Alexandra Athanasiou

• Doctor of Medicine
• Institut Curie

Background Over the next 5 years, new breast cancer screening guidelines recommending magnetic resonance imaging (MRI) for certain patients will significantly increase the volume of imaging data to be analyzed. While this increase poses challenges for radiologists, artificial intelligence (AI) offers potential solutions to manage this workload. How...

Misdiagnosis in breast imaging can have significant implications for patients, healthcare providers, and the healthcare system as a whole. Some of the potential implications of misdiagnosis in breast imaging include delayed diagnosis or false reassurance, which can result in a delay in treatment and potentially a worse prognosis. Misdiagnosis can a...

Breast cancer is one of the leading causes of negligence claims in radiology. The objective of this document is to describe the specific main causes of errors in breast imaging and provide European Society of Breast Imaging (EUSOBI) recommendations to try to minimize these. Technical failures represent 17% of all mammographic diagnostic negligence...

Breast complaints are frequent reasons for consultations in primary care or breast clinics. Breast pain, breast lumps, and nipple discharge are the most common complaints. Less common symptoms such as skin changes and axillary abnormalities also require specific diagnostic approaches. Imaging the symptomatic breast should be performed by appropriat...

The incidence of breast cancer and, therefore, the need for breast reconstruction are expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: breast implants and...

The incidence of breast cancer and therefore need for breast reconstruction is expected to increase. The many reconstructive options available and the changing aspects of the field make this a complex area of plastic surgery, requiring knowledge and expertise. Two major types of breast reconstruction can be distinguished: Breast Implants and Autolo...

Axillary lymphadenopathy is a common side effect of COVID-19 vaccination, leading to increased imaging-detected asymptomatic and symptomatic unilateral axillary lymphadenopathy. This has threatened to negatively impact the workflow of breast imaging services, leading to the release of ten recommendations by the European Society of Breast Imaging (E...

Benign lesions are the most common lesions encountered on breast imaging. They constitute a large and heterogeneous group with various clinical and imaging findings ranging from developmental abnormalities to epithelial and stromal proliferative lesions, benign neoplasms, and inflammatory conditions. Due to their variety of presentation, they can o...

Background: Breast cancer response to neoadjuvant chemotherapy (NAC) is typically evaluated through the assessment of tumor size reduction after a few cycles of NAC. In case of treatment ineffectiveness, this results in the patient suffering potentially severe secondary effects without achieving any actual benefit. Purpose: To identify patients...

Breast density is an independent risk factor for the development of breast cancer and also decreases the sensitivity of mammography for screening. Consequently, women with extremely dense breasts face an increased risk of late diagnosis of breast cancer. These women are, therefore, underserved with current mammographic screening programs. The resul...

Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed...

We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriat...

This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite in...

Objectives: While magnetic resonance imaging (MRI) is considered a helpful diagnostic tool in breast imaging, discussions are ongoing about appropriate protocols and indications. The European Society of Breast Imaging (EUSOBI) launched a survey to evaluate the utilisation of breast MRI in clinical practice. Methods: An online survey reviewed by...

Purpose: Firstly to evaluate the feasibility and diagnostic performance of three-dimensional (3 D) shear wave elastography (SWE) volume measurements in patients with breast lesions compared to breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) lesion volumes and 3D-US B-mode volumes. Secondly to assess the treatment monitoring pe...

Gynaecological malignancies in young women may seriously compromise their familial planning as they involve surgical approach that can be difficult to conciliate with fertility preservation. There has been increased interest in this domain with elaboration of specific surgical treatments achieving uterine fundus sparing such as radical vaginal trac...

Les masses kystiques complexes sont définies comme des lésions constituées par des composantes anéchogènes (kystiques) et échogènes (solides), contrairement aux kystes compliqués dont le contenu liquidien échogène mime une lésion solide. Les masses complexes sont classées ACR4 et nécessitent une vérification histologique par prélèvements percutanés...

Complex cystic masses are defined as lesions composed of anechoic (cystic) and echogenic (solid) components, unlike complicated cysts, the echogenic fluid content of which imitates a solid lesion. Complex masses are classified as ACR4 and require histological verification by percutaneous biopsy and/or surgical ablation. The etiology is diverse, and...

