Background: The multifocality and multicentrality of breast cancer (MFMCC) are the significant aspects that determine a specialist’s choice between applying breast-conserving therapy (BCT) or performing a mastectomy. This study aimed to assess the usefulness of mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in women diagnosed with breast cancer before qualifying for surgical intervention to visualize other (additional) cancer foci. Methods: The study included 60 breast cancer cases out of 630 patients initially who underwent surgery due to breast cancer from January 2015 to April 2019. MG, CESM, and MRI were compared with each other in terms of the presence of MFMCC and assessed for compliance with the postoperative histopathological examination (HP). Results: Histopathological examination confirmed the presence of MFMCC in 33/60 (55%) patients. The sensitivity of MG in detecting MFMCC was 50%, and its specificity was 95.83%. For CESM, the sensitivity was 85.29%, and the specificity was 96.15%. For MRI, all the above-mentioned parameters were higher as follows: sensitivity—91.18%; specificity—92.31%. Conclusions: In patients with MFMCC, both CESM and MRI are highly sensitive in the detection of additional cancer foci. Both CESM and MRI change the extent of surgical intervention in every fourth patient.

(1) Background: The aim of this study was to analyze the incidence of shoulder dislocation and to estimate non-modifiable risk factors in rural and urban subgroups in Poland. (2) Methods: The study covered the entire Polish population, divided into urban and rural subgroups and observed between 1 January 2014 and 31 December 2014. The study population consisted of Polish patients with a diagnosis of shoulder dislocation (S43.0) in accordance with the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Records were obtained from the public health care provider National Health Found (Narodowy Fundusz Zdrowia, NFZ). Based on these data, we assessed shoulder dislocation incidence and risk rates, stratifying the study sample by sex, age and place of residence (rural or urban) using the Central Statistical Office (GUS) personal territorial code (TERYT). (3) The incidence was 25.97/100,000 person-years in rural areas and 25.62/100,000 person-years in urban areas. We did not find significant differences in the incidence between the two subgroups. The highest incidence (75.12/100,000 person-years) and the highest risk for shoulder dislocation were found among subjects 80+ years old living in urban areas. Furthermore, men in the third decade of their life living in urban areas showed the highest risk (OR = 7.8, 95% CI; 6.44–9.45, p < 0.001). In both subgroups, the likelihood of shoulder dislocation was significantly lower for the female sex and among children ≤9 years old. However, girls living in rural areas presented with a significantly higher likelihood for dislocation compared with their peers living in urban environments. (4) Conclusions: No significant difference in the incidence rate of shoulder dislocation between Polish residents living in rural and urban areas emerged. The highest incidence was observed among female subjects 80+ years old living in urban environments. The highest risk was found among men in the third decade of their life living in urban areas. In addition, girls in the first decade of their life living in rural areas had more shoulder dislocations than girls living in urban environments. Shoulder dislocation is dominant in female subjects aged 70–79 living in rural areas and in females 80+ years old living in urban areas.

Contrast-enhanced spectral mammography (CESM) is a promising, digital breast imaging method for planning surgeries. The study aimed at comparing digital mammography (MG) with CESM as predictive factors in visualizing multifocal-multicentric cancers (MFMCC) before determining the surgery extent. We analyzed 999 patients after breast cancer surgery to compare MG and CESM in terms of detecting MFMCC. Moreover, these procedures were assessed for their conformity with postoperative histopathology (HP), calculating their sensitivity and specificity. The question was which histopathological types of breast cancer were more frequently characterized by multifocality–multicentrality in comparable techniques as regards the general number of HP-identified cancers. The analysis involved the frequency of post-CESM changes in the extent of planned surgeries. In the present study, MG revealed 48 (4.80%) while CESM 170 (17.02%) MFMCC lesions, subsequently confirmed in HP. MG had MFMCC detecting sensitivity of 38.51%, specificity 99.01%, PPV (positive predictive value) 85.71%, and NPV (negative predictive value) 84.52%. The respective values for CESM were 87.63%, 94.90%, 80.57% and 96.95%. Moreover, no statistically significant differences were found between lobular and NST cancers (27.78% vs. 21.24%) regarding MFMCC. A treatment change was required by 20.00% of the patients from breast-conserving to mastectomy, upon visualizing MFMCC in CESM. In conclusion, mammography offers insufficient diagnostic sensitivity for detecting additional cancer foci. The high diagnostic sensitivity of CESM effectively assesses breast cancer multifocality/multicentrality and significantly changes the extent of planned surgeries. The multifocality/multicentrality concerned carcinoma, lobular and invasive carcinoma of no special type (NST) cancers with similar incidence rates, which requires further confirmation.

Purpose: To assess the effectiveness of contrast-enhanced mammography (CEM) recombinant images in detecting malignant lesions in patients with extremely dense breasts compared to the all-densities population.Material and methods: 792 patients with 808 breast lesions, in whom the final decision on core-needle biopsy was made based on CEM, and who received the result of histopathological examination, were qualified for a single-centre, retrospective study. Patient electronic records and imaging examinations were reviewed to establish demographics, clinical and imaging findings, and histopathology results. The CEM images were reassessed and assigned to the appropriate American College of Radiology (ACR) density categories.Results: Extremely dense breasts were present in 86 (10.9%) patients. Histopathological examination confirmed the presence of malignant lesions in 52.6% of cases in the entire group of patients and 43% in the group of extremely dense breasts. CEM incorrectly classified the lesion as false negative in 16/425 (3.8%) cases for the whole group, and in 1/37 (2.7%) cases for extremely dense breasts. The sensitivity of CEM for the group of all patients was 96.2%, speci­ficity – 60%, positive predictive values (PPV) – 72.8%, and negative predictive values (NPV) – 93.5%. In the group of patients with extremely dense breasts, the sensitivity of the method was 97.3%, specificity – 59.2%, PPV – 64.3%, and NPV – 96.7%.Conclusions: CEM is characterised by high sensitivity and NPV in detecting malignant lesions regardless of the type of breast density. In patients with extremely dense breasts, CEM could serve as a complementary or additional examination in the absence or low availability of MRI.

(1) Background: The purpose of the study was a retrospective, comparative assessment of complications of the surgical sentinel node biopsy (SNB) procedure in breast cancer using the radiotracer method and the SentiMag^® method on groups of patients after 3.5 years of use. (2) Methods: The material was a group of 345 patients with primary surgical breast cancer who underwent the SNB procedure with the use of a radiotracer in combination with wide local excision (WLE), simple amputation (SA) with SNB and an independent SNB procedure in the period from May 2018 to January 2021 in the Department of Oncological Surgery. Of the patients who were monitored in the Hospital Outpatient Clinic, 300 were enrolled. The analyzed group was compared in terms of the occurrence of the same complications with the group of 303 patients also operated on in our center in the period from January 2014 to September 2017, in which SN identification was performed using the SentiMag^® method. (3) Results: The most common complications found were sensation disorders in the arm, which occurred in 16 (14.1%) patients using the radiotracer method, SentiMag^®-11 (9.9%). By comparing the complication rate between the methods with the radiotracer (n = 300) and SentiMag^® (n = 303), no significant differences were found. (4) Conclusions: Sentinel node (SN) identification using the radiotracer method and the SentiMag^® method are comparable diagnostic methods in breast cancer, with a low risk of complications.