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Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions. [ABSTRACT FROM AUTHOR]

Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions.

Objective: The aim of this study is to conduct a systematic evaluation of the diagnostic efficacy of Breast Imaging Reporting and Data System (BI-RADS) 4 benign and malignant breast lesions using magnetic resonance imaging (MRI) radiomics. Methods: A systematic search identified relevant studies. Eligible studies were screened, assessed for quality, and analyzed for diagnostic accuracy. Subgroup and sensitivity analyses explored heterogeneity, while publication bias, clinical relevance and threshold effect were evaluated. Results: This study analyzed a total of 11 studies involving 1,915 lesions in 1,893 patients with BI-RADS 4 classification. The results showed that the combined sensitivity and specificity of MRI radiomics for diagnosing BI-RADS 4 lesions were 0.88 (95% CI 0.83–0.92) and 0.79 (95% CI 0.72–0.84). The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 4.2 (95% CI 3.1–5.7), 0.15 (95% CI: 0.10–0.22), and 29.0 (95% CI 15–55). The summary receiver operating characteristic (SROC) analysis yielded an area under the curve (AUC) of 0.90 (95% CI 0.87–0.92), indicating good diagnostic performance. The study found no significant threshold effect or publication bias, and heterogeneity among studies was attributed to various factors like feature selection algorithm, radiomics algorithms, etc. Overall, the results suggest that MRI radiomics has the potential to improve the diagnostic accuracy of BI-RADS 4 lesions and enhance patient outcomes. Conclusion: MRI-based radiomics is highly effective in diagnosing BI-RADS 4 benign and malignant breast lesions, enabling improving patients’ medical outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Breast lesions are mainly classified as benign and malignant. When breast cancer is diagnosed, the patient is evaluated and a treatment plan is prepared. For benign lesions, follow-up or surgery may be performed. Imaging and biopsy results are essential when deciding on surgery. In particular, when there is a discrepancy between radiologic imaging and pathology results, excision may be useful for definitive diagnosis. We planned to present an approach to suspicious breast lesions with radiology pathology discordance through the presentation of three patients diagnosed with malignancy. Between February 2018 and March 2023, patients who underwent wire marking and excision for suspicious breast lesions were analyzed. Three patients diagnosed with malignancy after total excision were analyzed in detail. Of 33 patients, 2 (6.06%) patients had ductal carcinoma in situ and 1 (3.03%) patient had invasive tubular carcinoma. Preoperative and postoperative pathological findings were consistent with benign changes in all three cases. After total excision, a definitive diagnosis was made, and follow-up and treatment were planned. In cases of radiology-pathology discordance, total excision may be effective in detecting atypia, carcinoma in situ, or invasive carcinoma not detected on pathologic examination. Therefore, even if the biopsy result is not malignant, wire-guided total excision of radiologically suspicious lesions should be considered as a diagnosis and treatment method. [ABSTRACT FROM AUTHOR]

Rationale and objectives: Clinical research is crucial for evaluating new medical procedures and devices. It is important for healthcare units and hospitals to minimize the disruptions caused by conducting clinical studies; however, complex clinical pathways require dedicated recruitment and study designs.This work presents the effective introduction of novel microwave breast imaging (MBI), via MammoWave apparatus, into the clinical routine of an operative screening and diagnostic breast imaging department for conducting a multicentric clinical study. Materials and methods: Microwave breast imaging, using MammoWave apparatus, was performed on volunteers coming from different clinical pathways. Clinical data, comprising demographics and conventional radiologic reports (used as reference standard), was collected; a satisfaction questionnaire was filled by every volunteer. Microwave images were analyzed by an automatic clinical decision support system, which quantified their corresponding features to discriminate between breasts with no relevant radiological findings (NF) and breasts with described findings (WF). Results: Conventional breast imaging (DBT, US, MRI) and MBI were performed and adapted to assure best clinical practices and optimum pathways. 180 volunteers, both symptomatic and asymptomatic, were enrolled in the study. After microwave images' quality assessment, 48 NF (15 dense) and 169 WF (88 dense) breasts were used for the prospective study; 48 (18 dense) breasts suffered from a histology-confirmed carcinoma. An overall sensitivity of 85.8 % in breasts lesions’ detection was achieved by the microwave imaging apparatus. Conclusion: An optimum recruitment strategy was implemented to assess MBI. Future trials may show the clinical usefulness of microwave imaging, which may play an important role in breast screening.

This study investigates the feasibility of using texture radiomics features extracted from mammography images to distinguish between benign and malignant breast lesions and to classify benign lesions into different categories and determine the best machine learning (ML) model to perform the tasks. Six hundred and twenty-two breast lesions from 200 retrospective patient data were segmented and analysed. Three hundred fifty radiomics features were extracted using the Standardized Environment for Radiomics Analysis (SERA) library, one of the radiomics implementations endorsed by the Image Biomarker Standardisation Initiative (IBSI). The radiomics features and selected patient characteristics were used to train selected machine learning models to classify the breast lesions. A fivefold cross-validation was used to evaluate the performance of the ML models and the top 10 most important features were identified. The random forest (RF) ensemble gave the highest accuracy (89.3%) and positive predictive value (66%) and likelihood ratio of 13.5 in categorising benign and malignant lesions. For the classification of benign lesions, the RF model again gave the highest likelihood ratio of 3.4 compared to the other models. Morphological and textural radiomics features were identified as the top 10 most important features from the random forest models. Patient age was also identified as one of the significant features in the RF model. We concluded that machine learning models trained against texture-based radiomics features and patient features give reasonable performance in differentiating benign versus malignant breast lesions. Our study also demonstrated that the radiomics-based machine learning models were able to emulate the visual assessment of mammography lesions, typically used by radiologists, leading to a better understanding of how the machine learning model arrive at their decision. [ABSTRACT FROM AUTHOR]

