Diagnosis Of Breast Automatic Full Volume Imaging Technique For Breast Cancer

Objective:This prospective study aims to evaluate the efficacy of preoperative automated breast volume scanner (ABVS) in the detection of multifocal multicentric breast carcinoma (MMBC), defined by pathology on surgical specimens, and the effect of ABVS information on therapeutic decisions.Materials and methods:Two hundred and fifty-four patients who were suspected of having breast cancer underwent ABVS examination prior to surgery and133women with breast carcinoma pathologically diagnosed on surgical specimens. The gold standard was pathologic examination of the whole excised breast (slice thickness,5mm). The radiologists were evaluated all neoplastic foci, and blinded to the original mammograms and conventional hand-held ultrasonography (HHUS) reports. With regards to ABVS, our considered size of the lesions, BI-RADS classification and imaging pattern and lesion characteristics. According to the histological size, the lesions were classified as:1st cancer,2nd lesion,3rd lesion,4th lesion, and5th lesion. Any pathologically identified malignant foci not previously described in the original imaging reports, were defined as undetected or missed lesions. Sensitivity and positive predictive values were calculated for ABVS and HHUS for detecting the presence of the index cancer as well as additional satellite lesions.Results:Of94breasts, pathologic findings revealed32unifocal,46multifocal, and16multicentric cancers for a total of196malignant foci (171invasive and25in situ). Overall sensitivity was84.7%(166/196) for HHUS and87.8%(172/196) for ABVS (not significant);90.6%(155/171) and89.5%(153/171) for invasive foci (not significant); and44.0%(11/25) and76.0%(19/25) for in situ foci (p<0.05), respectively. HHUS and ABVS missed30and24malignant foci, respectively, with median diameters of7.5mm and8.0mm (not significant) and an invasive-noninvasive ratio of1.1:1(16/14) and3.0:1(18/6)(not significant), respectively. The overall positive predictive value (PPV) was75.1%(166/221) for HHUS and86.0%(172/200) for ABVS (p<0.05). In malignant foci with a mass-like imaging pattern, sensitivity was93.7%for HHUS and92.5%for ABVS (not significant), and the PPV was86.5%and86.6%(not significant), respectively. In malignant foci with non-mass-like pattern, the sensitivity was60.4%and77.8%(p=0.01), and the PPV was48.5%and84.5%(p<0.001), respectively. ABVS imaging identified15HHUS occult malignant lesions. On the basis of these US findings, therapy was correctly changed in12patients (13.0%). The diagnostic performance in terms of understaging, correct staging, and overstaging on a breast-by-breast basis are13.8%,73.4%,12.8%for ABVS and17.0%,59.6%,23.4%for HHUS.Conclusions:In patients with MMBC, preoperative ABVS imaging is useful for detecting additional synchronous malignancies that are not detected on conventional HHUS. ABVS was more sensitive than conventional HHUS for the detection of multiple malignant foci in non-mass-like imaging pattern and non-invasive cancer foci. The use of preoperative ABVS imaging as an adjunct to conventional HHUS in women with MMBC is especially beneficial. Objective:The goal of the study described here was to compare the accuracy of an automated breast volume scanner (ABVS) with that of hand-held ultrasound (HHUS) in assessing the pre-operative extent of pure ductal carcinoma in situ (DCIS).Materials and methods:This prospective study consisted of33patients with histopathologically proven pure DCIS who received conventional HHUS and ABVS examinations. The discrepancy and correlation coefficients were calculated to assess differences in sizes determined by imaging and histopathologic examination.Results:Mean age was51.8y. Mean lesion size as assessed with the ABVS did not differ significantly from that determined by histopathology. Lesion size was adequately estimated, under-estimated or over-estimated with the ABVS in64%,15%and21%of patients, and with HHUS in42%,15%and42%, respectively (p<0.05). The coefficient of correlation between histopathologic and ABVS measurements was higher than that between histopathologic and HHUS measurements.Conclusions:The ABVS appears to assess the extent of the lesion better than HHUS and can provide more accurate information pre-operatively.