47 results on '"Heywang-Köbrunner, Sylvia H."'
Search Results
2. Breast ultrasound: recommendations for information to women and referring physicians by the European Society of Breast Imaging
- Author
-
Evans, Andrew, Trimboli, Rubina M., Athanasiou, Alexandra, Balleyguier, Corinne, Baltzer, Pascal A., Bick, Ulrich, Camps Herrero, Julia, Clauser, Paola, Colin, Catherine, Cornford, Eleanor, Fallenberg, Eva M., Fuchsjaeger, Michael H., Gilbert, Fiona J., Helbich, Thomas H., Kinkel, Karen, Heywang-Köbrunner, Sylvia H., Kuhl, Christiane K., Mann, Ritse M., Martincich, Laura, Panizza, Pietro, Pediconi, Federica, Pijnappel, Ruud M., Pinker, Katja, Zackrisson, Sophia, Forrai, Gabor, Sardanelli, Francesco, and for the European Society of Breast Imaging (EUSOBI) , with language review by Europa Donna–The European Breast Cancer Coalition
- Published
- 2018
- Full Text
- View/download PDF
3. Use of novel artificial intelligence computer-assisted detection (AI-CAD) for screening mammography: an analysis of 17,884 consecutive two-view full-field digital mammography screening exams.
- Author
-
Heywang-Köbrunner, Sylvia H, Hacker, Astrid, Jänsch, Alexander, Hertlein, Michael, Mieskes, Christoph, Elsner, Susanne, Sinnatamby, Ruchira, and Katalinic, Alexander
- Subjects
- *
DIGITAL mammography , *MEDICAL screening , *ARTIFICIAL intelligence , *MAMMOGRAMS , *RECEIVER operating characteristic curves - Abstract
Background: Novel artificial intelligence computer-assisted detection (AI-CAD) systems based on deep learning (DL) promise to support screen reading. Purpose: To test a DL-AI-CAD system compared to human reading on consecutive screening mammograms. Material and Methods: In this retrospective study, 17,884 consecutive anonymized screening mammograms, double-read from January to November 2018, were processed by the DL-AI-CAD system. AI-CAD reading was considered positive if the AI-CAD case scores exceeded 30 (range = 1–100) and the lesion was correctly marked. Likewise, human reading (R1 or R2, respectively) was considered positive if the lesion was correctly identified and called. Receiver operating characteristic (ROC) analysis was performed and accuracy data were calculated. Ground truth for benign lesions: absence of malignancy after cancer registry matching (2022); for malignancy: histopathologic proof; evaluation was patient-based. Results: In total, 114 screen-detected and 17 interval cancers (ICA) occurred. ROC analysis of screen-detected cancers yielded an AUC of 89% for AI-CAD. Sensitivity/specificity was 81.7%/80.2% for AI-CAD; 77.1%/91.7% for R1; 78.6/91.6% for R2. Combining each human reading with AI-CAD was as sensitive as human double-reading (all approximately 88%), but less specific (approximately 75%) compared to human double-reading (approximately 87%). These AI-CAD combinations required consensus readings for twice as many cases as the human combination. Four of 17 ICA exceeded a case score of 30; two of four CAD correctly marked the quadrant of the subsequent ICA. Conclusion: Including ICA cases, this AI-CAD achieved comparable sensitivity to human reading at lower specificity. Combining human reading and AI-CAD allows increasing sensitivity compared to single-reading. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey
- Author
-
Sardanelli, Francesco, Aase, Hildegunn S., Álvarez, Marina, Azavedo, Edward, Baarslag, Henk J., Balleyguier, Corinne, Baltzer, Pascal A., Beslagic, Vanesa, Bick, Ulrich, Bogdanovic-Stojanovic, Dragana, Briediene, Ruta, Brkljacic, Boris, Camps Herrero, Julia, Colin, Catherine, Cornford, Eleanor, Danes, Jan, de Geer, Gérard, Esen, Gul, Evans, Andrew, Fuchsjaeger, Michael H., Gilbert, Fiona J., Graf, Oswald, Hargaden, Gormlaith, Helbich, Thomas H., Heywang-Köbrunner, Sylvia H., Ivanov, Valentin, Jónsson, Ásbjörn, Kuhl, Christiane K., Lisencu, Eugenia C., Luczynska, Elzbieta, Mann, Ritse M., Marques, Jose C., Martincich, Laura, Mortier, Margarete, Müller-Schimpfle, Markus, Ormandi, Katalin, Panizza, Pietro, Pediconi, Federica, Pijnappel, Ruud M., Pinker, Katja, Rissanen, Tarja, Rotaru, Natalia, Saguatti, Gianni, Sella, Tamar, Slobodníková, Jana, Talk, Maret, Taourel, Patrice, Trimboli, Rubina M., Vejborg, Ilse, Vourtsis, Athina, and Forrai, Gabor
- Published
- 2017
- Full Text
- View/download PDF
5. Breast MRI: EUSOBI recommendations for women’s information
- Author
-
Mann, Ritse M., Balleyguier, Corinne, Baltzer, Pascal A., Bick, Ulrich, Colin, Catherine, Cornford, Eleanor, Evans, Andrew, Fallenberg, Eva, Forrai, Gabor, Fuchsjäger, Michael H., Gilbert, Fiona J., Helbich, Thomas H., Heywang-Köbrunner, Sylvia H., Camps-Herrero, Julia, Kuhl, Christiane K., Martincich, Laura, Pediconi, Federica, Panizza, Pietro, Pina, Luis J., Pijnappel, Ruud M., Pinker-Domenig, Katja, Skaane, Per, Sardanelli, Francesco, and for the European Society of Breast Imaging (EUSOBI), with language review by Europa Donna–The European Breast Cancer Coalition
- Published
- 2015
- Full Text
- View/download PDF
6. Preservation of histopathologic assessment by use of a special technique for tissue inactivation by radiofrequency
- Author
-
Heywang-Köbrunner, Sylvia H., Weiwad, Wieland, Lampe, Dieter, and Buchmann, Jörg
- Published
- 2002
- Full Text
- View/download PDF
7. CT-guided obturator nerve block for diagnosis and treatment of painful conditions of the hip
- Author
-
Heywang-Köbrunner, Sylvia H., Amaya, Beatrice, Okoniewski, Matthias, Pickuth, Dirk, and Spielmann, Rolf-Peter
- Published
- 2001
- Full Text
- View/download PDF
8. Use of Ultrasound-Guided Percutaneous Vacuum-Assisted Breast Biopsy for Selected Difficult Indications
- Author
-
Heywang-Köbrunner, Sylvia H., Heinig, Anke, Hellerhoff, Karin, Holzhausen, Hans Jürgen, and Nährig, Jörg
- Published
- 2009
- Full Text
- View/download PDF
9. Proceedings of the consensus conference on breast conservation, April 28 to May 1, 2005, Milan, Italy
- Author
-
Schwartz, Gordon F., Veronesi, Umberto, Clough, Krishna B., Dixon, Michael J., Fentiman, Ian S., Heywang-Köbrunner, Sylvia H., Holland, Roland, Hughes, Kevin S., Margolese, Richard, Olivotto, Ivo A., Palazzo, Juan P., and Solin, Lawrence J.
