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We performed a retrospective review of 5375 aspirations performed during the last 16 years of noncomplex cysts. Cytology results and outcomes following aspirations of simple and complicated cysts performed by the senior author at our institution were reviewed. Complex cysts with associated solid components which were core biopsied are excluded from this review. We present our data as the largest series to date performed by one breast radiologist at a single institution. Our data separate cysts with atypia or malignant cytology into those sampled concurrently with solid neoplasms and those which were isolated lesions. Various technical issues which have not been previously addressed in the literature are discussed. Noncomplex cysts are benign 99% of the time. Cysts with papillary cytology require no further workup. Margin-negative seromas do not require cytologic analysis of fluid. Sixteen malignancies were revealed (0.3%), eight of which were solitary cysts (0.1%). Atypical cytology predicted malignancy in 21%; therefore, atypical cytology requires further workup. Malignant cytology was associated with breast cancer in 90.9% of patients; therefore, all patients with malignant cytology require biopsy.

Rationale and Objectives To determine the incidence of breast cancer in women presenting for fine needle aspiration of sonographically diagnosed complicated breast cysts. Materials and Methods Institutional review board approval was obtained. A retrospective study was performed of 186 consecutive women who presented for fine needle aspiration of 243 sonographic complicated cysts detected by clinical examination or imaging between January 2002 and August 2003. Sonographic complicated cysts were defined as those meeting most but not all criteria for simple cysts similar to current Breast Imaging Reporting and Data System classification. We excluded solid masses, cysts with solid components, intracystic masses, and simple cysts. Prospective mammography, ultrasound, and procedure reports were reviewed. A case was considered positive if cytology, core needle biopsy, or surgical excision was positive for cancer. Final diagnosis was established by biopsy, cytology, clinical resolution, or stability over time. Results One of 243 (0.4%) lesions proved malignant (95% confidence interval 0–1.94%); 210/243 (86.4%) of cases yielded fluid on aspiration. Of 141 samples submitted to cytology, 138 (97.9%) were benign and 3 (2.1%) atypical. All cases of atypia were benign at surgical excision. Ninety five of 243 (39.1%) aspiration samples with typical cyst fluid were discarded. A total of 33/243 (13.6%) cases did not yield fluid, 1 of which was positive for cancer. Thirty cases underwent core needle or excisional biopsy for imaging discordance with benign results. Conclusions Breast cancer presenting as a complicated cyst by ultrasound was rare (0.4%, 95% confidence interval 0–1.94%). These results provide support for classification of complicated cysts as probably benign.

Summary Background 7% of women in the western world develop palpable breast cysts. Studies of the relation between cysts and breast cancer have conflicting results. There are two clearly defined types of cyst. We investigated whether one cyst type is associated with a higher rate of breast-cancer development than the other. Methods We studied 1374 women with palpable breast cysts presenting between 1981 and 1987, who had cysts aspirated between 1981 and 1989. Cysts were classified as type I if the sodium/potassium (Na + /K + ) ratio in the cyst fluid was less than 3, or type II if the Na + /K + ratio was 3 or more. Data on incidence of breast cancer were available until January, 1995, and we compared them with the expected numbers of cancers calculated from age-specific breast-cancer incidence in Scotland in 1988. Findings 65 cancers developed during follow-up. The overall standardised incidence rate of breast cancer in patients with palpable cysts was 2·81 (95% Cl 2·17–3·59). The relative incidence rate was increased for all cyst types. The standardised incidence rate of developing breast cancer among women younger than 45 years was highest at 5·94 (2·97–10·63), with a significant trend for decreasing relative incidence rate with age (p Interpretation Women with breast cysts are at an increased risk of breast cancer, especiallly at younger ages. The type of cyst did not alter the associated relative incidence rate of breast-cancer development.

In this work, an attempt is made to simulate the skin temperature profile of breasts in the presence of Cysts. For the first time a study comparing the temperature profiles of normal breasts with Breast Cysts is undertaken. Heat transfer mechanism is modelled as the Penne's Bio-heat equation on 2D breast sections. The equation is solved using the Finite Element Method. The Cysts are simulated for typical depths and sizes. It is observed that for Cysts at depths greater than 5 cm and of sizes less than 0.5 cm the effect on the surface temperature is negligible. It is also found that in all configurations surface temperature drops. Cyst of maximum radius when placed closest to the skin surface, the temperature declines the most. Therefore this study seems to help in reducing the false positive rate during screening and in the early diagnosis of breast cancer using infrared imaging.

