Journal of Breast Imaging最新文献

{"title":"The Management of Antithrombotic Therapy in Image-Guided Breast Biopsy: A Systematic Review With Meta-Analysis.","authors":"Mario Villani, Fabio Zecca, Falko Ensle, Lisa Jungblut, Alexandra Athanasiou, Bérénice Boulet, Ilse Vejborg","doi":"10.1093/jbi/wbaf062","DOIUrl":"10.1093/jbi/wbaf062","url":null,"abstract":"<p><strong>Objective: </strong>Antithrombotic therapy (AT) is crucial for preventing life-threatening thromboembolic events (TEEs). However, concerns about bleeding events (BEs) often lead to AT discontinuation before image-guided breast biopsy (iBB). This systematic review and meta-analysis assess the necessity and safety of AT suspension prior to iBB.</p><p><strong>Methods: </strong>A systematic review was conducted using Embase and PubMed/MEDLINE databases through July 2024. Studies evaluating BEs in patients who had AT and were undergoing iBB were included. Case reports, surveys, and nonretrievable full texts were excluded. Data analysis was performed using Review Manager v5.4. The risk-of-bias assessment was based on the Risk Of Bias in Non-randomized Studies of Interventions tool.</p><p><strong>Results: </strong>Of the 216 studies screened, 8 met the inclusion criteria, which comprised 1154 patients undergoing AT and 10 370 controls. Bleeding events occurred in 203 (17.9%) patients with AT and 1110 (10.7%) controls, yielding a pooled odds ratio of 1.89 (Z = 5.23; P < 0.001). Heterogeneity was moderate (I² = 34%). Variability existed in AT drugs, iBB techniques, and definitions of \"clinically relevant BE.\" Only 3 (0.23%) BEs were considered \"clinically relevant\" in 1 study.</p><p><strong>Conclusion: </strong>Although current evidence is burdened by unstandardized reporting and data fragmentation, it supports the safety of performing iBB without suspending ongoing AT because local BEs, although slightly more frequent under AT, are predominantly minor and clinically irrelevant. Antithrombotic therapy continuation can improve diagnostic efficiency, minimize delays, limit patient anxiety, and reduce health care costs. Our quantitative findings support AT continuation in the context of iBB while providing a clinical rationale that addresses the TEE risks associated with AT interruption-an issue often underrepresented in prior literature.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"136-148"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Are Generally Supportive of Artificial Intelligence in Breast Imaging: A Multisite Survey of Breast Imaging Patients.","authors":"Lars J Grimm, Katerina Dodelzon, Sonya Bhole, Christine E Edmonds, Lisa A Mullen, Jay R Parikh, Caroline P Daly, James A Epling, Soren Christensen, Brian N Dontchos","doi":"10.1093/jbi/wbaf066","DOIUrl":"10.1093/jbi/wbaf066","url":null,"abstract":"<p><strong>Objective: </strong>To understand the perspective of patients undergoing breast imaging on the use of artificial intelligence (AI) in breast cancer screening.</p><p><strong>Methods: </strong>A 36-item survey was administered to breast imaging patients at 6 academic and 2 private practice groups in the United States. The survey included questions regarding demographics, breast imaging history, and electronic health literacy. Respondents were asked Likert scale questions on the role of AI in breast cancer screening, the role of AI as an independent or complementary reader, and concerns regarding AI in breast imaging.</p><p><strong>Results: </strong>The survey yielded 3532 responses, a response rate of 69.9% (3532/5053). The median age was 55.9 years (SD, 12.3 years), and most respondents were White (73.0%, 2679/3532). Respondents indicated support for the role of AI to identify suspicious findings (70.6%, 2492/3532), triage findings for review (69.5%, 2382/3532), calculate breast density (73.2%, 2588/3532), and estimate breast cancer risk (61.9%, 2186/3532). Significantly higher support was noted among patients who were White, had more education, and had greater health literacy (all P <.05). There was strong agreement that it was necessary for radiologists to also review each examination (67.3%, 376/3532). Respondents were uncertain about whether AI (41.2%, 1456/3532) or radiologists (31.8%, 1124/3532) were responsible for errors. There was concern that AI will limit communication between patients and radiologists (75.7%, 2673/3532).</p><p><strong>Conclusion: </strong>Breast imaging patients have an overall favorable view of AI in breast cancer screening, with variable support by demographics. Education and outreach efforts should target perceived challenges to AI adoption to improve patient acceptance.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"169-177"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prone-to-Supine Breast MRI for Tumor Margin Visibility and Surgical Guidance.","authors":"Roberta M diFlorio-Alexander, Brook Byrd, Venkat Krishnaswamy, Misty Fox, Keith Paulsen, Richard J Barth, Timothy Rooney","doi":"10.1093/jbi/wbaf059","DOIUrl":"10.1093/jbi/wbaf059","url":null,"abstract":"<p><strong>Background: </strong>Supine breast MRI reproduces the surgical position during breast-conserving surgery, with early studies reporting the benefit of decreased positive margin rates. However, acquiring an additional contrast-enhanced supine breast MRI after a prone breast MRI in a second imaging session is clinically and financially challenging. The aim of this study was to evaluate the tumor-to-fibroglandular tissue contrast ratios and the ability to visualize tumor margins in a double-bolus prone-to-supine breast MRI obtained in a single imaging session.