Breast最新文献

{"title":"The impact of fractionation on secondary malignancies in postoperative breast cancer irradiation","authors":"Sophia Kiesl ,&nbsp;Mathias Düsberg ,&nbsp;Sophie T. Behzadi ,&nbsp;Rebecca Moser ,&nbsp;Jana Nano ,&nbsp;Thomas Huber ,&nbsp;Evelyn Klein ,&nbsp;Marion Kiechle ,&nbsp;Denise Bernhardt ,&nbsp;Stephanie E. Combs ,&nbsp;Kai J. Borm","doi":"10.1016/j.breast.2024.103819","DOIUrl":"10.1016/j.breast.2024.103819","url":null,"abstract":"<div><h3>Purpose</h3><div>Randomized studies demonstrated the oncological equivalence of (ultra-)hypofractionation compared to a 5-week schedule in postoperative radiotherapy of breast cancer. Due to the low incidence and long latency of secondary malignancies, there are currently no reliable clinical data regarding the influence of fractionation regimens on the development of secondary malignancies.</div></div><div><h3>Material and methods</h3><div>For 20 patients with right or left-sided breast cancer, postoperative treatment plans were created using 3D-CRT (n = 10) or VMAT (n = 10) for three different fractionation schedules: 5-week schedule with 50.4Gy in 1.8Gy (28fx), hypofractionation with 40.05Gy in 2.67Gy (15fx) and ultra-hypofractionation with 26Gy in 5.2Gy (5fx). The EARs (absolute additional cases of disease per 10,000 patient-years) for secondary malignancies in the lung, contralateral breast, esophagus, liver, thyroid, spinal cord, bones and soft tissue were calculated using a fraction-dependent dose-response model.</div></div><div><h3>Results</h3><div>Based on risk modulation, (ultra-)hypofractionation resulted in significantly lower EARs for lung cancer (LC), contralateral breast cancer (CBC) and soft tissue sarcoma (STS) (p &lt; .001). For the ultra-hypofractionated dose concept the median EARs for LC, CBC and STS were 42.8 %, 39.4 % and 58.1 % lower compared to conventional fractionation and 31.2 %, 25.7 % and 20.3 % compared to hypofractionation. The influence of fractionation on the risk of secondary malignancies for LC and CBC was less pronounced with 3D-CRT than with VMAT. For STS, however, the influence of fractionation was greater with 3D-CRT than with VMAT.</div></div><div><h3>Conclusion</h3><div>Based on this simulation study (ultra-)hypofractionated postoperative breast cancer irradiation may be associated with a lower risk of secondary malignancies compared to a 5-week schedule.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103819"},"PeriodicalIF":5.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of serum estradiol monitoring in women receiving adjuvant aromatase inhibitor for hormone receptor-positive early breast cancer","authors":"Shuqin Dai ,&nbsp;Xingping Wu ,&nbsp;Xuefang Huang ,&nbsp;Jibin Li ,&nbsp;Xi Wang ,&nbsp;Shusen Wang ,&nbsp;Jun Tang ,&nbsp;Yanxia Shi ,&nbsp;Xiaoming Xie ,&nbsp;Fei Xu ,&nbsp;Peng Liu ,&nbsp;Jiajia Huang ,&nbsp;Xinhua Xie ,&nbsp;Xin An ,&nbsp;Meiting Chen ,&nbsp;Rouxi Hong ,&nbsp;Wen Xia ,&nbsp;Qiufan Zheng ,&nbsp;Kuikui Jiang ,&nbsp;Yongyi Zhong ,&nbsp;Cong Xue","doi":"10.1016/j.breast.2024.103818","DOIUrl":"10.1016/j.breast.2024.103818","url":null,"abstract":"<div><h3>Purpose</h3><div>The limited understanding of long-term estradiol (E2) suppression poses challenges to the effectiveness of adjuvant therapy with aromatase inhibitors (AI), necessitating comprehensive serum E2 monitoring to address this issue. Therefore, our objective was to investigate serum E2 levels in women undergoing adjuvant AI treatment and evaluate the significance of such monitoring.</div></div><div><h3>Patients and methods</h3><div>In this prospective cohort study, we recruited women who had received adjuvant AI treatment, including those who underwent ovarian function suppression (OFS). Serum E2 levels were measured using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). The primary endpoint was the proportion of women with E2 levels exceeding 2.72 pg/mL, indicating inadequate suppression achieved with AI therapy.