The use of Tamoxifen as treatment for breast cancer is well established and its use experimentally as prophylaxis is promising, but little has been written about mammographically detected changes in breast parenchyma as a result of Tamoxifen therapy. We report two cases of spontaneous regression of breast cysts after Tamoxifen therapy for premenopausal breast cancer in the contralateral breast.

In the search for improved imaging modalities for detection and diagnosis of breast cancer, a high negative prediction value is also important. Photoacoustic (optoacoustic) imaging is a relatively new technique that has high potential for visualizing breast malignancies, but little is known about the photoacoustic appearance of benign lesions. In this work, we investigate the visibility of benign breast cysts in forward-mode photoacoustic mammography using 1064-nm light, as currently applied in the Twente photoacoustic mammoscope. Results from (Monte Carlo and k-wave) simulations and phantom measurements were used to interpret results from patient measurements. There was a strong agreement among the results from simulations, phantom, and patient measurements. Depending on the absorption contrast between cyst and breast tissue, cysts were visible as either one or two confined high-contrast areas representing the front and the back of the cyst, respectively. This edge enhancement is most likely the consequence of the local sudden change in the absorbed energy density and Grüneisen coefficients. Although the current forward-mode single-wavelength photoacoustic mammoscope cannot always unambiguously discriminate cysts from malignancies, this study reveals specific features of cysts compared to malignancies, which can be exploited for discrimination of the two abnormalities in future modifications of the imager.

1519 Objective: Breast cysts are the most common cause of benign breast masses. Simple breast cysts do not need further evaluation, but complex breast cysts require additional assessment due to the potential presence of malignancy. However these complex cysts have rarely been examined and quantified according the associated cancer detection rate. Our study is the first investigation that evaluates the malignancy rate of complex breast cysts identified by histo-pathological results. Material and Methods: Imaging findings of complex cysts were correlated retrospectively with clinical and pathologic outcomes. Results: 150 complex breast cysts were found in 132 women. We detected a high malignancy rate of 14%. Sonographic criteria of a complex cyst such as thick cyst wall (p=0.0006), lobulation (p=0.01) or hyperechogenicity (p=0.04) were predictive of neoplasm. Two or more criteria combined were associated with a 13.6 - fold higher risk of malignancy (p No significant financial relationships to disclose.

Background Ultrasound is commonly used during diagnosis of breast lesions. Our purpose was to study the role of sonography for risk stratification of malignancy in the diagnosis and management of palpable breast cysts. Methods This was a cohort study of 176 patients with palpable breast cysts. Sonographic findings were correlated with clinical and pathologic outcomes. Results Mean cyst size was 2.0 ± 1.8 cm. Cysts were simple, complex and probably benign, and complex and suspicious for neoplasm in 82.25%, 10.25% and 7.5% of patients, respectively. Thick cyst wall ( P = 0.0001), mural tumor ( P P = 0.034), and internal septae ( P = 0.031) were predictive of neoplasm. Of cysts >3 cm, 33% were cancerous ( P = 0.000027). After 378 days of follow-up, 26 % of cysts had recurred. Recurrence was more frequent in patients with bilateral or multiple cysts ( P = 0.004). Conclusions Sonography is useful in risk stratification of malignancy in breast cysts. There is a high risk of recurrence after cyst aspiration.

