Search

Background The breast is affected by a variety of benign disorders with a wide range of imaging and histopathological characteristics. Epidemiological investigations indicate that more than 50% of women will have one of the benign breast disorders beyond the age of 20 years. Objectives The objective of this study is to evaluate females with benign breast disorders attending the breast clinic in Duhok city by the triple assessment method. Patients and methods This is a prospective study conducted in Duhok Breast Clinic at Azadi Teaching Hospital from May 2017 to July 2018 which included 445 female patients with benign breast diseases. The patients were assessed by the triple assessment method (clinical examination, imaging and histopathological evaluation), females from all age groups were included. Patients with malignant disease and male patients were excluded from the study. Results The mean age of the patients was 34.65 years; breast pain was reported in 403 patients 73 patients presented with breast lump or lumps, 42 patients presented with nipple discharge, 36 patients were presented with nipple retraction. From these the total number of the patients 55 of them were reassured and no further work up was done, 235 sent for ultrasound examination,36 sent for mammography, 22 sent for both ultrasound and mammography and 4 patients were sent for MRI of the breast. Excisional biopsy done for 37 patients, FNAC in 28 patients, tru cut biopsy in 10 patients and cytological examination for the fluid discharge in 18 patients. Mastalgia was the commonest disorder seen in 376 patients, Ductectasia in 60 cases, Fibrocystic disease in 36cases, fibroadenoma in 33cases, breast cysts in 28 cases. Conclusions Benign breast diseases is a common problem in women, in this study mastalgia is the commonest followed by benign and inflammatory lesions. The use of the triple assessment to approach breast pathologies increase the diagnostic yield. Surgeons evaluating breast pain should have more rational criteria in using further sophisticated, expensive and invasive tests.

Breast cysts represent a difficult problem in mammology in terms of diagnosis and choice of treatment tactics. The introduction of a system for interpreting and logging the results of ultrasound examination of the mammary glands according to the BI-RADS scale into the daily practice of an ultrasound diagnostic doctor makes it possible to systematize the results obtained, to determine the tactics of optimal examination and management of patients with breast neoplasms, and ensures continuity in the conduct of medical and diagnostic measures.

The amount of ultrasound (US) breast examinations continues to grow rapidly because of the wider endorsement of breast cancer screening programs. Cysts are the most commonly diagnosed breast lesions. Atypical breast cysts can be a serious differentiation problem in the US. Our goal was to develop noninvasive automated US grayscale image analysis for the cystic and solid breast lesion differentiation based on mathematical image post-processing. We used a set of 217 ultrasound images of proven 107 cystic (including 53 atypical) and 110 solid lesions. Empirical statistical and morphological models of the lesions were used to obtain features. The AUC indicator and Student’s t test were used to assess the quality of the individual features. The Pearson correlation matrix was used to calculate the correlation between various features. The LASSO and stepwise regression methods were used to determine the most significant features. Finally, the lesion classification was carried out by the various methods. The use of LASSO regression for the feature selection made it possible to select the most significant features for classification. The sensitivity increased from 87.1% to 89.2% and the specificity—from 92.2 to 94.8%. After the correlation matrix construction, it was found that features with a high value of the correlation coefficient (0.72; 0.75) can also be used to improve the quality of the classification. The construction of the empirical model of the lesion pixels brightness behavior can provide parameters that are important for the correct classification of ultrasound images. The optimal set of features with the maximum discriminant characteristics may not be consistent with the correlation of features and the value of the AUC index. Features with a low AUC index (in our case 0.72) can also be important for improving the quality of the classification.

Cysts represent the most common cause of a breast mass in women. On the contrary, in men, the presence of a benign apocrine cyst is an exceedingly rare occurrence, with only a few cases reported in the literature. We describe herein a case of benign apocrine breast cyst without concurrent gynecomastia in a 41-year-old male. Diagnostic evaluation and management are discussed, along with a review of the literature. Given the extreme rarity of benign breast cysts in males, a thorough investigation is essential in male patients presenting with cystic breast lesions. Diagnostic breast imaging may be challenging. Surgical resection of the cyst should be considered in the presence of atypical imaging features to exclude underlying malignancy.

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.

Most breast cysts are benign , but sometimes they can be malignant indicating a microbiopsia with histological study. They must be characterized by mammography and ultrasound in order to guide management.We report the case of a 47-year-old woman with a large left breast cyst whose histological study was in favour of breast carcinoma.

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.

