Journal of Breast Imaging最新文献

{"title":"Triple-Negative Breast Cancer: Radiologic-Pathologic Correlation.","authors":"Amrita R Valluri, Gloria J Carter, Inna Robrahn, Wendie A Berg","doi":"10.1093/jbi/wbae085","DOIUrl":"https://doi.org/10.1093/jbi/wbae085","url":null,"abstract":"<p><p>Triple-negative breast cancers (TNBCs) are invasive carcinomas that lack ER and PR expression and also lack amplification or overexpression of HER2. Triple-negative breast cancers are histopathologically diverse, with the majority classified as invasive breast carcinomas of no special type with a basal-like profile. Triple-negative breast cancer is the most aggressive molecular subtype of invasive breast carcinoma, with the highest rates of stage-matched mortality and regional recurrence. Triple-negative breast cancer has a younger median age of diagnosis than other molecular subtypes and is disproportionately diagnosed in Black women and BRCA1 germline pathogenic mutation carriers. On US and mammography, TNBCs are most often seen as a noncircumscribed mass without calcifications; TNBCs can have circumscribed margins and mimic a cyst or have probably benign features that may result in delayed diagnosis. MRI is the most sensitive modality for detecting TNBC, with rim enhancement being a common feature, and MRI is also the most accurate imaging for assessing neoadjuvant chemotherapy response. Understanding the radiologic and pathologic findings of TNBC can aid in diagnosis.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972654","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":"Safety and Efficacy of Percutaneous Drain Placement for Postsurgical Breast Region Fluid Collections.","authors":"Sanna E Herwald, Wenhui Zhou, Debra Ikeda, Alexander Vezeridis","doi":"10.1093/jbi/wbae086","DOIUrl":"https://doi.org/10.1093/jbi/wbae086","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe the safety and efficacy of percutaneous drain placement for postoperative fluid collections in the breast.</p><p><strong>Methods: </strong>A retrospective review was conducted of the patient characteristics, intervention data, and clinical outcomes of the 43 adult patients who underwent percutaneous drain placement for fluid collections at a tertiary care hospital over a 13-year period ending February 28, 2023.</p><p><strong>Results: </strong>Most fluid collections treated with percutaneous drain placement were secondary to ipsilateral breast surgery (92%, 44/48), most commonly breast reduction (23%, 10/44) and mastectomy with immediate tissue expander reconstruction (16%, 7/44). Additional patients had fluid collections without prior ipsilateral breast surgery (8%, 4/48) and were excluded from further analysis. The fluid cultures from 39% of the cultured postsurgical fluid collections were positive (16/41), and Staphylococcus aureus was the most commonly cultured organism (15%, 6/41). The only immediate complication was the rupture of a tissue expander during drain placement in 1 patient. The median duration of percutaneous drainage for postsurgical fluid collections was 12 days (range: 1 to 49 days). Percutaneous drain placement achieved clinical success without any subsequent treatments in 73% (32/44) of patients. An additional 7% (3/44) of patients required subsequent image-guided aspiration procedures and/or percutaneous drain placements but avoided surgical treatment for a persistent fluid collection.</p><p><strong>Conclusion: </strong>Postsurgical fluid collections after diverse breast surgeries represented the vast majority of the fluid collections referred to our academic practice for percutaneous drain placement. Percutaneous drain placement was a safe and effective treatment in this patient population.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899175","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":"Peri-Implant Enhancement of the Breast: Imaging Features, Significance, and Management Strategies.","authors":"Santo Maimone, Shweta Srivastava, Olivia S Ho, Kristin A Robinson, Andrey P Morozov, Haley P Letter, Amie Leon, Brian D Rinker","doi":"10.1093/jbi/wbae084","DOIUrl":"https://doi.org/10.1093/jbi/wbae084","url":null,"abstract":"<p><strong>Objective: </strong>Peri-implant enhancement can be seen on contrast-enhanced breast MRI, but its association with malignancy has not been described, leading to considerable variability in assessment and recommendations by radiologists. This study evaluated imaging features, management, and outcomes of implant-related enhancement.