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ABSTRACT: Liquid crystal display (LCD) monitors and cathode ray tube (CRT) monitors are currently the two most common types used in digital mammography systems. The appropriate selection of a monitor is very important and requires balancing the monitor's performance and its cost. A previous study of soft-copy reading in digital mammography of microcalcifications showed that 3-megapixel (M) LCD monitors were similar in diagnostic performance to 5M CRT monitors in a diagnostic setting.
To compare 5M CRT monitors with 3M LCD monitors for soft-copy reading of digital mammography of a mass in a diagnostic setting.
Seventy mass lesions having undergone either breast biopsies or definitive surgery (46 malignant and 24 benign) and 30 normal cases were recruited into the study. The median size of the lesions was 16 mm (range 7-20 mm). The digital mammograms in the 100-case set were assigned to two blocks, block A (50 cases) and block B (50 cases), for 5M CRT and 3M LCD monitors. A single radiologist read all 100 cases with both types of monitors, starting with the images in block A on the 5M CRT monitors and then the images in block B on the 3M LCD monitors. The radiologist analyzed the soft-copy images on 5M CRT and 3M LCD monitors with 5 months between the interpretations to reduce the effects of learning and memory. Again, the reader started with the images in block A on the 3M LCD monitors and then read the images in block B on the 5M CRT monitors. A five-point rating scale for the probability of malignancy was used for interpreting the soft-copy mammograms. The mass descriptor was scored on a six-point scale. Breast density was scored on a four-point scale. The positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the criteria of the Breast Imaging Reporting and Data System. The interpretation time was also measured.
No significant difference was observed in the probability of malignancy (P=1), mass descriptor (P=0.317), and breast density (P=0.739). The PPV and NPV of soft-copy reading on the 5M CRT monitors were 91% (42/46) and 94% (51/54), respectively, identical to the results using 3M LCD monitors. The total interpretation time averaged 62 s for the 5M CRT monitors and 60 s for the 3M LCD monitors (P<0.0001).
Soft-copy reading of a digital mammography of mass with 3M LCD monitors was similar in diagnostic performance to 5M CRT monitors in this study. On the basis of the results of this and a previous study, 3M LCD monitors can replace 5M CRT monitors without any loss in the ability to diagnose digital mammograms.
Acta Radiologica 08/2008; 49(6):623-9. · 1.37 Impact Factor
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ABSTRACT: A recent study using dedicated contrast-detail phantoms showed that the image quality of a 3-megapixel (M) monitor can approach that of a 5M monitor in digital mammography.
To compare a 5M cathode ray tube (CRT) monitor with a 3M liquid crystal display (LCD) monitor for soft-copy reading of digital mammography of microcalcifications in a clinical setting.
100 screen-detected microcalcification lesions (34 malignant and 66 benign) without mass that had been evaluated with 11-gauge stereotactic vacuum-assisted breast biopsy or definitive surgery were recruited into the study. One radiologist analyzed the soft-copy mammograms on a 5M CRT monitor and a 3M LCD monitor with 5 months between interpretations and scored the likelihood of malignancy and calcification distribution on a five-point scale. Calcification morphology and breast density were scored on a four-point scale. Positive predictive value (PPV) and negative predictive value (NPV) were calculated on the basis of a Breast Imaging Reporting and Data System. The interpretation time was also measured.
There was no significant difference in the likelihood of malignancy (P = 0.655), calcification morphology (P = 0.168), calcification distribution (P = 0.11), and breast density (P = 0.0608). The PPV and NPV of soft-copy reading on the 5M CRT monitor was 57% (30/53) and 91% (43/47), respectively, identical to the results using the 3M LCD monitor. The total interpretation time averaged 88 s for the 5M CRT monitor and 67 s for the 3M LCD monitor (P<0.0001).
Soft-copy reading of a digital mammography of microcalcifications with a 3M LCD monitor was similar in diagnostic performance to a 5M CRT monitor in this study.
Acta Radiologica 09/2007; 48(7):714-20. · 1.37 Impact Factor
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ABSTRACT: Hookwire localization is the current standard technique for radiological marking of nonpalpable breast lesions. Stereotactic directional vacuum-assisted breast biopsy (SVAB) is of sufficient sensitivity and specificity to replace surgical biopsy. Wire localization for metallic marker clips placed after SVAB is needed.
To describe a method for performing computed tomography (CT)-guided hookwire localization using a radial approach for metallic marker clips placed percutaneously after SVAB.
Nineteen women scheduled for SVAB with marker-clip placement, CT-guided wire localization of marker clips, and, eventually, surgical excision were prospectively entered into the study. CT-guided wire localization was performed with a radial approach, followed by placement of a localizing marker-clip surgical excision. Feasibility and reliability of the procedure and the incidence of complications were examined.