- Published
- 2006
- Full Text
- View/download PDF
10. Consensus Conference on Breast Conservation, Milan, Italy, April 28–May 1, 2005
- Author
-
Schwartz, Gordon F., Veronesi, Umberto, Clough, Krishna B., Dixon, J. M., Fentiman, Ian S., Heywang-Köbrunner, Sylvia H., Holland, Roland, Hughes, Kevin S., Mansel, Robert E., Margolese, Richard, Mendelson, Ellen B., Olivotto, Ivo A., Palazzo, Juan P., and Solin, Lawrence J.
- Published
- 2006
11. MRI Detection of Distinct Incidental Cancer in Women With Primary Breast Cancer Studied in IBMC 6883
- Author
-
SCHNALL, MITCHELL D., BLUME, JEFFERY, BLUEMKE, DAVID A., DEANGELIS, GIA A., DEBRUHL, NANETTE, HARMS, STEVEN, HEYWANG-KöBRUNNER, SYLVIA H., HYLTON, NOLA, KUHL, CHRISTIANE K., PISANO, ETTA D., CAUSER, PETRINA, SCHNITT, STUART J., SMAZAL, STANLEY F., STELLING, CAROL B., LEHMAN, CONSTANCE, WEATHERALL, PAUL T., and GATSONIS, CONSTANTINE A.
- Published
- 2005
- Full Text
- View/download PDF
12. Magnetic Resonance Imaging of the Breast Prior to Biopsy
- Author
-
Bluemke, David A., Gatsonis, Constantine A., Chen, Mei Hsiu, DeAngelis, Gia A., DeBruhl, Nanette, Harms, Steven, Heywang-Köbrunner, Sylvia H., Hylton, Nola, Kuhl, Christiane K., Lehman, Constance, Pisano, Etta D., Causer, Petrina, Schnitt, Stuart J., Smazal, Stanley F., Stelling, Carol B., Weatherall, Paul T., and Schnall, Mitchell D.
- Published
- 2004
13. Interdisziplinäre Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms : Leitlinie der DGGG und DKG (S3-Level, AWMF-Registernummer 032/045OL, Dezember 2017) – Teil 1 mit Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms
- Author
-
Wöckel, Achim, Festl, Jasmin, Stüber, Tanja, Brust, Katharina, Stangl, Stephanie, Heuschmann, Peter Ulrich, Albert, Ute Susann, Budach, Wilfried, Follmann, Markus, Janni, Wolfgang, Kopp, Ina, Kreienberg, Rolf, Kühn, Thorsten, Langer, Thomas, Nothacker, Monika, Scharl, Anton, Schreer, Ingrid, Link, Hartmut, Engel, Jutta, Fehm, Tanja, Weis, Joachim, Welt, Anja, Steckelberg, Anke, Feyer, Petra, König, Klaus, Hahne, Andrea, Kreipe, Hans H., Knoefel, Wolfram Trudo, Denkinger, Michael, Brucker, Sara, Lüftner, Diana, Kubisch, Christian, Gerlach, Christina, Lebeau, Annette, Siedentopf, Friederike, Petersen, Cordula, Bartsch, Hans Helge, Schulz-Wendtland, Rüdiger, Hahn, Markus, Hanf, Volker, Müller-Schimpfle, Markus, Henscher, Ulla, Roncarati, Renza, Katalinic, Alexander, Heitmann, Christoph, Honegger, Christoph, Paradies, Kerstin, Bjelic-Radisic, Vesna, Degenhardt, Friedrich, Wenz, Frederik, Rick, Oliver, Hölzel, Dieter, Zaiss, Matthias, Kemper, Gudrun, Budach, Volker, Denkert, Carsten Michael, Gerber , Bernd, Tesch, Hans, Hirsmüller, Susanne, Sinn, Hans-Peter, Dunst, Jürgen, Münstedt, Karsten, Bick, Ulrich, Fallenberg, Eva, Tholen, Reina, Hung, Roswita, Baumann, Freerk T., Beckmann, Matthias Wilhelm, Blohmer, Jens-Uwe, Fasching, Peter Andreas, Lux, Michael Patrick, Harbeck, Nadia, Hadji, Peyman, Hauner, Hans, Heywang-Köbrunner, Sylvia H., Huober, Jens, Hübner, Jutta, Jackisch, Christian, Loibl, Sibylle, Lück, Hans-Jürgen, Minckwitz, Gunter von, Möbus, Volker, Müller, Volkmar, Nöthlings, Ute, Schmidt, Marcus, Schmutzler, Rita Katharina, Schneeweiss, Andreas, Schütz, Florian, Stickeler, Elmar, Thomssen, Christoph, Untch, Michael, Wesselmann, Simone, Bücker, Arno, and Krockenberger, Mathias
- Subjects
ddc:610 - Abstract
Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure. Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease. Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren. Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden. Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.
- Published
- 2018
14. Image-guided breast biopsy and localisation: recommendations for information to women and referring physicians by the European Society of Breast Imaging.
- Author
-
Bick, Ulrich, Trimboli, Rubina M., Athanasiou, Alexandra, Balleyguier, Corinne, Baltzer, Pascal A. T., Bernathova, Maria, Borbély, Krisztina, Brkljacic, Boris, Carbonaro, Luca A., Clauser, Paola, Cassano, Enrico, Colin, Catherine, Esen, Gul, Evans, Andrew, Fallenberg, Eva M., Fuchsjaeger, Michael H., Gilbert, Fiona J., Helbich, Thomas H., Heywang-Köbrunner, Sylvia H., and Herranz, Michel
- Subjects
BREAST biopsy ,MAGNETIC resonance mammography ,CORE needle biopsy ,BREAST imaging ,DIAGNOSTIC ultrasonic imaging personnel ,TOMOSYNTHESIS ,NEEDLE biopsy ,WOMEN physicians ,MAGNETIC resonance imaging - Abstract
We summarise here the information to be provided to women and referring physicians about percutaneous breast biopsy and lesion localisation under imaging guidance. After explaining why a preoperative diagnosis with a percutaneous biopsy is preferred to surgical biopsy, we illustrate the criteria used by radiologists for choosing the most appropriate combination of device type for sampling and imaging technique for guidance. Then, we describe the commonly used devices, from fine-needle sampling to tissue biopsy with larger needles, namely core needle biopsy and vacuum-assisted biopsy, and how mammography, digital breast tomosynthesis, ultrasound, or magnetic resonance imaging work for targeting the lesion for sampling or localisation. The differences among the techniques available for localisation (carbon marking, metallic wire, radiotracer injection, radioactive seed, and magnetic seed localisation) are illustrated. Type and rate of possible complications are described and the issue of concomitant antiplatelet or anticoagulant therapy is also addressed. The importance of pathological-radiological correlation is highlighted: when evaluating the results of any needle sampling, the radiologist must check the concordance between the cytology/pathology report of the sample and the radiological appearance of the biopsied lesion. We recommend that special attention is paid to a proper and tactful approach when communicating to the woman the need for tissue sampling as well as the possibility of cancer diagnosis, repeat tissue sampling, and or even surgery when tissue sampling shows a lesion with uncertain malignant potential (also referred to as "high-risk" or B3 lesions). Finally, seven frequently asked questions are answered. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
