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  • 1
    ISSN: 1524-4741
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Abstract: Invasive lobular carcinoma (ILC) may be a difficult tumor to detect early by physical examination, mammography, or ultrasound. We undertook this study to describe the spectrum of gadolinium enhancement and morphologic features of ILC on magnetic resonance imaging (MRI). Nineteen patients with ILC who presented with a palpable mass, a mammographically visible abnormality, or an unknown primary underwent preoperative MRI of both breasts using a T1-weighted high-resolution gradient echo sequence (pre- and postcontrast), and an echoplanar sequence during the administration of gadolinium. Using a quantitative measure of gadolinium uptake over time, called the extraction flow (EF) product, and a normal tissue threshold EF level of 25 or less, enhancement for 15 of the 19 cancers was characterized. By consensus, three radiologists categorized the morphologic features of the lesions. For the 15 cases of ILC that had echoplanar data, analysis showed peak EFs ranging between 25 and 120, and the majority showed EFs in the 30s. A substantial portion of two tumors enhanced in a similar fashion to normal breast tissue, with EFs in the low 20s. Morphologically MRI showed a focal mass in eight cases, regional enhancement in five, segmental enhancement in one, segmental enhancement with multiple small nodules in one, a mixture of a focal mass and regional enhancement in one, diffuse enhancement in one, multiple small nodules in one, and bilateral disease in one. Of the focal masses, seven were irregular in shape and one was round; six had ill-defined margins and two had spiculated margins. All eight enhanced heterogeneously. Four cases had multifocal disease and one case had unsuspected contralateral disease discovered only on MRI. MRI using a combination of morphology and a quantitative measure of gadolinium uptake was able to detect the majority of cases of ILC. However, there was a variable morphologic appearance and contrast enhancement pattern on MRI. A few lesions were difficult to distinguish from normal tissue. This suggests that some cases of ILC may be difficult to detect on MRI. 
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Inc
    The @breast journal 11 (2005), S. 0 
    ISSN: 1524-4741
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Abstract:  The purpose of this study was to evaluate the correlation between histologic tumor grade obtained at breast core needle biopsy (CNB) with that obtained from the excised breast specimen. A total of 899 records from all patients with breast cancer from January 1999 to January 2003 were reviewed. Of these, 341 lesions had CNB for diagnosis and had pathology results prospectively graded for both the core and excised specimens. Patient age, lesion type and size, imaging method for biopsy, number of cores, core pathology, surgery performed, final diagnosis, nuclear grade, and combined grade were recorded. In 286 lesions (83.9%), nuclear grade was reported for both core and excised specimens. Of these, 219 (76.6%) were in agreement. Of the 67 that differed, 66 (98.5%) differed by one grade; 46 (68.7%) were upgraded. The groups did not differ in average tumor size, tumor pathology, or number of cores. In 288 lesions (84.5%), combined grade was reported for both core and excised specimens. Of these, 214 (74.3%) were in agreement. Of the 74 that differed, 71 (95.9%) differed by one grade and 50 (67.6%) were upgraded. Again, there were no significant differences in tumor size, type, or number of cores. Overall, nuclear grade and combined grade obtained at CNB each showed agreement with the corresponding excised specimen grading approximately 75% of the time. Grading obtained by CNB, if changed by pathologic evaluation of the excised tumor, is most commonly upgraded. Differences, when they occurred, could not be attributed to tumor size, type, or the number of cores obtained. 
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Inc
    The @breast journal 10 (2004), S. 0 
    ISSN: 1524-4741
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Abstract:   The Breast Imaging Reporting and Data System allows radiologists to classify lesions as “probably benign—short interval follow-up suggested” (category 3). The purpose of this study is to evaluate the recent use of the category 3 designation in a national cancer detection program. We analyzed data from the National Breast and Cervical Cancer Early Detection Program, a nationwide collaboration between the Centers for Disease Control and Prevention (CDC) and local health agencies that provides cancer screening for low-income, uninsured women. The study population included all women at least 40 years old who had mammograms in the program through September 1999 (n = 826,424). Of the 826,424 mammograms, the percentage classified as category 3 in the initial phase (1991–1996, previously reported, n = 372,760) was 7.7%; of the most recent 453,664 mammograms (1996–1999), 6.0% were given this designation. During the same periods, the percentage of abnormal mammograms decreased from 2.6% to 2.1% and those needing “additional imaging” (category 0) increased from 5.0% to 6.9%. The percentage receiving a category 3, category 0, or abnormal designation decreased with increasing age for each classification. The percentage of category 3 mammograms varied by site from 1.1% to 12.2%. Overall the proportions of category 3 mammograms decreased over time, while requests for additional examinations increased. This suggests that patients were more likely than before to receive additional examinations prior to their final designation. The persistent wide variability in category 3 indicates further education and attention to the use of this category is warranted. 
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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