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PubMed1998

[Effect of MR mammography on surgical procedure in operative treatment of breast cancer].

In addition to conventional imaging techniques, magnetic resonance (MR) mammography is an important tool in the diagnosis of breast cancer. It has proved to be the method of choice especially for the differential diagnosis of discrepant findings between mammography and ultrasound as well as the detection of multifocal and multicentric disease. In this context MR mammography is a meaningful method for the planning of breast preserving surgery and seems likely to become routine practice as long as the preconditions for high quality performance are guaranteed.

Adult↗
PubMedDate not supplied

Comparative signal intensity measurements in dynamic gadolinium-enhanced MR mammography.

Increases in signal intensity enhancement were measured in defined regions of interest (ROIs) to allow distinction between malignant and benign tumors with dynamic gadolinium-enhanced magnetic resonance (MR) mammography. Twenty patients with palpable breast lesions (15 malignant, five benign) underwent MR mammography. The dynamic gradient-echo sequence was performed with intravenous bolus injection of gadopentetate dimeglumine and consisted of 25 images with a time resolution of 30 seconds. Contrast enhancement was calculated by comparing user-defined ROIs on pre- and postcontrast images. An increase in signal intensity of 70% or more on the 1-minute postcontrast image was used as the criterion of malignancy. MR mammographic results correlated with histopathologic findings in all patients when the defined ROI was in the most enhancing part of the tumor. For the ROI in areas of submaximal enhancement or when the ROI surrounded the whole lesion, only five and nine tumors, respectively, fulfilled the malignancy criterion. All malignant tumors showed large variations in signal intensity enhancement that depended on the position of the ROI in the tumor. Dynamic, gadolinium-enhanced MR mammography allows distinction of benign from malignant breast tumors when the selected ROI is in the most enhancing part of the lesion.

Breast↗
PubMed2005

Subtraction of in-phase and opposed-phase images in dynamic MR mammography.

PURPOSE: To develop and to evaluate an advanced image acquisition and analysis method for collecting T(1)-weighted dynamic 3D MR mammography data sets by using a combined in-phase (IP) and opposed-phase (OP) imaging procedure. MATERIALS AND METHODS: 3D MR mammography data sets were acquired by applying an interleaved gradient-echo OP and IP imaging sequence during administration of contrast agent. A phantom data set, two volunteer breast data sets, and six patient breast data sets were recorded. Subtraction of dynamic in-phase magnitude images was performed for clinical assessment. In addition, the magnitude subtraction (SIPOP) as well as the complex subtraction (cSIPOP) of the IP and OP magnitude and phase images were considered. RESULTS: The detection of small lesions, lesion boundaries, and tumor offshoots in fatty tissue was improved by the subtraction of IP and OP images without the risk of signal cancellation due to partial volume effects. CONCLUSION: Dynamic MR mammography acquisition of IP and OP images in combination with appropriate data processing yields important supplementary information that can support routinely applied diagnostics of breast lesions that are fully embedded in fatty tissue by only marginally increasing acquisition time.

Aged↗
PubMed2006

Evaluation of quantitative parametric analysis for characterization of breast lesions in contrast-enhanced MR mammography.

Our aim was to evaluate quantitative parametric analysis for characterization of breast lesions in contrast-enhanced magnetic resonance (MR) mammography. In 62 patients, contrast-enhanced MR mammography revealed 75 suspicious lesions, of which 18 were benign and 57 were malignant. The quantitative parametric analysis delineates signal intensity changes of contrast-enhanced lesions on a pixel-by-pixel basis. The initial rate of enhancement is coded by color intensity: a slow rate is coded to dark; a fast rate, bright. The postinitial enhancement change is coded by color hue: blue for increasing signal intensity, green for plateau, and red for decrease in signal intensity. Malignant lesions showed a significantly higher number of bright-red (P = 0.004) and medium-red (P < 0.001) pixels than benign lesions. Benign lesions showed significantly more blue pixels than did malignant lesions (P = 0.010). Of the 75 lesions, 72 (96%) showed heterogeneous distribution of pixel color hue. Quantitative parametric analysis of contrast kinetics in lesions can replace the subjective manual region of interest (ROI) method and makes a step toward standardization of MR mammography. It allows quantitative evaluation of different contrast kinetics parameters in contrast-enhanced breast lesions.