</div></div><div><h3>Results</h3><div>A total of 706 patients were enrolled, including 482 women with OFS in combination with AI. Among them, 116 women (16.4 %) exhibited E2 levels exceeding 2.72 pg/mL. The majority of serum E2 elevations (77.6 %) occurred within the first two years of initiating endocrine therapy. Younger age, no prior chemotherapy, shorter duration of the current treatment regimen, and lower follicle stimulating hormone (FSH) levels were associated with inadequate E2 suppression. Serum E2 concentrations demonstrated dynamic variations and occasional rebound following adjuvant AI therapy.</div></div><div><h3>Conclusions</h3><div>Despite receiving adjuvant AI treatment for nearly two years, a certain proportion of patients failed to achieve the adequate threshold of E2 suppression. Our findings emphasize the significance of monitoring serum E2 levels during adjuvant AI therapy, particularly within the first two years. Further research is imperative to facilitate a more comprehensive comprehension of E2 monitoring.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103818"},"PeriodicalIF":5.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast-cancer specific comprehensive archive of Patient-Reported Outcome Measures (PROMs) for clinical research and clinical practice in oncology: Results from the PRO4All project","authors":"Anna Amela Valsecchi ,&nbsp;Filippo Giovanardi ,&nbsp;Francesco Malandrini ,&nbsp;Michela Meregaglia ,&nbsp;Alberto Servetto ,&nbsp;Chiara Bennati ,&nbsp;Carmine Pinto ,&nbsp;Massimo Di Maio ,&nbsp;Oriana Ciani","doi":"10.1016/j.breast.2024.103817","DOIUrl":"10.1016/j.breast.2024.103817","url":null,"abstract":"<div><h3>Background</h3><div>Inclusion of patient-reported outcomes (PROs) in oncology clinical trials is strongly recommended. However, selecting the most appropriate patient-reported outcome measures (PROMs) is not easy. This study aimed to develop a breast cancer (BC) specific comprehensive archive of PROMs.</div></div><div><h3>Methods</h3><div>As part of the PRO4All project, we identified available PROMs in oncology by searching <span><span>facit.org</span><svg><path></path></svg></span>, <span><span>eortc.org</span><svg><path></path></svg></span>, <span><span>eprovide.mapi-trust.org</span><svg><path></path></svg></span>, PubMed, ema.europa.eu (European Public Assessment Reports) and published reviews. For this analysis, only BC tools were extracted. We described information about PROM name, type of questionnaire, questionnaire variant(s), recall period, number of items, and presence of minimum clinically important difference (MCID) reference in literature. Then, we assigned each item to a specific domain according to a predefined taxonomy of 38 items for outcome classification.</div></div><div><h3>Results</h3><div>We identified and analyzed 383 PROMs. Of these, 29 were BC specific, but 2 were excluded because the questionnaires description was not available. 6 (22.2 %) were variants of another questionnaire. All questionnaires were self-reported. In 6 cases (22.2 %) the recall period to consider was the “last week”. The mean number of items per questionnaire was 25.81 (range 6–71). 602 items were assigned to an outcome domain: emotional functioning/wellbeing in 26.6 % of cases, physical functioning in 14.1 %, delivery of care in 10.8 %, and general outcomes in 10.5 %. MCID reference was found only in 4 (14.8 %) cases.</div></div><div><h3>Conclusions</h3><div>The newly developed archive represents a useful tool to optimize the use of PROMs in the evaluation of treatments in BC patients, promoting a patient-centered approach both in clinical research and practice.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103817"},"PeriodicalIF":5.