Reasons Women at Elevated Risk of Breast Cancer Refuse Breast MR Imaging Screening: ACRIN 6666

Reasons Women at Elevated Risk of Breast Cancer Refuse Breast MR Imaging Screening: ACRIN 6666
Wendie A. Berg, Jeffrey D. Blume, Amanda M. Adams, Roberta A. Jong, Richard G. Barr, Daniel E. Lehrer, Etta D. Pisano, W. Phil Evans III, Mary C. Mahoney, Linda Hovanessian Larsen, Glenna J. Gabrielli, and Ellen B. Mendelson
Radiology 2010; 254:79–87
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Of 1215 women with elevated breast cancer risk who could, according to protocol guidelines, undergo breast MR imaging, only 57.9% agreed to participate
Claustrophobia was the most common reason (in 130 [25.4%] of 512 women) given for non-participation

Primary Breast Carcinoma: Association of Mammographic Calcifications with Osteopontin Expression

Primary Breast Carcinoma: Association of Mammographic Calcifications with Osteopontin Expression
Xiao Wang, Lan Chao, Guohui Ma, Liansheng Chen, Guangchao Jin, Mei Hua, Huiping Liu, Aimei Ouyang, and Xiulan Zhang
Radiology 2010 254:69-78
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Compared with osteopontin (OPN)-negative breast cancers, OPN-positive tumors were more likely to have calcifications, to be spiculated, to have pleomorphic calcifications, to be a triple-negative phenotype, and to be associated with axillary lymph node metastasis

Breast US Computer-aided Diagnosis System: Robustness across Urban Populations in South Korea and the United States

Breast US Computer-aided Diagnosis System: Robustness across Urban Populations in South Korea and the United States
Nicholas P. Gruszauskas, Karen Drukker, Maryellen L. Giger, Ruey-Feng Chang, Charlene A. Sennett, Woo Kyung Moon, and Lorenzo L. Pesce
Radiology 2009;253 661-671

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In general, the breast US computer-aided diagnosis system appears to be effective across different patient populations, but further investigation is warranted

Screening-detected Breast Cancers: Discordant Independent Double Reading in a Population-based Screening Program

Screening-detected Breast Cancers: Discordant Independent Double Reading in a Population-based Screening Program
Solveig Hofvind, Berta M. Geller, Robert D. Rosenberg, and Per Skaane
Radiology 2009;253 652-660

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We found that 23.6% of cancers had a discordant interpretation in prospective independent double-reading examinations performed in a population-based mammography screening program that included dedicated as well as general radiologists

Variability in Interpretive Performance at Screening Mammography and Radiologists' Characteristics Associated with Accuracy

Variability in Interpretive Performance at Screening Mammography and Radiologists' Characteristics Associated with Accuracy
Joann G. Elmore, Sara L. Jackson, Linn Abraham, Diana L. Miglioretti, Patricia A. Carney, Berta M. Geller, Bonnie C. Yankaskas, Karla Kerlikowske, Tracy Onega, Robert D. Rosenberg, Edward A. Sickles, and Diana S. M. Buist
Radiology 2009;253 641-651

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Fellowship training in breast imaging was the only radiologists' characteristic significantly associated with greater sensitivity and higher overall accuracy; however, fellowship-trained radiologists also had significantly higher false-positive rates

When Radiologists Perform Best: The Learning Curve in Screening Mammogram Interpretation

When Radiologists Perform Best: The Learning Curve in Screening Mammogram Interpretation
Diana L. Miglioretti, Charlotte C. Gard, Patricia A. Carney, Tracy L. Onega, Diana S. M. Buist, Edward A. Sickles, Karla Kerlikowske, Robert D. Rosenberg, Bonnie C. Yankaskas, Berta M. Geller, and Joann G. Elmore
Radiology 2009;253 632-640

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Radiologists without fellowship training in breast imaging significantly improved in their interpretation of screening mammograms as they gained clinical experience following residency, while radiologists who received fellowship training in breast imaging did not have this learning curve in clinical practice

