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State of the art of current modalities for the diagnosis of breast lesions

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Abstract

With the availability of numerous diagnostic techniques comes the possible risk of the unjustified use of such techniques and a lack of rational clinical application. Clearly, errors of this nature would affect the diagnostic accuracy and therefore reduce the possibilities for treatment. It is not uncommon for women and also for general practitioners to be misinformed about which is the most suitable technique or rather, which is the best combination of the various techniques. For this reason, inappropriate tests are often requested or, conversely, there is failure to request tests which would in fact make a useful contribution to safeguarding the patient’s health. This work has the following aims: (a) to set out precisely the real diagnostic contribution of each method, both radiological and otherwise, and suggest methods of application and indications consistent with the state of the art, and (b) to suggest the most effective and rational combinations of the various techniques and organisation of diagnostic activities.

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References

  1. Hackshaw AK, Paul EA. Breast self-examination and death from breast cancer: a meta-analysis. Br J Cancer 2003; 88:1047–1053.

    Article  CAS  PubMed  Google Scholar 

  2. Weiss NS. Breast cancer mortality in relation to clinical breast examination and breast self-examination. Breast J 2003; 9:86–89.

    PubMed  Google Scholar 

  3. Lamarque JL, Cherifcheikh J, Laurent JC, et al. La qualité en mastologie: criterès, contrôle. Manosmed, vol I. Montpellier: Sauramps médical, 1997.

  4. Cuzick J. Epidemiology of breast cancer—selected highlights. Breast 2003; 12:405–411.

    Article  PubMed  Google Scholar 

  5. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factor that influence them: an analysis of 27,825 patient evaluations. Radiology 2002; 225:165–175.

    PubMed  Google Scholar 

  6. Berlin L. The missed breast cancer redux: time for educating the public about the limitation of mammography? AJR 2001; 176:1131–1134.

    CAS  Google Scholar 

  7. Di Maggio C. Lo screening mammografico, questo sconosciuto. Atti LXIX Cong. Soc. It. di Ginecologia (SIGO). Padova: La Garangola; 1993:122–126.

  8. Controllo di qualità in mammografia: aspetti tecnici e clinici. Istituto superiore di sanità. ISTISAN 95/12 (ISSN 1123–3117). Rome, 1995.

  9. European guidelines for quality assurance in mammography screening, 3rd edn. Gennaio: EUREF, 2001.

  10. Hendrick RE, Basset L, Bosco MA, et al. Mammography quality control manual. Reston, Va: American College of Radiology, 1999.

  11. Perry NM (EUSOMA Working Party). Quality assurance in the diagnosis of breast disease. Eur J Cancer 2001; 37:159–172.

    CAS  Google Scholar 

  12. Cole EB, Pisano ED, Kistner EO, et al. Diagnostic accuracy of digital mammography in patients with dense breast. Radiology 2003; 226:153–160.

    PubMed  Google Scholar 

  13. Gambaccini M, Baldelli P. Mammografia digitale. Principi fisici e sviluppi futuri. Radiol Med 2003; 106:454–466.

    Google Scholar 

  14. Gennaro G, Baldelli P, Taibi A, Di Maggio C, Gambaccini M. Patient dose in full-field digital mammography: an Italian survey. Eur Radiol 2004; 14:645–652.

    Article  PubMed  Google Scholar 

  15. James JJ. The current status of digital mammography. Clin Radiol 2004; 59:1–10.

    Article  CAS  PubMed  Google Scholar 

  16. Pisano ED. Current status of full field digital mammography. Radiology 2000; 214:26–28.

    CAS  PubMed  Google Scholar 

  17. Baker JA, Rosen EL, Lo JY, et al. Computer-aided detection (CAD) in screening mammography. AJR 2003; 181:1083–1088.

    Google Scholar 

  18. Brem RF, Baun J, Lechner M, et al. Improvement in sensitivity of screening mammography with computer-aided detection: a multiinstitutional trial. AJR 2003; 181:687–693.

