Medicexchange.com News

Archive for the ‘Mammography’ Category

BIRADS score can be utilized for mucocele-like lesions related with Atypical Ductal Hyperplasia.

Intermediate concern calcifications of breast malignancy were detected more often in mucocele like breast lesions related with ADH.

 

The medical research study was conducted by Sun Mi Kim, Hak Hee Kim, Doo Kyung Kang, Hee Jung Shin, Nariya Cho, Jeong Mi Park and Joo Hee Cha from Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, South Korea; Department of Radiology, Division of Breast Imaging and Intervention, University of Iowa Hospitals, Iowa City, IA; Department of Radiology, Seoul National University Bundang Hospital, Seongnam-Si, South Korea; Department of Diagnostic Radiology (Ajou University, College of Medicine, Suwon and Department of Diagnostic Radiology, Seoul National University, Seoul, South Korea.)

The study is available in online journal of American Roentgen Ray Society, and the research objective was to assess varied radiological findings of mucocele-like tumors of the breast and tumors related with Atypical Ductal Hyperplasia (ADH) as per Breast Imaging Reporting and Data System (BIRADS) and sonographic cystic mass classification (Note: though the condition is not cancerous, but women with ADH have greater tendency for cancer.)

In a period of ten years, about 68 women with 72 mucocele like breast lesions were evaluated in a microscopic study at three medical institutions.

Through contemplative study – ultrasound and mammographic findings of 72 mucocele like breast lesions were analyzed by, in accordance with BIRADS scale, and radiological study results were associated with pathological results.

Mammography demonstrated 53 breast lesions with calcifications, with and without a mass: 39 were calcifications without a mass. Intermediate concern calcifications of breast malignancy were detected more often in mucocele like breast lesions related with atypical ductal hyperplasia, in comparison to pure mucocele-like tumors. About 69 of mucocele-like tumors showed as cystic lesions on sonography.

Septated/clustered cysts in breast and complex cystic breast masses were often visible in mucocele-like tumors related with atypical ductal hyperplasia. Positive value for breast imaging reporting and data system 4 calcifications was 13.3%, whereas that for BIRAD score of 5 it was 50%, respectively.

Conclusion: Mucocele-like lesions related with atypical ductal hyperplasia (ADH) were often visible as septated/clustered cysts in breast and complex cystic breast masses, associated with intermediate concern calcifications of breast malignancy, and BIRADS score can be utilized for management of mucocele-like tumors.

As per the study put forward at the Cancer Imaging and Radiation Therapy Symposium in Atlanta:

• Annual mammograms furnish similar consequences post breast conserving therapy for cancer patients, at lower health care cost
• Researchers tried to ascertain the clinical relevance and usefulness of follow up mammogram after Breast Conserving Therapy (BCT), when the patient is treated already with treated with a lumpectomy and radiation for stage breast cancer.

The conference was supported by Radiological Society of North America (RSNA) and the American Society for Radiation Oncology (ASTRO).

Annual mammograms are often carried on after BCT. Some of radiologists urge for interval mammogram (follow-up) after 6 months, after primary post-treatment mammogram, which is about 5 months after the culmination of radiotherapy, on the average, to ascertain constancy, to check out for cancer recurrence (Oncology).

For the trial study, about 88 of 467 BCT patients from Abington Memorial Hospital, Abington, PA had an interval mammogram (IM). This contributed to 4 biopsies that did not generate any recurrent or new cancer cases. The patients proceeded further for their annual mammograms after interval mammogram.

Medical researchers ascertained that ruling out IM would bring down higher healthcare costs, with no vital impact on patient outcomes.

Though an IM after BCT is normal, but physicians are required to reconsider their suggestion for an IM, to relieve patients with lower healthcare costs and unneeded biopsies.

Conclusion: Interval Mammograms after Breast Conserving Therapy is not recommended for patients, to save them money and unneeded biopsies.

New U.S. Preventive Services Task Force (USPSTF) cancer screening guidelines potentially bear on endurance in younger patients.

• USPSTF urged against annual mammograms for 40 year old women, if not the patients had genetic disorder, or familiar risk of radiation.
• Full field digital mammography (FFDM) is beneficial over film radiography for younger patients with dense breast mass.