15. Consensus Meeting of Breast Imaging: BI-RADS® and Beyond.
- Author
-
Müller-Schimpfle, Markus, Bader, Werner, Baltzer, Pascal, Bernathova, Maria, Fuchsjäger, Michael, Golatta, Michael, Helbich, Thomas H., Hellerhoff, Karin, Heywang-Köbrunner, Sylvia H., Kurtz, Claudia, Mundinger, Alexander, Siegmann-Luz, Katja C., Skaane, Per, Solbach, Chistine, and Weigel, Stefanie
- Subjects
BREAST tumor diagnosis ,BREAST tumor risk factors ,MAMMOGRAMS ,CONSENSUS (Social sciences) ,LYMPH nodes ,MAGNETIC resonance imaging ,MEETINGS ,RISK assessment ,ULTRASONIC imaging ,VOTING ,DECISION making in clinical medicine ,PHYSICIANS' attitudes - Abstract
Organizers of medical educational courses are often confronted with questions that are clinically relevant yet trespassing the frontiers of scientifically proven, evidence-based medicine at the point of care. Therefore, since 2007 organizers of breast teaching courses in German language met biannually to find a consensus in clinically relevant questions that have not been definitely answered by science. The questions were prepared during the 3 months before the meeting according to a structured process and finally agreed upon the day before the consensus meeting. At the consensus meeting, the open questions concerning 2D/3D mammography, breast ultrasound, MR mammography, interventions as well as risk-based imaging of the breast were presented first for electronic anonymized voting, and then the results of the audience were separately displayed from the expert votes. Thereafter, an introductory statement of the moderator was followed by pros/cons of two experts, and subsequently the final voting was performed. With ≥75% of votes of the expert panel, an answer qualified as a consensus statement. Seventeen consensus statements were gained, addressing for instance the use of 2D/3D mammography, breast ultrasound in screening, MR mammography in women with intermediate breast cancer risk, markers for localization of pathologic axillary lymph nodes, and standards in risk-based imaging of the breast. After the evaluation, comments from the experts on each field were gathered supplementarily. Methodology, transparency, and soundness of statements achieve a unique yield for all course organizers and provide solid pathways for decision making in breast imaging. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
16. Use of single-view digital breast tomosynthesis (DBT) and ultrasound vs. additional views and ultrasound for the assessment of screen-detected abnormalities: German multi-reader study.
- Author
-
Heywang-Köbrunner, Sylvia H., Hacker, Astrid, Jänsch, Alexander, Kates, Ronald, Wulz-Horber, Sabina, and German Reader Team
- Subjects
- *
TOMOSYNTHESIS , *ULTRASONIC imaging , *MAMMOGRAMS , *SENSITIVITY analysis , *WOUNDS & injuries , *BREAST , *BREAST tumors , *COMPARATIVE studies , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *RESEARCH bias ,RESEARCH evaluation - Abstract
Background Data on the value of digital breast tomosynthesis (DBT) for further assessment of screen-detected lesions are still limited. Purpose To compare screening mammography, single-view DBT and ultrasound-information (TS) vs. screening mammography, additional views and ultrasound-information (AV) for assessment of screen-detected abnormalities. Material and Methods The use of wide-angle DBT for screen-detected, soft-tissue abnormalities requiring additional views was investigated: 241 cases (206 benign and 35 malignant lesions), verified by histology or two-year follow-up, were read by ten readers as TS and as AV sets, yielding 2410 diagnoses for each set. Readings were randomly sequenced. Results The mean interval between readings was nine weeks (random sequence). Evaluation was breast-based. Overall, in terms of area under receiver operating characteristic (AUC; varying degree of suspicion cutoff), TS and AV readings showed similar performance: for TS, AUC was 0.889 (95% confidence interval [CI] = 0.871-0.907) and for AV, AUC was 0.903 (95% CI = 0.886-0.921). TS readings had slightly higher sensitivity than AV readings (96.9% vs. 95.4%) but lower specificity (50% vs. 58.1%) and more variations between reader performance; absolute false negatives (FN) were reduced in 8/16 readers, equal in 5/16, and increased in only 3/16. Conclusion This study broadly confirms previous data showing equivalence of DBT to AV. However, bias against TS may have occurred since the region of interest was not indicated in the TS set as compared to its obvious identification on the AV set by the selected spot views. A key finding is that reader experience with DBT may be more important than so far reported. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
17. Systematic review of 3D mammography for breast cancer screening.
- Author
-
Hodgson, Robert, Heywang-Köbrunner, Sylvia H., Harvey, Susan C., Edwards, Mary, Shaikh, Javed, Arber, Mick, and Glanville, Julie
- Subjects
BREAST cancer diagnosis ,MAMMOGRAMS ,SYSTEMATIC reviews ,TOMOSYNTHESIS ,THREE-dimensional imaging ,MEDICAL imaging systems ,CANCER in women - Abstract
This review investigated the relative performance of digital breast tomosynthesis (DBT) (alone or with full field digital mammography (FFDM) or synthetic digital mammography) compared with FFDM alone for detecting breast cancer lesions in asymptomatic women. A systematic review was carried out according to systematic reviewing principles provided in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A protocol was developed a priori . The review was registered with PROSPERO (number CRD42014013949). Searches were undertaken in October 2014. Following selection, five studies were eligible. Higher cancer detection rates were observed when comparing DBT + FFDM with FFDM in two European studies: the summary difference per 1000 screens was 2.43 (95% CI: 1.8 to 3.1). Both European studies found lower false positive rates for individual readers. One found a lower recall rate based on conditional recall. The second study was not designed to compare post-arbitration recall rates between FFDM and DBT + FFDM. One European study presented data on interval cancer rates; sensitivity and specificity for DBT + FFDM were both higher compared to FFDM. One large multicentre US study showed a higher cancer detection rate for DBT + FFDM, while two smaller US studies did not find statistically significant differences. Reductions in recall and false positive rates were observed in the US studies in favour of DBT + FFDM. In comparison to FFDM, DBT, as an adjunct to FFDM, has a higher cancer detection rate, increasing the effectiveness of breast cancer screening. Additional benefits of DBT may also include reduced recalls and, consequently, reduced costs and distress caused to women who would have been recalled. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
18. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.
- Author
-
Stets, Constanze, Brandt, Silvio, Wallis, Fintan, Buchmann, Jörg, Gilbert, F.J., Heywang-Köbrunner, Sylvia H., Buchmann, Jörg, and Heywang-Köbrunner, Sylvia H
- Published
- 2002
- Full Text
- View/download PDF
19. Tomosynthesis with synthesised two-dimensional mammography yields higher cancer detection compared to digital mammography alone, also in dense breasts and in younger women: A systematic review and meta-analysis.
