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Objective: to investigate the possibility of enhancing the efficiency of complex magnetic resonance (MR) imaging, including MR mammography with dynamic contrast-enhanced MRI and MR spectroscopy for the differential diagnosis of breast tumors.Material and methods. The investigation enrolled 87 patients with breast tumors and 15 healthy volunteers. The mean age of the examinees was 55.7±3.5 years. MR mammography with dynamic contrast-enhanced MRI and subsequent morphological diagnosis verification were performed in 100% of cases. MR spectroscopy was carried out in 93.1% of the patients with breast tumors.Results. There were 189 breast tumors, including 154 (81.5%) and 35 (18.5%) hypervascular and avascular ones, respectively. MR mammography could reveal only 36% of the hypervascular masses. The sensitivity of contrast-enhanced MR mammography was 97.1%, and the specificity was variable. Its specificity was 96.9% for BIRADS 2 and BIRADS 5 and 45% and 55% for BIRADS 4 and BIRADS 3, respectively. MR spectroscopy in addition to MR mammography could increase the overall specificity of the technique up to 98.3%.Conclusion. Comprehensive MR examination that involves MR mammography with dynamic contrast-enhanced MRI and MR spectroscopy makes it possible to visualize breast tissues, to identify additional masses, to investigate not only the morphological, but also chemical structure of the identified tumors, which allows the most precise differential diagnosis between benign and malignant lesions.

Paget's disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. Diagnosis and treatment of Paget's disease is controversial. Expert oncologists discuss on the update on the approaches of Paget's disease diagnosis and its treatment options. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

Axillary lymph node involvement is a very important poor prognostic factor in the clinical staging and management of breast cancer patients. Traditionally, axillary lymph node dissection (ALND) has been used for determining the status of the axillary lymph nodes. More recently the sentinel lymph node biopsy (SLNB) procedure has gained wider acceptance as the standard of care, having the advantage of being less invasivewhile providing good accuracy. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations in regards with the use of the two different procedures and other issues in patients with early breast cancer for the benefit of community oncologists.

Objective: To assess the impact of digital breast tomosynthesis (DBT) and magnetic resonance mammography (MRM) in enhancing the performance of digital mammography (DM) in the detection and evaluation of different breast lesions. Patients and methods: In this retrospective study, 98 patients with 103 breast lesions were assessed by DM, DBT and MRM. Mammography images were acquired using the “combo mode", where both DM and DBT scanned in the same compression. MRM was performed by 1T open system. Each lesion was assigned a blinded category in an individual performance for each modality. The resultant BI-RADS categories were correlated with reports of the pathology specimens or outcome of 18-month follow-up. Results: Both DBT and MRM showed equivalent sensitivity of 92%. The specificity for DBT and MRM was 80.7% and 89.7% respectively. The efficacy of DM was raised from 61% to 83.5% with DBT and 90.2% with MRM. The results of the three modalities and the final diagnosis revealed a significant correlation (p = 0.035).The association between the results of DBT and those of MRM showed statistically significant difference between DBT and MRM for diagnosing breast lesions (p = 0.001). Conclusion: Both MRM and DBT provide better performance than classic DM. Adding either of these modalities to the classic examination enhances diagnosis and precise disease distribution.

The Breast Imaging Reporting and Data System (BI-RADS) is a practical tool developed by the American College of Radiology to standardize the description of mammography, ultrasound study, and magnetic resonance mammography. BI-RADS includes recommendations for the structure of a protocol to describe radiologic studies; terminology to characterize three major types of lesions (focus, mass, contrasting area); as well as assessment categories and their corresponding recommendations for further patient management. The publication gives general information on the new edition of BI-RADS (2013) and illustrates its use to interpret magnetic resonance mammograms in breast cancer. The wider introduction of BI-RADS at all stages from screening to diagnostic verification will improve the quality of diagnosis and prognosis in breast tumor diseases.

AIM: To enhance the efficiency of diagnosis of breast tumors by comprehensive magnetic resonance imaging (MRI) involving dynamic contrast-enhanced magnetic resonance mammography (MRM) and magnetic resonance spectroscopy (MRS)/MATERIAL AND METHODS: Eighty-seven women aged 32 to 75 years with breast neoplasms were examined. MRM was performed on a Philips Achieva 3.0T TX scanner. The MRI protocol consisted of axial fat-suppressed T1- and T2-weighted spin-echo images and 8 postcontrast dynamic series. Changes in contrast-enhanced MRI of breast cancer (BC) were estimated by constructing the signal intensity-time curves. MRS was carried out using a PRESS sequence/RESULTS: Dynamic MRM determined type III signal intensity-time curve in 83.9% of the patients with BC and type II curve in 16.1% of those with breast malignancies and in 33.3% of those with breast fibroadenomas. Type I signal intensity-time curve was identified in 66.7% of the cases of fibroadenomas. Elevated choline concentrations in the malignancies were detected in 17.7% of cases. Their tumors were larger than 2 cm. The choline peak in the malignancies could not be revealed in the other cases, which was associated to the large voxel size exceeding the mass size. There was a drastic fall in the signal-to-noise ratio with smaller voxel sizes. Furthermore, higher choline levels were determined in 9.5% of the fibroadenoma cases. Comparison of MRS findings before and after contrast injection revealed the advantage of the latter, which is primarily attributed to the more accurate voxel position on the tumor than that during non-contrast-enhanced MRS/CONCLUSION: Dynamic intravenous contrast-enhanced MRM is an effective method for the differential diagnosis of breast masses. MRS cannot be included in the standard study protocol for women with breast masses for the present.

Advances in the imaging o f breast have paralleled the increased detection o f carcinoma breast. Although mammography remains the gold standard with a phenomenal backup by ultrasound; the natural architectural variations along with the discom fort o f compression and intrinsic radiation hazard led to a quest for further avenues. This articlc is a commentary regarding the trend changes in the conventional film-scrccn mammography reporting; its variations with digital, radio-nuclear, magnetic resonance (MR) and CT laser (CTLM ) techniques and the breast ultrasound com plem ented by Doppler and image guided biopsy systems. Current uses, limitations and potentials are discussed. KF.Y W ORDS: Breast imaging biopsy, digital mammography, magnetic resonance mammography, ultrasound CT laser mammography, scintimammography.

Advances in the imaging o f breast have paralleled the increased detection o f carcinoma breast. Although mammography remains the gold standard with a phenomenal backup by ultrasound; the natural architectural variations along with the discom fort o f compression and intrinsic radiation hazard led to a quest for further avenues. This articlc is a commentary regarding the trend changes in the conventional film-scrccn mammography reporting; its variations with digital, radio-nuclear, magnetic resonance (MR) and CT laser (CTLM ) techniques and the breast ultrasound com plem ented by Doppler and image guided biopsy systems. Current uses, limitations and potentials are discussed. KF.Y W ORDS: Breast imaging biopsy, digital mammography, magnetic resonance mammography, ultrasound CT laser mammography, scintimammography.