The medical research was conducted by: Paul Dale, M.D., Chief of Surgical Oncology and his colleagues (Nicole Shen, Linda Sue Hammonds, and Dick Madsen) of Ellis Fischel Cancer Center, University of Missouri-School of Medicine, Columbia, MO.

The medical research was put forward at the annual association meeting of American Society of Breast Surgeons.

Mammography for breast cancer proves good to women within the age group of 40-49 years. Leaving out people of this age group from annual mammogram under the reviewed guidelines for mammography – US Preventative Service Task Force (USPSTF), would in harmful way affect endurance.

A 10-year retrospective study carried on at the University of Missouri in Columbia, MO ascertains mammography that discovered out smaller breast tumors with less lymph node metastasis than other recognized through clinical breast screening of women in this age group.

Breast cancer has an improved medical prognosis when cared for prior breast tumors become conspicuous and classifiable through a doctor, or through self breast examination.

The breast cancer research study even ascertained that breast tumors recognized out through mammography in general had ameliorated consequences after discourse than that detected through clinical examinations.

Though the consequences of the medical research were not storming, on grounds of the know-know that Paul Dale has, the confined amount of research analyzing how the new rules of thumb by USPSTF might bear on breast cancer mortality rate was unanticipated.

In spite of substantial protests to new guidelines, few medical researchers have in distinction from others considered at mammography and its long-run affect on cancer (Oncology) outcomes in younger women.

The medical cancer research team of Dr. Dale evaluated data of patients for cancer treatment at tertiary hospital (referral center) in between 1998 and 2008.

About 1581 women were analyzed by – of which 20% were in the age group of 40 and 49, respectively.

Approximately 47% of the patients were analyzed through mammography; 53% were through clinical examinations, and other cancer screening methods.

In case of mammogram, the average size of tumor in the breast was 20 mm in diameter, though in other cancer screening the tumors were 30 mm in diameter.

The research team marks the divergence in tumor size, where the study likewise ascertained that the frequency of lymph node involvement in the clinically distinguished group was all but two times that of patients recognized out through mammogram.

Researchers reckoned the stats of five year disease free survival rate through relative survival methodological analysis, to be 94% for group on mammogram findings, and about 78% for other that did not go through mammogram. The lymph node negativity and tumor size were importantly related to increased survival rates.

The study discovered out that about 20% of women analyzed with breast cancer were under 50 years of age, and all but half of their tumors were identified out through mammography.

Dr. Dale marks that, with respect to latest advancements in directed treatment of early cancer, as per new guidelines – younger cancer patients would miss out chemotherapy, and have vital adverse cancer survival rates, when miss cancer screening, for early detection of tumor.

Conclusion: Mammographic screening in women aged 40-49 discovered out smaller tumors with less lymph node metastasis. Annual mammographic screening is urged for women of 40-49 years for cancer survival rate.

Mayo Clinic and Gamma Medica, Inc. have developed lower dose MBI system – which supports a 4 mCi MBI scan.

• MBI is being conceived to circumvent digital mammography, MRI, ultrasound etc.
• It showed 91% sensitivity (in combination with mammography), and 93% specificity over mammography in 1,000 patients.

In a recent Breast Imaging Meeting by Society of Nuclear Medicine conducted in Bethesda, Maryland from April 21-22, 2011 – Mayo Clinic (Rochester, MN) put forward highly awaited preliminary results of the clinical research studies, of about 2,400 patients on low dose Molecular Breast Imaging (MBI) cancer trial/screening in women with dense breasts.

The cancer clinical trial was funded by Susan G. Komen Foundation.

Women with dense breast that posed for digital mammogram between June 2010 and January 2011 were inscribed for this clinical study.

Research was conducted by Michael O’Connor, PhD – Medical Physicist, Carrie Hruska, PhD – Associate Consultant in Medical Physics, and Deborah J. Rhodes, MD – Lead clinical investigator.

Partakers experienced both molecular breast imaging (MBI) and mammogram. MBI was executed with 296 MBq (8mCi) injection of Tc-99m Sestamibi and dual head czt detectors, and developed in active frame to allow for genesis of 148 MBq (4 mCi) eq images.