    Google Scholar 

  19. Ciatto S, Rosselli del Turco M, Burke P, et al. Comparison of standard and double reading and computer-aided detection (CAD) of interval cancers at prior negative screening mammograms: blind review. Br J Cancer 2003; 89:1645–1649.

    Article  CAS  PubMed  Google Scholar 

  20. Freer TW, Ulissey MJ. Screening mammography with computer-aided detection: prospective study of 12,860 patients in a community breast center. Radiology 2001; 220:781–786.

    CAS  PubMed  Google Scholar 

  21. Lechener, Nelson M, Elvecrog E. comparison of two commercially available computer-aided detection (CAD) systems. Appl Radiol 2002; 31:31–35.

    Google Scholar 

  22. Stines J, Noel A, Levy L, et al. Digital mammography and computer assisted diagnosis. J Radiol 2002; 83:581–590.

    CAS  PubMed  Google Scholar 

  23. Feig SA. Can breast cancer be radiation induced? In: Logan WW, ed. Breast carcinoma. NewYork: Wiley Medical; 1977:5–14.

  24. Gregg EC. Radiation risks with diagnostic x-rays. Radiology 1977; 123:447–453.

    CAS  PubMed  Google Scholar 

  25. Dendy PP, Brugmans MJP. Low dose radiation risks. Br J Radiol 2003; 76:674–677.

    Article  CAS  PubMed  Google Scholar 

  26. Law J, Faulkner K. Concerning the relationship between benefit and radiation risk, and cancers detected and induced, in a breast screening programme. Br J Radiol 2002; 75:678–684.

    CAS  PubMed  Google Scholar 

  27. Sharan SK, Morimatsu M, Albrecht U, et al. Embryonic lethality and radiation hypersensitivity mediated by Rad51 in mice lacking Brca2. Nature 1997; 386:804–810.

    CAS  PubMed  Google Scholar 

  28. Tavassoli FA, Devilee P. Pathology and genetics of tumours of the breast and female genital organs. IARC–WHO–OMS. Lyon: IARC Press, 2003.

  29. Amici F, Baldassarre S, Giuseppetti GM. Imaging in senologia—Testo Atlante. Milan: Poletto, 2000.

  30. American College of Radiology. Illustrated breast imaging reporting and data system (BI-RADS), 4th edn. Reston, VA: American College of Radiology, 2003.

  31. ANAES (Agence National d’Accreditation e d’Evaluation de la Santè). Recommandations pour la pratique clinique. Synthèse des recommandations cancer du sein 1998. Paris: ANAES, 1998.

  32. Lattanzio V, Simonetti G. Mammografia: guida alla refertazione ed alla codifica dei risultati Re.Co.R.M. Napoli: Idelson-Gnocchi srl, 2002.

  33. Burrell HC, Pinder SE, Wilson AR, et al. The positive predictive value of mammographic signs. Clin Radiol 1996; 51:277–281.

    CAS  PubMed  Google Scholar 

  34. Giuseppetti G.M. L’ecografia senologica. Radiol Med 2002; 104:1–12.

    CAS  Google Scholar 

  35. Merritt CRB. Technology update. Radiol Clin North Am 2001; 39:385–397.

    CAS  PubMed  Google Scholar 

  36. Rizzatto G. Towards a more sophisticated use of breast ultrasound. Eur Radiol 2001; 11:2425–2435.

    Article  CAS  PubMed  Google Scholar 

  37. Jakobsen JA. Ultrasound contrast agents: clinical application. Eur Radiol 2001; 11:1329–1337.

    CAS  PubMed  Google Scholar 

  38. Martinez AM, Medina CJ, Bustos C, et al. Assessment of breast lesions using Doppler with contrast agents. Eur J Gynaecol Oncol 2003; 24:527–530.

