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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Conventional imaging (CI) for breast cancer includes mammography and ultrasound. Its limited efficiency is especially manifest for breast cancer follow-up after breast-conserving therapy (i.e. exclusive radiation therapy) and after breast implant. Lack of evidence for definitive diagnosis increases the number of invasive explorations. To improve the specificity of the diagnosis between recurrence or fibrosis, we describe the interest of new imaging (NI) techniques: post-contrast MRI, and MR angiography (MRA), realized in 1 exam. Between October 1993 and December 1994, 82 patients were eligible for these investigations. All patients had an history of conservative breast cancer treatment of breast implant following mastectomy. In all cases CI was not contributive for a precise diagnosis; therefore a biopsy was performed and confirmed the diagnosis of breast cancer. NI was done before biopsy and compared results are following. 19 more patients were evaluated for primary chemotherapeutic response, including a total of 101 patients. Regarding the follow-up of prosthesis and conservative treatment, the correlation with histological control was obtained in 95% with four false diagnoses due to confusion between retroprosthesis relapse and inflammation. Historadiologic correlation were close to 90% for the evaluation of primary chemotherapeutic response. Studies are ongoing to confirm those preliminary findings. Though expansive, these techniques might be cost-effective if they result in a substantial decrease of unnecessary surgical invasive procedures.
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PMID:[Breast cancer: role of MRI in follow-up of cases treated]. 764 8

We are reporting on a case of diabetes insipidus (DI) and anterior pituitary failure revealing a breast cancer metastasis. Ten years after being diagnosed with a unilateral breast cancer, the patient presented with asthenia, thirst, polyuria and nocturia improved by subcutaneous DDAVP. MRI revealed a thickened pituitary stalk. DI is uncommon, late and usually asymptomatic in breast cancer. The association with an anterior pituitary failure is even more rare. In our patient the metastasis is in the pituitary stalk and seems to be due to meningeal deposits. MRI appears to be the best procedure to perform, showing a thickening stalk. Extension to the pituitary gland is related to direct tumor invasion from adjacent structures rather than haematogenous spread.
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PMID:[Diabetes insipidus disclosing metastasis of breast adenocarcinoma]. 765 28

Twenty patients with clinically suspected breast cancer recurrence underwent MRI before and after paramagnetic contrast agent administration (MR mammography, MRM), after negative (4/20), questionable (11/20) or positive (5/20) X-ray mammography (XM). Spin-echo T1-weighted images before and after the i.v. administration of Gd-DTPA (0.15 mmol/kg) were acquired at 1, 3, 5, 7 and 10 minutes. Tissue behavior was studied directly on the images (qualitative analysis) and with dynamic curves of the signal-to-noise ratio and of enhancement rate (quantitative analysis). The histologic examination was performed in all cases--18 of them by surgical excision and in two by needle biopsy only. Seven of seven recurrences exhibited early (at 1 and 3 minutes) and focal qualitative enhancement, exceeding 100% at the quantitative analysis. Twelve of thirteen non-recurrences exhibited no significant qualitative enhancement, less than 40% at the quantitative analysis, while the extant lesion exhibited multifocal delayed (at 5-10 minutes) qualitative enhancement, about 60% at the quantitative analysis, and slight bilateral diffuse enhancement (proliferative dysplasia). MRM had 100% sensitivity, 92.3% specificity, 87.5% positive predictive value and 100% negative predictive value. XM had 100%, 30.8%, 43.7% and 100%, respectively (if we consider as positive all the questionable XM cases). To conclude, MRM is confirmed as a useful imaging technique in suspected breast cancer recurrences, especially after questionable XM exams.
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PMID:[Magnetic resonance mammography in suspected tumor recurrences]. 775 11

Metastases from solid tumors that seed the leptomeninges (meningeal carcinomatosis) are an important neurologic complication of systemic cancer. Recently many authors have reported that its incidence is increasing; particularly it has been demonstrated for breast cancer and small cell bronchogenic carcinoma. A cytologic examination of cerebrospinal fluid (CSF) establishes the diagnosis. Gadolinium-enhanced MRI has demonstrated superiority over other imaging with the clinical context and CSF analysis may lead to a rapid diagnosis and treatment of leptomeningeal carcinomatosis. Despite all measures, prognosis remains poor because of the presence of multiple metastases elsewhere.
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PMID:Leptomeningeal carcinomatosis: review of the literature. 785 76

The authors report a case of 'pseudosciatic' pain due to bone metastasis located in the sacroiliac joint secondary to breast cancer. Complementary investigations are mandatory in any case of sciatic pain starting at 80 years of age, even in the absence of the usual criteria suggesting a neoplastic origin. In this case our investigations revealed sacroiliac bone metastasis from the breast, explaining the clinical picture. Primary and secondary sacral tumors are uncommon. Their clinical manifestations are unspecific, consisting mainly of low back pain and sciatic pain. CT scan and MRI are the best tools to evaluate these lesions. Conservative management, combining radiotherapy and hormonal treatment, has been effective in terms of both pain and function.
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PMID:[Pseudo-sciatica of neoplastic origin: apropos of an unusual case]. 787 6