Objective: Gross cystic disease (GCD) is the most common benign breast pathology. Although breast cysts are not considered pre-malignant lesions, an increased risk of breast cancer has been reported for patients with type I cysts (Na+/K+ < 3). Furthermore, an augmented IGF-I/IGF-binding protein-3 (IGFBP-3) ratio has been described in breast cancer patients. The objective was to evaluate serum IGF-I and binding protein concentrations of type I and type II cyst patients as compared with healthy women. Methods: Twenty-four patients with type I cysts, 17 with type II cysts and 25 healthy women were evaluated. Serum IGF-I, IGFBP-3 and IGFBP-1 concentrations were measured by IRMA. Results: IGF-I concentrations were significantly higher in sera from patients with type I cysts than in patients with type II cysts. A highly significant decrease of IGFBP-3, the major IGFBP, was found in patients with type I cysts with respect to healthy women, whereas no significant difference was evident between the different cyst types. The IGF-I/IGFBP-3 ratio, an estimate of biologically active IGF-I, was very significantly higher in patients with type I cysts than in both type II patients and healthy women. IGFBP-1 levels were significantly lower in patients with type I than in controls and type II cysts. The IGF-I/IGFBP-1 ratio was significantly higher in patients with type I cysts than in type II bearers and healthy women. Estrogen levels correlated with IGF-I in patients and controls. Conclusions: The enhanced levels of IGF-I/IGFBP-3 found in patients with type I cysts could eventually be associated with the increased risk of breast cancer described for this group., Facultad de Ciencias Exactas

Women who have a breast cyst aspirated are at increased risk of developing breast cancer. We present an age-matched case control study comparing the reproductive characteristics of 352 women who had a breast cyst aspirated with a control group of 352 contemporaneous clinically normal women. Women with breast cysts were more likely to be nulliparous [odds ratio (OR) = 2.28, 95% confidence interval (CI) = 1.34-3.88] or have a late age at first live birth (chi 2 trend = 5.6, P less than 0.025), and a late menopause (chi 2 trend = 4.3, P less than 0.05). They were less likely to have ever used the oral contraceptive pill (OR = 0.38, 95% CI = 0.26-0.55) or to have used the pill for a short duration (chi 2 trend = 16.8, P less than 0.001), and were less likely to have had a hysterectomy (OR = 0.58, 95% CI = 0.36-0.93). They were more likely to wear a small bra (chi 2 trend = 18.6, P less than 0.001) and bra cup (chi 2 trend = 5.6, P less than 0.025). Nulliparity, late age at first live birth and late menopause are factors common to breast cancer risk.

Sir—J M Dixon and colleagues’ (May 22, p 1742) study adds to the body of evidence that palpable breast cysts are associated with an increased risk of breast cancer and shows that younger women are at increased risk. However, it does not address the important question of what are the other differences between women with palpable breast cysts who developed breast cancer compared with those who did not. The investigators did not report data on the risk and protective factors for breast cancer and more detailed information on the biochemical content of the cyst. In the methods they state that details were collected on menstrual status, previous benign disease, family history, parity, age at first pregnancy, and use of pill and hormone replacement therapy. However, they do not report these data or compare the two groups of women to find potential epidemiological differences, and thus clues to the pathogenesis of breast cancer in women with a history of breast cysts. The study involved collection of fluid from all cysts, which was analysed for the content of sodium and potassium ions, but the researchers should also have done a more detailed biochemical analysis. A profile of the type and amount of sex hormone and the relative amounts of growth factors associated with epithelial-cell proliferation, such as epidermal growth factor, in each cyst would have provided information on the biochemical environment and the level of proliferative stimulus present within the breast cysts. Such detailed information could have identified a pattern in women with a history of breast cysts who go on to develop breast c a n c e r and as a result potentially lead to the formulation of a biochemical screening test. A prospective study of routine histological assessment of palpable breast cysts assesses that the type and concentration of sex hormones and proliferative growth factors in the cysts, together with collection of relevant personal and family history, should be considered. No study to date has combined all this information to try and differentiate between cystic breast disease that is a marker for breast cancer from that which it is not. Such a study would also answer the question of whether cysts or associated hyperplastic lesions increase the risk of breast c a n c e r . This information is vital if an attempt is to be made to stratify women with breast cysts into risk groups for breast cancer and to thus identify women who will potentially benefit from early mammographic screening.