</p><p><strong>Methods: </strong>Thirty-nine patients with breast cancer had a standard prone breast MRI followed immediately by a second contrast injection in the supine position to obtain supine breast MRI (double-bolus prone-to-supine MRI protocol [P2S2]). A control group of 35 patients received a prone examination and an independent supine examination in 2 separate imaging sessions. Tumor-to-fibroglandular tissue contrast ratios (TFRs), a measure of tumor enhancement that informs the ability to visualize tumor margins, were statistically compared between cohorts. Two radiologists independently rated the ability to visualize tumor margins in the independent and double-bolus supine breast MRIs.</p><p><strong>Results: </strong>No significant differences were found in the mean TFR between the independent and P2S2 supine examinations (P = .79). Excellent agreement occurred between both readers regarding the ability to visualize the tumor margins in the independent and P2S2 supine MRIs with κ scores of 1.00 and 0.95, respectively.</p><p><strong>Conclusion: </strong>A supine breast MRI obtained in a single imaging session after a second contrast injection provided adequate tumor enhancement for tumor margin visualization and preoperative surgical guidance comparable with independent supine breast MRI.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"178-189"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary Extranodal Extension in Breast Cancer: Imaging Features With Histopathology Correlation.","authors":"Phat Tan Nguyen, Leah H Portnow, Matthew D Packer, Eva C Gombos","doi":"10.1093/jbi/wbaf083","DOIUrl":"10.1093/jbi/wbaf083","url":null,"abstract":"<p><p>Extranodal extension (ENE) is defined as the spread of tumor cells beyond the lymph node capsule. It is an independent prognostic factor in breast cancer associated with increased nodal disease burden, influencing subsequent treatment strategies. Extranodal extension has been reported in approximately 20% to 50% of patients with metastases to axillary lymph nodes. Despite its clinical relevance, ENE remains challenging to detect. Key imaging features indicative of ENE include irregular nodal contours, nodal matting, and perinodal edema on US and MRI. However, these findings are often not detected or are underreported. Pathologic evaluation confirms capsular permeation and perinodal soft tissue infiltration by tumor cells, which may be accompanied by a stromal response. Our case examples demonstrate the importance of integrating imaging and pathology for accurate ENE detection. Improved diagnostic accuracy with radiologic-pathologic correlation optimizes treatment planning and facilitates appropriate risk stratification for patients with breast cancer.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"207-216"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Arterial Calcifications in Mammography: Evaluating Diagnostic Accuracy, Reproducibility, and Clinical Feasibility of Visual Scoring Systems.","authors":"Jonathan Andreas Saenger, Jasmin Happe, Bjarne Kerber, Kilian Kaim, Ela Uenal, Denise Bos, Thomas Frauenfelder, Andreas Boss","doi":"10.1093/jbi/wbaf069","DOIUrl":"10.1093/jbi/wbaf069","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated (1) the reproducibility of 5 visual scoring systems for breast arterial calcifications (BACs) on mammography and their correlation with coronary artery calcifications (CACs), (2) their diagnostic accuracies, and (3) clinical applicability.</p><p><strong>Methods: </strong>In this retrospective study, 90 women (median aged 57 years, interquartile range [IQR] 15) who underwent both mammography and cardiac CT were included. Breast arterial calcification was scored using 5 visual systems: (1) dichotomous (present/absent), (2) 4-level vessel count, (3) 4-level severity, (4) combined 4-level (severity + vessel count), and (5) an advanced 3-level scale (incorporating vessel count, length, and density). Diagnostic performance was evaluated via sensitivity, specificity, and area under the curve (AUC). Interobserver agreement was assessed with Cohen's kappa; correlation with CAC (Agatston score) used Spearman's rho.</p><p><strong>Results: </strong>Breast arterial calcification was present in 17.8% (16/90) and showed a trend toward correlation with CAC (P = .05). The 4-level vessel count scale showed the strongest correlation with CAC (rho = 0.373; P <.001). The highest AUC (0.604) was achieved by the 4-level severity scale (sensitivity 44%, specificity 77%). Interobserver agreement was highest for the combined 4-level scale (κ = 0.835), followed by the 4-level vessel count (κ = 0.833), severity-only (κ = 0.819), 3-level vessel count (κ = 0.833), and the dichotomous scale (κ = 0.740). The dichotomous scale required the least time (mean 19 s/patient); the 3-level scale required the most (mean 51 s). The vessel count scale balanced accuracy, reproducibility, and efficiency (mean 34 s).</p><p><strong>Conclusion: </strong>Grading BACs is feasible, with consistently high interobserver agreement across scoring systems. The 4-level vessel count scale demonstrated a favorable balance of accuracy, reproducibility, and practicality, suggesting it may warrant further evaluation as a potential tool in mammography-based cardiovascular risk assessment.