- Author
-
Heywang-Köbrunner, Sylvia-H., Jänsch, Alexander, Hacker, Astrid, Weinand, Sina, and Vogelmann, Tobias
- Subjects
- *
DIGITAL mammography , *EARLY detection of cancer , *TOMOSYNTHESIS , *MAMMOGRAMS , *YOUNG women , *FERRANS & Powers Quality of Life Index , *META-analysis , *SYSTEMATIC reviews , *MEDICAL screening , *BREAST tumors - Abstract
Objectives: This systematic review and meta-analysis focuses on breast cancer screening performance outcomes stratified into breast density, age, and reading procedure using 'digital breast tomosynthesis (DBT) with synthesised two-dimensional mammography (s2D)' compared to 'digital mammography (DM) alone'.Methods: Studies comparing 'DBT with s2D' and 'DM' were searched in PubMed and Cochrane library. Pooled risk ratios (RR) using fixed or random effects models (F-/REM) for cancer detection rates (CDR), recall rates, interval cancer rates (ICR), biopsy rates, and positive predictive values (PPV) 1-3 were calculated. Outcomes were stratified into breast density (non-dense and dense), age (<60, ≥60), and reading procedure (double-/non-double reading). Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool.Results: We identified 13 studies. Using DBT plus s2D compared to DM alone resulted in a higher increase in CDR for dense ([number of studies included, FEM RR, 95% confidence interval (CI)]; n = 3, 1.60, 1.16-2.22) versus non-dense breasts (n = 3, 1.32, 1.08-1.61). Recall rates were lower in dense (n = 2, 0.84, 0.75-0.94), but much lower for non-dense breasts (n = 2, 0.65, 0.59-0.72). Age stratification resulted in small differences in CDR (<60: n = 2, 1.64, 1.18-2.29 / ≥60: n = 2, 1.56, 1.19-2.05). After screening with DBT plus s2D compared to DM alone the risk of being recalled was less in non-double (n = 3, 0.57, 0.54-0.60) than in double reading (n = 5, 0.95, 0.81-1.11) and the risk of cancer detection was higher in double reading (n = 6, 1.53, 1.40-1.67) than in non-double reading (n = 4, 1.17, 1.02-1.33).Conclusion: Since only few studies are available for meta-analyses statistical significance strongly depends on single study results. Taking this into account, the most important results concern the increase of CDR in women with dense breasts, the increased CDR in double reading, and the lower recall rates particularly with non-double reading. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
20. Advantages and Disadvantages of Mammography Screening.
- Author
-
Heywang-Köbrunner, Sylvia H., Hacker, Astrid, and Sedlacek, Stefan
- Subjects
BREAST tumor diagnosis ,BREAST tumor prevention ,RADIATION injuries ,AGE distribution ,MAMMOGRAMS ,DIAGNOSTIC errors ,TIME ,WOMEN'S health ,DISEASE incidence ,EARLY medical intervention ,INJURY risk factors - Abstract
Mammography screening is the only method presently considered appropriate for mass screening of asymptomatic women. Its frequent use, however, warrants diligent analysis of potential side effects. Radiation risk is far below the natural yearly risk of breast cancer and should not be used as an argument against screening. False-positive calls lead to additional imaging or histopathological assessment, mainly percutaneous breast biopsy. These measures are tolerated and accepted fairly well. Their number is limited by strict quality assurance and constant training. Interval cancers represent a limitation of breast screening that should prompt further research for optimization. Evaluation of overdiagnosis is a highly debated topic in the literature. According to the probably most realistic available calculations, overdiagnosis is acceptable as it is compensated by the potential mortality reduction. Nonetheless, this potential side effect warrants optimal adjustment of therapy to the patient's individual risk. The mortality reduction seen in randomized studies was confirmed by results from national screening programs. A recent case referent study indicated that improvements in mortality reduction run parallel to improved mammographic techniques. Use of less aggressive therapies is another valuable effect of screening. Awareness of potential problems, strict quality assurance, and further research should help to further develop screening programs. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
21. Breast Magnetic Resonance Imaging.
- Author
-
Fuchsjäger, Michael H., Boetes, Carla, Helbich, Thomas, Heywang-Köbrunner, Sylvia H., Ikeda, Debra, Morris, Elizabeth, and Sardanelli, Francesco
- Subjects
BREAST tumor diagnosis ,BREAST tumor prevention ,BREAST tumors ,BREAST surgery ,MAGNETIC resonance imaging ,TUMOR classification - Abstract
The article presents questions and answers related to Breast Magnetic Resonance Imaging (MRI) which include limitations of Breast MRI, change in diagnostic techniques after the introduction of 3-Tesla Magnet, Diffusion and Spectroscopy MRI techniques, and strategies to solve the issue of false positive results in low diagnostic specificity.
- Published
- 2010
- Full Text
- View/download PDF
22. Interdisciplinary consensus on the uses and technique of MR-guided vacuum-assisted breast biopsy (VAB): Results of a European consensus meeting
- Author
-
Heywang-Köbrunner, Sylvia H., Sinnatamby, Ruchi, Lebeau, Annette, Lebrecht, Antje, Britton, Peter D., and Schreer, Ingrid
- Subjects
- *
MAGNETIC resonance imaging , *MAMMOGRAMS , *BIOPSY , *MEDICAL literature , *COMPARATIVE studies , *DIAGNOSTIC imaging , *FOLLOW-up studies (Medicine) - Abstract
Abstract: Purpose: Quality assurance of MR-guided vacuum-assisted breast biopsy (VAB). Method: A consensus was achieved based on the existing literature and experience of an interdisciplinary group comprising European specialists in breast imaging and VAB. Results: Full imaging work-up must be completed according to existing standards before an indication for MR-guided VAB is established. The procedure should be reserved for lesions demonstrable by MRI alone. Acquisition of >24 cores (11-Gauge) should be routinely attempted, with the intention of sufficiently removing small lesions for accurate diagnosis. Following biopsy the patient should be re-imaged to demonstrate the biopsy site and its proximity to the lesion and hence the likely accuracy of the sampling. All patients should be discussed in a regular interdisciplinary conference and a documented consensus reached regarding patient management. Regular audit and review of all MR-guided VAB results and subsequent follow-up are recommended. Conclusion: This consensus includes protocols for the indication, performance parameters, interdisciplinary interpretation therapeutic recommendation, documentation and follow-up of MR-guided VAB. It does not replace official recommendations for percutaneous biopsy. [Copyright &y& Elsevier]
- Published
- 2009
- Full Text
- View/download PDF
23. Breast Screening in Germany.
- Author
-
Heywang-Köbrunner, Sylvia H.