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resource implications of evolving breast cancer radiotherapy treatment protocols","authors":"D.J. Coyle ,&nbsp;B. McClean ,&nbsp;R. Woods ,&nbsp;F. Duane ,&nbsp;J. Nicholson ,&nbsp;O. McArdle","doi":"10.1016/j.breast.2024.103816","DOIUrl":"10.1016/j.breast.2024.103816","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103816"},"PeriodicalIF":5.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of advanced oncoplastic surgery on breast-conserving surgery rates: A retrospective cohort study of 3,875 breast cancer procedures at a tertiary referral centre","authors":"Angus Reid ,&nbsp;Robert Thomas ,&nbsp;Andrew Pieri ,&nbsp;Adam Critchley ,&nbsp;Lorraine Kalra ,&nbsp;Jane Carter ,&nbsp;J.M. O'Donoghue ,&nbsp;Emily King ,&nbsp;Henry Cain","doi":"10.1016/j.breast.2024.103814","DOIUrl":"10.1016/j.breast.2024.103814","url":null,"abstract":"<div><h3>Introduction</h3><div>As the treatment of breast cancer advances, the focus has shifted from solely improving oncological endpoints to a greater weight being placed on cosmetic and psychological outcomes. The advent of advanced oncoplastic techniques allows for successful breast-conserving surgery (BCS) to patients who otherwise would have required a mastectomy. The aim of this study is to ascertain if the adoption of these procedures has assisted in the reduction of mastectomies performed.</div></div><div><h3>Methods</h3><div>A dataset of all breast cancer procedures based upon coding between April 2016 and July 2023 was evaluated, categorising procedures into: BCS, mastectomy, oncoplastic BCS and total reconstructions. R-Studio Software 4.3.1 (®) was used to explore statistical analysis and data visualisation. Registered as a clinical services evaluation study (Project ID: 14649).</div></div><div><h3>Results</h3><div>During the period stated, 3875 index breast cancer procedures were recorded (sample size = 3638 patients). The BCS rate increased from 66.2 % in 2016 to 80.7 % in 2023. Using a linear regression model, the BCS rate demonstrates an increase of 2.1 % each year (coefficient = 2.12, p-value = 0.0069). Concurrently, the rate of oncoplastic BCS increased from 10.5 % to 22.9 % (coefficient = 2.14, p-value = 0.00017). Using Pearson's product-moment, a positive correlation between these two variables is seen (coefficient = 0.86, p-value = 0.0056).</div></div><div><h3>Conclusion</h3><div>Having reviewed 3875 index breast cancer procedures over the past eight years, the BCS rate has shown a statistically significant increase and a positive correlation with the oncoplastic BCS rate. This suggests oncoplastic surgery has helped to reduce the rates of mastectomy at the centre.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103814"},"PeriodicalIF":5.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial toxicity in breast cancer patients receiving regional nodal irradiation: Variation by cancer subtype","authors":"Grace L. Smith ,&nbsp;Benjamin D. Smith ,&nbsp;Chi-Fang Wu ,&nbsp;Simona F. Shaitelman ,&nbsp;Mariana Chavez-MacGregor ,&nbsp;Rashmi Murthy ,&nbsp;Kelsey Kaiser ,&nbsp;Kimberly S. Ku ,&nbsp;Julia J. Shi ,&nbsp;Sanjay S. Shete ,&nbsp;Ying-Shiuan Chen ,&nbsp;Robert J. Volk ,&nbsp;Sharon H. Giordano ,&nbsp;Ya-Chen T. Shih ,&nbsp;Karen E. Hoffman","doi":"10.1016/j.breast.2024.103813","DOIUrl":"10.1016/j.breast.2024.103813","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated sociodemographic and clinical predictors of financial toxicity (FT) among patients with breast cancer with higher risk clinical factors warranting regional nodal irradiation (RNI).</div></div><div><h3>Methods</h3><div>Among 183 participants in a clinical trial of conventional vs. hypofractionated treatment with RNI, 125 (68 %) completed a pilot survey of FT measured using the validated Economic Strain and Resilience in Cancer (ENRICh) instrument, scored from 0 (minimal) to 10 (severe) FT. Associations with predictors were evaluated using Pearson correlation coefficients and Kruskal Wallis, Mann-Whitney U, and Jonckheere-Terpstra tests. Predictors of severe FT (ENRICh≥5) were tested using multivariable logistic regression with odds ratios converted to relative risks (RR).