Magnetic resonance imaging insights from active surveillance of women with ductal carcinoma in situ.

New approaches are needed to determine which ductal carcinoma in situ (DCIS) is at high risk for progression to invasive ductal carcinoma (IDC). We retrospectively studied DCIS patients who declined surgery (2002-2019), and received endocrine therapy (ET) and breast MRI. Baseline MRI and changes at 3 months and 6 months were analyzed by recursive partitioning to stratify IDC risk.

Utility and Outcomes of Preoperative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients.

There is a paucity of data and consensus guidelines on the utility of preoperative MRI for planned bilateral prophylactic mastectomy. The purpose of this study was to evaluate the utility of breast MRI performed in high-risk patients for the indication of planned bilateral prophylactic mastectomy, with attention given to the diagnostic performance for breast cancer detection. A secondary aim was to assess the potential impact of breast MRI findings on the decision to perform sentinel lymph node biopsy at the time of prophylactic mastectomy.

A case of acute onset gigantomastia in a 20-year-old woman.

Gigantomastia is an abnormal and rare breast condition characterized by excessive breast tissue growth that can result in physical and psychosocial debilitation. While the etiology is not fully understood, it is postulated that abnormal endogenous hormone stimulation plays a contributory role and often requires mastectomy for definitive treatment. Proliferation of all elements is commonly observed, including glands, ducts, stroma, fat, vessels and skin.

Microcalcifications Detected at Screening Mammography: Synthetic Mammography and Digital Breast Tomosynthesis versus Digital Mammography.

Purpose To compare the performance of two-dimensional synthetic mammography (SM) plus digital breast tomosynthesis (DBT) versus conventional full-field digital mammography (FFDM) in the detection of microcalcifications on screening mammograms. Materials and Methods In this retrospective multireader observer study, 72 consecutive screening mammograms recalled for microcalcifications from June 2015 through August 2016 were evaluated with both FFDM and DBT. The data set included 54 mammograms with benign microcalcifications and 18 mammograms with malignant microcalcifications, and 20 additional screening mammograms without microcalcifications used as controls.

Clinical Breast Magnetic Resonance Imaging: Technique, Indications, and Future Applications.

Breast magnetic resonance imaging (MRI) is the most sensitive imaging modality for the detection of breast cancer, and it is indicated for breast cancer screening in patients at high-risk of developing breast cancer. It is limited to this group given the high cost. In addition, breast MRI is also indicated for evaluating the extent of disease in patients with new breast cancer diagnoses, monitoring the response to neoadjuvant treatment, and evaluating implant integrity.

Screening Mammography in Women 40-49 Years Old: Current Evidence.

Objective: Breast cancer is an important health problem for women 40-49 years old, yet screening mammography for this age group remains controversial. This article reviews recent guidelines and supporting evidence on screening mammography in women of this age group.

Conclusion: Evidence supports the benefit of annual screening mammography in women 40-49 years old.

Clustered Microcysts on Breast Ultrasound: What Is an Appropriate Management Recommendation?

Objective: The objective of our study was to determine outcomes of lesions identified as clustered microcysts on breast ultrasound to augment the existing literature and help guide appropriate management recommendations.

Materials And Methods: We retrospectively identified cases at our institution, from January 2003 through December 2013, of all lesions classified as clustered microcysts at breast ultrasound. Breast ultrasound examinations were performed by the interpreting physician.

Value of diagnostic imaging for the symptomatic male breast: Can we avoid unnecessary biopsies?

Purpose: To review the use of diagnostic breast imaging and outcomes for symptomatic male patients.

Methods: We retrospectively evaluated 122 males who underwent diagnostic imaging for breast symptoms at our academic center.

Results: The majority (94%) of cases had negative or benign imaging, with gynecomastia being the most common diagnosis (78%).

Breast cancer screening.

Mammography remains the primary technique for breast cancer screening. Women with dense breast tissue may benefit from digital mammography and tomosynthesis, and women at high risk may benefit from magnetic resonance imaging. However, false-positive results are problematic.