MBI’s and mammograms were interpreted separately, where MBI’s were allotted an assessment score of 1-5 over BIRADS (Breast Imaging Reporting and Data System). The assessment scores of 3-5 on molecular breast imaging were conceived positive and contributed to diagnostic work-up.

About 440 women that were examined up to now, 6 patients were determined out with cancers. In line to Mammography – which did not find out any, MBI discovered out cancer in about 5 of 6 patients. The unexpended cancer was noticed on prophylactic mastectomy (7 mm invasive carcinoma).

MBI discovered out 2 cases of DCIS (Ductal Carcinoma In Situ) – 6 and 15 mm, tubular cancer (7mm), and invasive lobular carcinoma (36mm) that were hidden by Mammography.

About 79 women were called back for symptomatic valuation of the conclusion; almost 35 – due to predominant MBI alone; 40 because of incidental mammogram, and 4 due to both the examinations. Around 18 women had passed through diagnostic test/biopsy, where 16 women were cued by MBI, with positive predictive value (PPV) of 25%, while only 2 were being cued by Mammography with PPV of 0%. All the detected cancer cases were even seeable on the 148 MBq (4 mCi) equivalent images.

Though the study is on, but conclusion from this clinical research show out the significance of low-dose MBI, which can be a vital choice to mammography screening in women with dense breast. Medical researchers said, the re-examination after a year for this group, and advance study of incidental screening MBI is required to demonstrate out for sensitivity specificity.

The U.S. Food and Drug Administration have given approval for the for the first three dimensional mammography system.

Selenia Dimensions System, the first X-ray mammography device that provides three-dimensional (3-D) images of the breast for breast cancer screening and diagnosis is expected to increase the accuracy of breast cancer diagnosis.

The Selenia Dimensions System, an upgrade to Hologic’s existing FDA-approved 2-D system, can provide 2-D and 3-D X-ray images of the breasts. The 3-D images may help physicians more accurately detect and diagnose breast cancer.

The Selenia Dimensions System is marketed by Hologic Inc.

See the FDA press release here

In a recent study report published in the Clinical Journals of the American Society of Nephrology (CJSAN), the medical researchers have put forward the importance of routine mammograms beyond normal breast cancer screening, as the research team found out that routine mammograms that were performed on patients with breast cancer proved well in identifying out calcifications in the blood vessels of the patients that were affected with advanced kidney disorders!

The medical research team though took very less sample for evaluation on this topic, but says it to be a positive sign in the effective usage of mammogram, as found out that routine mammograms showed effective in depicting out arterial calcium deposits, which can even add value in the field of heart disease treatment!

In more than two-thirds of women with end-stage-renal-disease (ESRD), the custom mammogram showed calcium deposits in the breast arteries of them! In chronic kidney disease/syndromes (CKD), breast arterial calcification is a precise and relevant marker of medical vascular calcification, and occurrence is noticeably increased in end-stage-renal-disease, and other highly developed chronic kidney diseases! Researchers believe the arterial calcium deposits found in the patients (with CKD and/or ESRD) passed through mammogram will contribute in a better way by keeping a check on to the increased rate of death associated with heart disorders/syndromes! More to arterial calcifications/the inner layer of the blood vessels (in case of atherosclerosis), calcification can even occur in the middle layer of the artery! Calcium deposits in the middle layer of the arteries increase cardiovascular disorder risk, making the arteries rigid, and difficult to identify out!

The research team evaluated breast artery tissue samples from a slot of 16 women that had kidney disorders. All the taken out samples showed calcification of the breast artery, but not one amongst showed out to inner layer/intimal calcifications! On reviewing the routine mammograms that were performed on around 71 women affected with ESRD, the research team found 63 percent of patients affected with breast arterial calcifications! On the dissimilar front, in a combined group of women that were unaffected of kidney disorders, the routine mammogram showed out around 17 percent cases of breast arterial calcification! Even before the kidney disorder advanced to ESRD, around 35 percent women already had breast arterial calcification on mammograms that were carried out long back! Researchers found that in more than 90 percent of women that had breast artery calcification, already, showed calcifications in their other blood vessels, as well, and they believe calcium that was found deposited through mammogram can be an indicative marker of regular/generalized vascular calcifications, in patients with kidney disorders!