</div></div><div><h3>Results</h3><div>Of the sample, all received RNI, 92 % chemotherapy, 67 % axillary dissection, 26 % mastectomy without reconstruction, and 32 % mastectomy with reconstruction. At a median follow up of 1.48 years, median FT score was 2.13 (IQR 0.93–4.6), with 20.8 % of patients experiencing severe FT. Unadjusted worse FT score was associated with younger age (P = 0.003), Hispanic ethnicity (P = 0.006), lower income (P = 0.02), shorter interval from diagnosis to FT assessment (P = 0.02), and chemotherapy receipt (P = 0.05), but not with breast surgery type (P = 0.42), axillary surgery type (P = 0.33), or pathologic T (P = 0.68) or N stage (P = 0.47). In multivariable analysis, triple negative subtype was the sole clinical factor predicting severe FT (RR = 3.38; 95 % CI 1.48–4.99; P = 0.01).</div></div><div><h3>Conclusion</h3><div>Among patients with breast cancer receiving RNI, triple negative subtype was associated with severe FT, suggesting that tumor receptor subtype may help identify a key breast cancer subpopulation for early FT intervention.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103813"},"PeriodicalIF":5.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624001449/pdfft?md5=240ce5758423ff46df0a8799495b11b8&pid=1-s2.0-S0960977624001449-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-based strategies in breast mass ≤ 2 cm classification with mammography and tomosynthesis","authors":"Zhenzhen Shao ,&nbsp;Yuxin Cai ,&nbsp;Yujuan Hao ,&nbsp;Congyi Hu ,&nbsp;Ziling Yu ,&nbsp;Yue Shen ,&nbsp;Fei Gao ,&nbsp;Fandong Zhang ,&nbsp;Wenjuan Ma ,&nbsp;Qian Zhou ,&nbsp;Jingjing Chen ,&nbsp;Hong Lu","doi":"10.1016/j.breast.2024.103805","DOIUrl":"10.1016/j.breast.2024.103805","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnosis performance of digital mammography (DM) and digital breast tomosynthesis (DBT), DM combined DBT with AI-based strategies for breast mass ≤ 2 cm.</div></div><div><h3>Materials and methods</h3><div>DM and DBT images in 483 patients including 512 breast masses were acquired from November 2018 to November 2019. Malignant and benign tumours were determined by biopsies using histological analysis and follow-up within 24 months. The radiomics and deep learning methods were employed to extract the breast mass features in images and finally for benign and malignant classification. The DM, DBT and DM combined DBT (DM + DBT) images were fed into radiomics and deep learning models to construct corresponding models, respectively. The area under the receiver operating characteristic curve (AUC) was employed to estimate model performance. An external dataset of 146 patients from March 2021 to December 2022 from another center was enrolled for external validation.</div></div><div><h3>Results</h3><div>In the internal testing dataset, compared with the DM model and the DBT model, the DM + DBT models based on radiomics and deep learning both showed statistically significant higher AUCs [0.810 (RA-DM), 0.823 (RA-DBT) and 0.869 (RA-DM + DBT), P ≤ 0.001; 0.867 (DL-DM), 0.871 (DL-DBT) and 0.908 (DL-DM + DBT), P = 0.001]. The deep learning models present superior to the radiomics models in the experiments with only DM (0.867 vs 0.810, P = 0.001), only DBT (0.871 vs 0.823, P = 0.001) and DM + DBT (0.908 vs 0.869, P = 0.003).</div></div><div><h3>Conclusions</h3><div>DBT has a clear additional value for diagnosing breast mass less than 2 cm compared with only DM. AI-based methods, especially deep learning, can help achieve excellent performance.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103805"},"PeriodicalIF":5.