Potential Usefulness of Similar Images in the Differential Diagnosis of Clustered Microcalcifications on Mammograms

Potential Usefulness of Similar Images in the Differential Diagnosis of Clustered Microcalcifications on Mammograms
Ryohei Nakayama, Hiroyuki Abe, Junji Shiraishi, and Kunio Doi
Radiology 2009;253 625-631

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The inclusion of similar images can have beneficial effects for many cases in which the status of a lesion is unclear, and it can improve the performance of radiologists in observer studies

Mammography: Yet Another Challenge

Mammography: Yet Another Challenge
Daniel B. Kopans
Radiology 2009;253 587-589

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Miglioretti et al and Elmore et al could determine the criteria that the 18 radiologists with highest interpretive performance used; all radiologists could be taught these criteria to benefit those with lower performance

Why Do Purely Intraductal Cancers Enhance on Breast MR Images?
Christiane K. Kuhl
Radiology 2009;253 281-283

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Diagnosis and treatment of high-grade DCIS can be considered primary prevention of high-grade invasive cancer.

Thus, we have reason to assume that screening with MR imaging would offer a mortality benefit that is higher than that achieved with mammographic screening, not only because of the higher overall sensitivity offered by MR imaging but also because of its bias for selectively depicting prognostically relevant disease

On the basis of the results of the animal study performed by Jansen et al and clinical observations, there is compelling evidence to suggest that the imaging phenotype of a ductal carcinoma in situ (DCIS) lesion (its detectability at mammography and MR imaging, specifically the presence or absence of calcifications on mammograms and the presence or absence of calcifications and the degree of their enhancement on MR images) conveys important biologic information that will be useful when guiding DCIS treatment.

Breast Cancer Screening Results 5 Years after Introduction of Digital Mammography in a Population-based Screening Program

Breast Cancer Screening Results 5 Years after Introduction of Digital Mammography in a Population-based Screening Program
Nico Karssemeijer, Adriana M. Bluekens, David Beijerinck, Jan J. Deurenberg, Matthijs Beekman, Roelant Visser, Ruben van Engen, Annemieke Bartels-Kortland, and Mireille J. Broeders
Radiology 2009;253 353-358

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With the FFDM-CAD combination, detection performance is at least as good as that with SFM. The detection of ductal carcinoma in situ and microcalcification clusters improved with FFDM using CAD, while the recall rate increased.

Results indicate that with full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) and double reading, the detection is as good as that with screen-film mammography, and detection of clustered microcalcifications and ductal carcinoma in situ is improved with FFDM using CAD

Diffusion-weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?

Diffusion-weighted MR for Differentiation of Breast Lesions at 3.0 T: How Does Selection of Diffusion Protocols Affect Diagnosis?
Wolfgang Bogner, Stephan Gruber, Katja Pinker, Günther Grabner, Andreas Stadlbauer, Michael Weber, Ewald Moser, Thomas H. Helbich, and Siegfried Trattnig
Radiology 2009;253 341-351

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Optimum ADC determination and DW imaging quality at 3.0 T was found with a combined b value protocol of 50 and 850 sec/mm2. This provided a high accuracy for differentiation of benign and malignant breast tumors

Standardization of b values allows improved inter-study comparisons on the diagnostic accuracy of diffusion-weighted MR breast examinations

Influence of E-cadherin Expression on the Mammographic Appearance of Invasive Nonlobular Breast Carcinoma Detected at Screening

Influence of E-cadherin Expression on the Mammographic Appearance of Invasive Nonlobular Breast Carcinoma Detected at Screening
Sarah Doyle, Andrew J. Evans, Emad A. Rakha, Andrew R. Green, and Ian O. Ellis
Radiology 2009;253 51-55
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The high frequency of ill-defined masses and the low frequency of non-comedo microcalcification seen in invasive nonlobular breast cancer with E-cadherin loss are features similar to those seen in a series recording the mammographic appearance of invasive lobular cancer

Can Computer-aided Detection Be Detrimental to Mammographic Interpretation?