Purpose: To determine the benefit of ShearWave™ Elastography (SWE™) in the ultrasound characterization of BI-RADS® 3 breast lesions in a diagnostic population. Materials and methods: 303 BI-RADS® 3 lesions (mean size: 13.2 mm, SD: 7.5 mm) from the multicenter BE1 prospective study population were analyzed: 201 (66%) had cytology or core biopsy,...

Si l’on résume la méta-analyse publiée par Houssami et Hayes en 2008, analysant 19 études (total de 2 610 patientes, 9 prospectives, aucune avec randomisation) sur 35 publiées entre 1966 et 2007, la prévalence médiane des lésions surnuméraires homolatérales au cancer index détectées par l’IRM seule était de 16 % (6–34 %). La valeur prédictive posit...

L’élastographie est une méthode récente d’échographie développée depuis ces cinq dernières années qui estime la dureté (ou élasticité) ou les déplacements relatifs des tissus entre eux et en fournit une image d’élasticité, information historiquement évaluée par la palpation élément important du diagnostic clinique. Néanmoins, l’élasticité évaluée p...

The prevalence of metastatic basal cell carcinoma (MBCC) varies between 0.0028% and 0.55% of all cases. In total, more than 300 MBCC have been reported in the literature. We report the case of a 72 year old lady, who presented in September 2009 with a 10-year history of a progressively growing, giant, facial basal cell carcinoma (BCC). Clinical and...

A 60-year-old female patient presented with a palpable right breast mass of recent appearance. On physical examination, a non-tender, non-mobile, soft and deep mass was observed in the internal upper quadrant of the right breast. Imaging Findings Breast ultrasound confirmed the presence of a solid mass in the right internal upper quadrant. The lesi...

Secondary breast angiosarcomas are rare high-grade sarcomas that may complicate breast radiation. Their prevalence obviously increases with the increasing practice of breast-conservative therapy of breast cancer. The clinical manifestations, as slight modifications of the skin and palpable mass, are the first findings but may be mistaken and delay...

PURPOSE/AIM A. To explain the basic physics in breast ultrasound elastography B. To present the different techniques available nowadays C. To achieve a better comprehension of breast US elasticity images D. To discuss possible applications in every-day practice CONTENT ORGANIZATION A. Principles of physics in breast US elastography and correlatio...

To investigate the clinical accuracy of magnetic resonance imaging-guided breast vacuum-assisted biopsy (MR-VAB). Of 97 scheduled MR-VAB for single MRI lesions (negative second-look sonography) categorised as BI-RADS 4 or 5, 4 were cancelled (undetected lesion = 2, technical problems = 2). Twenty-one patients lost to follow-up were excluded. Twenty...

To determine the appearance of breast lesions at quantitative ultrasonographic (US) elastography by using supersonic shear imaging (SSI) and to assess the correlation between quantitative values of lesion stiffness and pathologic results, which were used as the reference standard. This study was approved by the French National Committee for the Pro...

A 65-year-old female patient consulted for right breast mass accompanied by cutaneous thickening which had developed insidiously in the last few months. She had a previous history of right breast cancer treated with lumpectomy and axillary dissection followed by radiotherapy and tamoxifen eleven years ago. A 65-year-old female consulted for right b...

Ultrasound elastography is a novel technique that enables an elasticity mapping of tissue stiffness. It consists an ultrasound quantitative tissue palpation that allows to detect hard lesions and is often associated with cancer lesion detection. By means of dedicated image processing, the degree of tissue deformability is presented by an elasticity...

Objectifs L’Elastographie ShearWaveTM (SWE) est une technique échographique en temps réel qui mesure l’élasticité des tissus en kilopascals (kPa). Cette quantification devrait compléter les informations échographiques conventionnelles et améliorer la caractérisation des lésions. Nous avons étudié rétrospectivement la reproductibilité de la techniqu...

Shear Wave Elastography (SWE) is a novel technique for obtaining elastogram of soft tissue by tracking the transverse shear waves that spread laterally away from a mechanical disturbance of the tissue. Elasticity is directly related to velocity with Young's modulus. The shear wave is generated within the tissue using acoustic radiation force. The S...

