Diagnosis Imaging of Breast Cancer

Diagnosis Imaging of Breast Cancer

Introduction

For this paper I have selected the following articles Three-Dimensional Ultrasound Imaging of Breast Cancer by a Realtime Intraoperative Navigation System, Comparison of Breast Magnetic Resonance Imaging,Mammography, and Ultrasound for Surveillance of Women at High Risk for Hereditary Breast Cancer Advantages and limitations of FDG PET in the follow-up of breast cancer, Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI, Mammography, Breast Ultrasound, and Magnetic Resonance Imaging for Surveillance of Women at High Familial Risk for Breast Cancer.

The selected five articles are extracted from various journals, and books. A systematic review of the abstracts of 50 related articles found in MEDLINE, EMBASE, BIREME, Pubmed, and science direct was performed to search for relevant references.

It is widely accepted that breast lesions should be assessed by the triple test involving clinical examination, imaging and needle biopsy, and a number of studies have confirmed that triple assessment is both sensitive and specific. some researchers Ideally, a preoperative diagnosis of cancer should indicate the histological type and grade of malignancy and give an accurate assessment of the extent of disease, such that only one operation is necessary to remove the cancer and assess the presence of nodal metastases. The National Health Service Breast Screening Programme (NHSBSP) target for preoperative diagnosis is 90%, and this is routinely achieved using core biopsies.3 and 4 However, second operations are needed in 10 to 33% of cancer operations4 because the extent of disease and the presence of lymph node metastases have been underestimated preoperatively.

Breast cancer may be unifocal, multifocal (more than one discrete lesion in a single quadrant) or multicentric (lesions in more than one quadrant of the breast). There is evidence that multifocal or multicentric disease is present in up to 40% of women diagnosed with primary breast cancer,5 but this is underdiagnosed by conventional imaging protocols; consequent failure to remove all malignant tissue may result in local recurrence.

Mammography is accepted as the diagnostic imaging method of choice in women with breast cancer, as it demonstrates 68 to 88% of neoplasms, provides a permanent record of the breast for future comparison and can show multifocal disease in 5 to 10% of cases.6 and 7 Targeted breast US is used as an adjunct to mammography in order to further characterize lesions and to guide needle biopsy. Although both mammography and US can demonstrate pathologically enlarged lymph nodes, neither reliably indicates the presence of micrometastases in lymph nodes.

There is no widely accepted protocol for US of women with suspected breast cancer. In many cases US is not performed. When requested it may entail targeted US of a localized area of the breast, or US of the whole ipsilateral breast or of both breasts and axillae. Several studies have shown that US can detect lesions that are mammographically occult, particularly in dense breasts.8 and 9 The potential benefits of rigorous US of both breasts and axillae include accurate assessment of size, and demonstration of multiple tumour foci, ...