Breast imaging reporting and data system (BI-RADS).

Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

https://www.unitypoint.org/desmoines/filesimages/Cancer%20Education/Oncology%20Nursing%20Conference/2015/2014%20NCCN%20Clin%20Pract%20Guidelines%20Male%20Sex%20Dysf.pdf

Clinical practice guidelines in oncology

ContextCurrent recommendations for women who have a BRCA1 or BRCA2 mutation are to undergo breast surveillance
from age 25 years onward with mammography annually and clinical breast examination
(CBE) every 6 months; however, many tumors are detected at a relatively advanced
stage. Magnetic resonance imaging (MRI) and ultrasound may improve the ability
to detect breast cancer at an early stage.ObjectiveTo compare the sensitivity and specificity of 4 methods of breast cancer
surveillance (mammography, ultrasound, MRI, and CBE) in women with hereditary
susceptibility to breast cancer due to a BRCA1 or BRCA2 mutation.Design, Setting, and ParticipantsA surveillance study of 236 Canadian women aged 25 to 65 years with BRCA1 or BRCA2 mutations who underwent
1 to 3 annual screening examinations, consisting of MRI, mammography, and
ultrasound at a single tertiary care teaching hospital between November 3,
1997, and March 31, 2003. On the day of imaging and at 6-month intervals,
CBE was performed.Main Outcome MeasuresSensitivity and specificity of each of the 4 surveillance modalities,
and sensitivity of all 4 screening modalities vs mammography and CBE.ResultsEach imaging modality was read independently by a radiologist and scored
on a 5-point Breast Imaging Reporting and Data System scale. All lesions with
a score of 4 or 5 (suspicious or highly suspicious for malignancy) were biopsied.
There were 22 cancers detected (16 invasive and 6 ductal carcinoma in situ).
Of these, 17 (77%) were detected by MRI vs 8 (36%) by mammography, 7 (33%)
by ultrasound, and 2 (9.1%) by CBE. The sensitivity and specificity (based
on biopsy rates) were 77% and 95.4% for MRI, 36% and 99.8% for mammography,
33% and 96% for ultrasound, and 9.1% and 99.3% for CBE, respectively. There
was 1 interval cancer. All 4 screening modalities combined had a sensitivity
of 95% vs 45% for mammography and CBE combined.ConclusionsIn BRCA1 and BRCA2 mutation
carriers, MRI is more sensitive for detecting breast cancers than mammography,
ultrasound, or CBE alone. Whether surveillance regimens that include MRI will
reduce mortality from breast cancer in high-risk women requires further investigation.

https://jamanetwork.com/journals/jama/articlepdf/199438/JOC32405.pdf

Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination.

This paper reviews ultrasound segmentation methods, in a broad sense, focusing on techniques developed for medical B-mode ultrasound images. First, we present a review of articles by clinical application to highlight the approaches that have been investigated and degree of validation that has been done in different clinical domains. Then, we present a classification of methodology in terms of use of prior information. We conclude by selecting ten papers which have presented original ideas that have demonstrated particular clinical usefulness or potential specific to the ultrasound segmentation problem

/pdf/ultrasound-image-segmentation-a-survey-55ssqpzk7q.pdf

Ultrasound image segmentation: a survey

OBJECTIVE. The purpose of our study was to provide new sonographic criteria for fine-needle aspiration biopsy of nonpalpable solid thyroid nodules.MATERIALS AND METHODS. Sonographic scans of 155 nonpalpable thyroid nodules in 132 patients were prospectively classified as having positive or negative findings. Sonographic findings that suggested malignancy included microcalcifications, an irregular or microlobulated margin, marked hypoechogenicity, and a shape that was more tall than it was wide. If even one of these sonographic features was present, the nodule was classified as positive (malignant). If a nodule had none of the features described, it was classified as negative (benign). The final diagnosis of a lesion as benign (n = 106) or malignant (n = 49) was confirmed by fine-needle aspiration biopsy and follow-up (>6 months) in 83 benign nodules, by fine-needle aspiration biopsy and surgery in 44 malignant and 15 benign lesions, and by surgery alone in five malignant and eight benign lesions. The sens...

New Sonographic Criteria for Recommending Fine-Needle Aspiration Biopsy of Nonpalpable Solid Nodules of the Thyroid

PURPOSE: To determine whether sonography could help accurately distinguish benign solid breast nodules from indeterminate or malignant nodules and whether this distinction could be definite enough to obviate biopsy. MATERIALS AND METHODS: Seven hundred fifty sonographically solid breast nodules were prospectively classified as benign, indeterminate, or malignant. Benign nodules had no malignant characteristics and had either intense homogeneous hyperechogenicity or a thin echogenic pseudocapsule with an ellipsoid shape or fewer than four gentle lobulations. Sonographic classifications were compared with biopsy results. The sensitivity, specificity, and negative and positive predictive values of the classifications were calculated. RESULTS: Benign histologic features were found in 625 (83%) lesions; malignant histologic features, in 125 (17%). Of benign lesions, 424 had been prospectively classified as benign. Two lesions classified as benign were found to be malignant at biopsy. Thus, the classification s...

G A Sisney

Papers

Solid breast nodules: use of sonography to distinguish between benign and malignant lesions.