To describe the imaging findings of germ cell tumours (GCT) containing non-germ cell malignant components (also designated teratoma with malignant transformation or TMT). The records of 14 male patients with GCT and a non-germ cell histological component TMT were retrospectively reviewed. All patients had computed tomography (CT) and/or magnetic re...

ShearWavetrade Elastography (SWE) is a new real time ultrasound imaging mode that quantitatively measures local tissue elasticity in kPa. Based on the Supersonic Shear Imaging concept (developed at the Laboratoire Ondes et Acoustique, Paris), this new concept may appear as a promising tool to improve breast lesion characterization. In vitro experim...

Imaging of angiogenesis is a challenge for modern imaging. Velocimetry in malignant breast lesions and density of malignant vessels are very low. In breast imaging, first results of contrast-enhanced ultrasound (CEUS) were disappointing. Microbubbles are fragile when examined with high frequency US, commonly used in breast imaging. Second-generatio...

Breast cancer is the most common female cancer, and the second cause of cancer-related mortality of women in our society. Mammography is the gold-standard method of breast imaging. However it is not an optimal screening tool, especially in cases of dense breast parenchyma. Even when optimally performed, its sensitivity ranges between 69 and 90%. Ul...

To prospectively determine the diagnostic accuracy of optical absorption imaging in patients with Breast Imaging Reporting and Data System (BI-RADS) 3-5 breast lesions. Forty-six patients with BI-RADS classification 3 (11%), 4 (44%) or 5 (44%) lesions, underwent a novel optical imaging examination using red light to illuminate the breast. Pressure...

SuperSonic Imagine has developed a unique ultrasound platform that can image supersonic shear wave (SSW) propagation and determine quantitative elastic properties of tissue. The accuracy of this system's elastography was evaluated with the characterization of breast nodules.

PurposeTo compare screening breast MRI with conventional screening techniques in high-risk patients with genetic mutation.

To compare screening breast MRI with conventional screening techniques in high-risk patients with genetic mutation. Prospective study of 85 patients (mean age of 43 years) with genetic mutation and screening > or = 2 years (mean of 2.7 years, 231 screening examinations). BI-RADS lesions 3-5 were biopsied; isolated BI-RADS 3 lesions on MRI were foll...

Abtract. This paper presents an initial clinical evaluation of in vivo elastography for breast lesion imaging using the concept of supersonic shear imaging. This technique is based on the combination of a radiation force induced in tissue by an ultrasonic beam and an ultrafast imaging sequence capable of catching in real time the propagation of the...

Elastography has many exciting new areas of application in the domains of diagnosis and therapy. We present in this overview the current gold standard given by MR elastography, which uses a full three-dimensional approach to solve locally for the unknown complex shear modulus at one frequency. clinical results for benign and malignant breast lesion...

Le cancer du sein est le cancer féminin le plus fréquent : il représente la deuxième cause de mortalité cancérologique à nos jours. La mammographie est considérée comme le gold-standard en imagerie mammaire, néanmoins sa sensibilité ne dépasse pas 69 %-90 %, surtout en cas de parenchyme mammaire de densité élevée. L’échographie mammaire est une mét...

MR Imaging is the most sensitive technique for detecting breast cancer. In patients with breast cancer, the additional value of MRI is validated in patients candidates for a breast-conserving surgery and when: cancer is occult, size evaluation is difficult at standard imaging, parietal involvement is suspected, and before neoadjuvant chemotherapy....

Primary breast amyloidosis is rare, usually manifestating as suspicious masses in mammography, with or without associated microcalcifications. The final diagnosis is based on fine needle aspiration cytology or biopsy yielding clumps of amorphous material surrounded by lymphocytes and giant cells that characterize this entity. In our case the only m...

Illustrated cases are presented here, for training the reader to BIRADS MRI. This article offers guidance in integrating findings from the different MR sequences, morphology and kinetics of an abnormal enhancement: report organization, use of lexicon for describing the detected lesion, final assessment with BI-RADS assessment categories.

This article reviews the technical aspects and interpretation criteria in breast MR imaging based on the first edition of breast imaging and reporting data system (BIRADS) published by the American College of Radiology (ACR) in 2003. In a second article, practical cases will be proposed for training the readers. The major aims of using this lexicon...