Adult↗
PubMed2000

The effects of HRT on screening mammography.

The effects of hormone replacement therapy on screening for breast cancer by mammography are reviewed. There is a decline in specificity in screen mammography for women over the age of 50 taking oral preparations, The use of HRT also reduces the sensitivity of breast screening by regular mammography.

Journal Article↗
PubMed2001

Pre-operative estimation of primary breast cancer size: a comparison of clinical assessment, mammography and ultrasound.

This prospective study aimed to determine which is the most precise modality for the pre-operative measurement of primary breast cancers: clinical palpation; mammography; or ultrasound. Analysis of the difference between the measurement of the maximum tumour diameter by these three modalities and by the histological measurement was performed in 210 cases. Clinical palpation tended to overestimate tumour size and gave the largest standard deviation of the difference. Ultrasound and mammography both gave a similar standard deviation of the difference, with ultrasound tending to underestimate tumour size. For all modalities, the standard deviation and the 95% confidence intervals of the difference increased with increasing tumour size. There is little difference between the precision of ultrasound and mammography in measuring tumour size. The wide 95% confidence intervals for any method of pre-operative tumour measurement should be considered when planning patient management.

Journal Article↗
PubMed1996

[Dynamic MR mammography: is the course of signal intensification suitable for the differentiation of different forms of mastopathy?].

PURPOSE: The capacity of dynamic contrast-enhanced MR mammography to distinguish between different forms and grades of mastopathy according to Prechtel's classification was evaluated in a retrospective study. PATIENTS AND METHODS: MR mammograms of 51 patients with histologically proven mastopathy were retrospectively evaluated in areas subsequently biopsied. RESULTS: Mean values of regressive and hyperplastic types of mastopathy differed significantly no significant differences were found between proliferating and non-proliferating mastopathies or Prechtel grades I-III mastopathy when MRI data obtained with a FLASH 3 D sequence (TR = 8.4 ms, TE = 3 ms, flip angle = 30 degrees at 1.0 T) were compared one minute, three, 5 and 8 minutes after i.v. bolus administration of contrast media (Gd-DTPA, 0.1 mmol/kg body weight). CONCLUSION: Our data indicate that dynamic contrast-enhanced MR mammography does not allow the differentiation of proliferating and non-proliferating mastopathy according to the Prechtel classification. Dynamic MR mammography assessment of breast cancer risk does not seem to be feasible.

Breast↗
PubMed2001

Value of 99mTc-MIBI scintimammography in women with impalpable breast lesions seen on mammography.

OBJECTIVE: To find out if 99mTc-methoxyisobutylisonitrile scintimammography (MIBI) is useful in the evaluation of impalpable breast lesions in women referred for biopsy after mammography screening. DESIGN: Observational and prospective study. SETTING: Radiological screening campaign in Spain. PATIENTS: 36 patients referred between September 1997 and June 1998 (37 biopsies) with impalpable breast lesions referred consecutively from a screening campaign. Ages ranged from 50 to 64 years. INTERVENTIONS: Mammography, ultrasound, MIBI, and wire-guided biopsy. MAIN OUTCOME MEASURES AND RESULTS: Mean values for sensitivity, specificity, positive predictive value, and negative predictive value for scintimammography were 78.9, 72.2, 75, and 76.5 respectively (p = 0.002). The logistic regression analysis showed that 99mTc-MIBI scintimammography result predicted (p = 0.003) the risk of breast cancer in this group of patients (odds ratio: 9.75), particularly infiltrating ductal carcinoma. CONCLUSIONS: MIBI scintimammography in patients referred for biopsy after mammography screening does not so much rule out cancer as confirm the diagnosis. Its practical benefit would be not so much avoiding biopsy for these patients as aiding in planning the radicality of their excision.

