• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.372-385
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• 2023

Breast cancer is one of the most common cancers and causes several complications in females. Currently, MRI is a necessary method for preoperative studies in patients with breast cancer. A high frequency of breast MRI can lead to an increase in the number of incidental extramammary findings. Moreover, it can provide accurate preoperative workup; therefore, the prognosis of patients can be improved. Herein, we provide several extramammary findings, including the mediastinum, lung, upper abdomen, bone, and soft tissue, correlating with US, chest CT, liver MRI, PET-CT, and bone scan.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3229-3232
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• 2015

Background: Triple-negative breast cancer (TNBC) is known to be associated with aggressive biologic features and a poor clinical outcome. Therefore, early detection of TNBC without missed diagnosis is a requirement to improve prognosis. Preoperative ultrasound features of TNBC may potentially assist in early diagnosis as characteristics of disease. Purpose: To retrospectively evaluate the sonographic features of TNBC compared to ER (+) cancers which include HER(-) and HER2 (+), and HER2 (+) cancers which are ER (-). Materials and Methods: From June 2012 through June 2014, sonographic features of 321 surgically confirmed ER (+) cancers (n=214), HER2 (+) cancers (n=66), and TNBC (n=41) were retrospectively reviewed by two ultrasound specialists in consensus. The preoperative ultrasound and clinicopathological features were compared between the three subtypes. In addition, all cases were analyzed using morphologic criteria of the ACR BI-RADS lexicon. Results: Ultrasonographically, TNBC presented as microlobulated nodules without microcalcification (p=0.034). A lower incidence of ductal carcinoma in situ (p<0.001), invasive tumor size that is>2 cm (p=0.011) and BI-RADS category 4 (p<0.001) were significantly associated with TNBC. With regard to morphologic features of 41 TNBC cases, ultrasonographically were most likely to be masses with irregular (70.7%) microlobulated shape (48.8%), be circumscribed (17.1%) or have indistinct margins (17.1%) and parallel orientation (68.9%). Especially TNBC microlobulated mass margins were more more frequent than with ER (+) (2.0%) and HER2 (+) (4.8%) cancers. Conclusions: TNBC have specific characteristic in sonograms. Ultrasonography may be useful to avoid missed diagnosis and false-negative cases of TNBC.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1397-1402
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• 2023

Nodular fasciitis is a benign fibroblastic proliferation rarely reported in the breast. We report the case of a 55-year-old woman who presented with imaging findings that resembled a malignancy. Mammography revealed an isodense nodule with partially indistinct margin in the right breast, showing the abnormality score 75% on artificial intelligence. Ultrasonography revealed an oval hypoechoic nodule with microlobulated margin, echogenic halo, increased blood flow, and soft elasticity. After core needle biopsy and excision, nodular fasciitis was diagnosed. Although nodular fasciitis of the breast is rare, it may mimic malignancy; therefore, it should be considered as a differential diagnosis to prevent unnecessary intervention.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4647-4650
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• 2013

Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8149-8153
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• 2014

Background: To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. Materials and Methods: Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. Results: The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). Conclusions: The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.776-781
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• 2023

Commonly, epidermal inclusion cysts (EICs) are benign cutaneous lesions that are lined with stratified squamous epithelium and may occur in all body parts, including the breasts. EICs in the breast (EICB) are commonly encountered clinically; it may be under-reported because of their mild and nonspecific clinical presentation. Malignant transformation of EICs is extremely rare, occurring 0.011%-0.045%. Presently, we report a rare case of squamous cell carcinoma arising from an EICB of a woman with invasive ductal carcinoma.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.454-458
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• 2017

Fibroadenoma are one of the most common benign tumors of the breast in young women. Fibroadenoma may be associated with fibrocystic change, proliferative epithelial changes, and extremely rarely with carcinoma. We report here two cases of malignancy arising from a breast fibroadenoma. The patients were 19 and 51 years old and presented with a lump of recent onset. A 19-year-old female patient was diagnosed with mass excision at another hospital, and re-excision was performed at the hospital. Ultrasonography and cytologic examination revealed fibroadenoma and malignancy in a 51-year-old female patient, who was treated with wide excision. The pathological report of the two cases was revealed as DCIS in a fibroadenoma. Because carcinoma arising within a fibroadenoma is so rare, there are few reports of its characteristics or guidelines for treatment. Careful analysis of the unusual carcinoma arising within a fibroadenoma of the breast led to appropriate diagnosis and treatment of various types of lesions. Herein, we report two cases of DCIS arising within a fibroadenoma of the breast and provide a review of the literature.

• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.751-759
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• 2023

Breast ultrasonography is difficult to image in fatty breasts and to find micro-calcification, but the discovery of micro-calcification is very important for breast cancer screening. Among the color Doppler artifact of ultrasound, twinkle artifact mainly occur on strong reflectors such as stones or calcification in images, and evaluation methods using them are clinically being used. In this study, we are conducting experiments on the color Doppler settings of ultrasound equipment, such as repetition frequency, ensemble, persist, wall filtering, smoothing, linear density, and dissociation value, by producing a breast simulation phantom using the largest amount of calcium phosphate among breast implants. The purpose of this study was to improve the contrast of twinkle artifact in breast ultrasound examinations and to maximize their use in clinical practice. As a result, the pulse repetition frequency occurred in the range of 3.6 kHz to 7.2 kHz, and did not occur above 10.5 kHz. For ensembles, twinkle artifact occurred in all sizes of calcification under low conditions, and in threshold settings, the twinkle artifact increased slightly only under 80 to 100 conditions, and did not occur in 1 mm size calcification. Persist, wall filter, smoothing, and line density settings did not have much meaning in the setting variable because conditions did not increase by condition, and pulse repetition frequency, ensemble, and thresholds had the greatest impact on the twinkling artifact image. This study is expected to help examiners select optimal conditions to effectively increase twinkle artifact by adjusting color Doppler settings.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.719-725
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• 2020

Metastases to the thyroid gland have rarely been reported in clinical settings, and the thyroid gland is an uncommon site for breast carcinoma metastasis. We report a case of a 64-year-old breast cancer patient diagnosed with metastatic breast carcinoma in the thyroid gland after performing ultrasonography (US)-guided core needle biopsy (CNB) and subsequent total thyroidectomy. On US, the thyroid lesion appeared to be mildly enlarged with multiple internal hypoechoic lines and a few microcalcifications without mass formation. Under US-guidance, CNB was performed by targeting the area with microcalcifications and subsequently diagnosed as metastatic breast carcinoma. Total thyroidectomy revealed that the patient had metastatic invasive ductal carcinoma of the breast with lymphatic spread involving both lobes and the isthmus of the thyroid gland. Although the thyroid gland is an uncommon metastatic site, the unusual features of thyroid metastasis can be observed on US; thus, US-guided CNB effectively aids the diagnosis of thyroid metastasis.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.379-394
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• 2020

Purpose To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.