Background: Normalized glandular dose (DgN) is an important dosimetric quantity in mammography. Aim: In this study, the effect of the presence of breast cysts and their size, number and location on DgN is evaluated. Materials and methods: The effect of the presence of cysts in breast was examined using MCNPX code. This was performed by taking homogeneous breast phantoms containing spheroid breast cysts into account. The radius of the cysts, numbers of the cysts, and depth of the cysts, and their location were variable. Various electron energies were also considered. Finally, these results were compared with the results of a cyst-less breast phantom. Results: The results show that the effect of the presence of cysts in the breast depends on the size, number and location of cysts. The presence of cysts at lower depths leads to a decrease in the DgN values, compared to the breast phantom without cysts. The presence of cysts in the breast phantom has an effect of -7 to +14 percent on the DgN values under the conditions considered in this modeling. This effect is independent of the X-ray tube voltage, the breast phantom thickness, and glandular ratio, and depends only on the number and size and location of the cysts. The bigger radius and number of cysts, the greater effect on DgN value.

Objective. Atypical breast cysts are often quite a serious problem in noninvasive ultrasound differential diagnosis. To develop a system for automated analysis of grayscale ultrasound images, which on the principles of mathematical processing would make it possible to increase the specificity of diagnosis in this situation.Material and methods. The authors developed the CystChecker 1.0 software package. To test this system, they used a set of 217 ultrasound images: 107 cystic (including 53 atypical lesions that were hardly differentially diagnosed by standard methods) and 110 solid (both benign and malignant) breast masses. All the masses were verified by cytology and/or histology. Visual assessment was carried out analyzing grayscale ultrasound, color/power Doppler, and elastography images.Results. Using the system developed by the authors could correctly identify all (n = 107 (100%)) typical cysts, 107 (97.3%) of 110 solid masses, and 50 (94.3%) of 53 atypical cysts. On the contrary, the standard visual assessment provided a possibility of correctly identifying all (n = 107 (100%)) typical cysts, 96 (87.3%) of 110 solid masses, and 32 (60.4%) of 53 atypical cysts (p < 0.05). The corresponding values of the overall specificity of automated and visual assessments were 98 and 87%, respectively.Conclusion. Using the system developed by the authors for automated analysis provides a higher specificity than the visual assessment of an ultrasound image, which is carried out by a qualified specialist.

Objective Parenchymal breast cysts are considered to be rare in men and are sparsely described in the literature. The purpose of this study was to review our institution’s experience with male breast cysts in an effort to improve overall understanding and management of this rare entity. Methods An institutional review board–exempt retrospective study was performed. Radiology reports for males who underwent mammogram and/or breast ultrasound at any of our institution’s primary or satellite locations from January 1995 to January 2020 were screened to find males with breast cysts. If cysts were reported and images were available, case review was performed to confirm parenchymal breast cyst(s) and patient characteristics were collated. Results Of 5425 male cases presenting for breast imaging, 19 (0.4%) cases of male breast cysts were confirmed, with a mean patient age of 41.6 years (range: 2–81 years). The most common indication leading to cyst discovery was a palpable lump, corresponding to the site of the cyst in 5 (26.3%) patients and near the site where cyst(s) were ultimately discovered in 7 (36.8%) patients. There were 8 (42.1%) instances of cysts without concurrent gynecomastia. Three (15.8%) men underwent needle sampling. There were no cases of atypia or malignancy on needle biopsy or on subsequent clinical follow-up, with median clinical follow-up of 70.3 months (range: 3.3–259.4 months). Conclusion Male breast parenchymal cysts are rare, but their prevalence is likely underestimated. If detected incidentally or upon targeted evaluation, biopsy may be averted if classic benign cyst features are identified.