Can Computer-aided Detection Be Detrimental to Mammographic Interpretation?
Liane E. Philpotts
Radiology 2009;253 17-22

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Understanding of the limitations of computer-aided detection is important for those interpreting mammograms; this cautious approach to the use of computer-aided detection should help optimize this presently imperfect system and minimize the possible detrimental effects

The Preponderance of Evidence Supports Computer-aided Detection for Screening Mammography

The Preponderance of Evidence Supports Computer-aided Detection for Screening Mammography
Robyn L. Birdwell
Radiology 2009;253 9-16

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Having a system to aid the human eye that does not take vacations, is not vulnerable to fatigue or environmental distractions, is without, emotion, and is designed specifically to assist the very human eye to "look over here" seems like a good idea

US Surveillance of Regional Lymph Node Recurrence after Breast Cancer Surgery

US Surveillance of Regional Lymph Node Recurrence after Breast Cancer Surgery
Hee Jung Moon, Min Jung Kim, Eun-Kyung Kim, Byeong-Woo Park, Ji Hyun Youk, Jin Young Kwak, Joohyuk Sohn, and Seung-Il Kim
Radiology 2009;252 673-681
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Ipsilateral lymph node recurrence is a predictor of distant metastasis, and lymph node evaluation during breast US is useful for early detection of lymph node recurrence in asymptomatic patients

Breast Imaging Reporting and Data System Lexicon for US: Interobserver Agreement for Assessment of Breast Masses

Breast Imaging Reporting and Data System Lexicon for US: Interobserver Agreement for Assessment of Breast Masses
Nouf Abdullah, Benoit Mesurolle, Mona El-Khoury, and Ellen Kao
Radiology 2009;252 665-672
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Breast Imaging Reporting and Data System subdivisions 4a, 4b, and 4c were poorly reproducible among radiologists, reflecting the lack of clear and objective factors to guide classification of a lesion according to the degree of suspicion of malignancy

Cancers in BRCA1 and BRCA2 Carriers and in Women at High Risk for Breast Cancer: MR Imaging and Mammographic Features

Cancers in BRCA1 and BRCA2 Carriers and in Women at High Risk for Breast Cancer: MR Imaging and Mammographic Features
Fiona J. Gilbert, Ruth M. L. Warren, Gek Kwan-Lim, Deborah J. Thompson, Ros A. Eeles, D. Gareth Evans, Martin O. Leach, and For the United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group
Radiology 2009;252 358-368
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Our review of the images from prior MR imaging examinations shows that the cancers grow in size and that enhancement curves change from type 1 to type 2 or 3 and demonstrate greater signal enhancement over time

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model
Etta D. Pisano, Suddhasatta Acharyya, Elodia B. Cole, Helga S. Marques, Martin J. Yaffe, Meredith Blevins, Emily F. Conant, R. Edward Hendrick, Janet K. Baum, Laurie L. Fajardo, Roberta A. Jong, Marcia A. Koomen, Cherie M. Kuzmiak, Yeonhee Lee, Dag Pavic, Sora C. Yoon, Wittaya Padungchaichote, and Constantine Gatsonis
Radiology 2009;252 348-357

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Our analysis results suggest that, image contrast was the most important factor in the improved performance of digital mammography, as compared with screen-film mammography, in the Digital Mammographic Imaging Screening Trial

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model
Etta D. Pisano, Suddhasatta Acharyya, Elodia B. Cole, Helga S. Marques, Martin J. Yaffe, Meredith Blevins, Emily F. Conant, R. Edward Hendrick, Janet K. Baum, Laurie L. Fajardo, Roberta A. Jong, Marcia A. Koomen, Cherie M. Kuzmiak, Yeonhee Lee, Dag Pavic, Sora C. Yoon, Wittaya Padungchaichote, and Constantine Gatsonis
Radiology 2009;252 348-357