- Subjects
MAMMOGRAMS ,BREAST exams ,BREAST cancer ,MEDICAL screening ,MEDICAL care - Abstract
Based on the data of large randomized studies, on data and experience from other, mainly European countries, where structured service screening has meanwhile been offered for many years, and on extensive reconsiderations of advantages and risks, in 2002 the German parliament had decided to introduce service screening in Germany. Meanwhile strict regulations have been issued for a comprehensive screening program. The goal of the program is to assure high quality of technique and of diagnosis, as well as adequate further assessment and treatment of screening-detected lesions to warrant both high rate of detection and a minimum of potential side effects. Such side effects could e.g. occur with a too high rate of false alarm or with inadequate surgical biopsies of discrete changes that eventually proved to be benign. For this purpose the program strictly follows the ‘European Guidelines for Quality Assurance in Mammography Screening and Diagnosis'. Significant educational demands and structural changes are imposed on doctors and personnel who want to participate in the program. The changes and their indicated goals are described and explained. The program, which is associated with fundamental alterations within our health system, is presently starting in Germany. The demanded strict documentation will allow close monitoring of the results, which will be evaluated. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
24. Screening in Women with Increased Breast Cancer Risk.
- Author
-
Artmann, Almut, Hellerhoff, Karin, and Heywang-Köbrunner, Sylvia H.
- Subjects
BREAST cancer ,CANCER patients ,GENETIC disorders ,CANCER genetics ,ONCOGENES ,MAMMOGRAMS ,CANCER diagnosis - Abstract
About 10% of all breast cancer cases occur on a hereditary basis. BRCA1/2 (breast cancer oncogenes) account for about 50% of all hereditary breast cancer cases. The remaining cases of suspected inherited origin given by family histories might be associated with other known or currently unknown genes. Deleterious mutations in the BRCA1 or BRCA2 genes are associated with an increased life-time risk of breast and ovarian cancer. BRCA1/2 carriers are more likely in to develop breast cancer at a young age compared with the general population. For women at high breast cancer risk with a mean age under 40 years at diagnosis reported sensitivities of mammography and ultrasound are low, ranging around 30-40%. Using magnetic resonance imaging (MRI) as a complementary imaging tool the sensitivity may increase to 90%. However, the specificity of MRI appears to be generally lower than that of mammography and ultrasound. The data differ depending on patient selection and study design. However, all studies indicate that contrast enhanced magnetic resonance imaging may be the most promising method. Further investigations are still needed to minimize the false-postive rate and to investigate the efficacy of MRI as an integral screening modalitiy in the surveillance of women with increased breast cancer susceptibility. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
25. Suspected Acute Appendicitis: Is Ultrasonography or Computed Tomography the Preferred Imaging Technique?
- Author
-
Pickuth, Dirk, Heywang-Köbrunner, Sylvia H., and Spielmann, Rolf P.
- Subjects
- *
SPIRAL computed tomography , *ULTRASONIC imaging , *APPENDICITIS diagnosis - Abstract
Objective: To compare the sensitivity and specificity of unenhanced spiral computed tomography (CT) and ultrasonography (US) in patients with suspected acute appendicitis. Design: Prospective study. Setting: University hospital, Germany. Subjects: 120 consecutive patients with acute appendicitis as a differential diagnosis, whose clinical findings were not enough to make operation essential, but were too severe to send home. Interventions: CT and US of the appendix. Main outcome measures: Sensitivity, specificity, and positive and negative predictive value. Results: The results were correlated with surgical and histopathological findings at appendicectomy or clinical follow-up. 93 patients had acute appendicitis, 27 patients did not. The sensitivity of CT was 95% and of US 87%. The corresponding specificities were 89% and 74%, positive predictive values 97% and 92%, negative predictive values 83% and 63%. In the 27 patients who did not have acute appendicitis, the correct diagnosis was established with CT in 14 patients and with US in eight. Conclusion: CT is more sensitive and specific than US in patients suspected of having acute appendicitis, but in whom the presentation is equivocal. The use of unenhanced spiral CT led to a significant improvement in the accuracy of preoperative diagnosis and a lower negative appendicectomy rate. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
26. Going from double to single reading for screening exams labeled as likely normal by AI: what is the impact?
- Author
-
Bosmans, Hilde, Marshall, Nicholas, Van Ongeval, Chantal, Balta, Christiana, Rodriguez-Ruiz, Alejandro, Mieskes, Christoph, Karssemeijer, Nico, and Heywang-Köbrunner, Sylvia H.
- Published
- 2020
- Full Text
- View/download PDF
27. Quantitative Parameters Measured by a New Sonographic Method for Differentiation of Benign and Malignant Breast Disease.
- Author
-
RICHTER, KARI and HEYWANG-KÖBRUNNER, SYLVIA H.
- Published
- 1995
- Full Text
- View/download PDF
28. Contrast-Enhanced Magnetic Resonance Imaging of the Breast.
- Author
-
HEYWANG-KÖBRUNNER, SYLVIA H. and Katzberg, Richard W.
- Published
- 1994
- Full Text
- View/download PDF
29. Misleading Changes of the Signal Intensity on Opposed-Phase MRI After Injection of Contrast Medium.
- Author
-
Heywang-Köbrunner, Sylvia H., Wolf, Hans Dieter, Deimling, Michael, Kösling, Sabrina, Höfer, Harry, and Spielmann, Rolf Peter
- Published
- 1996
- Full Text
- View/download PDF
30. Prototype Breast Coil for MR-Guided Needle Localization.
- Author
-
Heywang-Köbrunner, Sylvia H., Huynh, An Tuanh, Viehweg, Petra, Hanke, Wilhelm, Requardt, Hermann, and Paprosch, Iris
- Published
- 1994
- Full Text
- View/download PDF
31. Contrast-Enhanced MRI of the Breast after Limited Surgery and Radiation Therapy.
- Author
-
Heywang-Köbrunner, Sylvia H., Schlegel, Andrea, Beck, Rainer, Wendt, Thomas, Kellner, Wolfgang, Lommatzsch, Birgit, Untch, Michael, and Nathrath, Walter B. J.
- Published
- 1993
- Full Text
- View/download PDF
32. Differentiation of Breast Lesions by Measurements Under Craniocaudal and Lateromedial Compression Using a New Sonographic Method.
- Author
-
Richter ∗, Kari, Willrodt †, Ruth-Gesa, Opri †, Firu, and Heywang-KÖbrunner ‡, Sylvia H.
- Published
- 1996
- Full Text
- View/download PDF
33. Contrast-enhanced Magnetic Resonance Imaging of the Breast.
- Author
-
Viehweg, Petra, Paprosch, Iris, Strassinopoulou, Myrsini, and Heywang-Köbrunner, Sylvia H.