CT-guided wire localization surgical excision was successfully performed in all 19 women without any complications. The mean total procedure time was 15 min. The median distance on CT image from marker clip to hookwire was 2 mm (range 0-3 mm).
CT-guided preoperative hookwire localization with a radial approach for marker clips after SVAB is technically feasible.
Acta Radiologica 07/2007; 48(5):483-7. · 1.37 Impact Factor
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Journal of Clinical Pathology 12/2002; 55(11):879; author reply 879. · 2.31 Impact Factor
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ABSTRACT: CAG repeat number in the androgen receptor (AR) has been associated with decreased prostate cancer risk, and AR expression has been found in female breast cancer, often associated with apocrine differentiation. Because trinucleotide expansion can alter gene expression and protein function, we hypothesized that it might occur in breast neoplasms. We used a repeat expansion detection technique to determine CAG repeat lengths in DNA from breast biopsies. Three lesion types were microdissected: fibroadenoma (48 cases), ductal carcinoma in situ (DCIS, 24 cases), and invasive mammary carcinoma (18 cases). The maximum number of CAG repeats in either allele of each patient in these three groups was compared. Microsatellite repeat lengths in DCIS were longer than in fibroadenomas or invasive carcinomas (P= 0.017 comparing DCIS vs invasive carcinomas). Two cases of apocrine DCIS had very long repeat lengths, both exhibiting microsatellite lengths at the longest range of normal (32 and 33). Inherited differences in AR CAG length might influence the transition from DCIS to invasive breast cancer, perhaps by modulating function of AR in breast tissue. AR microsatellite polymorphisms could influence cellular differentiation in DCIS lesions, promoting formation of the apocrine subtype in the presence of longer CAG repeats.
The Breast 03/2000; 9(1):23-7. · 2.49 Impact Factor
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ABSTRACT: Little information is available regarding the invasive breast carcinoma risk associated with estrogen replacement therapy (ERT) in women with histories of histologically defined breast lesions.
A retrospective cohort study of a consecutive series of women who underwent breast biopsies that proved to be benign between 1952-1978 was conducted. Follow-up data were obtained for 9494 women (87.6% of women eligible for follow-up). To investigate the effect of ERT on invasive breast carcinoma risk, the analysis was restricted to women with premenopausal breast disease whose follow-up extended through menopause and who did not develop premenopausal breast carcinoma. Relative risks were calculated with respect to women who took ERT but whose benign breast biopsies had neither atypical hyperplasia (AH), complex fibroadenoma (CFA), nor proliferative disease without atypia (PDWA).
During 190,845 woman-years of follow-up there were 444 confirmed cases of invasive breast carcinoma in the entire cohort. Women with a history of AH had relative risks of invasive breast carcinoma of 2.87 (95% confidence interval [95% CI], 1.3-6.3) and 2.53 (95% CI, 1.0-6.3) if they did or did not take ERT, respectively. For women with a history of CFA these risks were 1.57 (95% CI, 0.72-3.4) and 1.46 (95% CI, 0.53-4.0), respectively, whereas for women with a history of PDWA they were 1.37 (95% CI, 0.88-2.1) and 1.13 (95% CI, 0.69-1.9), respectively.
ERT does not significantly elevate the risk of invasive breast carcinoma in women with previous histologically defined benign breast disease. Therefore, ERT is not contraindicated in these women.
Cancer 04/1999; 85(6):1277-83. · 4.77 Impact Factor
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ABSTRACT: Fibroadenoma is a common cause of benign breast masses in young women. These women have a slightly increased risk of subsequent breast cancer, particularly if their tumors have complex histologic patterns. We assessed monoclonality in fibroadenomas and correlated the results with histologic analysis. We performed a clonal analysis of 52 fibroadenomas from 43 patients using X-chromosome inactivation studies. The cases included fibroadenomas with complex and simple histology. Areas examined were predominantly stroma but epithelium was also present. DNA was isolated from paraffin-embedded tissue and was subjected to polymerase chain reaction amplification of the human androgen receptor gene with and without predigestion of the DNA with Hha 1. If a monoclonal process was identified, the epithelial and stromal components were subsequently microdissected and reanalyzed. 36/43 (83.7%) women were heterozygous. We studied 45 tumors in these 36 informative women. 1/20 (5% complex fibroadenomas and 1/25 (4%) simple fibroadenomas were monoclonal. The epithelial component of both monoclonal fibroadenomas was polyclonal. The one monoclonal simple fibroadenoma was also the only one with mixed features to contain a phyllodes component. In this case, monoclonality was found in the stroma of both the fibroadenoma and phyllodes regions. Monoclonality has been previously associated with phyllodes phenotype, but not with fibroadenomas, except for 3 fibroadenomas that recurred as phyllodes tumor. We report that monoclonality may also be seen occasionally in complex fibroadenomas, and was found in a tumors with mixed fibroadenoma/phyllodes features without clinical recurrence for 4 years.