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Our analysis results suggest that, image contrast was the most important factor in the improved performance of digital mammography, as compared with screen-film mammography, in the Digital Mammographic Imaging Screening Trial

Implementation of Digital Mammography in a Population-based Breast Cancer Screening Program: Effect of Screening Round on Recall Rate and Cancer Detec

Implementation of Digital Mammography in a Population-based Breast Cancer Screening Program: Effect of Screening Round on Recall Rate and Cancer Detection
Maria Sala, Mercè Comas, Francesc Macià, Juan Martinez, Montserrat Casamitjana, and Xavier Castells
Radiology 2009;252 31-39

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The results of this study show that recall rates and the rates of invasive tests performed were lower in the digital mammography group than in the screen-film mammography group, whereas no significant differences between the groups were observed for the overall cancer detection rate

Breast Percent Density: Estimation on Digital Mammograms and Central Tomosynthesis Projections

Breast Percent Density: Estimation on Digital Mammograms and Central Tomosynthesis Projections
Predrag R. Bakic, Ann-Katherine Carton, Despina Kontos, Cuiping Zhang, Andrea B. Troxel, and Andrew D. A. Maidment
Radiology 2009;252 40-49
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Currently, no standard method exists for breast percent density (PD) estimation on three-dimensional reconstructed images; until the emergence of such a method, PD could be estimated on central digital breast tomosynthesis (DBT) projections if DBT were to replace digital mammography in clinical practice

Can Compression Be Reduced for Breast Tomosynthesis? Monte Carlo Study on Mass and Microcalcification Conspicuity in Tomosynthesis

Can Compression Be Reduced for Breast Tomosynthesis? Monte Carlo Study on Mass and Microcalcification Conspicuity in Tomosynthesis
Robert S. Saunders, Jr, Ehsan Samei, Joseph Y. Lo, and Jay A. Baker
Radiology 2009;251 673-682

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The findings suggest that there is a potential to reduce breast compression in tomosynthesis without a negative effect on radiation dose or image quality, which will increase patient comfort and therefore possibly improve compliance with this new technology

Probabilistic Computer Model Developed from Clinical Data in National Mammography Database Format to Classify Mammographic Findings

Probabilistic Computer Model Developed from Clinical Data in National Mammography Database Format to Classify Mammographic Findings
Elizabeth S. Burnside, Jesse Davis, Jagpreet Chhatwal, Oguzhan Alagoz, Mary J. Lindstrom, Berta M. Geller, Benjamin Littenberg, Katherine A. Shaffer, Charles E. Kahn, Jr, and C. David Page
Radiology 2009;251 663-672

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We demonstrate that our Bayesian network can use a database of prospectively collected findings at mammography to calculate an accurate risk of malignancy and improve on radiologist performance measures in the classification of benign and malignant breast disease

Predicting Pathologic Response to Neoadjuvant Chemotherapy in Breast Cancer by Using MR Imaging and Quantitative 1H MR Spectroscopy

Predicting Pathologic Response to Neoadjuvant Chemotherapy in Breast Cancer by Using MR Imaging and Quantitative 1H MR Spectroscopy
Hyeon-Man Baek, Jeon-Hor Chen, Ke Nie, Hon J. Yu, Shadfar Bahri, Rita S. Mehta, Orhan Nalcioglu, and Min-Ying Su
Radiology 2009;251 653-662

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The study results suggest that when the reduction in choline-containing compounds was higher than the reduction in tumor size, the tumor was more likely to achieve pathologic complete response

Computer-aided Detection Evaluation Methods Are Not Created Equal

Computer-aided Detection Evaluation Methods Are Not Created Equal
Robert M. Nishikawa and Lorenzo L. Pesce
Radiology 2009;251 634-636

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For the evaluation of computer-aided detection, longitudinal studies (historical controls) are inherently different from cross-sectional studies (sequential reading) when cancer detection rate is used as an end point in a screening program

Full-Field Digital versus Screen-Film Mammography: Comparison within the UK Breast Screening Program and Systematic Review of Published Data

