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Sensitivity of imaging for multifocal-multicentric breast carcinoma

BACKGROUND: This retrospective study aims to determine: 1) the sensitivity of preoperative mammography (Mx) and ultrasound (US), and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC), defined by pathology on surgical specimens, and 2) to analyze the characteristics of both det...

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Autores principales: Bozzini, Anna, Renne, Giuseppe, Meneghetti, Lorenza, Bandi, Giuseppe, Santos, Gabriela, Vento, Anna Rita, Menna, Simona, Andrighetto, Stefania, Viale, Giuseppe, Cassano, Enrico, Bellomi, Massimo
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576336/
https://www.ncbi.nlm.nih.gov/pubmed/18826585
http://dx.doi.org/10.1186/1471-2407-8-275
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author Bozzini, Anna
Renne, Giuseppe
Meneghetti, Lorenza
Bandi, Giuseppe
Santos, Gabriela
Vento, Anna Rita
Menna, Simona
Andrighetto, Stefania
Viale, Giuseppe
Cassano, Enrico
Bellomi, Massimo
author_facet Bozzini, Anna
Renne, Giuseppe
Meneghetti, Lorenza
Bandi, Giuseppe
Santos, Gabriela
Vento, Anna Rita
Menna, Simona
Andrighetto, Stefania
Viale, Giuseppe
Cassano, Enrico
Bellomi, Massimo
author_sort Bozzini, Anna
collection PubMed
description BACKGROUND: This retrospective study aims to determine: 1) the sensitivity of preoperative mammography (Mx) and ultrasound (US), and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC), defined by pathology on surgical specimens, and 2) to analyze the characteristics of both detected and undetected foci on Mx and US. METHODS: Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. RESULTS: Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive). Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%); scattered fibroglandular density in 40 (24.3%), heterogeneously dense in 91 (55.1%) and dense in 31 (18.8%) cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45.5%. Re-reviewed Mx detected only 3 additional lesions. The sensitivity of Mx was affected by the presence of dense breast tissue which obscured lesions or by an incorrect interpretation of suspicious findings. US detected 73/80 index cancers (sensitivity of 91.2%), US missed 117 malignant foci with a mean tumor diameter of 6.5 mm; the sensitivity was 52.9% Undetected lesions by US were those smallest in size and present in fatty breast or in the presence of microcalcifications without a visible mass. US sensitivity was affected by the presence of fatty tissue or by the extent of calcification. CONCLUSION: Mx missed MMBC malignant foci more often in dense or fibroglandular breasts. US missed small lesions in mainly fatty breasts or when there were only microcalcifications. The combined sensitivity of both techniques to assess MMBC was 58%. We suggest larger studies on multimodality imaging.
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spelling pubmed-25763362008-10-31 Sensitivity of imaging for multifocal-multicentric breast carcinoma Bozzini, Anna Renne, Giuseppe Meneghetti, Lorenza Bandi, Giuseppe Santos, Gabriela Vento, Anna Rita Menna, Simona Andrighetto, Stefania Viale, Giuseppe Cassano, Enrico Bellomi, Massimo BMC Cancer Research Article BACKGROUND: This retrospective study aims to determine: 1) the sensitivity of preoperative mammography (Mx) and ultrasound (US), and re-reviewed Mx to detect multifocal multicentric breast carcinoma (MMBC), defined by pathology on surgical specimens, and 2) to analyze the characteristics of both detected and undetected foci on Mx and US. METHODS: Three experienced breast radiologists re-reviewed, independently, digital mammography of 97 women with MMBC pathologically diagnosed on surgical specimens. The radiologists were informed of all neoplastic foci, and blinded to the original mammograms and US reports. With regards to Mx, they considered the breast density, number of foci, the Mx characteristics of the lesions and their BI-RADS classification. For US, they considered size of the lesions, BI-RADS classification and US pattern and lesion characteristics. According to the histological size, the lesions were classified as: index cancer, 2nd lesion, 3rd lesion, and 4th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity was calculated for Mx, US and re-reviewed Mx for detecting the presence of the index cancer as well as additional satellite lesions. RESULTS: Pathological examination revealed 13 multifocal and 84 multicentric cancers with a total of 303 malignant foci (282 invasive and 21 non invasive). Original Mx and US reports had an overall sensitivity of 45.5% and 52.9%, respectively. Mx detected 83/97 index cancers with a sensitivity of 85.6%. The number of lesions undetected by original Mx was 165/303. The Mx pattern of breasts with undetected lesions were: fatty in 3 (1.8%); scattered fibroglandular density in 40 (24.3%), heterogeneously dense in 91 (55.1%) and dense in 31 (18.8%) cases. In breasts with an almost entirely fatty pattern, Mx sensitivity was 100%, while in fibroglandular or dense pattern it was reduced to 45.5%. Re-reviewed Mx detected only 3 additional lesions. The sensitivity of Mx was affected by the presence of dense breast tissue which obscured lesions or by an incorrect interpretation of suspicious findings. US detected 73/80 index cancers (sensitivity of 91.2%), US missed 117 malignant foci with a mean tumor diameter of 6.5 mm; the sensitivity was 52.9% Undetected lesions by US were those smallest in size and present in fatty breast or in the presence of microcalcifications without a visible mass. US sensitivity was affected by the presence of fatty tissue or by the extent of calcification. CONCLUSION: Mx missed MMBC malignant foci more often in dense or fibroglandular breasts. US missed small lesions in mainly fatty breasts or when there were only microcalcifications. The combined sensitivity of both techniques to assess MMBC was 58%. We suggest larger studies on multimodality imaging. BioMed Central 2008-09-30 /pmc/articles/PMC2576336/ /pubmed/18826585 http://dx.doi.org/10.1186/1471-2407-8-275 Text en Copyright © 2008 Bozzini et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bozzini, Anna
Renne, Giuseppe
Meneghetti, Lorenza
Bandi, Giuseppe
Santos, Gabriela
Vento, Anna Rita
Menna, Simona
Andrighetto, Stefania
Viale, Giuseppe
Cassano, Enrico
Bellomi, Massimo
Sensitivity of imaging for multifocal-multicentric breast carcinoma
title Sensitivity of imaging for multifocal-multicentric breast carcinoma
title_full Sensitivity of imaging for multifocal-multicentric breast carcinoma
title_fullStr Sensitivity of imaging for multifocal-multicentric breast carcinoma
title_full_unstemmed Sensitivity of imaging for multifocal-multicentric breast carcinoma
title_short Sensitivity of imaging for multifocal-multicentric breast carcinoma
title_sort sensitivity of imaging for multifocal-multicentric breast carcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576336/
https://www.ncbi.nlm.nih.gov/pubmed/18826585
http://dx.doi.org/10.1186/1471-2407-8-275
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