Background: Multiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency. Patients and methods: This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. Results: In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online. Conclusions: PFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020. IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of the study is to characterize the breast lesions on high-resolution Ultrasound and digital mammography to find the patterns and prevalence of different breast lesions in different age groups of our population. Results This prospective study was conducted at a breast care clinic of a tertiary care hospital from Jan 2018 to Dec 2019. Patients with breast-related complaints were enrolled. Patients under the 35 years of age were evaluated on High-Resolution Ultrasound (HR-USG) and those over 35 years of age on digital Mammography. Any lesion on digital mammography was characterized on HR-USG. Fine Needle Aspiration (FNAC) and Trucut biopsy was done where pathological correlation required. Data of all enrolled patients were recorded and analyzed. Patients with known cases of carcinoma breast on follow-up were excluded from the study. Total 6850 patients enrolled in our breast care clinic during study period. 5111 were above the age of 35 years while 1739 were under the age of 35 years. No lesion could be found in 3915 patients and were reported normal. 2935 patients were found to have different breast lesions. The frequency of different lesions was different in both age groups. The overall frequency of lesions was as malignancy 16.2%, benign lesions including Fibroadenoma, simple cysts, Lipoma and Galactocele 16%, inflammatory lesions including abscess 7.86% and Duct Ectasia 2.75%. Conclusions In developing countries where mass screening programs are deficient, Breast Care clinics in tertiary care hospitals have a noteworthy role in early detection of breast cancer and other breast lesions.

Objective: сomparative assessment of the diagnostic efficiency of magnetic resonance imaging (MRI) and contrastenhanced ultrasound examination in the primary diagnosis of breast cancer based on propensity score matching.Materials and methods. From 2017 to 2018 on the basis of the National Medical Research Center of Oncology named after N.N. Petrov 176 women with various complaints of breast diseases were examined using MRI, which was carried out on a Magnetom Aera (Siemens) and Signa Excite HD (GE) apparatus with a magnetic field strength of 1.5 T and special surface breast coil. From 2018 to 2019 on the basis of the National Medical Research Center of Oncology named after N.N. Petrov 277 women with various complaints of breast diseases were examined using multiparametric ultrasonography (US) consisting of gray-scale US, color Doppler US, strain US, and contrast enhanced US, performed on a Hitachi Hi Vision Ascendus ultrasound scanner using a linear transducer in the frequency range 5–13 MHz. To verify the lesions, the patients underwent histological or cytological examination. The results of ultrasound examination, histological and cytological conclusions were entered into the database containing 453 diagnostic records: 277 were obtained using the multiparametric US and 176 – using the MRI method. To solve the problem, the propensity score matching algorithm was used: building a model, calculating conditional probabilities, balancing, checking the balance quality, evaluating efficiency. The main and auxiliary characteristics of the methods of MRI and contrast-enhanced ultrasound before and after the selection of pairs are given in the work.Conclusion. The proposed algorithm is implemented in the R language. The results of the program are that both diagnostic methods showed excellent results, 95 % confidence intervals almost completely overlap, from which a preliminary conclusion should be made that these methods are equivalent in efficiency in the primary diagnosis of breast cancer.

This study aims to compare the Magnetic Resonance Imaging (MRI) and Shear Wave Elastography (SWE) data and investigate their contribution to diagnosis when both are individually used and combined. This study included the consent of 46 diagnostic biopsy patients after their breast MRI examination was performed. Mass appearance patients in the sonographic evaluation were SWE examined before the biopsy. In MR examination, lesion localization, size, contrast curves, contrast enhancement features, intensity in the fat-suppressed T2A sequence, Emean value in SWE examination, and histopathological results were examined. Individual and combined use of MRI and SWE findings were evaluated with histopathological results. The diagnosis consistency was compared according to the histopathological results of the malignant-benign defined lesions. Higher sensitivity in MRI; higher specificity and accuracy in SWE were acquired when both methods were compared. The accuracy of MRI improved when MRI use is combined with SWE. The combined use of SWE with MRI increases the diagnostic accuracy in breast lesion characterization. We observed that lesions showing a type 3 enhancement curve and iso-hypointense on the T2W sequence in breast MRI could be predicted to show a stiff elasticity pattern on SWE due to higher elastography values. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the stiffness of different histological types of breast lesions by obtaining shear wave elastography (SWE) and apparent diffusion coefficient (ADC) values, and to determine the contribution of these two methods to the diagnosis. Materials and Methods: In total, 70 patients with biopsy-proven breast lesions were included in the study. The mean SWE values of breast lesions were recorded and ADC values of these lesions were calculated. Receiver operating characteristic (ROC) curve analyses and the diagnostic accuracies of SWE-ADC values were determined. Results: The mean SWE values were 45.47 ± 25.11 kPa and 3.51 ± 1.04 m/s in benign group, and 161.11 ± 219.34 kPa and 5.96 ± 1.06 m/s in malignant group, respectively. The mean ADC values were 1.38 ± 0.32 (×10–3 mm2/s) in benign group and 0.96 ± 0.22 (×10–3 mm2/s) in malignant group, respectively. When the diagnostic performances of both imaging modalities on mass stiffness are evaluated, statistically significant negative correlations were found between SWE lesion values and ADC lesion values. Conclusion: Evaluation of tissue elasticity has recently been used frequently in the diagnosis of breast diseases. SWE-ADC values, which are negatively correlated in the diagnosis of breast masses, may prove to be a powerful alternative diagnostic tool that can be used interchangeably, as appropriate. [ABSTRACT FROM AUTHOR]