- Published
- 1998
34. Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey
- Author
-
Sardanelli, Francesco, Aase, Hildegunn S, Álvarez, Marina, Azavedo, Edward, Baarslag, Henk J, Balleyguier, Corinne, Baltzer, Pascal A, Beslagic, Vanesa, Bick, Ulrich, Bogdanovic-Stojanovic, Dragana, Briediene, Ruta, Brkljacic, Boris, Camps Herrero, Julia, Colin, Catherine, Cornford, Eleanor, Danes, Jan, De Geer, Gérard, Esen, Gul, Evans, Andrew, Fuchsjaeger, Michael H, Gilbert, Fiona J, Graf, Oswald, Hargaden, Gormlaith, Helbich, Thomas H, Heywang-Köbrunner, Sylvia H, Ivanov, Valentin, Jónsson, Ásbjörn, Kuhl, Christiane K, Lisencu, Eugenia C, Luczynska, Elzbieta, Mann, Ritse M, Marques, Jose C, Martincich, Laura, Mortier, Margarete, Müller-Schimpfle, Markus, Ormandi, Katalin, Panizza, Pietro, Pediconi, Federica, Pijnappel, Ruud M, Pinker, Katja, Rissanen, Tarja, Rotaru, Natalia, Saguatti, Gianni, Sella, Tamar, Slobodníková, Jana, Talk, Maret, Taourel, Patrice, Trimboli, Rubina M, Vejborg, Ilse, Vourtsis, Athina, and Forrai, Gabor
- Subjects
Adult ,Digital mammography ,Breast Neoplasms ,Middle Aged ,3. Good health ,Europe ,Middle East ,Breast cancer ,Digital breast tomosynthesis (DBT) ,Population-based screening ,Recall rate ,Humans ,Mass Screening ,Female ,Early Detection of Cancer ,Aged ,Mammography - Abstract
UNLABELLED: EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is
35. Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, G
- Author
-
Sardanelli, Francesco, Aase, Hildegunn S., Álvarez, Marina, Azavedo, Edward, Baarslag, Henk J., Balleyguier, Corinne, Baltzer, Pascal A., Beslagic, Vanesa, Bick, Ulrich, Bogdanovic-Stojanovic, Dragana, Briediene, Ruta, Brkljacic, Boris, Camps Herrero, Julia, Colin, Catherine, Cornford, Eleanor, Danes, Jan, De Geer, Gérard, Esen, Gul, Evans, Andrew, Fuchsjaeger, Michael H., Gilbert, Fiona J., Graf, Oswald, Hargaden, Gormlaith, Helbich, Thomas H., Heywang-Köbrunner, Sylvia H., Ivanov, Valentin, Jónsson, Ásbjörn, Kuhl, Christiane K., Lisencu, Eugenia C., Luczynska, Elzbieta, Mann, Ritse M., Marques, Jose C., Martincich, Laura, Mortier, Margarete, Müller-Schimpfle, Markus, Ormandi, Katalin, Panizza, Pietro, Pediconi, Federica, Pijnappel, Ruud M., Pinker, Katja, Rissanen, Tarja, Rotaru, Natalia, Saguatti, Gianni, Sella, Tamar, Slobodníková, Jana, Talk, Maret, Taourel, Patrice, Trimboli, Rubina M., Vejborg, Ilse, Vourtsis, Athina, and Forrai, Gabor
- Subjects
3. Good health - Abstract
European radiology 27(7), 2737-2743 (2017). doi:10.1007/s00330-016-4612-z, Published by Springer, Berlin
36. E20. Implementation of screening for breast cancer
- Author
-
Heywang-Köbrunner, Sylvia H.
- Published
- 2010
- Full Text
- View/download PDF
37. Magnetic resonance imaging: The evolution of breast imaging.
- Author
-
Heywang-Köbrunner, Sylvia H., Hacker, Astrid, and Sedlacek, Stefan
- Subjects
MAGNETIC resonance imaging of cancer ,BREAST cancer diagnosis ,BIOPSY ,MAMMOGRAMS ,ADJUVANT treatment of cancer ,COMPARATIVE studies - Abstract
Abstract: Introduction and aims: To provide an overview of the principle of current breast MRI, the available evidence concerning its indications and optimum use and future potentials. Methods and results: To date sensitivities of 90–91% have been achieved with a specificity of 72–75%. MRI is the most sensitive method for detecting invasive carcinoma and comparable to mammography concerning detection of DCIS. The achievable specificity, false positive and biopsy rates, however, are much lower than for screening mammography thus do not allow its use for screening of the general population. Indications with proven advantages concern screening of women at high risk and special diagnostic problems that cannot be solved by conventional imaging and percutaneous biopsy: search for primary tumour in CUP syndrome, differentiation of nipple retraction, differentiation of scarring versus recurrence and selected difficult cases. There is no proven benefit for its general use for preoperative staging. One major problem may concern the imperfect interface between imaging and surgery. Further research is also needed for the use of MRI in women at intermediate risk. In women at low risk MRI screening is not recommended. Novel possibilities of MRI concern diffusion weighted imaging as well as MR spectroscopy. Their value for improved lesion differentiation is not yet fully established. Their main potential appears to concern an improved and earlier prediction of response to neoadjuvant therapy. Future developments might address development of more specific contrast agents, replacement of vascular enhancing agents by special MR techniques, testing of sodium MRI or image fusion with other imaging modalities. Discussion/conclusion: MRI allows new patho-physiological information and thus can complement the information available by conventional methods. Present research should concentrate on improving specificity, improving the interface of imaging and surgery and has to include outcome analyses. Due to issues of specificity the responsible use of MRI should be limited to appropriate indications. [Copyright &y& Elsevier]
- Published
- 2013
- Full Text
- View/download PDF
38. Proceedings of the consensus conference on Breast Conservation, Milan, Italy, April 28–May 1, 2005
- Author
-
Schwartz, Gordon F., Veronesi, Umberto, Clough, Krishna B., Dixon, J.M., Fentiman, Ian S., Heywang-Köbrunner, Sylvia H., Holland, Roland, Hughes, Kevin S., Mansel, Robert E., Margolese, Richard, Mendelson, Ellen B., Olivotto, Ivo A., Palazzo, Juan P., Solin, Lawrence J., Heywang-Köbrunner, Sylvia H, and Consensus Conference Committee
- Published
- 2006
- Full Text
- View/download PDF
39. Magnetic resonance imaging of the breast: Recommendations from the EUSOMA working group
- Author
-
Sardanelli, Francesco, Boetes, Carla, Borisch, Bettina, Decker, Thomas, Federico, Massimo, Gilbert, Fiona J., Helbich, Thomas, Heywang-Köbrunner, Sylvia H., Kaiser, Werner A., Kerin, Michael J., Mansel, Robert E., Marotti, Lorenza, Martincich, Laura, Mauriac, Louis, Meijers-Heijboer, Hanne, Orecchia, Roberto, Panizza, Pietro, Ponti, Antonio, Purushotham, Arnie D., and Regitnig, Peter
- Subjects
- *
MAGNETIC resonance mammography , *BREAST cancer , *BREAST diseases , *MEDICAL imaging systems , *CANCER patients - Abstract
The use of breast magnetic resonance imaging (MRI) is rapidly increasing. EUSOMA organised a workshop in Milan on 20–21st October 2008 to evaluate the evidence currently available on clinical value and indications for breast MRI. Twenty-three experts from the disciplines involved in breast disease management – including epidemiologists, geneticists, oncologists, radiologists, radiation oncologists, and surgeons – discussed the evidence for the use of this technology in plenary and focused sessions. This paper presents the consensus reached by this working group. General recommendations, technical requirements, methodology, and interpretation were firstly considered. For the following ten indications, an overview of the evidence, a list of recommendations, and a number of research issues were defined: staging before treatment planning; screening of high-risk women; evaluation of response to neoadjuvant chemotherapy; patients with breast augmentation or reconstruction; occult primary breast cancer; breast cancer recurrence; nipple discharge; characterisation of equivocal findings at conventional imaging; inflammatory breast cancer; and male breast. The working group strongly suggests that all breast cancer specialists cooperate for an optimal clinical use of this emerging technology and for future research, focusing on patient outcome as primary end-point. [Copyright &y& Elsevier]
- Published
- 2010
- Full Text
- View/download PDF
40. Consensus Conference on Breast Conservation
- Author
-
Schwartz, Gordon F., Veronesi, Umberto, Clough, Krishna B., Dixon, J. Michael, Fentiman, Ian S., Heywang-Köbrunner, Sylvia H., Holland, Roland, Hughes, Kevin S., Mansel, Robert E., Margolese, Richard, Mendelson, Ellen B., Olivotto, Ivo A., Palazzo, Juan P., and Solin, Lawrence J.