Aged↗
PubMed2001

Contrast-enhanced near-infrared laser mammography with a prototype breast scanner: feasibility study with tissue phantoms and preliminary results of imaging experimental tumors.

RATIONALE AND OBJECTIVES: Near-infrared (NIR) optical mammography without contrast has a low specificity. The application of optical contrast medium may improve the performance. The concentration-dependent detectability of a new NIR contrast medium was determined with a prototype optical breast scanner. In vivo imaging of experimental tumors was performed. METHODS: The NIR contrast agent NIR96010 is a newly synthesized, hydrophilic contrast agent for NIR mammography. A concentration-dependent contrast resolution was determined for tissue phantoms consisting of whole milk powder and gelatin. A central part of the phantoms measuring 2 x 2 cm2 without contrast was replaced with phantom material containing 1 micromol/L to 25 nmol/L NIR96010. The composite phantoms were measured with a prototype NIR breast scanner with lasers of lambda1 = 785 nm and lambda2 = 850 nm wavelength. Intensity profiles and standard deviations of the transmission signal in areas with and without contrast were determined by linear fit procedures. Signal-to-noise ratios and spatial resolution as a function of contrast concentration were determined. Near-infrared imaging of five tumor-bearing SCID mice (MX1 breast adenocarcinoma, tumor diameter 5-10 mm) was performed before and after intravenous application of 2 micromol/kg NIR96010. RESULTS: Spectrometry showed an absorption maximum of the contrast agent at 755 nm. No spectral shifts occurred in protein-containing solution. Signal-to-noise ratio in the transmission intensity profiles ranged from 1.1 at 25 nmol/L contrast to 28 at 1 micromol/L. At concentrations <40 nmol/L, no differentiation from the background was possible. The transitional area between the contrast-free edge of the phantom and the central contrast-containing part appeared in the profiles as a steep increase with a width of 4.2 +/- 1.8 mm. The experimental tumors were detectable in nonenhanced images as well as contrast-enhanced images, with better delineation after contrast administration. In postcontrast absorption profiles, a 44.1% +/- 11.3% greater absorption increase was seen in tumor tissue compared with normal tissue. CONCLUSIONS: The laser wavelength lambda1 of the prototype laser mammography device was not situated at maximum absorption of the contrast agent NIR96010 but on the descending shoulder of the absorption spectrum. This implies a 20% signal loss for contrast detection. Despite the nonideal measurement conditions, concentrations as low as 40 nmol/L were detectable in vitro. In vivo, all tumors were detectable in color-coded nonenhanced scans as well as in contrast-enhanced scans, with better delineation after contrast administration.

Alkenes↗
PubMed1977

The consultant surgeon and mammography.

It is important that the mounting wave of criticism of mammography in breast screening programmes should not obscure the fact that it remains the most accurate method of diagnosing breast cancer short of biopsy. Furthermore, breast cancer may be diagnosed by mammography at an early stage before it has spread to regional lymph nodes, at a time when the prognosis is better. At this time it may be beneficial to outline the role of mammography as an aid to the consultant surgeon in the management of patients referred with breast problems.

Adult↗
PubMed2003

The value of scatter removal by a grid in full field digital mammography.

Our objective in this study was to investigate the usefulness of an anti-scatter grid in digital mammography using a contrast detail phantom. The mammography system we investigated was a GE Senographe 2000D. We carried out phantom measurements under various conditions with and without using the anti-scatter grid. A new version of the CDMAM phantom (version 3.4) was used. This phantom consists of a matrix of square cells with disks of varying size and contrast. For given exposure conditions detectability of these disks can be determined and used for construction of contrast detail curves. Previously, a computer program was developed at our institute that performs a fully automatic analysis of the phantom recordings using the ideal observer model. Breast thickness was simulated by a homogeneous layer of PMMA in the range of 1 to 7 cm. Series of images were recorded for different KeV and target-filter combinations depending on the simulated thickness. The dose was kept constant for each thickness with and without using a grid. It appeared that image quality improved for simulated breast thickness below 5 cm when the grid was removed. In the range from 5 to 7 cm contrast detail curves obtained with or without a grid were similar. Results suggest that for compressed breast thickness in the range of 1 to 7 cm a grid might not be needed in the digital mammography system we investigated. Below 5 cm, omitting the grid may allow lower dose to the patient without losing image quality.