Aim:To reduce operator dependency and achieve greater accuracy, the computer-aided diagnosis (CAD) systems are becoming a useful tool for detecting noninvasively and determining tissue characterization in medical images. We aimed to suggest a CAD system in discriminating between benign and malignant breast masses.Methods:The dataset was composed of 105 randomly breast magnetic resonance imaging (MRI) including biopsy-proven breast lesions (53 malignant, 52 benign). The expectation-maximization (EM) algorithm was used for image segmentation. 2D-discrete wavelet transform was applied to each region of interests (ROIs). After that, intensity-based statistical and texture matrix-based features were extracted from each of the 105 ROIs. Random Forest algorithm was used for feature selection. The final set of features, by random selection base, splatted into two sets as 80% training set (84 MRI) and 20% test set (21 MRI). Three classification algorithms are such that decision tree (DT, C4.5), naive bayes (NB), and linear discriminant analysis (LDA) were used. The accuracy rates of algorithms were compared.Results:C4.5 algorithm classified 20 patients correctly with a success rate of 95.24%. Only one patient was misclassified. The NB classified 19 patients correctly with a success rate of 90.48%. The LDA Algorithm classified 18 patients correctly with a success rate of 85.71%.Conclusion:The CAD equipped with the EM segmentation and C4.5 DT classification was successfully distinguished as benign and malignant breast tumor on MRI.

Objective: In this prospective study, the diagnostic performance of the new version of superb microvascular imaging (SMI) in differentiating malignant from benign lesions was evaluated. Material and Methods: Ninety breast lesions were included. During color SMI examination, both free-hand region of interest (ROI) and box ROI were used. Vascular index (VI) values were obtained from the lesion using both types of ROI and from normal breast tissue via box ROI. VI values, monochrome SMI grading and histopathological results were compared. The efficacy of color SMI and monochrome SMI was investigated in differentiating between benign and malignant breast lesions. Results: The cut-off value, in the differentiation of benign and malignant lesions with color SMI was 0.50 for box ROI, while it was 0.30 for free-hand ROI. The specificity of VI values obtained with box ROI was higher than that of free-hand ROI when differentiating malignant lesions from benign. Comparison of VI values from a lesion and from normal breast tissue showed that VI values in malignant lesions were significantly higher (p<0.05). The VI values of benign lesions and VI values of normal breast tissue were similar. There was a statistically significant relationship between monochrome SMI grading and the malignancy or benign status of the lesion (p<0.001). Conclusion: Drawing the lesion circumference free-hand using a free-shape ROI did not enhance the sensitivity and specificity. Contrary to popular belief, a more easy and practical measurement method may be more suitable for SMI examination. It is hoped that this will be one of the earliest studies to assess the clinical performance of the latest version of SMI. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the second cause of cancer death in women. Shear wave elastography (SWE) is an ultrasound (US) procedure that can improves the sensitivity and the specificity in the diagnosis of breast lesions. Objectives: To evaluate the value of SWE to discriminate benign from malignant Breast Imaging-Reporting and Data System (BI-RADS) IV breast lesions. Materials and methods: A cross sectional analytic study was done in the Radiology Department, Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq. The study period was one year (February 2020 to January 2021). The study included 42 female patients with suspicious breast lesions in the group BI-RAD 4 by mammography and US. Shear wave elastography was done for all patients. The final diagnosis of all breast lesions were done by fine needle aspiration cytology or true cut biopsy or excisional biopsy. Results: The final histological diagnosis showed that 23 (54.8%) of study patients were with benign breast lesions. There was a statistically significant association between the quality of SWE and histopathological diagnosis as the proportion of malignant breast lesions was significantly higher among the patients with score 5 (homogenous dark blue) images (85.7%, P= 0.004). Subjectts with malignant lesions had a significantly higher mean of E-mean SWV than those with benign lesions (133.8 versus 75.47 kPa, P = 0.001). The best cut point of E-mean SWV was 83 kPa (E-mean SWV > 83 kPa is predictive for malignant lesion of breast) with 89.5% sensitivity, 60.9% specificity, and 73.8% accuracy. Conclusion: SWE have a significant diagnostic value in differentiation of BI-RADS IV breast lesions into benign and malignant in both qualitative and quantitative patterns. The best cut off value in SWE is 83 KPa for E-mean. [ABSTRACT FROM AUTHOR]

Abstract Background Fine needle aspiration cytology is a simple, relatively accurate, non-invasive, and cost-effective method of diagnosing most breast pathologies. To date, there is no sufficient data depicting the distribution of breast lesions detected by fine needle aspiration cytology in our healthcare setting. The aim of this study was to elucidate the general distribution of breast lesions diagnosed by cytology test at Eritrean National Health Laboratory. Methods This retrospective study was carried out on 905 symptomatic patients between the years 2013 and 2017 at Eritrean National Health Laboratory. Diagnosis was made by fine needle aspiration cytology in patients with palpable breast lump and in some patients direct smear was prepared from a nipple discharge. Statistical analysis was carried out using Statistical Package for the Social Sciences version 23. Results A total of 905 patients were included in the study, of whom 871 (96.24%) were females. The age range of patients was from 13 to 93 years with mean and standard deviation of 33 ± 14.9 years. Breast lump, occurring in 892 (98.56%), was the most frequent presenting symptom. Fibroadenoma and fibrocystic breast lesions were the most prevalent lesions accounting for approximately 40% and 15%, respectively. Malignant breast lesions were seen predominantly in females above the age of 40 years with the highest frequency observed in the age range between 51 and 60 years. Pearson Chi-squared test showed significant association between patients’ age above 40 years and the risk of having a malignant breast lesion (p

