To determine the contribution of apparent diffusion coefficient (ADC), and relative ADC (rADC) values to differentiate between benign and malignant breast masses. Magnetic resonance imaging (MRI) of the breast with diffusion-weighted imaging (DWI) of patients with benign or malignant breast masses diagnosed either by histopathological findings or by follow-up imaging were evaluated retrospectively. Histopathological analyses were performed for 71 lesions (80.7%) while the remaining were followed up every six months for one year. DWI was performed using b-values of 0 and 1000 sec/mm2, and ADC and rADC were calculated and compared. A receiver operating characteristic (ROC) curve and Youden index were used to evaluate the parameter's optimal threshold and diagnostic value. Statistical significance was set as p < 0.05. Eighty-eight lesions from a total of 81 patients, aged between 16 and 73 (mean age 42 ± 11.3) years were obtained and evaluated. Pathological results of 34 (38.6%) out of 71 lesions were malignant and 37 lesions (42%) were benign. Seventeen (19.3%) lesions remained stable at one-year follow-up and were accepted as benign breast masses. Mean ADC values of benign and malignant lesions were 1.584 × 10-3mm2/sec and 0.884 × 10-3mm2/sec (p < 0.05), respectively. Sensitivity and specificity of ADC were 88% and 87%, respectively at a cut-off value of 1.04 × 10-3mm2/sec. Mean rADC was 0.931 for benign lesions and 0.557 for malignant lesions (p < 0.05). Sensitivity and specificity were 82% and 83% at a cut-off value of 0.639. No prominent superiority of rADC over ADC is identified in the differentiation of breast masses. ADC and rADC values derived from DWI can be equally useful in clinical setting to differentiate benign from malignant breast masses.

Background : To investigate the diagnostic performance of the elastography-based strain index ratio in the differential diagnosis of malignant and benign breast lesions. Material/Methods : Seventy-nine breast masses that were classified as BI-RADS category 3, 4, and 5 on B-mode...

The aim of this study was to evaluate efficiency of time use for radiologists and operational costs of automated breast ultrasound (ABUS) versus handheld breast ultrasound (HHUS). This study was approved by the Institutional Review Board, and informed consent was waived. One hundred and fifty-three patients, aged 21–81 years, underwent both ABUS and HHUS. The time required for the ABUS scanning and radiologist interpretation and the combined scanning and interpretation time for HHUS were recorded for screening and diagnostic exams. One-Way ANOVA test was used to compare the methods, and Cohen Kappa statistics were used to achieve the agreement levels. Finally, the cost of the methods and return of interest were compared by completing a cost analysis. The overall mean ± standard deviation examination time required for ABUS examination was 676.2±145.42 seconds while mean scan time performed by radiographers was 411.76±67.79 seconds, and the mean radiologist time was 234.01±81.88 seconds. The overall mean examination time required for HHUS was 452.52±171.26 seconds, and the mean scan time and radiologist time were 419.62±143.24 seconds. The reduced time translated into savings of 7.369 TL/month, and savings of 22% in operational costs was achieved with ABUS. The radiologist’s time was reduced with ABUS in both screening and diagnostic scenarios. Although a second-look HHUS is required for diagnostic cases, ABUS still saves radiologists time by enabling a focused approach instead of a complete evaluation of both breasts. Thus, ABUS appears to save both medical staff time and operational costs.

Coronavirus disease 2019 (COVID-19) has placed an unprecedented burden on healthcare systems and restricted resources for non-COVID patients worldwide. Treatment approaches and follow-up plans have been modified to prevent the risk of infection for patients and healthcare workers. Patients prefer to delay or cancel their treatments during the peak period of infection. We retrospectively reviewed the characteristics of patients with breast cancer who were consulted at our outpatient clinic right after early COVID-19 peak in May and June 2020 and compared them with the same period in 2017 to 2019. The number of patients who consulted at our outpatient medical oncology clinic declined in May and June 2020. This decline was regardless of stage and was larger in May than in June 2020. In general, the distribution of tumor subtypes [luminal, human epidermal growth factor receptor 2 (HER-2) positive, and triple negative] was not different from 2017 to 2020. Less than half of the patients received adjuvant chemotherapy following early COVID-19 peak in May and June 2020. Few patients received chemotherapy for metastatic disease, whereas many metastatic patients received endocrine therapy. None of the consulted new patients had a non-invasive disease. More patients received endocrine therapy than chemotherapy. The presentation patterns of patients with breast cancer after early COVID-19 peak differed from those during the same period in the last 3 years. The pandemic affected the number of new patients consulted and the way medical oncologists treat their patients.

Localized amyloidosis in the breast is a very rare disease and may mimic malignant lesions. A 60-year-old woman who had a history of breast-conserving surgery presents with a new a well-defined oval opacity accompanied by many round tight clustered micro- and macrocalcifications on mammograms. It could not be visualized sonographically due to the intense posterior acoustic shadowing of the fat necrosis areas and contrast enhancement was not detected in this area on the dynamic contrast enhanced magnetic resonance images. At pathological examination breast amyloidosis was detected. Amyloidosis of the breast is a rare disease, but it can mimic malignancy and should be included in the differential diagnosis.

We aimed to determine the value of standalone and supplemental automated breast ultrasound (ABUS) in detecting cancers in an opportunistic screening setting with digital breast tomosynthesis (DBT) and compare this combined screening method to DBT and ABUS alone in women older than 39 years with BI‐RADS B‐D density categories. In this prospective opportunistic screening study, 3466 women aged 39 or older with BI‐RADS B‐D density categories and with a mean age of 50 were included. The screening protocol consisted of DBT mediolateral‐oblique views, 2D craniocaudal views, and ABUS with three projections for both breasts. ABUS was evaluated blinded to mammography findings. Statistical analysis evaluated diagnostic performance for DBT, ABUS, and combined workflows. Twenty‐nine cancers were screen‐detected. ABUS and DBT exhibited the same cancer detection rates (CDR) at 7.5/1000 whereas DBT + ABUS showed 8.4/1000, with ABUS contributing an additional CDR of 0.9/1000. Standalone ABUS outperformed DBT in detecting 12.5% more invasive cancers. DBT displayed better accuracy (95%) compared to ABUS (88%) and combined approach (86%). Sensitivities for DBT and ABUS were the same (84%), with DBT + ABUS showing a higher rate (94%). DBT outperformed ABUS in specificity (95% vs. 88%). DBT + ABUS exhibited a higher recall rate (14.89%) compared to ABUS (12.38%) and DBT (6.03%) ( p < .001). Standalone ABUS detected more invasive cancers compared to DBT, with a higher recall rate. The combined approach showed a higher CDR by detecting one additional cancer per thousand.