The study result holds up true the hypothesis that CKD preorders to medical calcification that medical research team believes can positively add value to the cardiovascular disease prevention! Mammogram will be a useful tool for examining out the progression/developments of medical calcifications, as most of the women with CKD are at the right age of being recommended for mammograms! The research team even understands the necessity of further research and studies on arterial calcium deposits in patients affected with kidney disorders, to determine out, if early detection and appropriate treatment action might help to trim down the linked perils of cardiovascular disease!

The study had some vital restraining factors, as had small amount of patient sample, but the researchers consider that this advancement of mammogram will surely add more value in the domain of cardiovascular disorders, by helping care providers keep a check on heart diseases!

Focused breast ultrasound examination (radiology) has proved well in breast biopsy procedures, for breast cancer detection, of women below 40 years of age, affirmed through the study results presented over in the American Journal of Roentgenology.

Breast ultrasound images (utilizing ultrasound equipment/systems) help the physicians identify out breast cancer facts (for recognizing out cyst/tumors in breast), and ultrasound has been urged specifically by medical experts to be considered as primary medical imaging technique for evaluating out breast nodules, painful lumps in breast (oncology), in women below 30 years of age.

For the neophytes, breast ultrasound scan/examination is primarily being used for to diagnose/analyze out breast irregularities (for breast cysts/lumps/tumors), to set apart probable irregularities recognized out on mammography. Medical research scientists affirm that for women below 30 years of age (with focal breast pain/ multifocal breast cancer), focused/concentrated ultrasound scanning is highly preferred than other applicable imaging techniques and modalities, as it has proved by time and testing that ultrasound guided breast biopsy (ultrasonography) is good for primary level image evaluation of the disorder.

But, questions do arise from this and that corner about the effectiveness/preciseness of ultrasound scan (medical imaging equipment), and simultaneous mammography for a mass public.

Medical research scientists took over data from year 2002-2006 on varied patients, identifying and reviewing out ultrasound scan/examinations carried on them, of the patients (women, below 30 years of age) with focal breast pain/multifocal breast cancers (symptoms and other), performed at Seattle Cancer Care Alliance (Seattle, WA). The results were decided on by breast biopsy, ultrasound observation (around 2 months) and by other means!

On the whole, breast malignancy (malignant tumors) recognized out in the research study by the team was around 0.4% (percent), and they affirmed that ultrasound proved very well (100% by all means) in precisely detecting out breast malignant tumors, as because all the tumors were recognized out utilizing the very technique, of ultrasonography. For the same reason (as ultrasound proved well), there was no scope left for mammography to come in picture, and prove anything wrong, or help in more effective diagnosis, as the results (through ultrasound) showed 100% negative predictive value (of the patients who were precisely diagnosed on breast tumors).

On the concluding note, the importance of ultrasound sonography (diagnostic sonography) has definitely been proved by all means to be a good medical imaging technique for primary evaluation of focal breast pain/multifocal breast cancer in young women (below the age of 30 years, and so).

A recent study report published in journal of Radiology states that radiologists possibly will be able to tell apart differently the malignant cancer (breast lumps/tumors) from benign breast lesions in a patient, by effectively utilizing out optical and x-ray medical imaging.

Medical research scientists (Martinos Center for Biomedical Imaging, Massachusetts) built up a coalesced medical imaging system (optical, x-ray), accomplished in getting hold of the function and integrative (structural) information of the human breast.

The technologies used were Digital Breast Tomosynthesis (DBT), and Diffuse Optical Tomography (DOT). For the neophytes, DBT helps in detection of breast lumps, and tumors (Oncology), and DOT in gauging concentration of hemoglobin, oxygen saturation levels, and cellular features/characteristics, on grounds of infra-red laser beam being soaked up, and dispersed out inside the breast tissue/breast mass.

Radiologists can even co-register optical and x-ray information on a patient, for charting out doubtful conclusions/findings of the medical investigation, for analyzing out the functional characteristics/attributes of specific breast regions.

