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Purpose: In this prospective study, it is aimed to correlate the histopathological evaluation findings of the patients having lesions referred for excisional biopsy due to BI-RADS (Breast Imaging Reporting and Data System) 3, BI-RADS 4, BI-RADS 5 lesions detected by ultrasonography, with their elastography elasticity index values, to investigate the role of elastography and to determine elastography elasticity index cut-off value for the malignant benign differentiation of these lesions. Material and Method: In November 2008-February 2009, seventy female patients referred to the Department of Radiology in Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, who were found to have solid breast lesions by ultrasonography, were evaluated prospectively. The colour score and elasticity index values of the masses were assessed. Results: Statistically, elasticity index cut-off value for the malignant-differentiation of the lesions was calculated as 4.05. For the same differention, the sensitivity and specificity of elastography were calculated as 90% and 97%, respectively, whereas positive predictive value and negative predictive value were determined as 90% and 97.5%, respectively. Conclusion: Real-time elastography is a quite useful imaging technique, that is useful for benign malignant differentiation of suspicious breast lesions with high sensitivity and specificity as well as high positive and negative predictive values. [ABSTRACT FROM AUTHOR]

Idiopathic lobular granulomatous mastitis (ILGM) is a relatively rare disease in women during reproductive life and may commonly mimic carcinoma. Histopathology is the most definitive method of diagnosis. Herein, we report three cases who had very similar clinical-radiological findings to malignancy. None of the women has systemic disorder or history of a specific infection. All lesions were widely excised. Histopathological investigation revealed a lobular, non-caseating granulomatous inflammation. Clinicians should consider the possibility of idiopathic granulomatous mastitis in young women with clinical and radiological findings which are similar to malignancy of breast lesions. [ABSTRACT FROM AUTHOR]

Objective: The development and extensive use of methods of breast imaging has increased the diagnosis of non-palpable breast lesions (NPBL). Although several methods have been applied in the localization of NPBL throughout the world, the technique of wire-guided localization is used as a standard. The aim of this study is to present the results of ROLL (Radioguided occult lesion localization), which is a new technique in our clinic for localization of NPBL. Materials and Methods: We included 44 patients who had NPBL in the study. The lesions were localized preoperatively with TC-99m labelled human serum albumin. A gamma probe was used to determine the place of lesion and to guide the excisional biopsy. We assessed the duration of the localization, the excisional biopsy and hospital stay, the volume of the excised piece, the surgical margin in the malign facts, complication, cost calculation, and the comfort of the procedure from the points of view of the surgeon, radiologist and patient for every case. Results: We successfully localized and excised all lesions with ROLL. As a result of the pathologic evaluation, 54.4% of the lesions were reported as benign, 45.6% as malign. An adequate surgical margin was obtained in 71.4% of the malignant lesions. Conclusion: ROLL is an alternative method to wire-guided localization for NPBL. [ABSTRACT FROM AUTHOR]

The effectiveness of screening has been proven as secondary preventive approach from breast cancer. One of the effective screening ways is clinical breast examination (CBE) and it must be performed for early detection of breast cancer. CBE should only be performed annually by specially trained health professionals to every woman who comes into any health unit for any reason. It must be performed through the trinity of clinical history, inspection and palpation, on seated and lying position, by using the finger pads of the three middle fingers with vertical strip pattern. For healthy woman, only mammographic (MMG) screening is enough for imaging screening approach. MMG should be performed on two positions, namely "craniocaudal and mediolateral oblique". MMG screening for healthy woman should start at 40 years of age, and should be continued until 70 years of age. Breast ultrasonography and breast magnetic resonance imaging (MRI) is not recommended for routine screening on healthy women. The endications of MRI usage for "diagnostic" approach are limited and defined detailed in which condition should be used. The Positron emission tomography - computed tomography (PET-CT) is not an alternative way of screening of far metastatic tumors agains the classic screenings. The standarts of technic and reports of all ways of usage of breast imaging must be defined nationally and implement the related accreditation programmes. The needle biopsies should be preferred for pathological diagnosis on women suspected to have breast cancer clinically and/or radiologically. [ABSTRACT FROM AUTHOR]