Equipment Failure Analysis↗
PubMed1999

Mammography adherence and beliefs in a sample of low-income African American women.

The purpose of this article is to describe the relation of perceptions of perceived breast cancer risks and perceived benefits and barriers to mammography and stage of mammography adherence in a convenience sample of low-income African American women. The theoretical framework of the Health Belief Model and the Transtheoretical Model were used to identify concepts and stage of mammography adherence. Data were obtained in waiting rooms of multipurpose centers. Scores for susceptibility and benefits were lowest for those who were in (a) precontemplation (had not thought about having a mammogram); as compared to (b) contemplation (had thought about having a mammogram, but not yet acted); (c) action (had a mammogram as recommended by the American Cancer Society); and (d) relapse (had a mammogram in the past, but overdue). Barriers scores were highest for those who had not had a mammogram (precontemplators and contemplators). In addition, individual barriers were significantly lower for women in action. Results have implications for interventions to increase screening in low-income African American women.

Journal Article↗
PubMed2005

Predicting biopsy outcome after mammography: what is the likelihood the patient has invasive or in situ breast cancer?

BACKGROUND: As many as 1,000,000 breast biopsies are performed annually in the United States. Although substantial effort has been devoted to estimating breast cancer risk, there have been no studies to predict outcome in women undergoing breast biopsy. METHODS: A population-based study was undertaken to develop and test models for predicting the probability of invasive breast cancer and/or ductal carcinoma-in-situ in 7670 women undergoing breast biopsy after mammography. Logistical prediction models were developed by using data from 6129 randomly selected women and tested with data from the remaining women. RESULTS: The overall cancer prevalence among women undergoing biopsy was 22.4%. Prevalence in women with mammograms highly suggestive of malignancy (category 5) was 84.6%, with minimal variation in individual cancer probabilities due to age. A total of 24.6% of women with suspicious mammograms (category 4) had cancer, but individual probability estimates ranged from .01 to .86, depending on age, presence of a lump, previous biopsy, menopausal status, and use of postmenopausal hormone therapy. These variables also influenced biopsy outcome in women with other mammography assessments (categories 0-3), but the overall prevalence was lower (8.6%), and estimated probabilities ranged from .01 to .45. When cancer was present, the probability of invasive disease was influenced by mammogram assessment category, absence of mammogram calcifications, and presence of a lump. CONCLUSIONS: The probabilities of invasive cancer and ductal carcinoma-in-situ in women undergoing biopsy can be more accurately predicted by using clinical characteristics in addition to mammography findings. This information could potentially influence decisions regarding immediate biopsy or continued surveillance.

Adolescent↗
PubMed2004

The neoplastic transformation potential of mammography X rays and atomic bomb spectrum radiation.

Considerable controversy currently exists regarding the biological effectiveness of 29 kVp X rays which are used for mammography screening. This issue must be resolved to enable proper evaluation of radiation risks from breast screening. Here a definitive assessment of the biological effectiveness of 29 kVp X rays compared to the quality of radiation to which the atomic bomb survivors were exposed is presented for the first time. The standard radiation sources used were (a) an atomic bomb simulation spectrum and (b) 2.2 MeV electrons from a strontium-90/yttrium-90 (90Sr/90Y) radioactive source. The biological end point used was neoplastic transformation in vitro in CGL1 (HeLa x human fibroblast hybrid) cells. No significant difference was observed for the biological effectiveness of the two high-energy sources for neoplastic transformation. A limiting relative biological effectiveness (RBE(M)) of 4.42 +/- 2.02 was observed for neoplastic transformation by 29 kVp X rays compared to these two sources. This compares with values of 4.67 +/- 3.93 calculated from previously published data and 3.58 +/- 1.77 when the reference radiation was 200 and 220 kVp X rays. This suggests that the risks associated with mammography screening may be approximately five times higher than previously assumed and that the risk-benefit relationship of mammography exposures may need to be re-examined.