Full-Field Digital versus Screen-Film Mammography: Comparison within the UK Breast Screening Program and Systematic Review of Published Data
Sarah Vinnicombe, Snehal M. Pinto Pereira, Valerie A. McCormack, Susan Shiel, Nick Perry, and Isabel M. dos Santos Silva
Radiology 2009;251 347-358

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We found similar cancer detection rates for screen-film mammography (SFM) and full-field digital mammography (FFDM) using hard-copy image reading; meta-analysis of published data, along with our UK study findings, showed that FFDM performed, in terms of process measures, at least as well as conventional SFM

Small Breast Cancers: In Vivo Percutaneous US-guided Radiofrequency Ablation with Dedicated Cool-Tip Radiofrequency System

Small Breast Cancers: In Vivo Percutaneous US-guided Radiofrequency Ablation with Dedicated Cool-Tip Radiofrequency System
Guglielmo Manenti, Francesca Bolacchi, Tommaso Perretta, Elsa Cossu, Chiara A. Pistolese, Oreste C. Buonomo, Elena Bonanno, Augusto Orlandi, and Giovanni Simonetti
Radiology 2009;251 339-346

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Because of the high variability of normal breast tissue composition among individuals (dense or fatty breasts), breast masses are not always surrounded by tissues with homogeneous conductivity; therefore, it is of primary importance to have a radiofrequency generator, a needle electrode, and a procedure protocol suitable for the variable composition of breast tissue.

Comparison of Soft-copy and Hard-copy Reading for Full-Field Digital Mammography

Comparison of Soft-copy and Hard-copy Reading for Full-Field Digital Mammography
Robert M. Nishikawa, Suddhasatta Acharyya, Constantine Gatsonis, Etta D. Pisano, Elodia B. Cole, Helga S. Marques, Carl J. D'Orsi, Dione M. Farria, Kalpana M. Kanal, Mary C. Mahoney, Murray Rebner, Melinda J. Staiger For the Digital Mammography Image Screening Trial investigator group
Radiology 2009;251 41-49

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DMIST Reader Study findings -
In a large reader study, it was found that there was no advantage to soft-copy reading of full-field digital mammograms over digitally printed images

BUT the display formats were not optimized and display software remains an evolving process, particularly for soft-copy reading

Positive Predictive Value of Specific Mammographic Findings according to Reader and Patient Variables

Positive Predictive Value of Specific Mammographic Findings according to Reader and Patient Variables
Aruna Venkatesan, Philip Chu, Karla Kerlikowske, Edward A. Sickles, and Rebecca Smith-Bindman
Radiology 2009;250 648-657

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Another UCSF classic paper. Asymmetry is the finding with the lowest cancer yield at screening examinations; with asymmetry, invasive cancer (particularly among women younger than 70 years) was infrequently identified and was commonly a false-positive result

Triple-Negative Breast Cancer: Correlation between MR Imaging and Pathologic Findings

Triple-Negative Breast Cancer: Correlation between MR Imaging and Pathologic Findings
Takayoshi Uematsu, Masako Kasami, and Sachiko Yuen
Radiology 2009;250 638-647

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MR imaging findings of a unifocal lesion, mass lesion type, smooth mass margin, heterogeneous rim enhancement, persistent enhancement pattern, and very high signal intensity on T2-weighted images can be used to detect triple-negative breast cancer

Large-Core Breast Biopsy: Abnormal Salivary Cortisol Profiles Associated with Uncertainty of Diagnosis

Large-Core Breast Biopsy: Abnormal Salivary Cortisol Profiles Associated with Uncertainty of Diagnosis
Elvira V. Lang, Kevin S. Berbaum, and Susan K. Lutgendorf
Radiology 2009;250 631-637

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Uncertainty about the final diagnosis after LCBB is associated with substantial biochemical distress, which may have adverse effects on immune defense and wound healing. Results indicate the need for more rapid communication of biopsy results
Not only how but also when biopsy results become available to the patient is important to avoid the dysregulation of cortisol secretion, even if the results are benign