cancer. Breast cysts contain fluid (breast cyst fluid, BCF) in which high concentrations of steroids, growth factors and cytokines are present. Factors, such as interleukin-1 and interleukin-6, which can markedly increase aromatase activity in cultured breast fibroblasts have also been detected in BCF. In this study we have examined the ability of BCF to regulate the formation and hydrolysis of oestrone sulphate (ElS) in breast cancer cells. High concentrations of ElS are present in some BCFs and normal or malignant breast tissues, and it is possible that steroid sulphates, such as ElS, modulate the availability of oestrogen to the oestrogen receptor (ER). The ability of BCF to regulate ElS formation or hydrolysis was examined in I MCF-7 (ER+), ZR-75-1 (ER+), or MDA-MB-231 (ER-) breast cancer cells. BCF was collected from women by fine-needle aspiration and, after measurement of the Na+/K’ electrolyte ratio, added to cells at 5% v/v. After exposure of cells to BCF for 48 h the medium was removed and EIS formation or hydrolysis assayed using either [6,7-3H]El or [6,7-3H]E1S as the respective substrates. In most cases, BCF markedly inhibited ElS hydrolysis in MCF-7 cells (41 f 15%, mean f SD, n= 11) while stimulating sulphate formation (85 f 28%) with the degree of inhibition or stimulation being correlated with the BCF Na+/K’ electrolyte ratio. BCF had little effect on sulphate hydrolysis of formation in ZR-751 cells but, in contrast to MCF-7 cells, stimulated ElS hydrolysis in MDA-MB-231 cells (40 * 29%) while inhibiting sulphate formation in these cells (56 * 11%). The isolation and identification of factors in BCF that can reduce the formation of biologically available oestrogen while enhancing the synthesis of inactive oestrogen conjugates could lead to the development of novel strategies for the treatment of women with breast cancer.

Breast cyst aspiration and fine-needle or needle-core biopsy of palpable and nonpalpable breast masses can be cost-effective and in some situations provide instant resolution of cystic masses. The limitations of the techniques must be known if the benefits are to be exploited. New evaluations on cyst fluid demonstrating proteins (common to breast cancer) have been demonstrated, as well as assessment of electrolyte ratios in fluid. These may give additional information regarding cyst character and potential risks for breast cancer. Physicians involved in the treatment of breast disease must be aware of these advances as well as being clinically adept in fine-needle aspiration.

Since September, 1951, when the Committee for the Study of Delay in the Diagnosis of Breast Cancer in Philadelphia County started functioning, I have, as its chairman, presumed to have a special interest in early diagnosis of this most frequent of cancers. At the same time, it has been brought to my attention that on occasion physicians have tended to jump the gun, so to speak, and resort to radical measures without adequate biopsy. In spite of our zeal in encouraging early diagnosis, surely unnecessary surgery of any kind is to be avoided. Most of us completely distrust the confident diagnostician who can accurately diagnose a breast mass without biopsy, depending upon history and physical examination alone, and we look somewhat askance at the surgeon who can always distinguish between the benign and the malignant by gross examination of the biopsy specimen. I would prefer the physician who is willing

A total of 149 breast cysts have been treated with primary aspiration. Findings were abnormal in 36 patients, 30 of whom underwent excision of the breast cyst with cancer being found in four. Careful examination of the breast after aspiration and follow-up are necessary, but, provided these precautions are observed, this type of treatment is simple, safe, and cheap besides often giving the patient relief at the first consultation.

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. There is no clear association between PCOS and benign breast disease (BBD). The latter is a frequent benign disorder, affecting women between 20 and 50 years of age. To date, the classification remains controversial, and the risk of developing breast cancer that is associated with these changes is different depending on the histopathological findings. The most frequent changes are breast cysts, which are noted in up to 50% of patients older than 30 years of age. This up-to-date review presents the relationship between PCOS and BBD. In conclusion, there is no clear association between benign breast disease and PCOS. Further studies on a large population with prospectively collected data using updated PCOS criteria are necessary.