    CAS  PubMed  Google Scholar 

  39. Moon WK, Im JG, Noh DY, Han MC. Non palpable breast lesion: evaluation with power Doppler US and microbubble contrast agent—initial experience. Radiology 2000; 217:240–246.

    CAS  PubMed  Google Scholar 

  40. Wittingam TA. Tissue harmonic imaging. Eur Radiol 1999; 9:323–326.

    Article  CAS  PubMed  Google Scholar 

  41. Cilotti A, Bagnolesi P et al. Comparison of the diagnostic performance of high-frequency ultrasound in non-palpable lesions of the breast. Eur Radiol 1997; 7:1240–1244.

    Article  CAS  PubMed  Google Scholar 

  42. Kaplan SS. Clinical utility of bilateral whole-breast US in the evaluation of women with dense breast tissue. Radiology 2001; 221:641–649.

    CAS  Google Scholar 

  43. Kolb T, Lichy J, Newhouse JH. Occult cancer in women with dense breast: normal mammographic and physical examination findings: detection with screening US. Radiology 1998; 207:191–199.

    CAS  PubMed  Google Scholar 

  44. Moy L, Slanertz P, Moore MA, et al. Specificity of mammography and ultrasound in the evaluation of a palpable abnormality: retrospective review. Radiology 2002; 225:176–181.

    PubMed  Google Scholar 

  45. Zonderland HM, Coerkamp EG, Hermans J, et al. Diagnosis of breast cancer: contribution of US as an adjunct to mammography. Radiology 1999; 213:413–422.

    CAS  PubMed  Google Scholar 

  46. Feig SA. Breast masses: mammographic and sonographic evaluation. Radiol Clin North Am 1992; 30:67–94.

    CAS  PubMed  Google Scholar 

  47. Balu-Maestro C, Chapellier C, Bleuse A. Place de l’échographie dans le dépistage du cancer du sein. J Le Sein 2003; 13:127–134.

    Google Scholar 

  48. American College of Radiology. ACR standard for performance of the breast ultrasound examination. Reston, VA: American College of Radiology; 2000:389–392.

  49. Del Maschio A, De Gaspari A, Panizza P. Risonanza magnetica in senologia. Radiol Med 2002; 104:253–261.

    Google Scholar 

  50. Morris EA. Breast cancer imaging with MR. Radiol Clin North Am 2002; 40:349–355.

    Google Scholar 

  51. Teifke A, Lehr HA, Vomweg TW, et al. Outcome analysis and rational management of enhancing lesions incidentally detected on contrast-enhanced MRI of the breast. AJR 2003; 181:655–662.

    Google Scholar 

  52. Kuhl CK, Schmutzer RK, Leutner C, et al. Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancers susceptibility gene: preliminary results. Radiology 2000; 215:267–279.

    CAS  PubMed  Google Scholar 

  53. Podo F, Sardanelli F, Canese R, et al. The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of mammary tumors in subjects at high genetic risk. J Exp Clin Cancer Res 2002; 21:115–124.

    CAS  Google Scholar 

  54. Tilanus-Linthorst MM, Obdeijn IM, Bartels KC, et al. First experience in screening women at high risk for breast cancer with MR imaging. Breast Cancer Res Treat 2000; 63:53–60.

    Article  CAS  PubMed  Google Scholar 

  55. Schorn C, Fischer U, Luftner-Nagel S, et al. MRI of the breast in patients with metastatic disease of unknown primary. Eur Radiol 1999; 9:470–473.

    Article  CAS  PubMed  Google Scholar 

  56. Oellinger H, Heins S, Sander B, et al. Gd-DTPA enhanced MRI of breast: the most sensitive method for detecting multicentric carcinomas in female breast? Eur Radiol 1993; 3:223–226.

    Google Scholar 

  57. Slanetz PJ, Edmister WB, Weisskoff RM, et al. Occult contralateral breast cancer detected by breast MR. Radiology 1998; 209:416.