Breast Cancer Research and Treatment 08/1998; 50(2):185-91. · 4.43 Impact Factor
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ABSTRACT: Adenoid cystic carcinoma (ACC) of the breast, although quite uncommon, is histologically distinct and has an excellent prognosis. Our purpose was to characterize molecular markers of cellular differentiation and polarity to define better the role that these combined features might play in the excellent prognosis of ACC in this site.
We performed immunohistochemical stains for expression of vimentin (VM), cytokeratin (CK), smooth muscle actin (SMA), laminin (LAM), E-cadherin (E-cad), beta-catenin (beta-cat) and fodrin in 14 examples of ACC. Two types of intercellular lumens and defining lining cells were detected: true epithelial lumens were lined by CK positive cells that maintained the normal glandular luminal cells with an intact polarity and basolateral membrane compartment indicators: fodrin, E-cad and beta-cat. The second type of intercellular space was a pseudolumen, surrounded by myoepithelial cells that were strongly positive for VM and SMA, and lined by LAM. Double staining for VM and CK, VM and SMA, and CK and SMA detected occasional cytoplasmic co-expression of these markers in the myoepithelial cell compartment, but VM and SMA did not stain epithelial lumenal cells.
ACC of the breast is characterized by the presence of two types of intercellular lumens, one conserving basolateral markers of normal polarity (epithelial) with the other containing basement membrane material (abutted by myoepithelial cells). Dominance of VM staining may be a hallmark of ACC, along with maintained epithelial and myoeithelial compartments. This status of advanced, normal differentiation despite local invasion may be responsible for lack of distant metastasis.
Histopathology 04/1998; 32(3):232-8. · 3.08 Impact Factor
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ABSTRACT: Loss of heterozygosity and microsatellite instability have been often reported in breast cancer and seldom in proliferative breast disease (PBD). DNA samples from microdissected PBD lesions, including papillomas (25 lesions), from 8 women were analyzed by polymerase chain reaction for loss of heterozygosity and microsatellite instability at 10 loci including INT-2 oncogene locus, D17S796 (the p53 gene region), and D17S579 (in the region of the BRCA-1 gene). In a patient, five loci with microsatellite instability and two loci with loss of heterozygosity were identified in one papilloma with florid hyperplasia and atypia, and 10 other PBD lesions were negative for genetic alteration (GA) and atypia. Three loci with microsatellite instability were identified in another PBD lesion without atypia, whereas another lesion from this second patient had minimal atypia without GAs. These two patients have been well for more than 20 years. No other patient, including a woman developing cancer, had GAs. We detected GAs in PBD (25% of women, 8% of lesions). Incomplete correlation between GAs and anatomic atypia was suggested. It seems evident that several GAs in PBD lesions may not indicate clinically meaningful premalignancy for remaining breast.
American Journal Of Pathology 07/1997; 150(6):1925-32. · 4.89 Impact Factor
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ABSTRACT: CM101, a bacterial polysaccharide derived from group B streptococcus, induces pronounced inflammatory changes in and around tumor blood vessels 60 min after i.v. injection. A technique has been developed for implanting small numbers of tumor cells in the ear skin of mice. This allows macroscopic examination of the tumor and its supporting blood vessels as it reaches the 10000 cell size and greater. Treatments can be monitored in this model for effects on small "metastatic-like" tumor nodules by direct observation and by histological examination. Inflammatory changes were indicated by increased numbers of polymorphonuclear leukocytes (PMN) adjacent to and marginating within thin-walled blood vessels and within the tumor tissue. PMN were seen in the process of migrating through venules and enlarged capillaries, each with prominent endothelial cells. Tumor morphology was variable with evidence of occasional single necrotic cells. This contrasted with tumors in ears of dextran-treated or untreated mice, which had uniform tumor morphology, and acute inflammatory cells were rarely present.