Objective. To determine the application value of the mono-exponential model, dual-exponential model, and stretched-exponential model of MRI with diffusion-weighted imaging (DWI) in breast cancer (BC) lesions. Methods. Totally 64 cases with BC admitted to our hospital between June 2019 and October 2020 were enrolled in this study. They had 71 lesions in total, including 40 benign tumor lesions (including 9 breast cyst lesions) and 31 malignant tumor lesions. After DWI examination, with normal glands as control, mono-exponential model (ADC) map, dual-exponential model (Standard-ADC) map, slow apparent diffusion coefficient (Slow-ADC) map, fast-apparent diffusion coefficient (Fast-ADC) map, and stretched-exponential model (DDC) map were processed, and corresponding values were generated. Then, the situation and significance of each parameter in breast cysts, benign breast tumor lesions, and malignant tumor lesions were analyzed. Results. The values of ADC, Standard-ADC, and DDC of breast cysts were higher than those of normal glands (all P < 0.05 ), and the values of ADC and DDC of benign breast tumor lesions were lower than those of normal glands ( P < 0.05 ). In addition, malignant breast tumor lesions had lower values of ADC, Standard-ADC, Slow-ADC, and DDC and a higher Fast-ADC value compared to normal glands (all P < 0.05 ). Compared with benign tumor lesions, malignant tumor lesions had lower values of ADC, Standard-ADC, Slow-ADC, and DDC and a higher value of Fast-ADC (all P < 0.05 ). Moreover, the receiver operating characteristic (ROC) curve-based analysis revealed that all the above models could be adopted to effectively evaluate the deterioration of benign breast tumor lesions (all P < 0.05 ), and DDC value had the most significant diagnostic effect on malignant tumor lesions ( P < 0.05 ). Conclusion. Both dual-exponential model and stretched-exponential model of DWI can help effectively evaluate the progression of benign breast tumors, and the stretched-exponential model is more effective in the diagnosis of malignant breast tumors. These models are of great help to the future clinical diagnosis of BC.

The purpose of this research was to develop and evaluate the effectiveness of a new way of cytological diagnosis of breast cancer, based on the premise that before aspiration the cyst contents, an ozone-oxygen mixture at a concentration of 5 ug/ml is introduced into the cyst cavity, then the mixture is evacuated with the subsequent introduction of the saline solution in a quantity of 150 % of initial volume. The cytological preparations are made for microscopic examination in order to verify morphologically the diagnosis from the obtained aspirate after centrifugation. The article highlights the results of examination of 67 patients with suspected intracystic breast cancer with usage of traditional and new methods of fine- needle aspiration biopsy. The sensitivity of the traditional method of fine-needle aspiration biopsy in the diagnosis of this pathology according to the results of the research is 81.80 %, the sensitivity of the new method is 97.06 % (p < 0.05), which proves the expedience of usage of a new method in breast cancer detection.

Bio-heat transfer is a branch of bio-medical engineering which has its foundation linked to engineering disciplines of heat transfer. The thermal properties and behaviour of various malfunctioning tissues in human body varies as compared with normal tissues. Among various cancer tissues one which is commonly diagnosed in women is breast cyst (cancer causing fluid). The aim of present work is to develop one, two and three-dimensional computational models to study bio-heat transfer problems using finite difference method. First of all, a numerical model based on finite difference method is developed to solve Pennes’s bio-heat transfer equation in one-dimension to get temperature profiles normal to skin surface and validated with existing analytical solutions. Secondly, the numerical model is extended to study the thermal behaviour of human breast section embedded with cyst using two-dimensional cylindrical coordinate systems and validated with previous researcher’s results. The effect of size, location and presence of multiple cysts on surface temperature is studied. Lastly, the work is extended for the case of three-dimensional breast section with cyst located at the centre. The numerical results obtained using one, two and three-dimensional computational models will be highly helpful in the early detection of breast cancer tissues and also the location of it inside the body.

Intracystic breast carcinoma is a rare clinical entity accounting for 0.5-2% of all breast cancers. It represents a distinctive clinical form rather a histological subtype of breast cancer and can either be in situ or invasive tumor. We herein describe a rare case of intracystic breast carcinoma arising from the wall of a cyst in a postmenopausal patient, who presented with a rapidly growing complex breast cyst. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. Complex breast cysts may represent a diagnostic and therapeutic challenge. An underlying malignancy has been reported in 21-31% of the cases. Preoperative diagnosis is challenging. Complex breast cysts with thick wall, thick inner septations, and intracystic solid components should undergo histological evaluation in order to rule out an underlying malignancy. The cytological analysis may be inconclusive. Ultrasound-guided biopsy is the diagnostic modality of choice. The correlation of clinical features, with imaging and histopathological findings is very important for the optimal treatment. In cases of discordance, a complete surgical excision is necessary with careful assessment of the extent of the disease and appropriate treatment.