In during the medical research, collective Digital Breast Tomosynthesis and Diffuse Optical Tomography were carried out on around 125 patients (with a mean age of about 56 years).

Optical data was attained in the process (with compressed breast) using detector probes (pick up alpha particles) and optical source (for experiment and research) putting together with the DBT component. After this, the optical probes were taken off, by not re-adjusting/altering the breast compression, and the DBT scan (Digital Breast Tomosynthesis) was acted upon.

The research team was thrilled of adding up optical imaging system to DBT, as it is affordable, protected, and quick, and most of all supports noninvasive procedures.

Of about 189 breasts being examined over for breast lumps/tumors (in 125 patients), around 51 cases reported positive on breast lesions, and decided on by breast biopsy results, 26 were malignant breast cancer cases (out of 51 breast lesions), and other 25 were benign breast lumps.

The 26 malignant cases that were being recorded had Hemoglobin concentration (Hb) considerably larger than in the glandular breast tissue (normal, unaffected breast tissue) of similar breast.

Complex breast cysts and benign lesions had comparably lower Hemoglobin concentration (Hb) than malignant breast lesions.

Research scientists are up for reducing redundant biopsies and affirmed the importance of optical and x-ray medical imaging in offering potential solutions for such; after the tests were performed on various patients, researchers came to the conclusion that the oxygen saturation levels were comparably lower in breast cysts in contrast to the same in malignant/solid benign breast mass/lesions, and glandular breast tissues.

On the concluding note, even though complex breast cysts are easy to be analyzed out utilizing breast ultrasound, identifying out breast cysts from benign/malignant breast lesions by getting a breast mammogram would save the patients angst and overheads/expenses related with the subsequent procedure. Medical research scientists are confident that the combined system (optical, x-ray imaging) will perk up the competence and diagnostic accuracy/correctness of breast screening.

A recent study report published in the journal of American College of Radiology states that the overpowering majority of Breast Cancer Surveillance Consortium that works together to progress breast cancer (Oncology) study and research executes magnetic resonance imaging (MRI) of human breast in the US, is up to equivalence level with other – European Society of Breast Imaging (proffer guiding principles for analytical interventional breast procedures), and American College of Radiology Imaging Network (National Cancer Institute cooperative group) technological standard and requisites.

The Breast Cancer Surveillance Consortium (BCSC) is a shared effort for to perk up breast cancer research and treatment.

Breast magnetic resonance imaging has been taken on by community practice medical facilities in occupational therapy, where most of the affected women (breast cancer) go through breast imaging (mammography) in the US. But on the other side, not much is recognized out of the scientific and technological quality of magnetic resonance imaging (MRI) carried out at these medical facilities.

The idea behind the research of the medical team was to study and weigh up MRI tools and acquirement methods at present utilized by a range of community practice medical facilities over different parts in the US. The team decided to make use of data available from the Breast Cancer Surveillance Consortium for to settle on its conformity with existing bare minimum standards specifically put down by American College of Radiology Imaging Network (ACRIN) and European Society of Breast Imaging (ESOBI).

Breast magnetic resonance imaging (MRI) carried out by BCSC medical facilities were recognized out in the process, and inquired up concerning breast magnetic resonance imaging tools/equipments and its critical technical parameters, and the end results were computed out and the proportion of medical facilities coping up with ACRIN and ESOBI medical standards were estimated at.

Researchers found at the end that out of 23 medical facilities carrying out breast magnetic resonance imaging (MRI), the final results were taken up from around 14 medical facilities that stuck on bare minimum standards for breast magnetic resonance imaging (MRI) equipment over community medical practice.

Medical equipments were found in conformity with advocated 1.5T MRI field strength, and all the scanners made use of breast coil, as proposed by ACRIN and the ESOBI. Moreover, the researchers feel the need of breast magnetic resonance imaging technique to be optimized for the effective usage, following up with critical technical parameters.

Besides, the research team sighed with relief (amongst most of the facilities that were being reviewed by) on realizing the fact that all (researched out facilities) met the terms and medical standards of ACRIN and ESOBI for breast magnetic resonance imaging equipment.

On the concluding note with a smile on our face, we remind you not to miss going through our other sections for more on radiology, nuclear medicine and medical research and development reports.