Polygenic model of DNA repair genetic polymorphisms in human breast cancer risk.

Genetic variations in DNA repair may impact repair functions, DNA damage and breast cancer risk. Using data/samples collected from the first 752 Caucasians and 141 African-Americans in an ongoing case-control study, we examined the association between breast cancer risk and 18 non-synonymous single-nucleotide polymorphisms (nsSNPs) in four DNA repair pathways-(i) base excision repair: ADPRT V762A, APE1 D148E, XRCC1 R194W/R280H/R399Q and POLD1 R119H; (ii) nucleotide excision repair: ERCC2 D312N/K751Q, ERCC4 R415Q, ERCC5 D1104H and XPC A499V/K939Q; (iii) mismatch repair: MLH1 I219V, MSH3 R940Q/T1036A and MSH6 G39E and (iv) double-strand break repair: NBS1 E185Q and XRCC3 T241M. In Caucasians, breast cancer risk was significantly associated with ADPRT 762VV [odds ratio (OR) = 1.

Polymorphisms in CYP1B1, GSTM1, GSTT1 and GSTP1, and susceptibility to breast cancer.

Polymorphisms in the cytochrome P450 1B1 (CYP1B1) and glutathione S-transferase (GST) drug metabolic enzymes, which are responsible for metabolic activation/detoxification of estrogen and environmental carcinogens, were analyzed for their association with breast cancer risk in 541 cases and 635 controls from a North Carolina population. Each polymorphism, altering the catalytic function of their respective enzymes, was analyzed in Caucasian and African-American women. As reported in previous studies, individual polymorphisms did not significantly impact breast cancer risk in either Caucasian or African-American women.

DNA-repair genetic polymorphisms and breast cancer risk.

Mammalian cells are constantly exposed to genotoxic agents from both endogenous and exogenous sources. Genetic variability in DNA repair contributes to deficient repair and breast cancer risk. Using samples collected in an ongoing, clinic-based, case-control study (253 cases and 268 controls), we tested whether breast cancer risk is associated with four amino acid substitution variants in three DNA repair genes, including XRCC1 Arg194Trp and XRCC1 Arg399Gln in base excision repair, XRCC3 Thr241Met in homologous recombination repair, and ERCC4/XPF Arg415Gln in nucleotide excision repair.

Method for combined FDG-PET and radiographic imaging of primary breast cancers.

The purpose of the study was to demonstrate the feasibility of a hybrid functional/anatomic breast imaging platform with biopsy capability for facilitating lesion detection and diagnosis. This platform consists of an investigative dedicated positron emission mammography (PEM) device mounted on a stereotactic X-ray mammography system, permitting sequential acquisition of mammographic and emission images during a single breast compression. There is automatic coregistration of images from both modalities, and these results can be successfully correlated with histopathologic findings.

Positron emission mammography: initial clinical results.

Background: Evaluation of high-risk mammograms represents an enormous clinical challenge. Functional breast imaging coupled with mammography (positron emission mammography [PEM]) could improve imaging of such lesions. A prospective study was performed using PEM in women scheduled for stereotactic breast biopsy.

Diagnostic accuracy of digital mammography in patients with dense breasts who underwent problem-solving mammography: effects of image processing and lesion type.

Purpose: To determine effects of lesion type (calcification vs mass) and image processing on radiologist's performance for area under the receiver operating characteristic curve (AUC), sensitivity, and specificity for detection of masses and calcifications with digital mammography in women with mammographically dense breasts.

Materials And Methods: This study included 201 women who underwent digital mammography at seven U.S.

Interpretation of digital mammograms: comparison of speed and accuracy of soft-copy versus printed-film display.

Purpose: To compare the speed and accuracy of the interpretations of digital mammograms by radiologists by using printed-film versus soft-copy display.

Materials And Methods: After being trained in interpretation of digital mammograms, eight radiologists interpreted 63 digital mammograms, all with old studies for comparison. All studies were interpreted by all readers in soft-copy and printed-film display, with interpretations of images in the same cases at least 1 month apart.