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096097762400136X/pdfft?md5=23778896652ae9c47710fa8e71a02f2e&pid=1-s2.0-S096097762400136X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of risk factors influencing patient-reported arm symptoms post-breast cancer treatment: Accounting for radiotherapy impact","authors":"Yuqin Liang ,&nbsp;Yuedan Zhou ,&nbsp;Ruud Houben ,&nbsp;Karolien Verhoeven ,&nbsp;Sofia Rivera ,&nbsp;Liesbeth J. Boersma","doi":"10.1016/j.breast.2024.103812","DOIUrl":"10.1016/j.breast.2024.103812","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically review risk factors for patient-reported arm symptoms (AS) in breast cancer (BC), considering radiotherapy (RT) impact, using the EORTC QLQ-BR23 questionnaire (BR23).</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane Library, MEDLINE, and Web of Science were searched using the keywords \"breast neoplasms\", \"radiotherapy\", and \"BR23\" up to March 5th, 2024. Inclusion criteria: both univariate and multivariate analyses. Exclusion criteria: pregnancy, recurrence, distant metastasis BC, reirradiation, or lack of RT. The risk of bias of included papers was assessed using the Critical Appraisal Skills Program (CASP) checklist. Descriptive and meta-analyses were conducted using risk ratio (RR) or standardized mean difference (SMD) with 95 % confidence intervals (CI) as effect measures. A random-effects model was applied if I² &gt; 50 %.</div></div><div><h3>Results</h3><div>Eighteen out of 734 studies were included, with sample sizes ranging from 172 to 2208. Commonly reported risk factors included axillary lymph node dissection (ALND), mastectomy, chemotherapy (CT), and RT (6, 5, 4, and 4 studies, respectively). In meta-analyses, ALND was a risk factor for arm pain (RR [95 % CI] = 1.75 [1.14; 2.71]), lymphedema (RR [95 % CI] = 5.41 [3.48; 8.39]), and overall AS (SMD [95 % CI] = 0.49 [0.14; 0.83]) compared to sentinel lymph node biopsy. RT was not a risk factor, but axillary RT significantly increased overall AS (SMD [95 % CI] = 0.55 [0.40; 0.70]) compared to no axillary RT.</div></div><div><h3>Conclusion</h3><div>ALND and mastectomy were the primary risk factors for patient-reported AS. Axillary RT was a significant risk factor, whereas general RT was not.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103812"},"PeriodicalIF":5.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624001437/pdfft?md5=10ff023227409fb4ee60cd029f41a62c&pid=1-s2.0-S0960977624001437-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal ultrasound assessment of mass and non-mass enhancements by MRI: Diagnostic accuracy in idiopathic granulomatous mastitis and breast cancer","authors":"Liang Yin ,&nbsp;Xi Wei ,&nbsp;Qing Zhang ,&nbsp;Lingling Xiang ,&nbsp;Yun Zhang ,&nbsp;Deqian Wang ,&nbsp;Peiqin Chen ,&nbsp;Xuan Cao ,&nbsp;Zakari Shaibu ,&nbsp;Rong Qin","doi":"10.1016/j.breast.2024.103797","DOIUrl":"10.1016/j.breast.2024.103797","url":null,"abstract":"<div><h3>Purpose</h3><div>Idiopathic granulomatous mastitis (IGM) poses diagnostic challenges due to its diverse clinical and radiological presentations, often mimicking malignancies. This study aimed to assess the diagnostic efficacy of multimodal ultrasound for mass and non-mass enhancements in Dynamic Contrast-Enhanced MRI (DCE-MRI) of IGM and breast cancer.</div></div><div><h3>Methods</h3><div>A retrospective analysis involved patients confirmed histopathologically with IGM and BC. All patients underwent conventional ultrasound (C-US), ultrasound elastography (UE), contrast-enhanced ultrasound (CEUS), and DCE-MRI examinations. Blinded experienced radiologists assessed imaging findings. Diagnostic accuracy, sensitivity, and specificity were calculated for mass and non-mass enhancements.</div></div><div><h3>Results</h3><div>For mass enhancements (ME), multimodal ultrasound demonstrated strong efficacy (AUC = 0.8651, 95 % CI: 0.7431 to 0.9871), exhibiting high sensitivity (83.3 %) and specificity (92.4 %) in differentiating IGM from breast cancer. However, for non-mass enhancements (NME), multimodal ultrasound showed limited accuracy (AUC = 0.6306) with lower sensitivity (65.6 %) and specificity (81.2 %) in distinguishing between IGM and breast cancer.