    Google Scholar 

  58. Panizza P, De Gaspari A, Vanzulli A, et al. Role of MR mammography (MRM) in planning preoperative chemotherapy treatment and analyzing results. Eur Radiol 1997; 7:242.

    Google Scholar 

  59. Rieber A, Zeitler H, Rosenthal H, et al. MRI of breast cancer: influence of chemotherapy on sensitivity. Br J Radiol 1997; 70:452–458.

    CAS  Google Scholar 

  60. Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol 2003; 6:1213–1223.

    Google Scholar 

  61. Dao TH, Rahmouni A, Campana F, et al. Tumor recurrences versus fibrosis in the irradiated breast: differentiation with dynamic gadolinium enhancement MR imaging. Radiology 1993; 187:751–755.

    PubMed  Google Scholar 

  62. Solomon B, Orel SG, Reynolds C, et al. Delayed development of enhancement in fat necrosis after breast conservation therapy: a potential pitfall of MR imaging of the breast. AJR 1998; 170:966–968.

    CAS  Google Scholar 

  63. Ahn CY, Shaw WW, Narayanan K, et al. Definitive diagnosis of breast implant rupture using magnetic resonance imaging. Plast Reconstr Surg 1993; 94:681–691.

    Google Scholar 

  64. Gorzica DC, De Bruhl ND, Mund DF, Basset LW. Linguine sign at MR imaging it represent collapse silicone implant shell? Radiology 1994; 191:576–577.

    CAS  PubMed  Google Scholar 

  65. Reynolds HE, Buckwalter KA, Jackson VP et al. Comparison of mammography, sonography, and magnetic resonance imaging in the detection of silicone-gel breast implant rupture. Ann Plast Surg 1994; 33:247–257.

    CAS  PubMed  Google Scholar 

  66. Liberman L, Morris EA, Dershaw DD, et al. Fast MRI-guided vacuum assisted breast biopsy: initial experience. AJR 2003; 181:1283–1293.

    Google Scholar 

  67. Panizza P, De Cobelli F, De Gaspari A, et al. MR-guided stereotactic breast biopsy: technical aspects and preliminary results. Radiol Med 2003; 106:232–244.

    Google Scholar 

  68. Viehweg P, Heinig A, Amaya B, et al. MR-guided interventional breast procedures considering vacuum biopsy in particular. Eur Radiol 2002; 42:32–39.

    CAS  Google Scholar 

  69. Di Maggio C, La Grassa M, Pescarini L, et al. Interventistica radio-stereoguidata tradizionale e digitale. In: Nori J, Mazzocchi M, eds. Senologia. Stato dell’arte in interventistica. Napoli: Idelson-Gnocchi; 2003:9–18.

  70. Helbich TH, Matzek W, Fuchsjager MH. Stereotactic and ultrasound-guided breast biopsy. Eur Radiol 2004; 14:383–393.

    Article  CAS  PubMed  Google Scholar 

  71. Pisano ED, Fajardio LL, Caudry DJ, et al. Fine-needle aspiration biopsy of nonpalpable lesions in a multicenter clinical trial. Radiology 2001; 219:785–792.

    CAS  PubMed  Google Scholar 

  72. Sauer T, Myrvold K, Lomo J, et al. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening. Breast 2003; 12:314–319.

    Article  PubMed  Google Scholar 

  73. Jackman RJ, Burbank F, Parker SH, et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology 2001; 218:497–502.

    CAS  PubMed  Google Scholar 

  74. Deurloo EE, Tanis PJ, Gilhuijs KG, et al. Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in breast cancer. Eur J Cancer 2003; 39:1068–1073.

    Article  CAS  PubMed  Google Scholar 

  75. Di Maggio C, La Grassa M, Pescarini L, et al. Indicazioni al prelievo con ago ed alla scelta metodologica. In: Nori J. Mazzocchi M, eds. Senologia. Stato dell’arte in interventistica. Napoli: Idelson-Gnocchi; 2003:33–41.