Abstract Objectives IL17 is a critical pro-inflammatory cytokine that is involved in inflammation, multidrug resistance and growth persistence pathways in cancer. This study is aiming at studying the expression of IL17 and hormonal receptors expression in benign and malignant breast lesions using immunohistochemical staining methods. Results A total of 137 cases of breast lesions were studied, 97 (70.8%) were malignant and 40 (29.2%) were benign cases. Age range for malignant and benign cases were between 26 and 80 years [mean age 50 ± 2 years], and 20 to 70 years [mean age 41 ± 4 years], respectively, Odds ratio = 2.3 [1.78–1.99, 95% CI]. The majority of the histopathological diagnosis of the benign and malignant lesions were 21 (15.3%) fibro-adenomas and 87 (63.5%) invasive ductal carcinoma, respectively. Expression of IL17 and age were insignificantly negatively correlated for both groups; benign cases [r = − 0.054, P value 0.742] and malignant cases [r = − 0.080, P value 0.444]. IL17 expression was showing insignificant association with age group, P value 0.065. IL17 expression showed a statistical significance based on the different histopathological diagnosis, P value 0.035. Expression levels of estrogen, progesterone, and human epidermal receptors were showing insignificant difference among IL17 expression categories, P values 0.678, 0.623, and 0.361, respectively.

Background: Histological diagnosis is crucial to the management of breast diseases. It determines the kind of disease, the treatment modalities, and the outcome of management. Our department receives breast biopsies from the northern sector of Ghana constituting over 50% of the Ghanaian population. This study aimed at elucidating the pattern of disease and associated traditional prognostic indices of breast cases in our department over a period of 9 years. Methods: Information on the demographic characteristics and the histological diagnoses made on all breast cases received and processed in the department were accessed and entered into an Excel spreadsheet. Slides were reviewed and IHC was done on suitable cases. Descriptive statistics were generated using IMB-SPSS version 23. Results: A total of 4276 breast cases were received by the department within the study period, with 97.6% being female. Age ranged (female/male) from 10 to 98/13 to 102 years, with mean ages of 38.2 years (SD ± 16.7) and 41.15 years (SD ± 21.6), respectively. Cases were evenly distributed in both left and right breasts and 4.3% were bilateral. Inflammatory conditions were seen in 7.5% of cases. The most diagnosed benign tumor was fibroadenoma (54%), followed by fibrocystic change (8.1%). Gynecomastia was diagnosed in 66.3% of males. Malignant cases were 38.6%, with invasive carcinoma NST being the most frequent (87.5%). Histological grades were I = 9.4%, II = 41.6%, and III = 49%. Molecular subtypes were luminal A (19.8%), luminal B (9.9%), Her2 (16%), and TNBC (54.3%). Conclusion: Our findings show an increase in breast cancer cases compared to previous studies in our center, suggesting increased awareness and improved diagnosis. However, this increase is consistent with most studies in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: The aim of the study is to characterize the breast lesions on high-resolution Ultrasound and digital mammography to find the patterns and prevalence of different breast lesions in different age groups of our population. Results: This prospective study was conducted at a breast care clinic of a tertiary care hospital from Jan 2018 to Dec 2019. Patients with breast-related complaints were enrolled. Patients under the 35 years of age were evaluated on High-Resolution Ultrasound (HR-USG) and those over 35 years of age on digital Mammography. Any lesion on digital mammography was characterized on HR-USG. Fine Needle Aspiration (FNAC) and Trucut biopsy was done where pathological correlation required. Data of all enrolled patients were recorded and analyzed. Patients with known cases of carcinoma breast on follow-up were excluded from the study. Total 6850 patients enrolled in our breast care clinic during study period. 5111 were above the age of 35 years while 1739 were under the age of 35 years. No lesion could be found in 3915 patients and were reported normal. 2935 patients were found to have different breast lesions. The frequency of different lesions was different in both age groups. The overall frequency of lesions was as malignancy 16.2%, benign lesions including Fibroadenoma, simple cysts, Lipoma and Galactocele 16%, inflammatory lesions including abscess 7.86% and Duct Ectasia 2.75%. Conclusions: In developing countries where mass screening programs are deficient, Breast Care clinics in tertiary care hospitals have a noteworthy role in early detection of breast cancer and other breast lesions. [ABSTRACT FROM AUTHOR]

Aim: To reduce operator dependency and achieve greater accuracy, the computer-aided diagnosis (CAD) systems are becoming a useful tool for detecting noninvasively and determining tissue characterization in medical images. We aimed to suggest a CAD system in discriminating between benign and malignant breast masses. Methods: The dataset was composed of 105 randomly breast magnetic resonance imaging (MRI) including biopsy-proven breast lesions (53 malignant, 52 benign). The expectation-maximization (EM) algorithm was used for image segmentation. 2D-discrete wavelet transform was applied to each region of interests (ROIs). After that, intensity-based statistical and texture matrix-based features were extracted from each of the 105 ROIs. Random Forest algorithm was used for feature selection. The final set of features, by random selection base, splatted into two sets as 80% training set (84 MRI) and 20% test set (21 MRI). Three classification algorithms are such that decision tree (DT, C4.5), naive bayes (NB), and linear discriminant analysis (LDA) were used. The accuracy rates of algorithms were compared. Results: C4.5 algorithm classified 20 patients correctly with a success rate of 95.24%. Only one patient was misclassified. The NB classified 19 patients correctly with a success rate of 90.48%. The LDA Algorithm classified 18 patients correctly with a success rate of 85.71%. Conclusion: The CAD equipped with the EM segmentation and C4.5 DT classification was successfully distinguished as benign and malignant breast tumor on MRI. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role of Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient (ADC) values in the differential diagnosis of solid lesions of the breast. Materials and Methods: Diffusion-weighted images and ADC values from 36 women with 37 solid lesions definitely diagnosed through breast biopsy and post-surgical histopathology were evaluated retrospectively. ADC values obtained from malignant and benign solid lesions of the breast were compared using the t-test. The optimum threshold value for use in differentiating benign and malignant lesions was determined using ROC analysis, and sensitivity and specificity values were calculated.Results: Histological analysis identified 23 lesions and 14 benign lesions. Mean age (49 ± 7.8 years) was higher in the group with malignant breast lesions than in the group with benign breast lesions (37.3 ± 8.2) (p 0.05). The mean ADC value (1.1 ± 0.2 × 10-3 mm2/s) in the patients with malignant breast lesions was significantly lower than in the group with benign breast lesions (1.49 ± 0.18 × 10-3 mm2/s) (p 0.05). When the threshold value to be used in the ROC curve was applied the differentiation of benign and malignant solid lesions, the sensitivity was 78.3% and specificity was 100%.Conclusions: Diffusion-weighted MRI and ADC values have the potential to contribute to the diagnosis of solid lesions in the breast at conventional MR examination by differentiating between benign and malignant tumors. [ABSTRACT FROM AUTHOR]