Breast pain (mastalgia) is experienced by ≤70% of women during their lifetime1 and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units — in one study it accounted for 41% of referrals.2 This article reviews the management of breast pain within primary care and criteria for referral. Cyclical breast pain is the condition experienced by two-thirds of patients with true mastalgia. It is influenced by hormonal changes over the menstrual cycle, usually worsening in the last week of a cycle and relieved at the onset of menses. Pharmacological hormonal agents can exacerbate symptoms. Contributing factors such as caffeine, iodine deficiency, and dietary fat intake have been suggested, but no link definitively proven.3 Non–cyclical breast pain accounts for around one-third of patients with true mastalgia.4 It does not follow a menstrual pattern. Causes could be large pendulous breasts, breast cysts, pregnancy, thrombophlebitis, trauma, and previous breast surgery.3 Inflammatory conditions such as mastitis (both lactational and non-lactational) and breast abscess are painful, and …

AIMS Apolipoprotein D (ApoD) is a protein that is regulated by androgen and oestrogen, and is a major constituent of breast cysts. Although ApoD has been reported to be a marker of breast cancer, its prognostic importance in invasive breast cancer is unclear. The aim of this study was to investigate the relationship between ApoD protein expression, oestrogen receptor-α (ERα) expression and androgen receptor (AR) expression in predicting breast cancer outcome. METHODS AND RESULTS ApoD levels were measured by the use of immunohistochemistry and video image analysis on tissue sections from a breast cancer cohort (n = 214). We assessed the associations of ApoD expression with disease-free survival (DFS), metastasis-free survival (MFS), and overall survival (OS). We also assessed the relationship between ApoD expression, AR expression and ERα expression in predicting OS. ApoD expression (>1% ApoD positivity) was found in 72% (154/214) of tissues. High ApoD positivity (≥20.7%, fourth quartile) was an independent predictor of MFS and OS, and conferred a 2.2-fold increased risk of developing metastatic disease and a 2.1-fold increased risk of breast cancer-related death. ApoD positivity was not associated with AR or ERα nuclear positivity. However, patients with (≥1%) ERα-positive cancers with low (

Aim. To assess the breast condition in females using levonorgestrel-containing intrauterine system (20 μg) for 5-year period, by repeated ultrasound monitoring. Methods. Results of regular clinical examination and breast ultrasound repeated during 5 years of follow up in 118 women aged 30 to 55 years, continuously using levonorgestrel-containing intrauterine system (20 μg) for 5-year period, were analyzed. Results. According to the results of 5-year sonographic monitoring of breast condition in females using levonorgestrel-containing intrauterine system, breast cancer was diagnosed in 2 (1.7%) patients during the first 6 months of the research; no other cases were discovered during the subsequent follow-up. Fibroadenoma of the breast was diagnosed in 3 (2.5%) women, which was lower compared to statistical prevalence in general population (5%). By the end of the follow-up period, no mammary gland adenosis foci were found at ultrasound. The number of patients with breast cysts decreased, as well as the number of breast cysts in single patient, which were found in 41 (34.7%) female patients before the treatment and in 13 (11.0%) patients after a year of treatment with levonorgestrel-containing intrauterine system. No mammary gland dilatation was diagnosed before levonorgestrel-containing intrauterine system was administered, during the first year of treatment it was revealed in 16 (13.5%) patients. According to the results of ultrasonography, maximal size of fibrous glandular complex after 5 years of treatment was 16.2 mm, mean - 10.2 mm (before the treatment - 18.2 and 14.2 mm respectively, after 1 year of treatment - 17.4 and 13.3 mm respectively. Conclusion. The use of levonorgestrel-containing intrauterine system was associated with favorable effects on breast condition. No adenosis foci were further found, the number of patients with mammary gland cysts decreased as well as the number of the cysts, the fibrous glandular complex thickness has decreased, revealing the downward trend for breast focal masses formation.

