• Title, Summary, Keyword: breast ultrasonography

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Breast Cancer in Women Younger than 35-Years-Old: Correlation of MRI Findings with Clinicopathological Features and Immunohistochemical Subtypes (35세 이하 젊은 여성의 유방암: 자기공명영상 소견과 임상병리학적 및 면역조직화학 특성과의 상관관계)

  • Lee, Sae Hyung;Kang, Bong Joo;An, Yeong Yi
    • Journal of the Korean Society of Radiology
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    • v.79 no.4
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    • pp.196-203
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    • 2018
  • Purpose: Breast cancer of young women shows poor prognosis, but the imaging findings has not been well known. We evaluated the MRI characteristics of young women. Materials and Methods: From January 2009 to December 2013, we included 91 patients under the age of 35 who were diagnosed histologically as breast cancer and underwent MRI. The relationship between the clinical and histopathological prognostic factors was obtained using electronic medical records and the retrospective analysis of MRI findings was statistically analyzed. Results: The most common imaging findings of breast mass were irregular shape (53.7%), irregular margin (53.7%), heterogeneous enhancement (53.8%), and type 3 kinetic curve pattern (57.1%). In the multivariate analysis, the rim enhancement was significantly related to the higher tissue grade (p = 0.001), estrogen receptor negative (p < 0.001), and progesterone receptor negative (p < 0.001). The irregular mass shape (p = 0.015) and type 3 kinetic curve (p = 0.002) were related to lymph node metastasis. Conclusion: MRI findings of breast cancer in young women (${\leq}35-years-old$) are not different from those of general breast cancer, but the rim enhancement, irregular mass shape and type 3 kinetic curve are related with pathologic factors of poor prognosis.

Multimodal analgesia with multiple intermittent doses of erector spinae plane block through a catheter after total mastectomy: a retrospective observational study

  • Hong, Boohwi;Bang, Seunguk;Chung, Woosuk;Yoo, Subin;Chung, Jihyun;Kim, Seoyeong
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.206-214
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    • 2019
  • Background: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. Methods: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). Results: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB ($33.0{\mu}g$; interquartile range [IQR], $27.0-69.5{\mu}g$) than in the control group ($92.8{\mu}g$; IQR, $40.0-155.0{\mu}g$) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). Conclusions: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.

The Prognostic Values of Preoperative Tumor Volume and Tumor Diameter in T1N0 Papillary Thyroid Cancer

  • Lim, Seung Taek;Jeon, Ye Won;Suh, Young Jin
    • Cancer Research and Treatment
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    • v.49 no.4
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    • pp.890-897
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    • 2017
  • Purpose The current TNM staging system for papillary thyroid cancer (PTC), which is based on tumor diameter, may not precisely reflect the true tumor burden. Therefore, we investigated whether preoperative tumor volume might more accurately reflect tumor burden and predict prognosis in patients with T1N0 PTC than preoperative tumor diameter. Materials and Methods We retrospectively reviewed data from 1,659 patients with T1N0 PTC, and after exclusion, a total of 1,081 patients were ultimately included. Tumor volume (V) was calculated for all patients using preoperative ultrasonography, and patients were grouped according to tumor diameter (T1a vs. T1b) and tumor volume (V1a vs. V1b). The recurrence-free survival (RFS) rates were then compared for these groups. Results The mean follow-up time was $66.12{\pm}28.75$ months, and 97.2% of the cohort experienced RFS. The optimal volume cut-off was defined as $0.545cm^3$. There were no differences in RFS rates between T1a/T1b groups (all ages) and V1a/V1b groups (< 45 years of age). However, ${\geq}45$-year-old patients in the V1b group had a significantly poorer RFS rate than those in the V1a group. These results were confirmed by multivariate analysis. Conclusion Our results indicate that preoperative tumor volume may be more useful for predicting prognosis than tumor diameter in ${\geq}45$-year-old patients with T1N0 PTC.

Ultrasonographic Mass Screening for Thyroid Carcinoma (초음파를 이용한 갑상선암의 집단검진)

  • Chung Woong-Yoon;Chang Hang-Seok;Kim Eun-Kyung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.177-181
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    • 1999
  • Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

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Usefulness of Color-overlay Pattern of Breast Elastic Ultrasonography (유방 탄성초음파의 Color overlay pattern에 대한 유용성)

  • An, Hyun;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.401-406
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    • 2017
  • Breast cancer rates are increasing every year, biopsy for diagnosing breast cancer is increasing as well. Biopsy also invasive test, have bad side effects from patients anxiety, infection, bleeding. In this study, Conduct a survey of 69 patients who brest lesion patient, both B-mode ultrasound and elastography exam and B-mode ultrasound was classified according to the BI-RADS category, and the elastography exam was classified according to the Color overlay pattern that the value of the kPa expressed in relation to the propagation velocity of Transverse waves. The optimal cut off value of the highest sensitivity and specificity was 54.70 kPa. In the color overlay pattern, Dark Blue 42 people, Light blue ~ Red 27 people classified results and BI-RADS classification results, benign 40 people and malignant 29 people classified results showed similar results. Therefore, It is judged that the color overlay pattern is positive when classified into Dark Blue, and malignant when classified into Light blue ~ Red. In conclusion, breast elastography is expected to play a innovative role in reducing the number of breast cancer examinations and classify between benign and malignant tumor.

