare the performance of fundamental and harmonic images created with short-lag spatial coherence (SLSC), M-weighted SLSC (M-SLSC), SLSC combined with robust principal component analysis with no M-weighting (r-SLSC), and r-SLSC with M-weighting (R-SLSC), relative to traditional fundamental and harmonic B-mode images, when distinguishing solid from fluid breast masses.

Clinical and Imaging Features of MRI Screen-Detected Breast Cancer.

Background: Supplemental screening with breast MRI is recommended annually for patients who have greater than 20% lifetime risk for breast cancer. While there is robust data regarding features of mammographic screen-detected breast cancers, there is limited data regarding MRI-screen-detected cancers.

Patients And Methods: Screening breast MRIs performed between August 1, 2016 and July 30, 2022 identified 50 screen-detected breast cancers in 47 patients.

Self-scheduling of Screening Mammograms Using an Online Patient Portal: Initial 8-year Experience at a Multisite Academic Institution.

Objective: The goal of this study was to determine patient factors associated with the use of self-scheduling of screening mammograms (SMs) using an online portal.

Methods: All SMs scheduled at our multisite academic institution from January 1, 2015, to December 31, 2022, were included. The frequency of self-scheduling via an online portal was calculated per year.

Yield of Familial Hypercholesterolemia Genetic and Phenotypic Diagnoses After Electronic Health Record and Genomic Data Screening.

Background Data mining of electronic health records to identify patients suspected of familial hypercholesterolemia (FH) has been limited by absence of both phenotypic and genomic data in the same cohort. Methods and Results Using the Geisinger MyCode Community Health Initiative cohort (n=130 257), we ran 2 screening algorithms (Mayo Clinic [Mayo] and flag, identify, network, deliver [FIND] FH) to determine FH genetic and phenotypic diagnostic yields. With 29 243 excluded by Mayo (for secondary causes of hypercholesterolemia, no lipid value in electronic health records), 52 034 excluded by FIND FH (insufficient data to run the model), and 187 excluded for prior FH diagnosis, a final cohort of 59 729 participants was created.

Can breast MRI predict pathologic response following neoadjuvant chemotherapy for breast cancer? A retrospective cohort study.

Purpose: For patients treated with neoadjuvant chemotherapy (NAC) for breast cancer, it is standard of care to perform pre- and post-NAC imaging to evaluate response to therapy prior to surgery. In this study we assess outcome metrics of magnetic resonance imaging (MRI) following NAC.

Methods: We conducted a retrospective analysis of patients with invasive breast cancer who underwent a breast MRI before and after NAC between 2016 and 2021 at a single, multisite academic institution.

Contemporary Homozygous Familial Hypercholesterolemia in the United States: Insights From the CASCADE FH Registry.

Background Homozygous familial hypercholesterolemia (HoFH) is a rare, treatment-resistant disorder characterized by early-onset atherosclerotic and aortic valvular cardiovascular disease if left untreated. Contemporary information on HoFH in the United States is lacking, and the extent of underdiagnosis and undertreatment is uncertain. Methods and Results Data were analyzed from 67 children and adults with clinically diagnosed HoFH from the CASCADE (Cascade Screening for Awareness and Detection) FH Registry.

Concomitant Use of Biopsy Clips and Wire Localization in Invasive Breast Cancer is Associated With Successful Clip Retrieval.

Introduction: Surgical management of the axilla in patients with clinically node-positive breast cancer has shifted to less invasive surgical approaches, such as sentinel lymph node dissection (SLND) and targeted axillary dissection (TAD). Successful retrieval of the biopsy clip marking the lymph node of interest is crucial for assessment of pathologic response and locoregional disease control.

Methods: We performed a retrospective review of patients ≥18 years old with invasive breast cancer and biopsy-proven axillary LN involvement, who underwent LN clip placement from January 2012 to July 2017 at Johns Hopkins Hospital.

Coherence Metrics for Reader-Independent Differentiation of Cystic From Solid Breast Masses in Ultrasound Images.

Traditional breast ultrasound imaging is a low-cost, real-time and portable method to assist with breast cancer screening and diagnosis, with particular benefits for patients with dense breast tissue. We previously demonstrated that incorporating coherence-based beamforming additionally improves the distinction of fluid-filled from solid breast masses, based on qualitative image interpretation by board-certified radiologists. However, variable sensitivity (range: 0.

High-risk lesions in the breast diagnosed by MRI-guided core biopsy: upgrade rates and features associated with malignancy.

Purpose: This study assessed the upgrade rates of high-risk lesions (HRLs) in the breast diagnosed by MRI-guided core biopsy and evaluated imaging and clinical features associated with upgrade to malignancy.

Methods: This IRB-approved, retrospective study included MRI-guided breast biopsy exams yielding HRLs from August 1, 2011, to August 31, 2020. HRLs included atypical ductal hyperplasia (ADH), lobular carcinoma in situ (LCIS), atypical lobular hyperplasia (ALH), radial scar, and papilloma.

Brain MRI and clinical exam findings in women with multiple gadolinium-based contrast agent (GBCA) exposures due to screening breast MRIs.

Objectives: Multiple exposures to gadolinium-based contrast agents (GBCAs) is known to be associated with gadolinium deposition in the brain in certain patients. Such deposition has been correlated with specific brain MRI findings, although most available data is in patients with underlying neurologic disorders. We aim to prospectively evaluate brain MRI signal changes as well as neurologic and neuropsychologic testing results in women undergoing screening breast MRI.

Disparities Associated With Patient Adherence to BI-RADS 3 Assessment Follow-up Recommendations for Mammography and Ultrasound.

Objective: To assess the relationship between sociodemographic factors and adherence rates in patients with a BI-RADS 3 assessment.

Methods: This retrospective cohort study reviewed data from all patients with a BI-RADS 3 assessment on mammography and ultrasound examinations at a single, multisite academic institution, which serves a diverse urban-suburban population, from January 1, 2015, to December 13, 2017. Appropriate follow-up was defined as returning for the first follow-up examination 3 to 9 months after the index examination.

Solitary Dilated Ducts Revisited: Malignancy Rate and Implications for Management.

Rationale And Objectives: A solitary dilated duct (SDD) is a single asymmetrically dilated breast duct with diameter more than 2 mm. The Breast Imaging Reporting and Data System (BI-RADS) fifth edition recommends additional imaging and biopsy for SDDs without demonstrated benign etiology, however management of this rare entity remains controversial. This study describes practice patterns, malignancy rate, and features associated with high-risk/malignant SDDs to better stratify patients requiring biopsy versus follow-up.

Comparison of Diagnostic Mammography-Guided Biopsy and Digital Breast Tomosynthesis-Guided Biopsy of Suspicious Breast Calcifications: Results in 1354 Biopsies.

Studies have shown improved targeting and sampling of noncalcified lesions (asymmetries, masses, and architectural distortion) with digital breast tomosynthesis (DBT)-guided biopsy in comparison with digital mammography (DM)-guided stereotactic biopsy. Literature that compares the two techniques specifically for sampling calcifications has been scarce. The purpose of this study was to compare the performance and outcomes of DM- and DBT-guided biopsy of suspicious calcifications.

Outcomes of Canceled Tomosynthesis-Guided Biopsy of Architectural Distortion Due to Nonvisualization.

Objective: Architectural distortion without a sonographic correlate is an indication for digital breast tomosynthesis-guided vacuum-assisted biopsy (DBT-VAB). However, when the finding is not visualized on the day of biopsy, the procedure is canceled. This study reports the outcomes of canceled DBT-VAB of architectural distortion due to nonvisualization.