Hitomi Sakata

Fibromatosis of the breast: A case report

We report a case of fibromatosis clinically suggestive of breast cancer, in which cancer treatment was prevented by fine needle aspiration (FNA) cytology. The patient was a 46-year-old Japanese woman who presented with nipple retraction of the left breast. Mammography demonstrated thickened nipple skin and an ill-defined, fairly dense tumor retracting the nipple. Ultrasonography showed an irregular hypoechoic tumor with a thick boundary echo and back echo attenuation. FNA was performed, and the aspirates consisted of isolated pleomorphic spindle cells showing large nuclei with fine chromatin and lacy cytoplasm, and papillary epithelial and myoepithelial cells. Thus an epithelial malignant tumor was ruled out. In this case, in which carcinoma was clinically strongly suspected and in which aspirates consisted of isolated pleomorphic spindle cells, fibromatosis should be considered to avoid unnecessary radical surgery.

Diagnostic imaging strategy for MDCT- or MRI-detected breast lesions: use of targeted sonography

BackgroundLeading-edge technology such as magnetic resonance imaging (MRI) or computed tomography (CT) often reveals mammographically and ultrasonographically occult lesions. MRI is a well-documented, effective tool to evaluate these lesions; however, the detection rate of targeted sonography varies for MRI detected lesions, and its significance is not well established in diagnostic strategy of MRI detected lesions. We assessed the utility of targeted sonography for multidetector-row CT (MDCT)- or MRI-detected lesions in practice.MethodsWe retrospectively reviewed 695 patients with newly diagnosed breast cancer who were candidates for breast conserving surgery and underwent MDCT or MRI in our hospital between January 2004 and March 2011. Targeted sonography was performed in all MDCT- or MRI-detected lesions followed by imaging-guided biopsy. Patient background, histopathology features and the sizes of the lesions were compared among benign, malignant and follow-up groups.ResultsOf the 695 patients, 61 lesions in 56 patients were detected by MDCT or MRI. The MDCT- or MRI-detected lesions were identified by targeted sonography in 58 out of 61 lesions (95.1%). Patients with pathological diagnoses were significantly older and more likely to be postmenopausal than the follow-up patients. Pathological diagnosis proved to be benign in 20 cases and malignant in 25. The remaining 16 lesions have been followed up.Lesion size and shape were not significantly different among the benign, malignant and follow-up groups.ConclusionsApproximately 95% of MDCT- or MRI-detected lesions were identified by targeted sonography, and nearly half of these lesions were pathologically proven malignancies in this study. Targeted sonography is a useful modality for MDCT- or MRI-detected breast lesions.

Successful use of multi-detector row computed tomography for detecting contralateral breast cancer.

Objective: We retrospectively evaluated whether multi-detector row computed tomography (MDCT) could contribute to the early detection of contralateral breast cancer in women with a diagnosis of breast cancer and no suspicious lesions on a mammogram or an ultrasonogram of the contralateral breast. Methods: A total of 518 women with newly diagnosed unilateral breast cancer underwent MDCT. Multi-detector row CT was performed using a 16-detector row CT scanner set for 2-mm collimation, 120 kilovolt (peak), and 180 mA. Axial images of the contralateral breast were evaluated. Results: Four hundred fifty-nine women were eligible for this study. There were suspicious malignant lesions only on MDCT in 21. Multi-detector row CT contributed to the diagnosis of contralateral occult breast cancer in 12 women (2.6%), including 1 in whom breast cancer was later diagnosed at another institution. Conclusions: Multi-detector row CT has a potential role in detecting contralateral breast cancer in women who are at high risk.