Aim of the study: To analyse the diagnostic performance of contrast-enhanced spectral mammography (CESM) based on morphologic and enhancement patterns of mass lesions in dense breast using different protocols: CESM without delayed image and CESM with delayed image. Material and methods: A total of 151 informed women with suspicious for malignancy mass lesions in dense breast were included in this study. All of them underwent CESM using 2 protocols. A total of 155 lesions were pathomorphologically verified. We analysed morphologic patterns on low-energy (LE) images and recombined images (RI) by defining the shape, margin, and dynamic patterns based on delayed images. Results: The comparative analysis revealed that the shape and margins on RI were more significant than those on LE images. The dynamic indicators of CESM were found to be highly significant in dense breasts. The correlation between kinetic curve and histological results demonstrated that a persistent type of curve was common for benign lesions, accounting for 15/22 (68.1%); plateau and washout - for malignant lesions, accounting for 24/89 (26.9%) and 61/89 (68.5%), respectively. Delayed image leads to an increase of specificity up to 12.4%, which is statistically significant. The area under the curve (AUC) in CESM with delayed image is larger than that in CESM without delayed image (p < 0.01). Conclusions: CESM is sensitive for the differential diagnosis of breast lesions. CESM with delayed image has higher specificity than CESM without delayed image. Delayed images with plateau and washout are typical for malignancy. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer (BC) is a common form of cancer among women globally. It is considered 5th cause of death in females with equally to 522,000 patients / year. Nowadays it is considered 15.4% of death in developed countries after lung cancer. In developing nations, breast cancer considered the 1st cause of death for females 324,000 cases of deaths (14.3%) for total deaths. Method: One hundred and six female patients with breast lesion were collected from the Al-Hussein Teaching Hospital Laboratory/Histopathology department -Al-Muthanna province, during the period from January 2018 to January 2020. The data for cases were collected to study the age, type of breast lesion whether benign or malignant. Haematoxylin/Eosin staining done in Al-Hussein Teaching Hospital Laboratory / Histopathology department. Results: Cross sectional study for 106 patients done in Al- Muthanna proven for assessment breast mass and identify malignant and benign lesion, mean age of patients was (39.4 ± 15.8) years old, with min age 13 years and max age was 81 years old. Types of biopsy taken from surgeon were 71% excisional biopsy, 21% mastectomy and 8% true cut biopsy. After pathological assessment of biopsies showed 51% malignant and 49% benign. In addition, this assessment distributed as following: fibroadenoma 31.1%, IDC/ grade II 29.2%, IDC/ grade III 9.4%, ILC and fibrocystic changes 5.7% and IDC grade I 3.8% and other types of malignant and benign after pathological assessment. Significant association between age groups and cancer of breast. Conclusion: After pathological assessment of biopsies, malignant breast cancer (IDC/ grade II, IDC/ grade III, ILC and fibrocystic changes) most common changes, significant association between age group and breast cancer development more age group 41- 50 years old and then (31- 40), (51- 60) years old respectively. [ABSTRACT FROM AUTHOR]

Objectives: IL17 is a critical pro-inflammatory cytokine that is involved in inflammation, multidrug resistance and growth persistence pathways in cancer. This study is aiming at studying the expression of IL17 and hormonal receptors expression in benign and malignant breast lesions using immunohistochemical staining methods. Results: A total of 137 cases of breast lesions were studied, 97 (70.8%) were malignant and 40 (29.2%) were benign cases. Age range for malignant and benign cases were between 26 and 80 years [mean age 50 ± 2 years], and 20 to 70 years [mean age 41 ± 4 years], respectively, Odds ratio = 2.3 [1.78–1.99, 95% CI]. The majority of the histopathological diagnosis of the benign and malignant lesions were 21 (15.3%) fibro-adenomas and 87 (63.5%) invasive ductal carcinoma, respectively. Expression of IL17 and age were insignificantly negatively correlated for both groups; benign cases [r = − 0.054, P value 0.742] and malignant cases [r = − 0.080, P value 0.444]. IL17 expression was showing insignificant association with age group, P value 0.065. IL17 expression showed a statistical significance based on the different histopathological diagnosis, P value 0.035. Expression levels of estrogen, progesterone, and human epidermal receptors were showing insignificant difference among IL17 expression categories, P values 0.678, 0.623, and 0.361, respectively. [ABSTRACT FROM AUTHOR]