Highlights • Hydatid cyst should be considered as a differential diagnosis of all breast tumors. • Ultrasound, cytology and MRI play an important preoperative diagnostic of hydatid cyst of the breast. • Treatment of hydatid cyst of the breast essentially based on surgical pericystectomy associated with medical treatment based on albendazole., Introduction The hydatid cyst of the breast is a rare pathology even in countries endemic to tuberculosis, however there remains a differential diagnosis evoked in front of any breast tumor. The clinic, mammography and ultrasound sometimes allow us to suspect the hydatid nature of the lesion. The definitive diagnosis remains histological and the treatment is always surgical. From one case, we recall the important role that cytology can play in preoparatory diagnosis. Case presentation We report an observation of 59-year-old patient who lives in a tuberculosis endemic area of morocoo. the patient presented to our institute with palpable nodule in the right breast associated with pain of long duration. Clinical examination shows 2 masses occuping the entire upper outer quadrant of the right breast. Radiological explorations (mammography + ultrasound) objectified: A voluminous opacity of the QSE of the right breast corresponding on ultrasound to two cystic with anechoic content. the first classified ACR2 BIRADS. the second has ultimately echogenic content with a sloping portion producing the appearance of pseudo vegetation,classified ACR3 BIRADS. A fine needle aspiration of the cyst only showed the presence of altered polynuclear, without evidence of tumor cells. Treatment consisted of surgical excision such as perikystectomy and pathology examination demonstrated breast hydatidosis.postoperative evolution was favourable. Patient was put on medical treatment based on albendazole immediately.The patient was monitored for one year without local or distant recurrences. Conclusion Although hydatid disease of the breast remains a rare localization of tuberculosis disease, it should nevertheless be considered as a differential diagnosis of breast tumors. Ultrasound, cytology and MRI play an important preoperative diagnostic role. Treatment is essentially based on surgical pericystectomy associated with medical treatment based on albendazole.

The aim: study of the effectiveness of the combined treatment of cysts in women after cosmetic breast endoprosthesis with the help of ozone therapy and drug Mastodinon. Material and methods. For 1.5 years with dynamic control after 6-12 months. clinical-x-ray-sonographic examination of the mammary glands of 21 women aged 34 to 42 years with different variants of mastopathy and cysts after cosmetic endoprosthesis was carried out. For therapeutic purposes, a fine needle aspiration biopsy of breast cysts was performed under ultrasound control, followed by the introduction of an ozone-oxygen mixture into the cavity at a concentration of 40-80 mcg/ml, in parallel, a herbal preparation Mastodinon was prescribed for 1 tab. X 2 times a day for 3 months. Results. The examined patients complained of pain, a feeling of swelling, the presence of insomnia, periodic feeling of heaviness and swelling, a sense of fear, apprehension and uncertainty associated with the surgical intervention to install implants. Clinical-x-ray-sonographic examination in all patients revealed fibrocystic mastopathy of varying severity with cysts from 0.5 to 2 cm. Control studies every 6 months during the year showed positive dynamics of combined treatment of breast cysts after ozone therapy and the use of Mastodinon as a stable therapeutic effect in 91% of cases. In 20 of the 21 cases, the cysts did not recur, the clinical symptoms of mastalgia did not bother. Conclusion. Combined conservative treatment of breast cysts after cosmetic endoprosthesis with sequential introduction into the emptied cavity of ozone-oxygen mixture at a concentration of at least 70-80 mcg/ml with the appointment of the drug Mastodinon for 3 months. Stably reduces clinical manifestations of fibrocystic mastitis and eliminates recurrence of cysts in 91% of cases, improves the quality of life of patients.

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.

“Rusty pipe syndrome” is a condition that needs to be considered in a primiparous woman who presents with bilateral bloody nipple discharge in the early postpartum period. Its prevalence is low and can occur due to physiological condition that arises primarily in primiparous women with increased alveolar and ductal vascularization associated with the onset of lactation. Here, we report a case of a 29-year-old primigravida who presented with bilateral painless bloody nipple discharge after delivery. Her breast examination showed no signs of infection or structural changes, and breast ultrasound did not reveal any significant observations except for a bilateral simple breast cyst. Six days after the onset of lactation, the bloody nipple discharge ceased and lactation continued on demand.

Benign breast cyst is common in females in the reproductive age group. However, it is rare in males. Males without gynecomastia are not considered candidates for development of benign breast cyst. Here, we report a case of a large benign apocrine cyst in a young adult male breast. A 16-year-old adolescent male presented with complaints of swelling on the right breast of 2-month duration. He noticed gradual increase in the size of the swelling. No history of nipple retraction, nipple discharge, similar swellings in the opposite breast or axilla, pain, or fever. Examination of the right breast showed a soft cystic swelling under right nipple areolar complex of size 4 × 4 cm size. Ultrasound evaluation of right breast showed oval anechoic cystic lesion measuring 4.4 × 4 × 1 cm in retroareolar location with fine internal contents and axilla showed a small lymph node with preserved hilum (maximum size 6 mm) in right axilla. FNA from the breast cyst yielded turbid fluid and cytology was inconclusive. He underwent excision biopsy under GA. Histopathology showed benign apocrine cyst with papillary hyperplasia and prominent apocrine metaplasia. His postoperative period and outpatient follow-up were uneventful. Apocrine cyst in male breast is a rare clinical entity. Triple assessment and excision helps in complete recovery.