In this retrospective study plain radiographs, radionuclide bone scans, computed tomography (CT) and magnetic resonance (MRT) examinations of 115 patients with metastatic carcinoma of the spine were analyzed. In 32 patients metastases were proven histologically and in the remainder by follow-up studies. Altogether, 513 vertebrae were evaluated. Forty-one patients had histologically proven breast cancer, 14 renal cell carcinoma, 11 prostate cancer, 8 melanoma. 8 tumors of the gastrointestinal system and 7 bronchial carcinoma. Evaluation of the plain films showed that the initial site of metastasis (n = 463) was the vertebral body in 441 cases and the pedicles in 294 cases. In CT scans most of the lesions confined to one part of the vertebral body (36 of 98) were localized in the posterior part. Twelve percent of the metastases were diagnosed with conventional radiography and 17% of those diagnosed with CT were not detected in skeletal scintigraphy. MRI was rarely used in diagnosing occult vertebral metastases (n = 37); 22% of the metastases demonstrated by MRI were not detected in skeletal scintigraphy. We concluded that only in 63.8% was the pedicle sign the initial site of metastasis on plain films. Bone scans and plain films are the most important diagnostic procedures for detecting and monitoring vertebral metastases. CT and MRI are only needed in patients with neurological symptoms and persistent pain.
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PMID:[Spinal metastases. Value of diagnostic procedures in the initial diagnosis and follow-up]. 789 39

Magnetic resonance imaging at high spatial resolution, dynamic-contrast enhanced imaging, and localized 31P magnetic resonance spectroscopy were applied to monitor in vivo growth and tamoxifen treatment of MCF7 human breast tumors implanted in athymic mice. Correlation of the imaging data with histological findings demonstrated significant differences between viable carcinoma, fibrous, and necrotic regions on T2 weighted images. At an early stage after tamoxifen treatment rapid necrosis preceded tumor regression suggesting tamoxifen inhibition of angiogenesis. The necrosis was followed by growth of reperative fibrous tissue at the boundary of the viable cancer cells and the necrotic regions. The dynamic of contrast enhancement after tamoxifen treatment revealed high permeability of microvessels at this boundary cord. In parallel to the induction of the repair process the tumor energy profile changed, showing a significant increase in the ratio of ATP to inorganic phosphate. Initial attempts to use MRI for evaluating the response of breast cancer patients to treatment are also described.
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PMID:Magnetic resonance imaging and spectroscopy of MCF7 human breast cancer: pathophysiology and monitoring of treatment. 795 26

We investigated the utility of bone marrow MRI for diagnosing marrow metastases from breast cancer compared with radionuclide bone scan, iliac crest marrow biopsy with histology and antibody immunostaining, and clinical follow-up. We report the results of 43 MRI studies in 32 patients and discuss the evolution and comparison of optimal MRI techniques. MRI appears to be the most accurate diagnostic method, and short TI Inversion Recovery (STIR) the most reliable pulse sequence for this group of patients with breast cancer.
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PMID:Bone marrow MRI: techniques and accuracy for detecting breast cancer metastases. 796 82

Despite the increasing incidence of breast cancer in recent years, early detection of breast cancer improves the curative rate and quality of life (QOL). Advances in diagnostic imaging are making early detection increasingly common. Although mammography (MMG) is the most popular examination method and yields excellent image description, diagnosis is influenced by imaging technique and ability to read the images. A clear image can be achieved if the MMG image acquired at 28 Kv using an M0 filter is energy subtracted at 32 Kv using an Rh filter. Ultrasonography can be excellent for qualitative diagnosis of a tumor, but changes in blood flow volume, as demonstrated by Doppler imaging, makes early detection difficult. Breast scintigraphy by 201TlCl can clearly demonstrate palpable breast cancer and also lymph node metastasis, but poor spatial resolution remains a problem. High resolution CT is effective for detection of lymph node metastasis. MRI offers excellent qualitative diagnosis of tumors, but detection of ultra-small lesions is difficult even using contrast medium. The detection rate and proportion of early breast cancer detected on the whole will rise if MMG is introduced into the present mass screening for breast cancer, but its implementation requires improved facilities, imaging capability, and experience in image reading.
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PMID:[Early diagnosis of breast cancer]. 803 78

An investigation was undertaken to determine the characteristics of spinal breast cancer metastases with respect to MR signal intensity (SI), patho-anatomy and uptake of the bone-seeking radionuclide 18F measured with positron emission tomography (PET). Patients with spinal metastases from breast cancer, or spinal specimens, were examined with MRI and the results were correlated to histopathological findings, or they were examined with conventional radiography and CT in correlation with cryomicrotomical images, with CT and dynamic 18F-PET; or with MRI, CT, skeletal scintigraphy and conventional radiography, compared with one another. Metastases were detected in all anatomical parts of the vertebrae. The areas with bone marrow replacement by tumour were larger in the cryosectional images than was apparent on CT. Metastases were often in contact with the vertebral cortex or end-plates, and fractures occurred in destructive lesions. Neurovascular compromise was detected only at few levels and was caused by vertebral collapse rather than epidural tumour growth. Metastases (in vivo) displayed low SI on T1-weighted, low or intermediate SI on proton density-weighted, and high or intermediate SI on T2-weighted and "phase contrast" images, except for highly sclerotic metastases, which showed low SI on all sequences. Sensitivity was high and specificity limited since connective tissue in the vertebrae and bone marrow with high cellularity had similar SI. Both MRI and CT were more sensitive than conventional radiography and skeletal scintigraphy for revealing metastases in the cervical spine. On PET there was an increased uptake of 18F in metastases, both in osteosclerotic lesions and in osteolytic defects in the bone. Post-mortem MR examinations showed different SIs than MRI in vivo. The T1-and T2-relaxation times and SI were dependent on tissue temperature. Reversal of contrast between some tissues occurred at 5 degrees C in T1-weighted images.
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PMID:Clinical and experimental imaging of breast cancer metastases in the spine. 817 6


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