Objective: To determine the false negative and underestimation rates of stereotactic 14-gauge automated core needle breast biopsy (CNB) in Phramongkutklao Hospital. Materials and Methods: A retrospective review of 124 breast lesions receiving stereotactic 14-gauge automated CNB, with either subsequent surgical excision or complete 2-year mammographic follow-up to confirm benignity was performed. The false negative rate and underestimation rate of both high-risk lesions and ductal carcinoma in situ (DCIS) were calculated. Results: The 124 lesions presented as microcalcifications. CNB revealed 80 benign, 13 high risk (seven papillomas, five atypical ductal hyperplasia, and one atypical gland proliferation), and 31 malignant lesions. One of the 37 lesions that had a final diagnosis of carcinoma was benign at CNB, a false negative rate of 2.7%. Three of the five atypical ductal hyperplasia (60%) and two of the seven papillomas (28.6%) turned out to be cancer at surgical excision, while two of the 20 DCIS (10%) had invasive component at final diagnosis. Conclusion: The false negative rate of stereotactic 14-gauge automated CNB of microcalcifications in Phramongkutklao Hospital was 2.7%. The underestimation rates of atypical ductal hyperplasia, papilloma, and DCIS were 60%, 28.6%, and 10%, respectively. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to compare the diagnostic performance of the fat‐to‐lesion strain ratio (FLR) and gland‐to‐lesion strain ratio (GLR) for patients with indeterminate or suspicious breast lesions on ultrasound (US) imaging under a controlled precompression technique and to see whether the technique improves the reproducibility of FLR and GLR measurement. Methods: Fifty‐three lesions in 39 consecutive patients who had scheduled core biopsy or excision surgery based on US findings were examined by US elastography. Each lesion was acquired under controlled precompression by 2 sonographers independently. Both the FLR and GLR of the lesion were calculated. For diagnostic performance, the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were obtained. Interobserver reliability between different sonographers was assessed by the intraclass correlation coefficient (ICC). Results: Forty lesions were benign, and 13 lesions were malignant. Both the FLR and GLR were significantly higher in malignant than benign lesions (P < .05). The FLR yielded higher accuracy and specificity compared to the GLR (accuracy, 79.2% versus 60.4%; and specificity, 87.5% versus 50.0%). With the controlled precompression applied at less than 25% during elastography, the interobserver agreement was excellent for FLR measurements (ICC, 0.853; 95% confidence interval, 0.738–0.920) and GLR measurements (ICC, 0.779; 95% confidence interval, 0.619–0.87). Conclusions: The FLR performed better than the GLR in the detection of breast malignancy; thus, fatty tissue was a better reference tissue for calculating the strain ratio on malignant breast tumor elastography. Keeping precompression to less than 25% will enable different operators to acquire similar elastograms with reproducible FLR and GLR readings. [ABSTRACT FROM AUTHOR]

With the development of ultrasound imaging modern methods such as contrast- -enhanced ultrasound (CEUS) have become part of everyday practice. This imaging method has already gained an important role in the diagnostic algorithm of liver and kidney lesions. However, its use in other fields is still a marginal issue. The role of CEUS in the differential diagnostic algorithm of breast lesions is a topic of many foreign literature studies. The following text describes the methodology of breast CEUS and discusses its inclusion into daily radiology practice. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the diagnostic efficiency of coronal ultrasonic characteristics by automated breast volume scanning (ABVS) in differentiating benign from malignant breast lesions, and further compare the differential diagnostic values of handheld ultrasound (HHUS), ABVS, HUUS combined with ABVS, and molybdenum target X-ray (MTXR) in benign and malignant lesions. Materials and Methods: This study was retrospectively performed in 84 patients with 87 breast lesions. All breast lesions were diagnosed by ABVS, HHUS, and MTXR, then confirmed using histopathologic examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated, as well as receiver operating characteristic (ROC) curve with the area under the curve (AUC) was analyzed to predict the diagnostic values of coronal ultrasonic characteristics by ABVS as well as HHUS, ABVS, HHUS combined with ABVS, and MTXR in breast benign and malignant lesions. Results: Convergence sign and lotus root sign of malignant lesions and the weeping willow sign of benign lesions could be observed in ABVS coronal image. Mass margin and surrounding halo also had high sensitivity, specificity, accuracy, PPV, and NPV. In addition, HHUS combined with ABVS, HHUS, ABVS, and MTXR had similar sensitivity, specificity, accuracy, PPV, NPV, and AUC in differentiating benign from malignant breast lesions. Conclusions: ABVS coronal image have high application value in differential diagnosis of benign and malignant breast lesions. In addition, HHUS combined with ABVS, HHUS, ABVS or MTXR have similar diagnostic efficiencies in differentiating benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Introduction: Screening and diagnostic efforts for breast cancer are critical because the disease has a high rate of successful outcomes with early identification and treatment. The mammography (MG) and Ultrasonography/ ultrasound (USG) are individually effective diagnostic modalities for detection of breast pathologies.Materials and Methods: This cross-sectional, prospective, hospital-based study was carried out with an aim to evaluate breast lesions using digital MG and ultrasonography (USG) independently and in combination with fine-needle aspiration cytology (FNAC) correlation.Results: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MG in detecting carcinoma breast were 77.77%, 97.72%, 87.5%, and 95.55%, respectively. The sensitivity, specificity, PPV, and NPV of USG in detecting carcinoma breast were 55.55%, 97.72%, 83.33%, and 91.48%, respectively. In our study population, 83.01% of breast lesions were benign, and of them, 77.27% were diagnosed by MG alone and 72.72% were diagnosed by USG alone. When these modalities were combined, 97.72% of the lesions were diagnosed. The correlation coefficients of MG alone (0.792), USG alone (0.631), and MG and USG combination (0.884) with FNAC are all positive, and P values are significant of all the modalities.Conclusion: This study confirms that the MG and ultrasound (USG) when combined have significantly higher sensitivity and NPV than observed for a single modality in detecting the both benign and malignant lesions of the breast. [ABSTRACT FROM AUTHOR]

In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound (US), contrastenhanced US (CEUS), combined US and CEUS and magnetic resonance imaging (MRI) in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve. The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and 91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them (kappa < 0.20). In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions. [ABSTRACT FROM AUTHOR]

