• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1090-1103
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• 2022

Purpose To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) with the two-dimensional synthesized mammogram (2DSM), compared to full-field digital mammography (FFDM), for suspicious microcalcifications in the breast ahead of stereotactic biopsy and to assess the diagnostic image visibility of the images. Materials and Methods This retrospective study involved 189 patients with microcalcifications, which were histopathologically verified by stereotactic breast biopsy, who underwent DBT with 2DSM and FFDM between January 8, 2015, and January 20, 2020. Two radiologists assessed all cases of microcalcifications based on Breast Imaging Reporting and Data System (BI-RADS) independently. They were blinded to the histopathologic outcome and additionally evaluated lesion visibility using a fivepoint scoring scale. Results Overall, the inter-observer agreement was excellent (0.9559). Under the setting of category 4A as negative due to the low possibility of malignancy and to avoid the dilution of malignancy criteria in our study, McNemar tests confirmed no significant difference between the performances of the two modalities in detecting microcalcifications with a high potential for malignancy (4B, 4C, or 5; p = 0.1573); however, the tests showed a significant difference between their performances in detecting microcalcifications with a high potential for benignancy (4A; p = 0.0009). DBT with 2DSM demonstrated superior visibility and diagnostic performance than FFDM in dense breasts. Conclusion DBT with 2DSM is superior to FFDM in terms of total diagnostic accuracy and lesion visibility for benign microcalcifications in dense breasts. This study suggests a promising role for DBT with 2DSM as an accommodating tool for stereotactic biopsy in female with dense breasts and suspicious breast microcalcifications.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.21-30
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• 2010

Purpose : To examine the imaging findings of mucinous breast carcinoma and to evaluate the difference in these findings based on the histopathologic grade. Materials and Methods : We retrospectively analyzed the imaging features according to BI-RADS in 29 patients with surgically proven mucinous carcinoma. The histopathologic grade was classified as well-differentiated, moderately-differentiated and poorly-differentiated. Based on these criteria, the differences in imaging findings were statistically analyzed. Results : Mammography was available in 20 cases, which contained 17 mass lesions (85%) and 3 cases of normal findings. On ultrasonography (27 cases), mucinous carcinoma was observed as a mass with an oval shape (59.3%), a microlobulated margin (55.6%) or an inhomogeneous isoechogenicity (74.1%). On MRI (21 cases), mucinous carcinoma was commonly observed to have a lobular shape (76%), smooth margin (86%) or heterogeneous contrast-enhancement (61.9%). On the kinetic curve, there was a delayed wash-out pattern (52.3%). There were no significant differences in the imaging findings for each histopathologic grade except that a welldifferentiated tumor had an abrupt interface. Conclusion : A well-differentiated mucinous carcinoma tended to have an abrupt interface on ultrasonography, as compared with the moderately-differentiated one. Mucinous carcinoma showed a heterogeneous enhancement and a delayed washout kinetic curve pattern on dynamic MRI.

• Investigative Magnetic Resonance Imaging
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• v.21 no.4
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• pp.233-241
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• 2017

Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6285-6288
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• 2015

Background: Breast cancer is commonly diagnosed at late stages in countries with limited resources. In Morocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce the proportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening program based on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiary level. So far, there is no systematic information on the performance of the screening program for breast cancer in Morocco. The aim of this study was to analyze early performance indicators. Materials and Methods: A retrospective evaluative study conducted in Temara city. The target population was the entire female population aged between 45-70 years. The study was based on process and performance indicators collected at the individual level from the various health structures in Tamara between 2009 and 2011. Results: A total of 2,350 women participated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were married and 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3% (190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred for a specialist consultation. The positive predictive value of clinical breast examination versus mammography was 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5 category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented 0.58%. Conclusions: These first results of the programme are very encouraging, but there is a need to closely monitor performance and to improve programme procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.183-189
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• 2009

Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.398-408
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• 2023

Purpose This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast. Materials and Methods Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision. Results All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy. Conclusion Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.