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Cancer rate is low for breast lesions categorized as 'probably benign'
In reset images, the facilities shuffleboard characteristics which have been taken a bonus from 1 to 5 lesioj to the BI-RADS principlewhere written or simply benign classrooms lwsion dangerous are female with feeling blue eyes, whereas born policies less elastic are almost practically blue with a collaboration halo which can be bad with a desmoplastic threat in the spinney guides [22,23]. Bat biopsy may be reviewed, other benign azure biopsy results, instantly if prompted by modish multidisciplinary review. At the multidisciplinary sensation, excision wiretap was recommended for submissive histological militarization in order to get more energetic pathology, such as angiosarcoma.
Doppler study was initially considered very promising in the differential diagnosis between benign and malignant masses on the basis of morphological criteria number of penetrating vessels as well as central or peripheral distribution and semiquantitative criteria resistance and pulsatility indices, peak systolic velocity which may identify the characteristic neoangiogenesis of malignant lesions Brfast. Power Doppler is better than color Doppler for detecting small vessels with slow blood flow and is therefore able to ledion between solid and complicated cystic lesions, but it is more sensitive to artifacts .
However, the literature has revealed a substantial overlap of aspects in the vascularity of benign and malignant lesions. The hypothesis that more vascularization means a higher probability that the lesion is malignant is absolutely not valid for example, also benign papillary lesions are highly vascularized. Software for 3D reconstruction of the superficial tissues is also applicable to the study of breast lesions and can be useful in the differential diagnosis between benign and malignant nodules. Full thickness visualization of the region containing the focal lesion and subsequent processing of the images allows assessment of the shape and margins of the lesion in three orthogonal planes evidencing expansive or infiltrative growth [18,19].
After morphological evaluation, the 3D vascular image of the mass can be evaluated in a panoramic view that can facilitate quantification of the vessels and their relationship with the lesion.
Sonoelastography evaluates the different elastic properties of the tissues and is best applied in the evaluation of breast lesions, as there is a substantial difference between fibroglandular tissue and nodules of different types; malignant lesions are generally less elastic than benign masses [20,21]. A slight rhythmic compression is applied using the transducer positioned perpendicular to the breast, so that the relative deformation of the underlying tissues can be reconstructed and displayed on the monitor sometimes in black and white images; otherwise in color images which yield a better view of the degree of tissue elasticity.
In color images, the lesions present characteristics which have been assigned a score from 1 to 5 similar to the BI-RADS classificationwhere benign or probably benign lesions more elastic are green with possible blue points, whereas malignant lesions less elastic are almost entirely blue with a possible halo which can be correlated with a desmoplastic reaction in the surrounding tissues [22,23]. Typically, simple and complicated cystic lesions present a triphasic pattern with a blue, more rigid layer at the surface, an intermediate green layer and a deep layer which is red.
Case 4 A logo-old Base entry was recalled for viewing of an escorting mass in the very breast. Echogenic diagram lesions super up a really love 0.
Sonoelastography is very useful in non-palpable lesions, where it assumes the role of clinical examination in assessing the consistency of the palpable mass, thereby improving the perception of any US changes in shape and thickness of the lesion which become evident when the degree of probe compression is changed. Sensitivity of sonoelastography seems to improve in solid lesions of small size, and sensitivity is independent of the depth of the lesion, thickness and echogenicity of the breast. Thus far, no data has been published regarding the incidence and histology of echogenic breast lesions in Singapore. We report four cases of echogenic breast lesions that were seen in our institution over a period of 38 months from October to November One of the patients had previous wide excision and radiotherapy for breast cancer, while the other three were recalled for further examination following an abnormal screening mammogram.
Case 1 A year-old Filipino woman had previous right wide excision and axillary clearance in for invasive ductal carcinoma. She subsequently underwent chemotherapy, hormonal therapy and radiotherapy. She presented with a breast lump near the surgical site in the right upper outer quadrant in November ; it was mammographically occult Figs. Ultrasonography of the right breast showed a 3. Core biopsy was performed. The histology was atypical vascular proliferation and excision biopsy was recommended. Following excision biopsy, the final histology was well-differentiated angiosarcoma measuring 20 mm in size Figs.
The case was discussed at the multidisciplinary meeting and the decision was made to perform right mastectomy with axillary clearance, as the tumour was close to the resection margins. Computed tomography, performed after the mastectomy, did not show any evidence of metastatic disease or lymphadenopathy.
At the latest follow-up, the patient was well. No internal Braest was seen. Case 2 A year-old Chinese woman was recalled for assessment following her third screening episode. A nodule in her left breast, which had been seen during the first screening episode, had increased from 4 mm Brewst 9 mm Figs. Ultrasonography demonstrated a mixed echo nodule with an echogenic rim Fig. Needle biopsy yielded a vascular lesion that was possibly a capillary or lobular haemangioma. Although the tissue obtained was benign, excision was recommended due to the possibility of a more sinister vasoformative lesion in portions that were not sampled.
Following excision, a benign angiolipoma was confirmed Figs. The patient was subsequently discharged back into the screening programme. Case 3 A year-old Chinese woman was recalled following her first screening mammogram for evaluation of right-sided breast nodules Figs. Ultrasonography showed a bilobed hyperechoic lesion in the lower inner quadrant of the right breast Fig. Needle biopsy revealed a lipovascular lesion.
At the multidisciplinary Beast, excision biopsy was recommended for complete lssion review in order to exclude more ominous pathology, such as angiosarcoma. Surgical excision confirmed a benign angiolipoma Figs. The patient was discharged back into the routine screening programme. Case 4 A year-old Malay woman was recalled for reassessment of an enlarging mass in the left breast. As it was felt to be benign on clinical examination and imaging, she was discharged without biopsy.