Purpose: Identifying an additional MRI-detected breast lesion on second-look ultrasonography (US) is technically challenging because of lesion displacement with the patient's position change. The aim of this study is to help identify MRI-detected lesions on second-look US by developing a probing area, called 'the predictive detection area' (PDA), and by assessing the PDA. Methods: We measured the nipple-to-lesion distances (NLDs) for 16 breast lesions on prone- and supine-position MRI sets and calculated the difference and angle between the two NLD vectors, representing the lesion displacement. The minimum and maximum differences and angles were chosen to form the PDA. Another 22 breast lesions, detected in the prone MRI, were identified on US by probing the PDA to evaluate the probability of existence. Results: The width between the minimum and maximum differences in two NLDs and the angle to form the PDA for the upper-inner, upper-outer, and lower-outer quadrants were 23.0 mm and 95.0°, 29.0 mm and 41.0°, and 18.0 mm and 17.0°, respectively. The respective probabilities of existence were 100, 80, and 100%. Conclusions: The PDA had a high probability of existence and was acceptably accurate; therefore, the PDA in a second-look US has the potential to help operators to quickly identify additional MRI-detected lesions. [ABSTRACT FROM AUTHOR]

Purpose The aim of this paper is to provide access to a database consisting of the raw radio-frequency ultrasonic echoes acquired from malignant and benign breast lesions. The database is freely available for study and signal analysis. Acquisition and validation methods The ultrasonic radio-frequency echoes were recorded from breast focal lesions of patients of the Institute of Oncology in Warsaw. The data were collected between 11/2013 and 10/2015. Patients were examined by a radiologist with 18 yr' experience in the ultrasonic examination of breast lesions. The set of data includes scans from 52 malignant and 48 benign breast lesions recorded in a group of 78 women. For each lesion, two individual orthogonal scans from the pathological region were acquired with the Ultrasonix SonixTouch Research ultrasound scanner using the L14-5/38 linear array transducer. All malignant lesions were histologically assessed by core needle biopsy. In the case of benign lesions, part of them was histologically assessed and another part was observed over a 2-year period. Data format and usage notes The radio-frequency echoes were stored in Matlab file format. For each scan, the region of interest was provided to correctly indicate the lesion area. Moreover, for each lesion, the BI- RADS category and the lesion class were included. Two code examples of data manipulation are presented. The data can be downloaded via the Zenodo repository () or the website . Potential applications The database can be used to test quantitative ultrasound techniques and ultrasound image processing algorithms, or to develop computer-aided diagnosis systems. [ABSTRACT FROM AUTHOR]

Background: The study aimed to improve breast cancer diagnosis with new ultrasound (US) modalities. We examined whether real-time elastography (RTE) complements the diagnostic performance of US.Methods: The Ethical Committee approved the study. Patients provided written informed consent and received a whole breast workup. Breast lesions were evaluated by US and RTE. Lesions were assessed by BI-RADS, Tsukuba score (TS) and strain ratio (SR).Results: The study included 164 breast lesions of which 101 were benign and 63 malignant. Women with benign lesions were predominantly premenopausal with sonographic dense breast tissue. Women with breast cancer were mostly postmenopausal, with a low sonographic density. Benign lesions had a mean TS of 2.05, which was significantly lower than the mean TS of 3.25 for malignant lesions. The SR for benign lesions (SR 1.83) was significantly smaller than for breast cancer (SR 4.83). Sensitivity and specificity was 95 and 81% for BI-RADS, 39 and 94% for TS, and 57 and 83% for SR, with a cutoff at 2.5. The combination of BI-RADS, TS and SR yielded a sensitivity of 95% and a specificity of 85%.Conclusion: Besides morphologic features revealed by US, elastic properties of breast lesions obtained by RTE can be exploited for diagnostic breast imaging. [ABSTRACT FROM AUTHOR]

Purpose To investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to distinguish benign from malignant breast lesions. Materials and methods Retrospective analysis of data pertaining to 117 patients with breast lesions who underwent DCE-MRI and IVIM-DWI examination with 3.0 T MRI was conducted. A total of 128 lesions were pathologically confirmed (47 benign and 81 malignant). Between-group differences in DCE-MRI parameters (Morphology, enhancement pattern, maximum slope of increase (MSI) and time–signal curve (TIC) type) and IVIM-DWI parameters (f value, D value and D* value) were assessed. Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions. The diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI, to distinguish benign from malignant breast lesions, was evaluated using pathology results as the gold standard. Results Lesion morphology, MSI, and TIC type ( P < 0.05), but not the enhancement pattern ( P > 0.05), were significantly different between the benign and malignant groups. The f (8.53 ± 2.14) and D* (7.64 ± 2.07) values in the malignant group were significantly higher than those in the benign group (7.68 ± 1.97 and 6.83 ± 2.13, respectively), while the D value (0.99 ± 0.22) was significantly lower than that (1.34 ± 0.17) in the benign group ( P < 0.05 for all). On logistic regression analysis, the sensitivity, specificity and accuracy of DCE-MRI were 90.1%, 70.2% and 82.8% respectively; the corresponding figures for the combination of IVIM-DWI and DCE-MRI were 88.8%, 85.1%, and 87.5%respectively. Conclusion IVIM-DWI method as an adjunct to DCE-MRI can improve the specificity and accuracy in differential diagnosis of benign and malignant lesions of breast. [ABSTRACT FROM AUTHOR]