</p><p><strong>Methods: </strong>This multisite IRB-approved retrospective review queried all breast MRI reports for keywords describing peri-implant enhancement, fluid, and/or masses (plus synonymous descriptions) and implant-associated malignancies, with subsequent imaging and chart review. Peri-implant enhancement and implant features were characterized. Assessments and outcomes were evaluated via clinical and imaging follow-up, aspiration/biopsy, and/or capsulectomy to evaluate for association of peri-implant enhancement with implant-related malignancy.</p><p><strong>Results: </strong>A total of 100 patients had peri-implant enhancement. Uniform thin peripheral enhancement was most common (79/100, 79%). Capsulectomy was performed in 31/100 (31%), with benign capsular fibrosis/inflammation discovered in 26/31 (83.9%). Breast implant-associated anaplastic large cell lymphoma was present in 2/100 (2%), both with textured implants, while 98/100 (98%) had no implant-related malignancy. MRI recommendations varied: resume routine imaging (26/100, 26%), clinical management (18/100, 18%), follow-up MRI (17/100, 17%), MRI-directed US (17/100, 17%), aspiration/biopsy (11/100, 11%), and surgical consultation (10/100, 10%).</p><p><strong>Conclusion: </strong>Peri-implant enhancement is a nonspecific imaging finding with a low malignant association, especially when seen in isolation (no associated effusion, mass, or adenopathy). Implant surface texture should be considered in management recommendations; diagnostic capsulectomy is not recommended in patients with smooth implants. Additional studies are encouraged to validate nonoperative management recommendations.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872983","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":"Upgrade Rate of Exclusively MRI-Detected Papillomas in Asymptomatic Patients Undergoing Screening or Extent of Disease Examinations.","authors":"Kathryn Watts Zamora, Ceren Yalniz, Kudratjot Brar, Yufeng Li, Stefanie Zalasin, Stefanie Woodard","doi":"10.1093/jbi/wbae080","DOIUrl":"https://doi.org/10.1093/jbi/wbae080","url":null,"abstract":"<p><strong>Objective: </strong>To determine the upgrade rate of exclusively MRI-detected benign papillomas in asymptomatic high-risk patients, patients with a history of cancer, or patients with known malignancy.</p><p><strong>Methods: </strong>This IRB-approved retrospective study reviewed all breast MRI-guided biopsies yielding papilloma on pathology for all asymptomatic patients undergoing breast MRI for high-risk screening, newly diagnosed breast cancer, or a personal history of breast cancer. All cases were followed by excision or 2-year imaging follow-up. The upgrade rate was determined. Fisher's exact test was used to determine the significance of associated factors, including lesion type, lesion size, and ipsilateral malignancy.</p><p><strong>Results: </strong>Of the 258 MRI-guided biopsies, 117 met the inclusion criteria. A 4% (5/117) upgrade rate was found with a 3% (4/117) upgrade rate to ductal carcinoma in situ (DCIS) and a 1% (1/117) upgrade rate to invasive malignancy for all identified papillomas. When evaluating all papillomas, the only associated feature identified to be statically significant for risk of upgrade was ipsilateral malignancy with a 60% (3/5) upgrade rate with a P-value of .0057. When separately evaluating benign papillomas only by excluding those with atypia or additional high-risk lesion at biopsy, a 4% (3/80) upgrade rate to DCIS was found. There was no upgrade to invasive malignancy.</p><p><strong>Conclusion: </strong>Upgrade of MRI-detected papillomas in asymptomatic high-risk patients, patients with a history of cancer, or patients with known malignancy is 4% in this population, which suggests these lesions may warrant surgical excision.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847911","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":"Cystic Neutrophilic Granulomatous Mastitis: Imaging Features With Histopathologic Correlation.","authors":"Joseph J Villavicencio, Sophia R O'Brien, Tom Hu, Samantha Zuckerman","doi":"10.1093/jbi/wbae077","DOIUrl":"https://doi.org/10.1093/jbi/wbae077","url":null,"abstract":"<p><p>Cystic neutrophilic granulomatous mastitis (CNGM) is a rare type of granulomatous lobular mastitis (GLM) with a distinct histologic pattern characterized on histopathology by clear lipid vacuoles lined by peripheral neutrophils (\"suppurative lipogranulomas\"), often containing gram-positive bacilli and strongly associated with Corynebacterial infection (in particular, Corynebacterium kroppenstedtii). Cystic neutrophilic granulomatous