Introduction: Palpable breast lumps are one of the most prevalent breast problems in women who visit a doctor. Most of these lumps are benign, and many of these benign lumps, have cystic nature. One of the suggested treatments for breast cyst is vitamin B6 intake. So, this study aimed to determine the effect of vitamin B6 on reducing the number and the size of breast cysts and reducing the amount of recurrence after aspiration. Materials and Methods: This study is a double-blind randomized clinical trial. Patients simply divided into two groups randomly, intervention group (receiving 150 mg vitamin B6 twice a day for two months) and control group (placebo). After data collection, the database produced, and information came in by SPSS-22 software. Descriptive results extracted in the form of tables and graphs. In all cases was used α=0.05. Results: At the end of the study, 65 patients (34 people in the intervention group, and 31 people in the control group) studied. At the end of the survey in the non-palpable cysts, was observed a significant decrease in the number and the size of breast cysts in each group receiving vitamin B6 or placebo. Still, the difference was not significant in comparing the two groups. 19 patients (2.29%) had palpable cysts that aspiration performed in all cases. After the study period, no recurrence of cysts observed in any of the intervention and control groups. Conclusion: The study showed that vitamin B6 had no effect on reducing the size and the number of non-palpable breast cysts and prevent recurrence of palpable cysts after aspiration.

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.

RATIONALE AND OBJECTIVE: The purpose of this work is to determine if the speed of sound value of a breast cyst can aid in the clinical management of breast masses. Breast macrocysts are defined as fluid-filled tissue masses greater than 1 cm in diameter and are thought to be aberrations of normal development and involution, often associated with apocrine metaplasia. The benign natural history of breast cysts is well known, and it is important to obtain high specificity in breast imaging to avoid unnecessary biopsies in women who have benign disease, particularly in those women with dense breast tissue. Transmission ultrasound is a tomographic imaging modality that generates high-resolution, 3D speed of sound maps that could be used to identify breast tissue types and act as a biomarker to differentiate lesions. We performed this study to investigate the microanatomy of macrocysts observed using transmission ultrasound, as well as assess the relationship of speed of sound to the physical and biochemical parameters of cyst fluids. MATERIALS AND METHODS: Cyst fluid samples were obtained from 37 patients as part of a case-collection study for ultrasound imaging of the breast. The speed of sound of each sample was measured using a Quantitative Transmission Ultrasound scanner in vivo. Electrolytes, protein, cholesterol, viscosity and specific gravity were also measured (in the aspirated cyst fluid) to assess their relationship to the speed of sound values obtained during breast imaging. RESULTS: We found positive correlations between viscosity and cholesterol (r = 0.71) and viscosity and total protein × cholesterol (r = 0.78). Additionally, we performed direct cell counts on cyst fluids and confirmed a positive correlation of number of cells with speed of sound (r = 0.74). The speed of sound of breast macrocysts, as observed using transmission ultrasound, correlated with the cytological features of intra-cystic cell clumps. CONCLUSION: On the basis of our work with speed as a classifier, we propose a spectrum of breast macrocysts from fluid-filled to highly cellular. Our results suggest high speed cysts are mature macrocysts with high cell counts and many cellular clumps that correlate with cyst microanatomy as seen by transmission ultrasound. Further studies are needed to confirm our findings and to assess the clinical value of speed of sound measurements in breast imaging using transmission ultrasound.

PURPOSE A substantial percentage of recalls (up to 20%) in screening mammography is attributed to extended round lesions. Benign fluid-filled breast cysts often appear similar to solid tumors in conventional mammograms. Spectral imaging (dual-energy or photon-counting mammography) has been shown to discriminate between cysts and solid masses with clinically acceptable accuracy. This work explores the feasibility of using convolutional neural networks (CNNs) for this task. METHODS A series of Monte Carlo experiments was conducted with digital breast phantoms and embedded synthetic lesions to produce realistic dual-energy images of both lesion types. We considered such factors as nonuniform anthropomorphic background, size of the mass, breast compression thickness, and variability in lesion x-ray attenuation. These data then were used to train a deep neural network (ResNet-18) to learn the differences in x-ray attenuation of cysts and masses. RESULTS Our simulation results showed that the CNN-based classifier could reliably discriminate between cystic and solid mass round lesions in dual-energy images with an area under the receiver operating characteristic curve (ROC AUC) of 0.98 or greater. CONCLUSIONS The proposed approach showed promising performance and ease of implementation, and could be applied to novel photon-counting detector-based spectral mammography systems.