</div></div><div><h3>Conclusion</h3><div>Multimodal ultrasound displayed good diagnostic efficacy for mass enhancements in DCE-MRI for IGM and breast cancer, while for non-mass enhancement patterns, DCE-MRI remains the most valuable radiological modality for comprehensively assessing this condition's complexities.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103797"},"PeriodicalIF":5.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of [18F]FDG PET/CT in patients with invasive breast carcinoma of no special type: Literature review and comparison between guidelines","authors":"David Groheux ,&nbsp;Sofia C. Vaz ,&nbsp;Philip Poortmans ,&nbsp;Ritse M. Mann ,&nbsp;Gary A. Ulaner ,&nbsp;Gary J.R. Cook ,&nbsp;Elif Hindié ,&nbsp;John Patrick Pilkington Woll ,&nbsp;Heather Jacene ,&nbsp;Isabel T. Rubio ,&nbsp;Marie-Jeanne Vrancken Peeters ,&nbsp;Elizabeth H. Dibble ,&nbsp;Lioe-Fee de Geus-Oei ,&nbsp;Stephanie L. Graff ,&nbsp;Fatima Cardoso","doi":"10.1016/j.breast.2024.103806","DOIUrl":"10.1016/j.breast.2024.103806","url":null,"abstract":"<div><h3>Purpose</h3><p>The recently released EANM/SNMMI guideline, endorsed by several important clinical and imaging societies in the field of breast cancer (BC) care (ACR, ESSO, ESTRO, EUSOBI/ESR, EUSOMA), emphasized the role of [¹⁸F]FDG PET/CT in management of patients with no special type (NST) BC. This review identifies and summarizes similarities, discrepancies and novelties of the EANM/SNMMI guideline compared to NCCN, ESMO and ABC recommendations.</p></div><div><h3>Methods</h3><p>The EANM/SNMMI guideline was based on a systematic literature search and the AGREE tool. The level of evidence was determined according to NICE criteria, and 85 % agreement or higher was reached regarding each statement. Comparisons with NCCN, ESMO and ABC guidelines were examined for specific clinical scenarios in patients with early stage through advanced and metastatic BC.</p></div><div><h3>Results</h3><p>Regarding initial staging of patients with NST BC, [¹⁸F]FDG PET/CT is the preferred modality in the EANM-SNMMI guideline, showing superiority as a single modality to a combination of contrast-enhanced CT of thorax-abdomen-pelvis plus bone scan in head-to-head comparisons and a randomized study. Its use is recommended in patients with clinical stage IIB or higher and may be useful in certain stage IIA cases of NST BC. In NCCN, ESMO, and ABC guidelines, [¹⁸F]FDG PET/CT is instead recommended as complementary to conventional imaging to solve inconclusive findings, although ESMO and ABC also suggest [¹⁸F]FDG PET/CT can replace conventional imaging for staging patients with high-risk and metastatic NST BC. During follow up, NCCN and ESMO only recommend diagnostic imaging if there is suspicion of recurrence. Similarly, EANM-SNMMI states that [¹⁸F]FDG PET/CT is useful to detect the site and extent of recurrence only when there is clinical or laboratory suspicion of recurrence, or when conventional imaging methods are equivocal. The EANM-SNMMI guideline is the first to emphasize a role of [¹⁸F]FDG PET/CT for assessing early metabolic response to primary systemic therapy, particularly for HER2+ BC and TNBC. In the metastatic setting, EANM-SNMMI state that [¹⁸F]FDG PET/CT may help evaluate bone metastases and determine early response to treatment, in agreement with guidelines from ESMO.</p></div><div><h3>Conclusions</h3><p>The recently released EANM/SNMMI guideline reinforces the role of [¹⁸F]FDG PET/CT in the management of patients with NST BC supported by extensive evidence of its utility in several clinical scenarios.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103806"},"PeriodicalIF":5.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624001371/pdfft?md5=594ebfbce36c5b0c62a7e5446683b6bc&pid=1-s2.0-S0960977624001371-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}