mastitis has a distinct histopathologic appearance, but the imaging appearance is less well described and has been limited to case reports and small case series published primarily in pathology literature. Mammographic findings of CNGM include focal asymmetry, skin thickening, and irregular or oval masses. Sonographic findings of CNGM include irregular mass, complex collection/abscess, dilated ducts with intraductal debris, axillary lymphadenopathy, and skin thickening with subcutaneous edema. The imaging features of CNGM are nonspecific, and biopsy is required. Identifying a causative organism, when possible, requires a Gram stain, microbiological culture, and, potentially, molecular analysis. Although therapeutic options exist for CNGM, including antibiotics, steroids, and surgical intervention, there is no current consensus on optimal treatment.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829613","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":"Axillary Lymph Nodes T2 Signal Intensity Characterization in MRI of Patients With Mucinous Breast Cancer: A Pilot Study.","authors":"Noam Nissan, Jill Gluskin, Yuki Arita, R Elena Ochoa-Albiztegui, Hila Fruchtman-Brot, Maxine S Jochelson, Janice S Sung","doi":"10.1093/jbi/wbae078","DOIUrl":"https://doi.org/10.1093/jbi/wbae078","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the T2 signal intensity (SI) of axillary lymph nodes as a potential functional imaging marker for metastasis in patients with mucinous breast cancer.</p><p><strong>Methods: </strong>A retrospective review of breast MRIs performed from April 2008 to March 2024 was conducted to identify patients with mucinous breast cancer and adenopathy. Two independent, masked readers qualitatively assessed the T2 SI of tumors and lymph nodes. The T2 SI ratio for adenopathy and contralateral normal lymph nodes was quantitatively measured using the ipsilateral pectoralis muscle as a reference. Comparisons between malignant and nonmalignant lymph nodes were made using the chi-square test for qualitative assessments and the Mann-Whitney U test for quantitative assessments.</p><p><strong>Results: </strong>Of 17 patients (all female; mean age, 48.4 ± 10.7 years; range: 29-80 years), 12 had malignant nodes, while 5 had benign nodes. Qualitative assessment revealed that the primary mucinous breast cancer was T2 hyperintense in most cases (88.2%-94.1%). No significant difference in qualitative T2 hyperintensity was observed between malignant and nonmalignant nodes (P = .51-.84). Quantitative T2 SI ratio parameters, including the ratio of mean and minimal node T2 SI to mean ipsilateral pectoralis muscle T2 SI, were higher in malignant nodes vs benign and contralateral normal nodes (P <.05).</p><p><strong>Conclusion: </strong>Metastatic axillary lymph nodes exhibit high T2 SI, which could serve as a functional biomarker beyond traditional morphological assessment. Future studies should prioritize investigating more precise measurements, such as T2 mapping, and confirm these results in larger groups and across mucinous neoplasms in other organs.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829672","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":"Stop Training Artificial Intelligence Algorithms Now. Start Prospective Trials!","authors":"Robert M Nishikawa, Alisa Sumkin","doi":"10.1093/jbi/wbae083","DOIUrl":"https://doi.org/10.1093/jbi/wbae083","url":null,"abstract":"","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751977","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":"Evaluation of a Multi-Instant Multimodal Artificial Intelligence System Supporting Interpretive and Noninterpretive Functions.","authors":"Serena Pacilè, Pauline Germaine, Caroline Sclafert, Thomas Bertinotti, Pierre Fillard, Svati Singla Long","doi":"10.1093/jbi/wbae062","DOIUrl":"https://doi.org/10.1093/jbi/wbae062","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI) has been shown to hold promise for improving breast cancer screening, offering advanced capabilities to enhance diagnostic accuracy and efficiency. This study aimed to evaluate the impact of a multimodal multi-instant AI-based system on the diagnostic performance of radiologists in interpreting mammograms.</p><p><strong>Methods: </strong>We designed a multireader multicase study taking into account the evaluation of both interpretive and noninterpretive tasks. The study was approved by an institutional review board and is compliant with HIPAA. The dataset included 90 cancer-proven and 150 negative cases. The overall diagnostic performance was compared between the unaided vs aided reading condition. Intraclass correlation coefficient (ICC), Fleiss's kappa, and accuracy were used to quantify the agreement and performance on noninterpretive tasks. Reading time and perceived fatigue were used as comprehensive metrics to assess the efficiency of readers.