Background Breast disorders cause great anxiety for women especially when they occur in pregnancy because breast cancer is the most common cause of cancer related deaths in women. Majority of the disorders are Benign Breast Diseases (BBD) with various degrees of associated breast cancer risks. With increasing breast cancer awareness in Nigeria, we sought to determine the prevalence and characteristics of breast disorders among a cohort of pregnant women. Methods A longitudinal study of 1248 pregnant women recruited in their first trimester- till 26 weeks gestational age consecutively from selected antenatal clinics (ANCs), in Ibadan, Southwest Nigeria. A pretested interviewer- administered questionnaire was used to collect information at recruitment. Clinical Breast Examination (CBE) using MammaCare® technique was performed at recruitment and follow up visits at third trimester, six weeks postpartum and six months postpartum. Women with breast disorders were referred for Breast Ultrasound Scan (BUS) and those with Breast Imaging Reporting and Data System (BIRADS) ≥4 had ultrasound guided biopsy. Statistical analysis was performed using Stata version 14. Results Mean age of participants was 29.7 ± 5.2 years and mean gestational age at recruitment was 20.4 ± 4.4 weeks. Seventy-two participants (5.8%) had a past history of BBD and 345 (27.6%) were primigravidae. Overall, breast disorder was detected among 223 (17.9%) participants and 149 (11.9%) had it detected at baseline. Findings from the CBE showed that 208 (69.6%) of 299 breast disorders signs found were palpable lumps or thickenings in the breast, 28 (9.4%) were persistent pain, and 63 (21.1%) were abscesses, infection and mastitis. Twenty out of 127 (15.7%) participants who had BUS performed were classified as BIRADS ≥3. Lesions found by BUS were reactive lymph nodes (42.5%), prominent ducts (27.1%), fibroadenoma (9.6%), breast cysts (3.8%) and fibrocystic changes (2.5%). No malignant pathology was found on ultrasound guided biopsy. Conclusions Breast lump is a major breast disorder among pregnant women attending antenatal clinics in Ibadan. Routine clinical breast examination and follow up of pregnant women found with breast disorders could facilitate early detection of pregnancy associated breast cancer in low resource settings.

The paper presents the results of breast imaging for 47200 women. Breast cancer was detected in 862 (1.9%) patients, fibroadenoma in 1267 (2.7%) patients and isolated breast cysts in 1162 (2.4%) patients. Different types of fibrocystic breast disease (adenosis, diffuse fibrocystic changes, local fibrosis and others) were observed in 60.1% of women. Problems of breast cancer visualization during mammography, characterized by the appearance of fibrocystic mastopathy (sclerosing adenosis, fibrous bands along the ducts) have been analyzed. Data on the development of diagnostic algorithms including the modern techniques for ultrasound and interventional radiology aimed at detecting early breast cancer have been presented.

Background and purpose Simple breast cysts are a common sonographic finding and do not require further diagnostic evaluation. In contrast, atypical breast cysts do harbour a risk of malignancy. The purpose of this study was to evaluate the predictive value of sonographic findings that are considered characteristic of malignant atypical cyst-like lesions. Patients and methods Six descriptive sonographic criteria of 202 atypical cysts in 176 women were compared with histopathological findings after surgical excision and their statistical association was evaluated. Results Of these six criteria thick cyst wall ( p p = 0.0001) and hyperechogenicity ( p = 0.003) were found to be highly predictive of breast cancer. The presence of two or more sonographic criteria was associated with a 10.3 times greater risk of malignancy ( p Conclusion The association between suspicious sonographic criteria and histology after surgery was evaluated. We propose surgical excision when two or more sonographic criteria are diagnosed in a single atypical breast cyst.