Journal of Cancer Research and Clinical Oncology 02/1996; 122(9):549-53. · 2.56 Impact Factor
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ABSTRACT: To study the structural components of microvilli of the KATO-III cell, we used anti-villin, -ezrin, and anti-MVM (microvillous membrane prepared against mouse intestinal microvilli) antibodies. Villin and ezrin cross-link actin bundles of microvilli such as those in the small intestine and renal proximal cells. Electromicroscopically, the cytoskeletal core of microvilli of the KATO-III cell was constituted of actin-filament bundles. The anti-villin antibody but not anti-ezrin antibody reacted with the KATO-III cell as demonstrated by FITC-immunofluorescence and PAP-staining. Anti-villin, anti-MVM, but not anti-ezrin antibody, reacted with the KATO-III cell surface and with intracellular materials. Western blot analysis using anti-villin and anti-MVM antibodies revealed proteins of approximately 95 kDa (villin), and 15 kDa in the microsomal membrane fractions of KATO-III cells, respectively. Immunocytochemical and confocal laser microscopic studies showed that the cell-surface and the intracellular microcysts of KATO-III cells were preferentially decorated by anti-villin and anti-MVM antibodies. These data suggested that some actin-binding proteins, such as villin, were localized at the cell surface and on some of the intracellular cytoplasmic structures of the KATO-III cell.
Cell Structure and Function 09/1995; 20(4):245-52. · 2.29 Impact Factor
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M Kasami,
M Yoshida,
J Isogaki,
H Ogawa,
K Shinmura,
Y Endo,
E Kiyokawa,
Y Naito,
T Arai,
T Kimura,
R Inoue,
H Sugimura
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ABSTRACT: Bilateral breast tumors, a malignant phyllodes tumor in the right breast and an invasive lobular carcinoma in the left breast, occurred in a 47-year-old woman with 46XX/46XY mosaic karyotype in her peripheral blood lymphocytes and intersex external genitalia. Postmortem examination revealed bilateral ovotestis. Three of the patient's sisters also had breast cancer. In situ hybridization with a Y-specific probe revealed Y-chromosome-specific signal in both tumors, suggesting that the clonal origin of tumors in this patient was Y-containing cells. Androgen-receptor polymorphism also revealed a monoallelic X chromosome pattern in the recurrent phyllodes tumor tissue taken at autopsy, in addition to loss of heterozygosity demonstrated at locus TP53. The slippage of the CA repeats in the tumor was also shown at the loci of D5S82 and D11S527. The mechanistic basis for the occurrence of bilateral malignant tumors of the breast, XX/XY mosaicism, and familial clustering of breast cancer is still unknown. The present study, however, suggests that the sex chromosome abnormality may have modified the cancer phenotype in a manner similar to breast cancer in Klinefelter's syndrome (though phenotypically male) and the Y chromosome may have promoted cell growth.
Pathology International 47(2-3):147-54. · 1.62 Impact Factor
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ABSTRACT: We present a case of spontaneous rupture of bladder diverticulum three years after postoperative whole pelvic irradiation (50.4 Gy) for carcinoma of the uterine cervix. The patient had suffered from a neurogenic bladder after hysterectomy, but excretory urography revealed no abnormalities. Bladder diverticulum was found two years later. Spontaneous rupture of the urinary bladder is one of the late complications associated with radiotherapy, although it is very rare. Postoperative neurogenic bladder may also be associated with rupture. We should be aware of this rare complication in patients who receive pelvic irradiation.
Radiation Medicine 18(4):261-5.
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ABSTRACT: CAG repeat number in the androgen receptor (AR) has been associated with decreased prostate cancer risk, and AR expression has been found in female breast cancer, often associated with apocrine differentiation. Because trinucleotide expansion can alter gene expression and protein function, we hypothesized that it might occur in breast neoplasms. We used a repeat expansion detection technique to determine CAG repeat lengths in DNA from breast biopsies. Three lesion types were microdissected: fibroadenoma (48 cases), ductal carcinoma in situ (DCIS, 24 cases), and invasive mammary carcinoma (18 cases). The maximum number of CAG repeats in either allele of each patient in these three groups was compared. Microsatellite repeat lengths in DCIS were longer than in fibroadenomas or invasive carcinomas (P= 0.017 comparing DCIS vs invasive carcinomas). Two cases of apocrine DCIS had very long repeat lengths, both exhibiting microsatellite lengths at the longest range of normal (32 and 33). Inherited differences in AR CAG length might influence the transition from DCIS to invasive breast cancer, perhaps by modulating function of AR in breast tissue. AR microsatellite polymorphisms could influence cellular differentiation in DCIS lesions, promoting formation of the apocrine subtype in the presence of longer CAG repeats.
The Breast.
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ABSTRACT: A 21-year-old woman with a 5-cm secretory carcinoma of the breast was successfully treated by wide segmental excision, including removal of a portion of the nipple. At presentation, she had a 5-year history of predominantly yellow and occasionally bloody discharge from the nipple. The tumour had classical histological features of secretory carcinoma with surrounding hyaline fibrous tissue predominating, a feature previously associated with a good prognosis. Identification by frozen section of extension near the nipple led to intraoperative excision of a nipple segment. She is healthy with a satisfactory cosmetic result 14 years after excision and has breast fed two children from the affected breast.
The Breast.