</p><p><strong>Results: </strong>The average area under the receiver operating characteristic curve increased by 7.4% (95% CI, 4.5%-10%) with the concurrent assistance of the AI system (P <.001). On average, readers found 8% more cancers in the assisted reading condition. The ICC went from 0.6 (95% CI, 0.55-0.65) in the unassisted condition to 0.74 (95% CI, 0.70-0.78) for readings done with AI (P <.001). An overall decrease of 24% in reading time and a reduction in perceived fatigue was also found.</p><p><strong>Conclusion: </strong>The incorporation of this AI system, capable of handling multiple image type, prior mammograms, and multiple outputs, improved the diagnostic proficiency of radiologists in identifying breast cancer while also reducing the time required for combined interpretive and noninterpretive tasks.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740890","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":"A How-to Guide for Community Breast Imaging Centers: Starting a Breast Imaging Fellowship.","authors":"Randy C Miles, Antonio R Lopez, Nhat-Tuan Tran, Christopher Doyle, Charmi Vijapura, Rifat A Wahab, David M Naeger","doi":"10.1093/jbi/wbae069","DOIUrl":"https://doi.org/10.1093/jbi/wbae069","url":null,"abstract":"<p><p>Opportunities exist to provide high-quality breast imaging fellowship training in the community setting. Various challenges exist, however, including obtaining funding for a fellowship position, creating an educational curriculum in a potentially nonacademic environment, and developing an overall competitive program that will attract radiology trainees. Here, we explore factors that contribute to the establishment of an academic breast imaging fellowship program in the community setting based on experience, including (1) providing guidance on how to secure funding for a breast imaging fellowship position; (2) developing a training curriculum based on established guidelines from the Accreditation Council for Graduate Medical Education, American College of Radiology, and Society of Breast Imaging; and (3) navigating the landscape of the recruitment process, from program branding to matching applicants.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740888","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":"Can Contrast-Enhanced Mammography Improve Positive Predictive Value for Diagnostic Workup of Suspicious Findings? A Single-Arm Prospective Study.","authors":"Jason Shames, Adrien Nguyen, Maria Sciotto, Lisa Zorn, Theresa Kaufman, Annina Wilkes, Alexander Sevrukov, Chhavi Kaushik, Ripple Patel, Suzanne Pascarella, Ashlee Byrd, Lydia Liao","doi":"10.1093/jbi/wbae081","DOIUrl":"https://doi.org/10.1093/jbi/wbae081","url":null,"abstract":"<p><strong>Objective: </strong>To assess the positive predictive value-3 (PPV3) and negative predictive value (NPV) of contrast-enhanced mammography (CEM) when added to the diagnostic workup of suspicious breast findings.</p><p><strong>Methods: </strong>This prospective study was IRB approved. We recruited 99 women with abnormal findings on digital breast tomosynthesis (DBT) and/or US to undergo CEM prior to biopsy. Based on final pathology outcomes, PPV3 and NPV were calculated and compared using N-1 chi-squared tests with P-values and 95% CIs.</p><p><strong>Results: </strong>Final pathologic outcome yielded 56.6% (56/99) benign, 5.1% (5/99) benign with upgrade potential (BWUP), and 38.4% (38/99) malignant lesions. Final pathologic outcomes for the 63 positive CEMs yielded 33.3% (21/63) benign, 6.3% (4/63) BWUP, and 60.3% (38/63) malignant lesions. Adding CEM to the diagnostic workup significantly increased PPV3 from 38.4% (38/99) to 60.3% (38/63) (P <.01; 95% CI, 6.1-36.2). Negative predictive value was 100% (36/36) for CEM, 92.9% (13/14; P = .1; 95% CI, -4.2 to 31.4) for DBT, and 75.9% (22/29; P <.05; 95% CI, 8.8-42.1) for US. The number of unnecessary biopsies could be reduced by 36.4% (from 100% [99/99] to 63.6% [63/99]).</p><p><strong>Conclusion: </strong>Adding CEM to the diagnostic workup of suspicious breast findings could improve PPV3 to prevent unnecessary biopsies.</p>","PeriodicalId":43134,"journal":{"name":"Journal of Breast Imaging","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717590","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}