Cell Transformation, Neoplastic↗
PubMed2026

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction.

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.

Journal Article↗
PubMed1998

[Initial experiences with radionuclide mammography at the Cottbus Carl-Thiem Clinic].

In the diagnosis of breast cancer, noninvasive methods are need in order to detect early stages of this disease. These methods have to have a high specificity in order to discriminate malignant and benign lesions. The scintimammography with 99mTc-MIBI might be such a new method. With this examination the early diagnosis of breast cancer might be improved and may reduce the need for diagnostic biopsies. The aim of our examinations was to get first experiences in comparison with the histological results. The histological results were considered to be the reference method. 25 scintigrafical examinations were evaluated, performed from August 1997 to January 1998. The scintigrafical results were recorded qualitative-visually with a score from 1 to 4. The histological results were received within 1 week after realization of the scintigrafical examination. 22 scintigrafical examinations were evaluated correctly. Of 16 benign lesions 14 were evaluated as true negative and 2 as false positive (fibroadenoma, haematoma). Of the 9 breast carcinomas 8 were evaluated as true positive and 1 false negative (lobular carcinoma in situ). In the case of unselected patients, low numbers of examinations and a diameter of the smallest carcinoma from 1.4 cm a sensitivity of 89% and a specificity of 88% has been observed. Our sensitivity and specificity was in the range of the current international scintimammography-studies. Statements about little breast carcinomas (diameter < 1 cm) are not yet available, because such patients were not examined. The scintimammography is not a screening test. It renders no additional information in the case of clear clinical results and/or clear mammography. Therefore useful indications have to be defined in subsequent scintimammography studies. Possible indications are: palpable breast lesions, which appear normal in mammography, uncertain results in mammography without palpable result and in the follow up of operations of breast cancer without mastectomy. It might be interesting to compare in the future new radiological methods and magnet resonance imaging and positron-emission tomography in the diagnosis of breast cancer with the represented conventional method.

Adult↗
PubMed1992

[Comparison of mammography and sonography in diagnosis of breast cysts].

Mammography and sonography were done in 479 women. In mammography cysts were suspected in 10 cases, in 20 cases solid lumps and in 49 cases no changes were detected. In sonography in 7 cases cysts were found in 23 solid lumps, in 49 no changes were detected. It was proved that sonography is much more accurate in detecting cysts than mammography.

Adult↗
PubMed2003

Association of breast arterial calcifications detected by mammography and coronary artery calcifications quantified by multislice CT in a population of post-menopausal women.

PURPOSE: To assess the correlation between the presence and extent of breast arterial calcifications (BAC) detected at mammography and the extent of coronary atherosclerosis, as evaluated by multislice computed tomography (MSCT) coronary calcium quantification in a population of post-menopausal women. MATERIALS AND METHODS: Seventy-four post-menopausal women aged under 65 years who had undergone mammography at our Department were studied by MSCT for coronary calcium quantification. The mammograms were screened for vascular calcifications which were graded according to severity and extension. The presence of coronary artery calcifications was assessed by MSCT using the < > cardiac reconstruction software. The data obtained were analyzed using the statistical package SPSS (version 10.1) for Windows. RESULTS: The presence and severity of breast arterial calcifications showed a strong correlation with coronary calcifications in both models. DISCUSSION AND CONCLUSIONS: The study demonstrated that the presence of BAC is strongly correlated with the amount of coronary calcium detected by MSCT and therefore with the extent of coronary atherosclerosis. Moreover, there is a linear correlation between BAC severity and coronary calcium content, each incremental increase in BAC severity being associated with an average increase in coronary calcium content. Therefore, the presence and severity of BAC may provide indirect qualitative and quantitative information on the calcium present in the coronaries. As mammography is increasingly used as a screening test for breast carcinoma, breast arterial calcifications may represent an important sign with epidemiological and clinical significance for primary prevention.

Breast↗