- Published
- 2006
- Full Text
- View/download PDF
41. Detection of Breast Cancer with Mammography: Effect of an Artificial Intelligence Support System.
- Author
-
Rodríguez-Ruiz A, Krupinski E, Mordang JJ, Schilling K, Heywang-Köbrunner SH, Sechopoulos I, and Mann RM
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, ROC Curve, Artificial Intelligence, Breast diagnostic imaging, Breast Neoplasms diagnostic imaging, Mammography methods, Radiographic Image Enhancement methods
- Abstract
Purpose To compare breast cancer detection performance of radiologists reading mammographic examinations unaided versus supported by an artificial intelligence (AI) system. Materials and Methods An enriched retrospective, fully crossed, multireader, multicase, HIPAA-compliant study was performed. Screening digital mammographic examinations from 240 women (median age, 62 years; range, 39-89 years) performed between 2013 and 2017 were included. The 240 examinations (100 showing cancers, 40 leading to false-positive recalls, 100 normal) were interpreted by 14 Mammography Quality Standards Act-qualified radiologists, once with and once without AI support. The readers provided a Breast Imaging Reporting and Data System score and probability of malignancy. AI support provided radiologists with interactive decision support (clicking on a breast region yields a local cancer likelihood score), traditional lesion markers for computer-detected abnormalities, and an examination-based cancer likelihood score. The area under the receiver operating characteristic curve (AUC), specificity and sensitivity, and reading time were compared between conditions by using mixed-models analysis dof variance and generalized linear models for multiple repeated measurements. Results On average, the AUC was higher with AI support than with unaided reading (0.89 vs 0.87, respectively; P = .002). Sensitivity increased with AI support (86% [86 of 100] vs 83% [83 of 100]; P = .046), whereas specificity trended toward improvement (79% [111 of 140]) vs 77% [108 of 140]; P = .06). Reading time per case was similar (unaided, 146 seconds; supported by AI, 149 seconds; P = .15). The AUC with the AI system alone was similar to the average AUC of the radiologists (0.89 vs 0.87). Conclusion Radiologists improved their cancer detection at mammography when using an artificial intelligence system for support, without requiring additional reading time. Published under a CC BY 4.0 license. See also the editorial by Bahl in this issue.
- Published
- 2019
- Full Text
- View/download PDF
42. B3 Lesions: Radiological Assessment and Multi-Disciplinary Aspects.
- Author
-
Heywang-Köbrunner SH, Nährig J, Hacker A, Sedlacek S, and Höfler H
- Abstract
B3 lesions comprise different histopathological entities that are considered benign but 'of unknown biological potential'. These entities may act as risk indicators (for both breasts) or as non-obligatory precursors of malignancy. Being diagnosed at percutaneous breast biopsy, an additional risk of underestimate exists. Imaging appearances, histopathological appearance and risk of associated malignancy are presented. B3 lesions of high risk, which thus should usually be excised, include atypical ductal hyperplasia (ADH), pleomorphic or necrotic type of lobular neoplasia (LIN 3), and papillary lesions with atypias. Intermediate risk may be associated with classic lobular carcinoma in situ (LIN 2) or flat epithelial atypia (FEA), and low risk with radial sclerosing lesions (RSLs) and papillary lesions without atypias. LIN 1 is mostly an incidental finding acting as risk indicator. Follow-up is adequate if the initial diagnostic problem is solved. According to international guidelines, risk and subsequent recommendations should be discussed for each individual patient, taking into account biological risk, representative sampling, lesion size, lesion extent, percentage of lesion removal, other individual risks, and the possibility of surveillance. With vacuum-assisted breast biopsy (VABB), surgery may be avoided for more of the small lesions at low risk. Further data collection and diligent evaluation may help to better assess the individual risk, to better adapt treatment recommendations and avoid overtreatment.
- Published
- 2010
- Full Text
- View/download PDF
43. Proceedings of the international consensus conference on breast cancer risk, genetics, & risk management, April, 2007.
- Author
-
Schwartz GF, Hughes KS, Lynch HT, Fabian CJ, Fentiman IS, Robson ME, Domchek SM, Hartmann LC, Holland R, Winchester DJ, Anderson BO, Arun BK, Bartelink H, Bernard P, Bonanni B, Cady B, Clough KB, Feig SA, Heywang-Köbrunner SH, Howell A, Isaacs C, Kopans DB, Mansel RE, Masood S, Palazzo JP, Pressman PI, Solin LJ, and Untch M
- Subjects
- Estrogen Replacement Therapy adverse effects, Female, Genes, BRCA1, Genes, BRCA2, Genes, p53, Genetic Counseling, Humans, Mutation, PTEN Phosphohydrolase genetics, Risk Factors, Breast Neoplasms etiology, Breast Neoplasms genetics, Risk Management
- Abstract
A consensus conference including thirty experts was held in April, 2007, to discuss risk factors for breast cancer and their management. Four categories of risk were outlined, from breast cancer "average" through "very high" risk, the latter including individuals with high penetrance BRCA1/2 gene mutations. Guidelines for management of patients in each of these categories were discussed, with the major portion of the conference being devoted to individuals with BRCA1/2 mutations. Prevalence of these mutations in the general populations was estimated to be 1 in 250-500 individuals, with an increased prevalence in Ashkenazic Jews and other founder groups. Risk reduction strategies for these individuals include surveillance, with or without chemoprevention drugs, or surgical procedures to remove the organs at risk, i.e., bilateral mastectomy and/or bilateral salpingo-oophorectomy. These risk reduction strategies were evaluated fully, and recommendations were made for the care of patients in each of the risk categories. These guidelines for patient care were approved by the entire group of experts.