  76. Nori J. Mazzocchi M. Senologia. Stato dell’arte in interventistica. Napoli: Idelson-Gnocchi, 2003.

  77. Parker SH, Klaus AJ, Schilling KJ, et al. Sonographically guided directional vacuum-assisted breast biopsy using a handled device. AJR 2001; 177:405–408.

    CAS  Google Scholar 

  78. Boyd NF, Byng JW, Jong RA. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 1995; 87:670–675.

    CAS  PubMed  Google Scholar 

  79. Boyd NF, Dite GS, Stone J, et al. Heritability of mammographic density, a risk factor for breast cancer. N Engl J Med 2002; 347:886–894.

    Article  PubMed  Google Scholar 

  80. Harvey JA, Bovbierg VE. Quantitative assessment of mammographic breast density: relationship with breast cancer risk. Radiology 2004; 230:29–41.

    PubMed  Google Scholar 

  81. Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 2000; 92:1081–1087.

    Article  CAS  PubMed  Google Scholar 

  82. Di Maggio C. Il servizio di senologia diagnostica. Radiol Med 1991; 81:585–591.

    Google Scholar 

  83. Di Maggio C. La diagnosi del tumore della mammella: linee guida ed aspetti organizzativi (UFSD). In: Piscioli F,Cristofolini M, eds. Modelli operativi di prevenzione secondaria del carcinoma mammario. Trento: Temi; 1996:361–379.

  84. Duffy SW, Tabar L, Chen HH, et al. The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish counties. Cancer 2002; 95:458–469.

    Article  PubMed  Google Scholar 

  85. Nystrom L, Andersson I, Bjurstam N, et al. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 2002; 359:909–919.

    Article  PubMed  Google Scholar 

  86. Peto R, Boreham J, Clarke M, Davies C, Beral V. UK and USA breast cancer deaths down 25% in year 2000 ad ages 20–69 years [letter]. Lancet 2000; 20:1822.

    Google Scholar 

  87. Shapiro S. Evidence on screening for breast cancer from a randomized trial. Cancer 1977; 39:2772–2782.

    CAS  PubMed  Google Scholar 

  88. Vanara F, Ponti A, Frigerio A, et al. Analisi dei costi di un programma di screening mammografico. Epidemiol Prev 1995; 19:318–329.

    CAS  PubMed  Google Scholar 

  89. Sickles EA, Wolverton DE, Dee KE. Performance parameters for screening and diagnostic mammography: specialist and general radiologists. Radiology 2002; 224:861–869.

    PubMed  Google Scholar 

  90. di Maggio C, Giuseppetti G, Gozzi G, et al. La mammografia nelle quarantenni: verso un chiarimento definitivo. Radiol Med 1994; 87:731–735.

    Google Scholar 

  91. Fletcher SW, Elmore JG. Mammographic screening for breast cancer. N Engl J Med 2003; 348:1672–1680.

    Article  PubMed  Google Scholar 

  92. Wald NJ, Chamberlain J, Hackshav A. Report of the European Society for Mastology on breast cancer screening. Breast 1993; 2:209–216.

    Google Scholar 

  93. Advisory Committee on Cancer Prevention. Recommendations on cancer screening in the European Union. Eur J Cancer 2000; 36:1473–1478.

    PubMed  Google Scholar 

  94. American Cancer Society. Guidelines for clinical cancer prevention, 1999–2003.

  95. Piscioli F, Cristofolini M. Modelli operativi di prevenzione secondaria del carcinoma della mammella. Trento: Tipolitografia Temi, 1996.

  96. Rosselli del Turco M. Programmi di screening per il carcinoma mammario. In: Veronesi U, et al., eds. Senologia oncologica. Milan: Masson; 1999:165–176.

  97. Maijd AS, Shaw de Paredes E, Doherty RD, et al. Missed breast carcinoma: pitfalls and pearls. Radiographics 2003; 23:881–895.