Purpose: To determine the clinical and demographical characteristics of patients with idiopathic granulomatous mastitis and to compare treatment methods. Materials and Methods: Demographic characteristics, clinical, microbiological and pathological findings, imaging and treatment methods, as well as the healing time of 47 patients diagnosed with idiopathic granulomatous mastitis were retrospectively analysed. Results: The median age of the patients was 36 (27-59) years. There were five patients with a lactation history in the last 6 months. Oral contraceptive use and nicotine abuse were seen in nine patients, respectively. Five patients had rheumatological diseases. The presence of a mass, discharge from the breast and erythematous lesions were the most frequently encountered complaints. Breast ultrasonography was performed on all patients, whereas 12 patients had mammography and 11 patients underwent magnetic resonance imaging. Hyperechogenic internal particles with intraductal debris was the most commonly encountered finding on ultrasonography, whereas asymmetric density on mammography and hyperintense peripheral irregular contrast enhancement on magnetic resonans imaging were seen. Microbiological cultures were performed on 28 patients. Six patients had a microbial infection and methicillin sensitive, coagulase negative Staphylococcus was revealed as the most frequently encountered microorganism. The diagnosis was proven by core biopsy in 29 patients and by incisional biopsy in 18 patients. Wide surgical excision was performed on 24 patients while 23 patients were treated with steroids as conservative follow-up therapy. The median duration of follow-up was 12 (1-96) months. The median healing time of 23 patients followed-up conservatively was 6 (1- 12) months. Six of the 23 patients followed-up conservatively had a recurrence. There was no recurrence in the patients who underwent wide surgical excision (p=0.009). Conclusion: As radiological findings are not specific for the differentiation of idiopathic granulomatous mastitis from malignant breast diseases, pathological and clinical evaluations play an important role in the diagnosis of idiopathic granulomatous mastitis. Surgical treatment is preferable to conservative follow-up. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the breast Ultrasound (US) findings in patients with mastalgia under the age of fourty. Materials and Methods: The breast US findings and BI-RADS (Breast imaging reporting and data system) categories of patients with mastalgia and asymptomatic cases refered to the Rize Education and Research Hospital, Early Diagnosis of Cancer Screening and Education Center between January 2008-December 2008 were evaluated retrospectively. Histories of the family breast cancer and hormone replacement therapy, side of the breast with mastalgia, and findings of the physical examinations were evaluated. Results: Both groups had 23 (%15,4 & %18,7) sonographically pathological findings and there was no statistically significantly difference between them (p = 0.475). US findings and BI-RADS (Breast imaging reporting ans data system) categories were also not statistically significantly different in both groups (p > 0.05). Conclusion: US findings and BI-RADS categories do not show statistically significance between the patients with and without mastalgia under the age of fourty. Prospective larger series are needed to be done and the endications of the breast ultrasound in this cases are needed to be discussed on this subject. [ABSTRACT FROM AUTHOR]

Objectives: Such methods used in the evaluation of nipple discharge as mammography, ultrasonograpyh, galactography or cytology, may be insuffi cient in the diagnosis and localization of the lesions because of high false negative and false positive results. With ductoscopy, intraductal pathologies can be directly visualized, cytological examinations and biopsies can be easily performed endoscopically. The purpose of this study is to evaluate and discuss the value of ductoscopy in the diagnosis and treatment of patients with pathologic nipple discharge. Materials and Methods: From November 2005 to September 2007, we performed ductoscopy and ductoscopy assisted ductal lavage to 111 patients, all female, suffering from nipple discharge by using LaDuScope S and LaDuScope T-flex. Results: We detected, ductoscopically, intraductal polypoid lesions in 24 patients, intraductal debris in 8 patients, DCIS in 1 patient. 18 out of 24 intraductal polypoid lesions could be excised endoscopically and the rest underwent ductoscopically assisted microductectomy. Conclusion: Ductoscopy is not performed at every center. Also there is no accepted consensus on the interpretations of the results of ductoscopy. But, since it provides the unique advantage of intraductal direct visualization of the lesions, and has the advantage of being a therapeutic tool, we believe that ductoscopy will be most useful instrument in the near future for the evaluation of nipple discharge. [ABSTRACT FROM AUTHOR]

Breast adenomyoepithelioma which is a rare tumor of the breast is characterised by biphasic proliferation of epithelial and myoepithelial cells of breast. It's hard to differentiate adenomyoepitheliomas from other neoplasms by radiological evaluation. Although generally having benign characteristics, adenomyoepitheliomas are rarely gaining malign transformation and making distant metastasis. Here, we present a 16-year old girl with a lump in her right breast. The lesion thought to be fi broadenoma in pyhsical examination, but by ultrasonographic examination it was found that there is a 3*2 cm solid lesion containing 4mm cyst. This is the youngest case with adenomyoepithelioma in the literature. Because of the difficulties in pathological diagnosis and having risks of local and distant metastasis, wide excision of these lesions are recommended in the treatment. [ABSTRACT FROM AUTHOR]

Juvenile fibroadenoma is common cause of breast masses in adolescent and young individuals. Giant fibroadenoma which is a type of fibroadenomas reaching extreme sizes in adolescent period could cause congestion and ulceration. Giant juvenile fibroadenomas are usually solitary and unilateral. With this study we discussed ultrasonographic and magnetic resonance imaging findings of unilateral juvenile fibroadenomas with diameters of 10 and 12 cm. [ABSTRACT FROM AUTHOR]

We report a case of 57-years-old postmenopausal woman who was admitted to our clinic with right breast pain and swelling. She had no history of breast trauma or surgery. We observed a metallic foreign body in the ultrasonographic examination of the right breast which can not be seen in the direct X-ray graphy. Excisional biopsy was performed and a sewing needle was excised. Metallic foreign bodies within the breast are occasionally seen on mammograms and can mimic microcalcifications. The origin of these metallic particles can range from surgical clips, guide wire, gunshot wounds to sewing needle. The interest of this case is that in patients with breast pain or swelling, foreign bodies must be kept in mind if they have no history of trauma or breast surgery. [ABSTRACT FROM AUTHOR]