- Published
- 2009
- Full Text
- View/download PDF
44. Imaging studies for the early detection of breast cancer.
- Author
-
Heywang-Köbrunner SH, Schreer I, Heindel W, and Katalinic A
- Abstract
Introduction: The effectiveness of mammographic screening has been proven at evidence level 1A. Mammography offers the best ratio of benefits to side effects of any screening method tested to date. In this literature review, we ask whether early detection might be improved still further by combining mammography with other imaging modalities., Methods: The authors performed a selective literature search for combined key words in the Medline and Cochrane Library databases from 1/2000 to 11/2007, screened all titles, and evaluated the full text of all original articles. We selected articles for further analysis according to systematic criteria (minimum numbers, avoidance of overlap) and also considered published guidelines., Results: No screening studies of comparable size to those for mammography are available for ultrasound or MRI. Smaller studies have indicated that the use of these two modalities might lead to the detection of additional cancers in selected subgroups. For mass screening an increase in the detection rate of 10% to 15% might become possible. This increase would probably be associated with a tripling of the breast biopsy rate, compared to mammography alone. The number of indeterminate cases in which short-term follow-up (i.e., at 6 months) would be recommended would increase roughly tenfold with MRI, and to an unknown extent with ultrasound. The related quality-assurance issues remain to be addressed., Discussion: Randomized controlled studies are needed for a realistic assessment of the achievable benefits and unavoidable side effects of combined screening. For women whose risk of breast cancer is not elevated, mammography remains the standard screening method.
- Published
- 2008
- Full Text
- View/download PDF
45. Diagnostic architectural and dynamic features at breast MR imaging: multicenter study.
- Author
-
Schnall MD, Blume J, Bluemke DA, DeAngelis GA, DeBruhl N, Harms S, Heywang-Köbrunner SH, Hylton N, Kuhl CK, Pisano ED, Causer P, Schnitt SJ, Thickman D, Stelling CB, Weatherall PT, Lehman C, and Gatsonis CA
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Algorithms, Bayes Theorem, Breast Neoplasms pathology, Contrast Media pharmacokinetics, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Middle Aged, Predictive Value of Tests, Prospective Studies, ROC Curve, Regression Analysis, Sensitivity and Specificity, Breast Neoplasms diagnosis, Magnetic Resonance Imaging methods
- Abstract
Purpose: To prospectively determine the prevalence and predictive value of three-dimensional (3D) and dynamic breast magnetic resonance (MR) imaging and contrast material kinetic features alone and as part of predictive diagnostic models., Materials and Methods: The study protocol was approved by the institutional review board or ethics committees of all participating institutions, and informed consent was obtained from all participants. Although study data collection was performed before HIPAA went into effect, standards that would be compliant with HIPAA were adhered to. Data from the International Breast MR Consortium trial 6883 were used in the analysis. Women underwent 3D (minimum spatial resolution, 0.7 x 1.4 x 3 mm; minimal temporal resolution, 4 minutes) and dynamic two-dimensional (temporal resolution, 15 seconds) MR imaging examinations. Readers rated enhancement shape, enhancement distribution, border architecture, enhancement intensity, presence of rim enhancement or internal septations, and the shape of the contrast material kinetic curve. Regression was performed for each feature individually and after adjustment for associated mammographic findings. Multivariate models were also constructed from multiple architectural and dynamic features. Areas under the receiver operating characteristic curve (Az values) were estimated for all models., Results: There were 995 lesions in 854 women (mean age, 53 years +/- 12 [standard deviation]; range, 18-80 years) for whom pathology data were available. The absence of enhancement was associated with an 88% negative predictive value for cancer. Qualitative characterization of the dynamic enhancement pattern was associated with an Az value of 0.66 across all lesion architectures. Focal mass margins (Az = 0.76) and signal intensity (Az = 0.70) were highly predictive imaging features. Multivariate models were constructed with an Az value of 0.880., Conclusion: Architectural and dynamic features are important in breast MR imaging interpretation. Multivariate models involving feature assessment have a diagnostic accuracy superior to that of qualitative characterization of the dynamic enhancement pattern., (RSNA, 2006.)
- Published
- 2006
- Full Text
- View/download PDF
46. Stereotactic vacuum-assisted breast biopsy in 2874 patients: a multicenter study.
- Author
-
Kettritz U, Rotter K, Schreer I, Murauer M, Schulz-Wendtland R, Peter D, and Heywang-Köbrunner SH
- Subjects
- Breast Neoplasms pathology, Female, Humans, Quality Assurance, Health Care, Reproducibility of Results, Biopsy methods, Breast Neoplasms diagnosis
- Abstract
Background: Vacuum-assisted breast biopsy (VAB) can replace surgical biopsy for the diagnosis of breast carcinoma. The authors evaluated the accuracy and clinical utility of VAB in a multicenter setting using a strict quality assurance protocol., Methods: In the current study, VABs were performed successfully for 2874 patients at 5 sites. Benign lesions were verified by follow-up. Surgery was recommended for malignant and borderline lesions. VAB was performed on patients with lesions rated as highly suspicious (6%), intermediate to suspicious (85%), or probably benign (9%). Fifty-eight percent of the lesions were < 10 mm and 70% had microcalcifications., Results: The authors identified 7% of patients with invasive carcinomas, 15% with ductal carcinomas in situ (DCIS), 5% with atypical ductal hyperplasias (ADH), and 0.6% with lobular carcinomas in situ. The results of the VAB necessitated an upgrade of 24% of patients with ADH to DCIS or DCIS and invasive carcinoma. Twelve percent of patients with DCIS proved to have invasive carcinoma. Seventy-three percent of the patients had benign lesions. Only 1 false-negative result was encountered (negative predictive value, 99.95%). Minor side effects were reported to occur in 1.4% of patients and 0.1% of patients required a subsequent intervention. Scarring relevant for mammography was rare among patients (i.e., 0.3% of patients had relevant scarring)., Conclusions: Quality-assured VAB was found to be highly reliable. VAB effectively identified patients with benign lesions and assisted therapeutic decisions. Most important, only a single case of malignancy was missed. A close interdisciplinary approach assured optimal results., (Copyright 2003 American Cancer Society.)
- Published
- 2004
- Full Text
- View/download PDF
47. Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication.
- Author
-
Heinig A, Lampe D, Kölbl H, Beck R, and Heywang-Köbrunner SH
- Subjects
- Adult, Breast Neoplasms pathology, Drug Administration Schedule, Female, Humans, Middle Aged, Predictive Value of Tests, Antineoplastic Agents, Hormonal administration & dosage, Breast pathology, Breast Neoplasms diagnosis, Breast Neoplasms prevention & control, Estrogen Receptor Modulators administration & dosage, Magnetic Resonance Imaging methods, Tamoxifen administration & dosage
- Abstract
Aims and Background: The value of breast MRI may be impaired by unspecific enhancement. This may leave patients with difficult-to-assess breast tissue with an uncertain diagnosis. We examined whether this unspecific enhancement (which is mostly due to proliferative or hyperplastic changes of benign breast tissue) may be suppressed by antiestrogen medication., Methods: In a trial of treatment, 10 peri- or postmenopausal patients who exhibited diffuse and/or focal enhancement on breast MRI before tamoxifen medication agreed to undergo a short-term tamoxifen treatment. MRI monitoring was performed 2, 4 and 8 weeks after onset of antiestrogen therapy (tamoxifen, 30 mg per day)., Results: Six patients showed a significant decrease of enhancement. Unchanged (n = 3) or increased (n = 1) enhancement was seen in 4 patients. One of the three patients with unchanged enhancement proved to have diffuse lobular carcinoma in situ., Conclusions: Part of the unspecific enhancement seen on breast MRI can probably be suppressed by short-term antiestrogen medication.
- Published
- 2002
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.