    PubMed  Google Scholar 

  98. Marra V, Frigerio A, Di Virgilio MR, et al. Il carcinoma mammario diagnosticato nello screening mammografico nei passaggi di incidenza. Radiol Med 1999; 98:342–346.

    CAS  Google Scholar 

  99. Raja MA, Hubbard A, Salman AR. Interval breast cancer: is it a different type of breast cancer? Breast 2001; 10:100–108.

    Article  CAS  PubMed  Google Scholar 

  100. Sylvester PA, Vipond MN, Kutt E. Rate and classification of interval cancers in the breast screening programme. Ann R Coll Surg Engl 1977; 79:276–277.

    Google Scholar 

  101. Bauce A, Benesso S, Galiano A. Relazione tra densità mammografica, età delle pazienti e sensibilità. Radiol Med 1998; 5 Suppl 1:271.

    Google Scholar 

  102. Feig SA. Increased benefit from shorter screening mammography intervals for women ages 40–49 years. Cancer 1997; 80:2035–2039.

    CAS  PubMed  Google Scholar 

  103. Michaelson JS, Halpern E, Kopans DB. Breast cancer computer simulation method for estimation of optimal intervals for screening. Radiology 1999; 212:551–560.

    CAS  PubMed  Google Scholar 

  104. Rosen EL, Baker JA, Soo MS. Malignant lesions initially subjected to short-term mammographic follow-up. Radiology 2002; 223:221–228.

    PubMed  Google Scholar 

  105. Zappa M, Falini P, Bonardi D, et al. Monitoring interval cancers in mammographic screening: the Florence District programme experience. Breast 2002; 11:301–305.

    Article  CAS  PubMed  Google Scholar 

  106. Bancej C, Decker K, Chiarelli A, et al. Contribution of clinical breast examination to mammography screening in the early detection of breast cancer. J Med Screen 2003; 10:16–21.

    Article  CAS  PubMed  Google Scholar 

  107. D’Angelo I, Pindaro L, Glorioso V, et al. Progetto primavera. Risultati del primo passaggio. In: Piscioli F,Cristofolini M, eds. Modelli operativi di prevenzione secondaria del carcinoma mammario. Trento: Temi; 1996:209–221.

  108. Kopans DB. Mammography screening is saving thousands of lives, but will it survive medical malpractice? Radiology 2004; 230:20–24.

    PubMed  Google Scholar 

  109. Guthrie TH. Breast cancer litigation: an update with practice guidelines. Breast J 1999; 5:335–339.

    Article  PubMed  Google Scholar 

  110. Bjurstam N, Bjorneld L, Duffy SW, et al. The Gothenburg Breast Screening Trial. Cancer 1997; 80:2091–2099.

    CAS  PubMed  Google Scholar 

  111. Smart CR, Hendrick RE, Rutledge JH, et al. Benefit of mammography screening in women aged 40 to 49 years. Cancer 1995; 75/7:1619–1626.

    Google Scholar 

  112. Dilhuydy MH, Monnereau A, Barreau B. Le dépistage “à la française”. Action programmée ou aménagement du diagnostic précoce individuel? J Le Sein 2003; 2:83–90.

    Google Scholar 

  113. Di Maggio C, Fioretti P, La Grassa M, et al. Screening mammografico o diagnostica clinica? Proposta di un modello unificato. Radiol Med 2001; 101:326–333.

    Google Scholar 

  114. Consiglio dell’Unione Europea. Raccomandazioni del 2-12-2003 sullo screening dei tumori. 2003/878/CE. G.U. Unione Europea 16.12.2003. L 327/34–37.

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    Cosimo Di Maggio

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Di Maggio, C. State of the art of current modalities for the diagnosis of breast lesions. Eur J Nucl Med Mol Imaging 31 (Suppl 1), S56–S69 (2004). https://doi.org/10.1007/s00259-004-1527-8

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