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"149-159"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on 30 Years of Radiology-Pathology Concordance Conferences.","authors":"Ellen B Mendelson","doi":"10.1093/jbi/wbaf073","DOIUrl":"10.1093/jbi/wbaf073","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"204-206"},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty Breasts and Palpable Lumps: Diagnostic Mammogram Alone May Be Sufficient to Exclude Cancer.","authors":"Dawn C Nwamuo, Grace H Lin, Shivani Gillon, Caitlin M Lydon, Amethyst Leimpeter, Jun Shan, Laurel A Habel, Ninah S Achacoso, Mark Westley, Tony Xu, Denis Mak, Catherine Lee, Dorota Wisner, Vignesh A Arasu","doi":"10.1093/jbi/wbaf080","DOIUrl":"https://doi.org/10.1093/jbi/wbaf080","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether diagnostic mammogram alone is sufficient to identify breast cancer in women with a palpable lump and almost entirely fatty breast density.</p><p><strong>Methods: </strong>All 2D full-field diagnostic mammograms performed in a large health system were retrospectively identified for patients assigned \"almost entirely fatty\" breast density from January 2014 through December 2018 who presented with a palpable lump and had at least 2 years of follow-up. Women were excluded if they had a history of breast cancer, ipsilateral surgery, or clinical suspicion of abscess. Other exclusions included axillary lumps, lumps located in the retroareolar or posterior one-third of the breast, and lumps in which the lump marker was visible in only 1 view. The investigators performed image-only review of the diagnostic mammogram, with blinding of the image reports and any ensuing outcomes. Subsequently, the associated US was assessed. Cancer outcomes were ascertained via linkage with the regional tumor registry.</p><p><strong>Results: </strong>A total of 1552 eligible women, mean age 58.7 years ± 13.4, with 1791 lumps, were identified. Of these, 1139 women (73%) had no mammographic correlate, and 86 women (6%) had cancers corresponding to their lump, with 1 cancer having no mammographic correlate. The risk of cancer with no mammographic correlate to the palpable lump was 0.1% (1/1139 ; 95% CI, 0.0-0.3).</p><p><strong>Conclusion: </strong>Diagnostic mammography alone has very low risk of missed cancer and is sufficient for evaluation of palpable symptoms in most women with fatty breast density.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying BI-RADS After Breast Cryoablation: New Categories Are Needed.","authors":"Richard W Ahn","doi":"10.1093/jbi/wbaf055","DOIUrl":"10.1093/jbi/wbaf055","url":null,"abstract":"<p><p>Breast imaging plays a unique role in radiology, serving as the gatekeeper for initial imaging evaluation and tissue diagnosis of breast cancers. However, the definitive treatment of nonmetastatic breast cancer remains surgical excision, with radiation and/or chemotherapy based on stage and tumor profile.1 The reemergence of breast cryotherapy, highlighted by the recent 5-year results of the ICE3 trial, has the potential to expand the scope of breast imaging radiologists into the treatment of breast cancers.2 There is also increasing interest in cryoablation for immune potentiation in triple-negative and metastatic breast cancers.3.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"109-111"},"PeriodicalIF":2.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unknown Case: Asymmetric Breast Uptake on Sestamibi Scan.","authors":"Jolie Jean, Janine T Katzen","doi":"10.1093/jbi/wbae072","DOIUrl":"10.1093/jbi/wbae072","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"120-122"},"PeriodicalIF":2.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metaplastic Breast Carcinoma: Radiologic-Pathologic Correlation.","authors":"Ashley C Bragg, Ravinder S Legha, Qingqing Ding, Wei-Tse Yang","doi":"10.1093/jbi/wbaf056","DOIUrl":"10.1093/jbi/wbaf056","url":null,"abstract":"<p><p>Metaplastic breast carcinoma (MBC) is a rare and aggressive malignancy pathologically defined by differentiation of the neoplastic epithelium to mesenchymal-like and/or squamous components. Metaplastic breast carcinoma is typically a triple receptor negative invasive breast cancer (TNBC). There are multiple subtypes of MBC, and imaging findings are nonspecific. Classically, MBC presents in postmenopausal women as an enlarging palpable mass. At presentation, MBC is often larger than non-MBC breast cancer, and distant metastases are more common. Axillary nodal involvement is, however, less frequent. Mammography commonly demonstrates a circumscribed oval, round, or lobulated mass with or without calcifications. Spiculated masses and architectural distortion are less common than in non-MBC breast cancer. US often demonstrates a round/oval solid mass with cystic spaces due to necrosis. A T2 hyperintense mass with rim enhancement is often demonstrated on MRI. Imaging findings of MBC can mimic benign tumors, such as phyllodes and non-MBC breast cancers, and radiologists should consider MBC in the differential diagnosis of a mass with these features, especially with a clinical history of a new or enlarging palpable finding. Pathologic diagnosis is important, but accurate diagnosis on core biopsy can be limited due to the heterogeneity of this entity and dependence on sampling the metaplastic component. Data suggest that MBC confers a worse long-term prognosis than non-MBC breast cancers, including other TNBCs.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":"77-86"},"PeriodicalIF":2.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}