A development chapter on radiological studies has been uncovered by Professor Zhipeng Wu (School of Electrical & Electronic Engineering, NTU) who in recent times came up with a new innovation, a handy scanner (radio frequency technology) that is capable enough identifying out cancerous tumors (malicious and other) at once in the breast, on a computer processor.

Breast cancer recognition by means of radio frequency/microwave technology in UK, US and Canada has been verified already by medical researchers, but up till now the process had by and large been carried out in clinics/hospitals and other specialized healthcare centers, and it used to consume some time for generating out the image/representations, which has now been made possible with the handy scanner invented by Zhipeng Wu.

Professor Wu even put forward his innovation (sensor system) to the Institution of Engineering & Technology (IET) Innovation Awards, and his hi-tech gadget has even been picked out in (both) Electronics and Measurement in Action categories, and the victors will be proclaimed in the month of November 2010, industry sources revealed.

Professor Wu, when asked on about his innovation, said – now, alarmed (breast cancer) patients can get to access immediately the captured representation of the breast for detecting out cancerous tumors, as the handy scanner (supported on the radio frequency technology) will evidently and cleanly show out the existence of any cancerous tumor in the female breast.

He said further, other than being a faster and minimally invasive way of testing out breast cancer, women can even be assessed at General Practitioner (GP) surgeries, for radically trimming down waiting time, and to keep away from redundant mammography etc. Moreover, the handy scanner can even be utilized effectively by the patient at home for incessantly scrutinizing out on conditions of the breast.

The copyrighted handy scanner by Professor Wu makes uses of computed tomography (CT), and operates following up with the same technology just as any mobile phone, requiring small amount of power for the operation, and this exactly makes it secured, and inexpensive, and moreover the scanner is compact and convenient/handy which will make it a preferred choice by medical professionals for breast screening of cancerous tumors, believes Professor Zhipeng Wu.

For the neophytes, October being National Breast Awareness month is a right time, when we got to share this with you, as breast cancer is the second widespread disease with maximum human loss, with around 8.2% of overall cancer fatalities.

How effective this handy scanner will be is to be seen further, said few market analysts, and continued further saying that the regular form of breast cancer detection is mammography, which has been found to work nicely with women over 50 years of age, with around 95% accuracy in diagnosis, but it is not proved that effective for younger women, as the discovery rate is estimated to be around 60% (of women below 50 years of age), as precise diagnosis of breast cancer is the need of the hour, and moreover early detection of cancer is always advisable, to keep a tab on increased death rates in women suffering from breast cancer.

For the enthusiasts, the handy scanner (radio frequency modulated) works on dielectric contrast between usual and sick breast tissues, unlike mammography where it works on abnormal regions of mass/density or breast calcifications for detecting out cancerous tumors.

Professor Wu demonstrated his invention, stating that the moment female breast goes into the cup, the picture comes into view on the display screen, and the presence of any cancerous tumor or other irregularities in the female breast will display out over the screen in red, as the sensor identifies out the dissimilarities in the tissue contrasts at varied radio frequencies. Since the affected and malicious tissues are more permeable and conductive, they come into view differently than other normal tissues on the screen.

Besides, handy scanner (radio frequency modulated) is capable enough generating out around 30 pictures/representations of breast (cancerous) tissues, per second, and which positively indicates the efficiency of the gadget carrying out breast scanning in a very short frame of time, and since the gadget is portable, conveniently supports real-time scanning of breast, and trims down the probability of omitting out any cancerous (breast) tumor during examination/scanning.

In other conventional methods, a gel or a liquid is to be applied prior carrying out scan over the breasts of any patient (e.g. Ultrasound scan), but in here with this handy scanner, it is by no means reliant on any such gel/liquid, and the test/examination can be carried out on a patient using oil, water to name a few, and more to that the patient can be scanned even without a bra on (as generally women have to take their bra off for breast scanning in conventional methods).

Professor Wu concluded saying that the research is to be carried more on this system, as the gadget has immense potential in diagnosing out breast cancer (Oncology)  in an effective way for eradicating it out, saving millions of human lives (women) located over the globe.