Objective- To detect the frequency distribution of various breast lesions on fine needle aspiration cytology (FNAC) and incidence of duct carcinoma in different age groups. Material and Method- 200 cases who presented with breast lesions for fine aspiration cytology with Papanicolaou stain, age group 15-60 years and both sexes were included in the study conducted over a period of June 2014 - May 2016. Results- FNAC was done on 200 cases of breast lesions, of which 150 (75.0%) were benign, 27 (13.5%) malignant, 11 (5.5%) benign breast disease with atypia, 4 (2%) suspicious, and 8(4.0%) unsatisfactory. Fibroadenoma was the most common benign lesion and ductal carcinoma was the common malignant lesion. There was significant association between benign breast lesions and age. Majorities were pre-menopausal females and commonest age group was 31-40 years. Conclusion- With experienced hands, fine needle aspiration cytology (FNAC) is a safe, cost effective and reliable technique for preoperative evaluation of palpable breast lumps. FNA features are more informative when combined with clinical and radiological findings. Fibro adenoma forms the majority of benign breast lesions, followed by duct carcinoma with increased incidence in the third decade. So, clinical breast examination and mammography screening in female subjects should be encouraged in developing countries from the third decade onward for early detection of breast carcinoma. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) has high sensitivity but low specificity for breast cancer, and consequently, new techniques to improve the specificity of breast MRI in diagnosing breast cancer are under development.Purpose: To assess the ability of the apparent diffusion coefficient (ADC) compared with the ADC ratio (ADCr) to differentially diagnose benign compared with malignant breast lesions.Material and Methods: Forty-eight women with breast lesions (average age, 45 years) underwent MRI scanning including T1-weighted dynamic contrast-enhanced (DCE) scanning and diffusion-weighted imaging (DWI). The average ADC and ADCr values for both lesions and pectoralis major muscles (ADCrmuscle and ADCrmuscle) were measured in patients with malignant (n = 25) and benign (n = 23) breast lesions. The ADCr of the contralateral breast (ADCr contralateral) was also evaluated. All histology was confirmed by pathological analysis of biopsied tissue. ADC and ADCr values were analyzed using receiver-operating characteristic (ROC) curves.Results: For benign lesions compared with malignant lesions, lesion-side ADC was 1.45 vs. 1.05, respectively (P < 0.001), normal-side ADC was 1.82 vs.1.64 (P = 0.002), ADCrmuscle was 1.35 vs. 0.9 (P < 0.001), and ADCrcontralateral was 0.79 vs. 0.64 (P = 0.001). ADCrmuscle showed higher sensitivity (82.61%) and specificity (96.00%) than ADCrcontralateral (60.87% and 92.00%, respectively) and ADC (69.57% and 96.00%) for discriminating malignant from benign lesions. The AUC using ADCrmuscle had higher discriminatory power (0.92, P < 0.001) for malignant versus benign breast lesions compared with either ADC (0.82, P < 0.001) or ADCrcontralateral (0.78, P = 0.001).Conclusion: The ADCrmuscle value showed higher sensitivity and specificity and improved diagnostic accuracy compared with either ADC or ADCrcontralateral in differentiating benign from malignant breast lesions. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most common causes of death in the female population worldwide and one of the most prevalent cancers among other types of cancer. An early and adequate diagnosis is a key factor for an appropriate treatment, increasing the probability of survival. In order to enhance the efficiency and effectiveness of a diagnosis, an image analysis system was implemented; its purpose was to provide support for radiologists in detection of lesions from mammograms. Image segmentation techniques were carried out to find breast lesions within the mammograms in the region of interest (ROI), which is related to the area where breast density is concentrated. Breast density is defined as the brightest part on the mammographic image and it is composed by glandular and adipose tissue where breast lesions are likely to be exposed. This study provides a methodology divided in two main segmentation techniques: 1) a region growing technique and 2) split and merge technique. This study also gives a complete description of image analysis and the tools used in it. [ABSTRACT FROM AUTHOR]

Objective: US elastography is an emerging technique that can be used during breast US examination. The increasing awareness of breast cancer led to an increase in mammography and breast US examinations. The specificity of these techniques is not high enough to prevent unnecessary biopsies. There is still a need for a more specific technique that can overcome this problem. This study aimed to evaluate the value of strain elastography in breast lesions. Materials and Methods: In this study, 110 lesions of 96 patients were evaluated with strain elastography. Five score system was used for lesion scoring. The histopathologic results of lesions were obtained and were accepted as gold standard. The sensitivity, specificity, PPV and NPV of the technique were calculated. Histopathologic and strain elastography results were correlated. Results: The sensitivity of US strain elastography was calculated as 83%, the specificity as 89%, the positive predictive value as 79% and the negative predictive value as 91%.There were no score 1 lesions. All score 2 lesions were benign. Score 5 had the highest true positivity rate. Conclusion: We believe that ultrasound elastography is an effective imaging technique that can be used as an adjunct for differential diagnosis, prior to the decision to biopsy a lesion in certain cases. [ABSTRACT FROM AUTHOR]

Reduction mammaplasty is a commonly performed operation for treatment of breast hypertrophy. It allows examination of specimens from a seemingly healthy population. Although there are many publications reporting the incidence of occult breast carcinomas, only a few studies have specifically examined the incidence of other breast lesions in reduction mammaplasty specimens. The authors conducted a single-centre retrospective chart review examining the incidence of benign and precancerous lesions in breast reduction specimens. Both age and the number of tissue sections were evaluated for the association with important pathologic findings. Of the 95 patients who underwent reduction mammaplasty, eight patients (8.4%) had atypical lesions. Fourteen patients (15%) had proliferative and 54 patients (57%) had non-proliferative breast lesions. No occult invasive breast cancer was identified in the breast reduction specimens. The existence of significant pathologic findings was not associated with age ( p = 0.231, student t-test). On the other hand, it was found to be associated with the number of tissue sections ( p = 0.046, Mann-Whitney U-test). This study reveals that breast reduction specimens should be analyzed histologically since a considerable amount of patients have breast lesions with increased cancer risk. Therefore, this analysis would guide the management of these patients in the follow-up period. [ABSTRACT FROM AUTHOR]