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Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up. Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded. Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases. Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the strength of quantitative imaging and metabolic parameters in differentiating invasive breast carcinomas with elevated Ki‐67 levels. Materials and Methods: A total of 123 patients with 129 breast lesions confirmed as invasive breast carcinoma underwent shear wave elastography (SWE), superb microvascular imaging (SMI) and positron emission tomography (PET)/CT or MRI. Adler's grade (classifying the microvascularity into four types) and Vascular Index (VI) was obtained by SMI as microvascular parameters. In addition, the stiffness value (Emean) was evaluated in kilopascal by SWE. The average of consecutive measurements was recorded as mean VI and mean Emean. PET scan parameters were obtained as SUVmax and SULpeak. Lesions were divided into two groups according to the Ki‐67 expression, low as ≤14 and high as >14. Results: Adler's grading was the most correlated imaging parameter with high Ki‐67 expression (p < 0.05), while VI and Emean had poor correlation (p > 0.05). SUVmax and SULpeak indicated a significant linear correlation with Ki‐67 but a moderate correlation with the high levels of Ki‐67 (p < 0,001). The sensitivity of VI, Emean, SUVmax and SULpeak was 64.6%, 66.7%, 65.7%, and 66.7% when the cut‐off point was set to 5.25, 102.5, 6.59, and 2.63, respectively. SUVmax had the highest AUC value of 0.740, according to the ROC curve analysis. Conclusions: Our results suggest that the quantitative parameters obtained by advanced imaging methods may be useful in predicting the high proliferation in invasive breast carcinomas. But none of them is eligible to be used as an independent biomarker in distinguishing aggressive behavior. Nevertheless, as a noninvasive method, visual assessment of microvascular morphology using SMI increases the prognostic efficiency in invasive breast carcinomas. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the role of quantitative values obtained by superb microvascular imaging (SMI) and shearwave elastography (SWE) in the prediction of malignancy in intraductal papilloma‐like lesions (IDPL). Methods: In the study, 61 patients between the ages of 14 to 73 years (mean age 44) diagnosed with IDPL on ultrasound (US) examination between the years 2020 and 2021 were included. The B‐Mode US findings (shape, margins, size, echo pattern, and accompanying ductal dilatation), SMI vascular index (SMIvi), E‐mean, and SWE‐ratio values were recorded. Results: There was a statistically significant difference between malignant (n = 14) and benign (n = 47) groups in terms of symptoms (P =.005), size (P =.042), shape (P =.002), margins (P =.001), echogenicity (P =.023), microcalcifications (P =.009), SMIvi (P =.031), E‐mean (P <.005), and SWE‐ratio (P =.007). According to receiver operating characteristic (ROC) curve analysis, sensitivity, specificity, accuracy, area under the curve (AUC), positive predictive values (PPV), and negative predictive values (NPV) were 57.1%, 87.2%, 80%, 0.722, 57.1%, 87.2% for US; 71.4%, 49%, 55.7%, 0.692, 30.3%, 85.7% for SMIvi; 85.7%, 71%, 74%, 0.864, 46%, 94.3% for E‐mean, and 50%, 75.4%, 83%, 0.707, 91.5%, and 50% for SWE‐ratio, respectively. Best results were obtained when SMI and SWE values were used together, achieving a sensitivity, specificity, accuracy, AUC, PPD, NPD of 78.6%, 93.6%, 93.4%, 0.872, 91.7%, and 93.9%, respectively. Conclusions: The SMI and SWE examinations are successful in the differentiation of benign and malignant intraductal lesions. They complement each other and contribute to B‐mode US in managing IDPLs especially when used together. Our study is the first to compare the quantitative data of SWE and SMI in the differentiation of IDPLs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up., Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded., Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases., Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)