Patient: Female, 59-year-old Final Diagnosis: Invasive breast carcinomas of no special type (NST) Symptoms: Recurrent hemorrhagic cystic lesion Medication: — Clinical Procedure: — Specialty: Surgery Objective: Challenging differential diagnosis Background: Breast trauma can always have diagnostic pitfalls. In the presence of a recurrent hemorrhagic cysts, cancer should always be suspected. Case Report: A 59-year-old woman noted a palpable mass after breast trauma from falling at home. Radiological exams showed a breast cyst with well-defined margins, with corpuscular and dense fluid components. First, a conservative approach was implemented. One week later, a fine-needle aspiration cytology (FNAC) of the mass showed bloody fluid without atypical cells. Three weeks later, the patient was emergently evaluated due to increased size of the lesion and anemia. To avoid further blood loss and due to suspected malignancy, an urgent surgical excision biopsy was planned. Histopathology revealed a poorly-differentiated carcinoma and the patient was treated with left modified radical mastectomy with axillary dissection. Adjuvant chemotherapy was administered. At 6-month follow-up, the patient was free from recurrences. Conclusions: Recurrent hemorrhagic cysts should always be investigated and considered as a possible cancer lesion. Sonography and cytological exam are the first steps in case of suspicious cysts, but false-negative results are common. In such cases, resection of the cyst should be considered. Immediate resection is valid in cases of diagnostic uncertainty or inability to assess the cyst with imaging or biopsy.

Deep neural networks have demonstrated potential to both create images and segment structures of interest directly from raw ultrasound data in one step, through an end-to-end transformation. Building on previous work from our group, subaperture beamformed IQ data from in vivo breast cyst data was the input to a custom network that outputs parallel B-mode and cyst segmentation images. Our new model includes bright point and line targets during training to overcome the limited field of view challenges encountered with our previous deep learning models, which were purely trained using simulations of cysts and homogeneous tissue structures. This new network resulted in cyst contrast values of $-33.07\pm 10.79\ \text{dB}, -32.09\pm 0.04 \text{dB}$ , and $-15.95\pm 12.04\ \text{dB}$ for simulated, phantom, and in vivo data, respectively, which is an improvement over the contrast of corresponding delay and sum (DAS) images (i.e., $-17.37\pm 6.06\ \text{dB},\ -17.14\pm 0.16\ \text{dB}$ , and $14.80\pm 1.30\ \text{dB}$ for simulated, phantom, and in vivo, respectively). Higher dice similarity coefficients (DSCs) were obtained with in vivo data with the new network ( .83 \pm 0.01$ ) when compared to our previous model ( .63\pm 0.03$ ), and fewer false positives were encountered. This work demonstrates the feasibility of using multi-task learning to simultaneously form a B-mode image and cyst segmentation with a wider field of view that is appropriate for in vivo breast imaging. These results have promising implications for multiple tasks, including emphasizing or de-emphasizing structures of interest for diagnostic, interventional, automated, and semi-automated decision making.

Background The present study aims to investigate the role of histogram analysis of intravoxel incoherent motion (IVIM) in the differential diagnosis of benign and malignant breast lesions. Methods The magnetic resonance imaging and clinical data of 55 patients (63 lesions) were retrospectively analyzed. The multi-b-valued diffusion-weighted imaging image was processed using the MADC software to obtain the gray-scaled maps of apparent diffusion coefficient (ADC)-slow, ADC-fast and f. The MaZda software was used to extract the histogram metrics of these maps. Combined with the conventional sequence images, the region of interest (ROI) was manually drawn along the edge of the lesion at the maximum level of the gray-scale image, and the difference of the data was analyzed between the benign and malignant breast lesions. Results There were 29 patients with 37 benign lesions, which included 23 fibroadenomas, 6 adenosis, 1 breast cysts, 4 intraductal papillomas, and 3 inflammations of breast. Furthermore, 26 malignant lesions in 26 patients, which included 20 non-specific invasive ductal carcinomas, 5 intraductal carcinomas and 1 patient with squamous cell carcinoma. The ADC-slow (mean and the 50th percentile) and f (minimum, mean, kurtosis, the 10th percentile and 50th percentile) of these malignant breast lesions were significantly lower than those of benign lesions (P P Conclusion The histogram analysis of ADC-slow (mean and the 50th percentile), ADC-fast (kurtosis) and f (minimum, mean, kurtosis, the 10th percentile and 50th percentile. Variance, skewness) can provide a more objective and accurate basis for the differential diagnosis of benign and malignant breast lesions.