The purpose of this prospective study is to determine the diagnostic accuracy of near-infrared breast optical absorption imaging in patients with Breast Imaging Reporting and Data System (BIRADS) 4-5 non-palpable lesions scheduled for biopsy, using pathology after core or excisional biopsy as a reference. The patient's breast was positioned onto a...

L’IRM est la technique la plus sensible pour la détection d’un cancer du sein. Les études multicentriques récentes ayant analysé l’IRM chez plus de 800 femmes retrouvent une sensibilité (cancers in situ et infiltrants) et une valeur prédictive négative (VPN) de 88 % (1–2). Si l’on ne considère que les cancers infiltrants, la sensibilité de l’IRM es...

Ľéchographie de contraste du sein est une application plus confidentielle que ľéchographie de contraste du foie ou des reins. Néanmoins plusieurs auteurs se sont intéressés à ľapplication des produits de contraste échographiques à ľimagerie du sein (1, 2), essentiellement pour la caractérisation des lésions. Les résultats des premières études étaie...

Retroperitoneal sarcomas are rare neoplasms. The aim of this article is to expose imaging protocols and useful radiological signs, to show the core biopsy technique for diagnosis, to precise imaging key points before treatment and for survey.

We report the case of a 83-year-old woman who presented with a left-breast lump. On physical examination the patient had a well-demarcated mass located in the upper outer quadrant of her left breast with a palpable unilateral axillary lymph node. Mammography and ultrasonography depicted a heterogeneous well-defined lesion measuring 6 cm in diameter...

PURPOSE To evaluate a new modality for imaging breast vessels through detection of methemoglobine by infrared photoluminescence diodes in patients scheduled for core or surgical biopsy. METHOD AND MATERIALS 72 consecutive patients (age 41-72) presenting BI-RADS 4 (n=40) or 5 (n=32) lesions depicted by routine mammography and/or ultrasonography wer...

PURPOSE To describe the CT and MR findings of non germ-cell malignant tumors arising in germ-cell tumors (also designated as teratoma with malignant transformation or TMT). METHOD AND MATERIALS The files of 14 males with TMT were reviewed retrospectively. All patients underwent a CT or MR examination before and after initial surgery and chemothera...

LEARNING OBJECTIVES 1. To learn the optimal settings for breast CE Ultrasonography. 2. To present the main indications for breast CE ultrasonography. 3. To present the results and the characterization features for benign and malignant breast lesions ABSTRACT Imaging of angiogenesis is a challenge for modern imaging.Indeed,velocimetry in malignant...

The purpose of our study was to explore and evaluate an innovative imaging approach, which consists on imaging the breast parenchyma by means of photoluminescence detectors (LED) and analysis of dynamic data. Breast magnetic resonance imaging (MRI) was chosen as the reference imaging method, as this is considered to be nowadays the gold standard fo...

The American College of Radiology has established guidelines for outcomes monitoring known as the Breast Imaging Reporting and Data System. The last edition of the BIRADS classification includes mammography, but also ultrasonography and MRI. Radiologists must be used to the BIRADS lexicon and the BIRADS assessment, in order to clarify mammography r...

Generalization of breast screening programs requires efficient double reading of mammograms, which allows reduction of false negative interpretations, but it may be difficult to achieve. CAD (Computed Aided Detection) systems are dramatically improving and can now assist in the detection of suspicious mammographic lesions, either suspicious microca...

Generalization of breast screening programs requires efficient double reading of mammograms, which allows reduction of false negative interpretations, but it may be difficult to achieve. CAD (Computed Aided Detection) systems are dramatically improving and can now assist in the detection of suspicious mammographic lesions, either suspicious microca...

Objectifs Evaluer l’apport de l’IRM mammaire pour les lesions non palpables du sein avec adenopathies axillaires positives en comparaison avec la mammographie et l’echographie. Materiels et methodes Les dossiers de trente patientes presentant des adenopathies axillaires positives pour adenocarcinome ont ete retrospectivement etudies. Aucune autre a...

Resume La neoangiogenese est une caracteristique reconnue des lesions malignes, en particulier des lesions mammaires. Or, l’echo-Doppler couleur dans le sein est difficile en raison de la lenteur des flux vasculaires et de la faible densite de la microvascularisation. Cependant, l’amelioration de la resolution du mode B et l’utilisation de sondes d...