Gray Scale Assessment of Axillary Lymph Nodes in Women Suspected of Breast Cancer

Breast cancer is currently listed as the number two disease in the United States contributing to death in elderly women. Because breast cancer is more prevalent and presents at an advanced stage in older women, less invasive procedures are needed to assess the extent of the disease. Axillary lymph nodes play a major role for staging breast cancer. Ultrasound has the potential to provide noninvasive, non-ionizing, measurements to assess axillary lymph nodes to determine the prognosis of the disease. Fifty four women ages 55 and older were consented for this study. These participants were recruited once they were referred to breast ultrasound following their mammogram. Additional time was allotted for the collection of possibly three axillary lymph nodes, in which the location, size, and shape was recorded. After about 3 months of the patient’s breast ultrasound, a chart audit was conducted to obtain pathological reports. These recorded measurements were then compared with published values of other research studies. A total of 139 axillary lymph nodes were imaged and evaluated. A strong association was found between the shape of the node and the length to diameter ratio (L/D). This comparison between measures had at calculated statistic p-value < 0.000. There was also a strong correlation between the L/D ratio and the morphology of the axillary lymph node which had a statistical p-value < 0.024. This feasible study was designed to explore a potential clinical guideline based on the use of L/D ratio and gray scale morphology to assess the axillary lymph nodes. With continued and expanded research, this technique may be used to screen for possible breast cancer metastases among older women at high risk for breast cancer.No embarg

Role of Ultrasonography in Diagnosis of Palpable Breast Lumps: One Year Cross Sectional Study

AbstractBackground: The breast is commonest site for development of cancer in female and accounts for around 1/5 of all malignancies in the sex. In the past few years ultrasonography of the breast for evaluation of radiologically dense breasts or cysts has been become the 1st line of investigation.Aims and Objectives: To assess the role of ultrasonography in diagnosis of palpable breast lumps.The most important clinical use of ultrasound imaging is its ability to differentiate between solid and cystic masses, benign and also by knowing the prior diagnosis the need for open biopsy and followed by surgery, the cost and time involved can be saved. In patients with dense breasts the FNAC may not hit the exact site of mass and can give inconclusive diagnosis. When Ultrasonography can pick up abscess of breast, needle aspiration can be done instead of incision and drainage. Breast ultrasonography should be considered as an extension of physical examination and it will improve the care available to patients and subsequently improve outcomes. Ultrasonography can expedite both diagnosis and treatmentResults: On analysis, 68 patients were included in study.  The sensitivity of ultrasonography for malignancy was 89.47%. The specificity of ultrasonography was malignant & benign lesions 100%. The positive predictive value of ultrasonography was 100%.Conclusion: Ultrasound has higher sensitivity in diagnosing malignant lesions hence should be considered as first line diagnostic tool for breast lesions. Keywords: Ultrasonography, Breast lum

Discrimination of sonographically detected breast masses using frequency shift color Doppler imaging in combination with age and gray scale criteria.

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135358/1/jum2001204343.pd

Breast Ultrasound Past, Present, and Future

This chapter will review the utilization of breast ultrasound for screening and diagnostic purposes. Currently, ultrasound is primarily used to investigate palpable lesions in women less than 30 years old, to provide further characterization of abnormal mammographic findings, and to guide invasive breast interventions. Innovations in ultrasound technology have improved the detection and diagnosis of breast cancer. Computer-aided detection (CAD), elastography, quantitative breast ultrasound technology, and ultrasound contrast agents (microbubbles) were developed to improve diagnostic accuracy. These advancements have the potential to impact overall survival by detecting cancers that are smaller and less aggressive

Ultrasound Imaging

Ultrasound Imaging - Current Topics presents complex and current topics in ultrasound imaging in a simplified format. It is easy to read and exemplifies the range of experiences of each contributing author. Chapters address such topics as anatomy and dimensional variations, pediatric gastrointestinal emergencies, musculoskeletal and nerve imaging as well as molecular sonography. The book is a useful resource for researchers, students, clinicians, and sonographers looking for additional information on ultrasound imaging beyond the basics

Imaging in Women\u27s Health

Women’s health is a large area of the medical field that is continuing to see growth and technological advancement. Gynecological, obstetric, and breast health are fields that are always in demand, and imaging plays a large role in caring for patients in these fields. This paper will discuss different areas of women’s health and explain how imaging can be used to assist in diagnosis and treatment. Imaging can include MRI, 2D ultrasound, 3D ultrasound, and x-ray. This paper will discuss basic gynecological health, complications that can arise in gynecological health, women’s health in college, preconception care, obstetrics, obstetric complications, breast health, post menopausal health, and other women’s health issues. Some topics discussed will be endometriosis, adenomyosis, breast cancer screening and treatment, endometrial cancer, pregnancy, pelvic floor health, and ovarian masses. It will also discuss the future of women’s health. From basic gynecological health through pregnancy, breast health and menopause, imaging is a vital tool used to help medical professionals diagnose, monitor and treat women through many stages of life

Imaging of the Breast

Early detection of breast cancer combined with targeted therapy offers the best outcome for breast cancer patients. This volume deal with a wide range of new technical innovations for improving breast cancer detection, diagnosis and therapy. There is a special focus on improvements in mammographic image quality, image analysis, magnetic resonance imaging of the breast and molecular imaging. A chapter on targeted therapy explores the option of less radical postoperative therapy for women with early, screen-detected breast cancers

Can high-frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

Aim To determine whether high-frequency ultrasound can predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to identify patients with axillary disease requiring surgery who would not normally, on clinical grounds, have an axillary dissection, so potentially improving outcome and survival rates. Materials and methods The ipsilateral and contralateral axillae of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Power Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, and measurements were also taken to determine the L/S ratio and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results In this study of patients with invasive breast cancer, ipsilateral lymph nodes with a cortical bulge ≥3 mm and/or at least two lymph nodes with absent echogenic centres indicated the presence of metastatic axillary lymph nodes (10 patients). The sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P value was 0.001 and the Kappa score was 0.55.\ud Conclusion This would indicate that high-frequency ultrasound can be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management