Background: Von Hippel-Lindau (VHL) syndrome represents a rare familial condition caused by germline mutations of the tumorsuppressor gene VHL, which is located on the short arm of chromosome 3p25. Only 20% of the cases arise from de novo mutations, most patients having a positive family history with an autosomal dominant transmission. VHL is characterized by the presence of vascular tumors including hemangioblastomas of the cerebellum, spinal cord, brain stem and retina and the appearance of multiple cysts in different organs. Frequently, patients can associate clear cell renal carcinoma (RCC) and pheochromocytomas, or endolymphatic sac tumors. Case reports: We present the cases of two sisters, diagnosed with VHL, with a positive family history (their father was diagnosed with VHL as well). The first patient, a 40 year old female, non-smoker, presented with multiple hemangioblastomas (right cerebellar, brainstem, right optic nerve, spinal cord), bilateral pheochromocytoma and multiple cysts (hepatic, renal and ovary) had a positive genetic analysis (VHL heterozygote mutation p.Arg167Gln) and underwent multiple surgical interventions. The second patient, her sister, 38 year old, presented with multiple emangioblastomas (cerebellar hemangioblastomas, right retinal hemangioblastoma), ovarian and breast cysts. Conclusions: Patients with rare tumors characteristic of VHL (e.g. retinal or cerebellar hemangioblastomas) should be evaluated clinically and molecularly for VHL. This includes reviewing a detailed family history focused on characteristic tumors.

The results of the study of the laser-induced radiation method effectiveness for the treatment of different sizes cysts are presented. It is shown that under the influence of laser radiation, the effects are observed: anti-inflammatory action, accelerating the regeneration of damaged tissues and improving the blood supply to organs. It is confirmed that during the short pulse of heating the tissue is faster than during continuous radiation, which eliminates the possibility of thermal damage to surrounding tissues, contributes to a significant reduction in the possibility of complications and shortening treatment time. The effectiveness of scleroobliteration of breast cysts using the laser-induced coagulation method was 98.4%, with the use of chemical sclerosis—82.7%. The incidence of cyst recurrence was found to be dependent on the cavity volume and decreased with the use of laser-induced sclerotherapy.

Introduction: Squamous cell carcinoma is a malignant neoplasm of epidermal keratinocytes, which rarely affects the breast, representing 0.1% to 2% of all types of breast cancer, and belonging to the heterogeneous group of metaplastic breast carcinomas. Clinically, it is associated with large tumors, tending toward cystic degeneration, with skin invasion and ulceration, and no specific radiological characteristics. It is also associated with a proliferative nature (Ki67) and triple-negative tumors. The prognosis is bleak, with a mean 5-year survival of 50% to 63%. Case report: A female patient, 37 years old, receiving palliative chemotherapy for stage IV endocervical adenocarcinoma (pT3 pN1 M1 – pleura) complained of a tumor in her left breast, with growth in the prior month. Physical examination revealed a palpable, mobile tumor in the central region of the left breast, measuring 11x9.5 cm, and with soft consistency. Mammography identified a regular, well-defined nodule in the left breast (BI-RADS 0). Breast ultrasound (BUS) indicated a simple cyst, with thin and regular walls, without a solid parietal component, measuring 7.6x5.2x4.3 cm. She underwent a BUS-guided relief biopsy of the cystic lesion with total removal of the lesion. Twenty days later, local recurrence occurred, and the lesion was drained again. Culture and cytology were negative for malignancy. She continued receiving chemotherapy. Eight months after the onset of symptoms, at the end of chemotherapy, and with no palpable lesion in the left breast, BUS revealed a simple 2.6 cm cyst, with no sign of flow on the Doppler study, and the patient was submitted to excision of cystic lesion guided by radioguided occult lesion localization (ROLL). Anatomopathological results indicated triple-negative metaplastic carcinoma, measuring 2.7 cm, with squamous differentiation and free surgical margins. Sentinel lymph node biopsy in the left axilla showed two lymph nodes free of neoplastic involvement. Adjuvant treatment consisted of FAC chemotherapy and hypofractionated radiotherapy. Currently, at 18 months of follow-up, she has no evidence of recurrence. Conclusion: Simple breast cysts are benign lesions, with active surveillance, except in the case of recurrence, residual mass after relief biopsy, or presence of bloody fluid in the biopsy material. This report describes a rare case of metaplastic carcinoma, which must be remembered as a differential diagnosis in recurrent breast cyst.