Autologous fat grafting (AFG) or lipofilling is nowadays a popular technique for breast reconstruction after breast cancer surgery. There is debate regarding the oncological safety and risks of this procedure in breast cancer patients. A systematic review of the literature published between January first 1995 and October first 2016 was conducted regarding the efficacy, safety and complications of this technique in breast cancer patients after their cancer treatment. The databases PubMed, Science Direct and Thomson Reuters Web of Science were used to search for qualified articles. Inclusion criteria were women with a personal history of breast cancer and at least one lipofilling procedure. Only studies containing a minimum of 20 patients were included in this systematic review. The search yielded a total of 23 suitable articles: 18 case series, 4 retrospective cohort studies and one prospective cohort study. The systematic review encompassed a total of 2419 patients. Medical imaging was used in the majority of the studies to assess the follow-up. Mammography was the most popular technique (65.2%), followed by ultrasound (47.8%) and MRI (30.4%). The prevalence of complications was the following: fat necrosis in 5.31%, benign lesions, like cysts or calcifications in 8.78%, infections in 0.96% and local cancer recurrence in 1.69%. AFG or lipofilling appears to be an oncological safe technique with a low morbidity in women with a history of breast cancer. In order to have a better understanding and evidence of the oncological safety a randomised controlled trial is urgently needed. We further recommend that all AFG be registered in the cancer register. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Objective The objective of this study is to assess whether the largest cyst diameter is useful for BI-RADS ultrasonography classification of predominantly solid breast masses with an oval shape, circumscribed margins, and largest axis parallel to the skin, which, except for the cystic component, would be likely classified as benign. Methods This study received approval from the local institutional review board. From March 2009 to August 2014, we prospectively biopsied 170 breast masses from 164 women. We grouped the largest cyst and mass diameters according to histopathological diagnoses. We used Student's t-test, linear regression, and the area under the receiver operating characteristic curve (AUC) for statistical assessment. Results Histopathological examination revealed 143 (84%) benign and 27 (16%) malignant masses. The mean largest mass diameter was larger among malignant (mean standard deviation, 34.1 16.6 mm) than benign masses (24.7 16.7 mm) (P < 0.008). The mean largest cyst diameter was also larger among malignant (9.9 7.1 mm) than benign masses (4.6 3.6 mm) (P < 0.001). Agreement between measurements of the largest mass and cyst diameters was low (R2 = 0.26). AUC for the largest cyst diameter (0.78) was similar to the AUC for the largest mass diameter (0.69) ( p = 0.2). A largest cyst diameter < 3, 3 to < 11, and 11 mm had a positive predictive value of 0, 15, and 52%, respectively. Conclusion A largest cystic component < 3 mm identified within breast masses that show favorable characteristics may be considered clinically inconsequential in ultrasonography characterization. Conversely, masses with a largest cystic component 3 mm should be classified as BI-RADS-US category 4. Resumo Objetivo Avaliar se o maior diâmetro do cisto é útil para a classificação ultrassonográfica BI-RADS de nódulos mamários predominantemente sólidos, com forma oval, margens circunscritas e maior eixo paralelo à pele que, exceto pela presença do componente cístico, seriam classificados como provavelmente benignos. Métodos Este estudo foi aprovado pelo Comitê de Ética local. De março de 2009 a agosto de 2014, 170 nódulos mamários de 164 mulheres foram prospectivamente biópsiados. As medidas do maior diâmetro do maior cisto e do maior diâmetro do nódulo foram agrupados de acordo com os diagnósticos histopatológicos. O teste t de Student, a regressão linear e a área sob a curva ROC (AUC) foram utilizados para a avaliação estatística. Resultados O exame histopatológico revelou 143 (84%) nódulos benignos e 27 (16%) nódulos malignos. A média da medida do maior diâmetro dos nódulos foi maior entre os nódulos malignos (média desvio padrão, 34,1 16,6 mm) do que nos nódulos benignos (24,7 16,7 mm) (p < 0,008). A média do maior diâmetro do maior cisto também foi maior entre os nódulos malignos (9,9 7,1 mm) do que nos nódulos benignos (4,6 3,6 mm) (p < 0,001). A concordância entre as medidas dos maiores diâmetros dos nódulos e do maior diâmetro do maior cisto foi baixa (R2 = 0,26). A AUC do maior diâmetro do maior cisto (0,78) foi semelhante à AUC do maior diâmetro do nódulo (0,69) (p = 0,2). Os maiores diâmetros dos maiores cistos medindo < 3; 3 e < 11; e 11 mm tiveram um valor preditivo positivo de 0, 15 e 52%, respectivamente. Conclusão Componentes císticos < 3 mm identificados dentro de nódulos mamários que apresentam as demais características provavelmente benignas podem ser considerados clinicamente irrelevantes na caracterização ultrassonográfica. Por outro lado, nódulos que apresentam um componente cístico medindo 3 mm devem ser classificadas na categoria BI-RADS-US 4.