Clinical Investigation of Incidentally Found Thyroid Carcinoma in Mass Screening (집단 검진에서 발견된 갑상선 우연암종에 대한 임상적 고찰)

  • 김은서;장항석
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.168-173
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    • 2001
  • Background and Objectives: The introduction of highly sensitive imaging techniques has made it possible to detect many non-palpable nodules, or“incidentaloma”in the thyroid. Discovery of these lesions raises concerns about their malignancy, but the optimal strategy for managing these lesions has not been clearly established. This study was designed to evaluate the usefulness of ultrasonographic exam with new diagnostic criteria and presume the value of mass screening for thyroid cancer. Materials and Methods : Mass screening for thyroid cancer were carried out in conjunction with mass screening for breast cancer. The subjects were 630 women aged 30 years or over. Thyroid glands were examined with 10 MHz transducer ultrasonography by one radiologist. Needle aspiration biopsy were performed when suspicious of malignancy under the new diagnostic criteria. Results and Conclusion : The new ultrasonographic criteria to diagnose thyroid cancer provided useful information and ensured more accurate evaluation. 7 cases of thyroid cancer were discovered and successfully managed. It should be further demonstrated that there is sufficient value of mass screening for thyroid cancer to perform it independently despite early cancer detection.

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Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast (유방의 유두상 병변의 진단에서 자기공명영상의 역할)

  • Lee, So-Mi;Kim, Hye-Jung;Gwak, Yeon-Joo;Lee, Hui-Joong;Jang, Yun-Jin;Shin, Kyung-Min;Park, Ji-Young;Jung, Jin-Hyang
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.41-46
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    • 2010
  • Purpose : To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. Materials and methods : Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusionweighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. Results : At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. Conclusion : MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.

A Case of Hypernatremic Dehydration in an Exclusively Breast-Fed Newborn Infant (모유수유 신생아에게 발생한 고나트륨혈성 탈수증 1례)

  • Park, Kyung Pil;Kim, Jin Kyung;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.790-795
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    • 2002
  • Sporadic reports of hypernatremic dehydration in breastfed newborn infants have appeared in medical literature for at least 3 decades. We report the first case of hypernatremic dehydration resulting from inadequate breast-feeding in Korea. A 14-day old baby, born to a mentally retarded mother, was transferred to our hospital with a body weight loss of 460 g since birth(17%) and a serum sodium(Na) level of 179 mEq/L, after initial hydration at another hospital. On admission, a cardiac murmur was heard and an enlarged liver was palpated. Cardiac ultrasonogram revealed ventricular septal defect and ostium secundum atrial septal defect. During hydration, a seizure-like attack developed. Serum Na decreased to 135 mEq/L on the 5th day of admission. Brain ultrasonography and brain magnetic resonance image revealed no remarkable abnormalities. Electroencephalography was normal. She suffered from prerenal azotemia, hyperglycemia and disseminated intravascular coagulation at admission but was treated successfully. Heart failure was also controlled with dobutamine, diuretics and digoxin.

Case Report of Deep Vein Thrombosis after Cohesive Silicone Gel Implant Basedaugmentation Mammoplasty (실리콘 보형물을 이용한 유방확대술 후 발생한 심부정맥혈전증 1례)

  • Kim, Do-Hoon;Yang, Eun-Jung;Lim, So-Young;Pyon, Jai-Kyong;Mun, Goo-Hyun;Oh, Kap-Sung;Bang, Sa-Ik
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.703-706
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    • 2011
  • Purpose: Augmentation mammoplasty by cohesive silicone gel implant is becoming more popular nowadays. Many types of complications have been reported, such as hematoma, seroma, infection, capsular contracture and etc. But there were no report of deep vein thrombosis(DVT) after augmentation mammoplasty in Korea. The authors experienced one case of DVT after augmentation mammoplasty using a cohesive silicone gel implant. Methods: A 38-year-old woman with breast cancer underwent reconstruction by tissue expander and augmentation mammoplasty by cohesive silicone gel implant, and exchange of expander to cohesive silicone gel implant. The operation was finished without any complicating event. On 4th day after the operation, the patient complained of intermittent right lower leg pain. By doppler ultrasonography, the patient was diagnosed with acute venous thrombosis of the popliteal vein, posterior tibial vein and peroneal vein. Results: Intravenous heparinization and oral warfarin were started immediately and elastic compression stocking was applied. Intravenous heparinization was continued until INR (blood coagulation unit) reached to target levels. The patient was discharged on 11th day of operation with oral warfarin. Other complication has not been reported after 10 weeks of operation. Conclusion: To our knowledge, this is the first report of DVT after silicone implant based breast augmentation.

Convergence Risk Factors for Thyroid Nodules Diagnosed Ultrasound (초음파검사로 진단된 갑상선결절의 융복합 위험요인)

  • Lee, Hye-Nam;Park, Yeon-Hwa
    • Journal of Digital Convergence
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    • v.14 no.1
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    • pp.305-310
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    • 2016
  • Recently as the ultrasonography became generalized, the annual change rate of the incidence of thyroid cancer extraordinarily grew to 24.5% in Korea. Therefore, the aim of this study was performed to identify the risk factors of thyroid cancer apart from conventional risk factors of dietary iodine and ionizing radiation. In this retrospective study, 411 patients underwent fine-needle aspiration biopsy were examined from January 2011 to March 2013. The subjects are divided into two groups which are 260 patients with benign nodule and 151 patients with malignancy nodule. We compared age, hematologic values, body mass index, waist circumference, menopausal status, breast nodules status, uterine myoma status, fatty liver status of targeted group of patients. According to the result, in thyroid cancer group with obesity, the number of case of breast nodules and myoma was higher, and their thyroid stimulating hormone values was higher than the benign nodule group. In order to establish factors influencing thyroid and thyroid cancer, there is a definite need for continuous study.