Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: methodology, safety, and experience of initial year.

The use of radioactive seed localization (RSL) as an alternative to wire localizations (WL) for nonpalpable breast lesions is rapidly gaining acceptance because of its advantages for both the patient and the surgical staff. This paper examines the initial experience with over 1,200 patients seen at a comprehensive cancer center. Radiation safety procedures for radiology, surgery, and pathology were implemented, and radioactive material inventory control was maintained using an intranet-based program.

Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy.

Purpose: To evaluate the safety and efficacy of pre-operative I-125 radioactive seed localization (RSL) as an alternative to wire localization (WL).

Methods: A waiver was granted by the institutional review board for this HIPAA compliant study. Review of 356 consecutive single site nonpalpable mammographic and ultrasound guided I-125 RSLs done between November 2011 and April 2012 was conducted.

Impact of tamoxifen on amount of fibroglandular tissue, background parenchymal enhancement, and cysts on breast magnetic resonance imaging.

The objective of this study was to evaluate the impact of tamoxifen treatment on amount of fibroglandular tissue (FGT), background parenchymal enhancement (BPE), and cysts on breast MRI. Retrospective search identified 96 women with breast cancer who had a breast MRI both before and during adjuvant tamoxifen therapy between 2002 and 2008. After exclusion of all irradiated breasts, 88 women were eligible.

Effect of aromatase inhibitors on background parenchymal enhancement and amount of fibroglandular tissue at breast MR imaging.

Purpose: To evaluate whether treatment with an aromatase inhibitor (AI) influences background parenchymal enhancement (BPE) or amount of fibroglandular tissue (FGT) at breast magnetic resonance (MR) imaging in postmenopausal women with prior history of breast cancer.

Materials And Methods: A waiver of authorization and patient consent was granted by the institutional review board for this HIPAA-compliant retrospective study. Postmenopausal women with breast cancer and MR imaging findings of the contralateral unaffected breast, before and during 6-12 months of AI treatment (anastrozole, letrozole, or exemestane), between August 1999 and June 2010 were retrospectively identified (n = 149).

Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI.

Objective: To evaluate the effect of menopausal status on the background parenchymal enhancement (BPE) and amount of fibroglandular tissue (FGT) on breast MRI.

Methods: Retrospective review identified 1,130 women who underwent screening breast MRI between July and November 2010. In 28 of these women, breast MRI was performed both at one time point while pre- and one time point while post-menopausal (median interval 49 months).

Background parenchymal enhancement at breast MR imaging and breast cancer risk.

Purpose: To examine the relationships between breast cancer and both amount of fibroglandular tissue (FGT) and level of background parenchymal enhancement (BPE) at magnetic resonance (MR) imaging.

Materials And Methods: A waiver of authorization was granted by the institutional review board for this retrospective HIPAA-compliant study. Among 1275 women who underwent breast MR imaging screening between December 2002 and February 2008, 39 breast carcinoma cases were identified.

D-dimer assay to exclude pulmonary embolism in high-risk oncologic population: correlation with CT pulmonary angiography in an urgent care setting.

Purpose: To prospectively evaluate (a) the diagnostic performance of D-dimer assay for pulmonary embolism (PE) in an oncologic population by using computed tomographic (CT) pulmonary angiography as the reference standard, (b) the association between PE location and assay sensitivity, and (c) the association between assay results and clinical factors that raise suspicion of PE.

Materials And Methods: This HIPAA-compliant study had institutional review board approval; informed consent was obtained. Five hundred thirty-one consecutive patients were clinically suspected of having PE; 201 were enrolled (72 men, 129 women; median age, 61 years) and underwent CT pulmonary angiography and D-dimer assay.

Comparison of interpretations of CT angiograms in the evaluation of suspected pulmonary embolism by on-call radiology fellows and subsequently by radiology faculty.

Objective: Our objective was to evaluate interobserver variability in interpretations performed by on-call radiology fellows and subsequently by attending radiologists of CT angiograms obtained for clinically suspected pulmonary embolism and to evaluate factors contributing to discrepancies.

Materials And Methods: Written interpretations made by on-call fellows were compared with reports approved by attending radiologists for all CT angiograms obtained for suspected pulmonary embolism after work hours and on weekends in a recent 19-month period. Interpretations were stratified as positive, negative, or equivocal for pulmonary embolism.

Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved?

Background: Skin-sparing mastectomy (SSM), which involves the resection of the nipple/areolar complex with the breast parenchyma, improves the aesthetic outcome for breast cancer patients. Most patients undergoing SSM desire reconstruction of the nipple/areolar complex for symmetry. These data explore the possibility of preserving the areola in selected mastectomy patients.