How can additional ultrasonography screening improve the detection of occult breast cancer in women with dense breasts?

Purpose: Although mammography is a gold standard for breast cancer screening, the number of cancers that cannot be detected with mammography is substantial, especially in dense-breast (DB) women. Breast sonography can be a useful and powerful screening tool in these cases. The aim of this study is to assess the application of whole-breast sonography in the evaluation of breast lesions in women with DB tissue and estimate its accuracy in comparison with mammography. Material and methods: A total of 207 asymptomatic DB women participated in this study. The breast tissue density was assessed using ACR BI-RADS. Patients underwent high-resolution ultrasonography of the breast in addition to physical examination and mammography. Different risk factors were also assessed. Results: 152 of 207 (73.4%) cases who had mammography performed had DB, and 55 (26.6%) cases had very dense breasts (very DBs). None of the cases had a positive history of malignancy, while 19% of them had a positive history of breast cancer in first- or second-degree relatives. Conclusions: All findings were higher in cases with DB compared to very DBs except for fibroadenoma, which was detected more in cases with very DBs. Our study showed that the prevalence of different breast lesions had a significant relationship with the density of the breast. In our study, 48.3% of the cases were diagnosed with a lesion in their sonography result, although 81.0% of them were benign lesions, and the other 19.0% needed follow-up or biopsy evaluation. A substantial number of mammographically occult breast lesions, either benign or malignant, could be detected by ultrasound in DB tissue

Evaluation of bronchiectasis in war chemically-injured patients via high resolution computed tomography

Background: Sulfur mustard (SM) gas as a vesicant chemical warfare was used in the Iran-Iraq war (1981–1989) against the Iranian warriors. Objective: This alkylating agent with the potential of producing chemical injury in the skin, eyes and lung, may damage both upper and lower respiratory tract, which in turn can cause different types of sequels such as asthma, bronchiectasis, chronic bronchitis and lung fibrosis. Methods: This study was performed on 274 patients with documented history of SM gas exposure. All of the participants complained of respiratory problems. Patients with positive history of cigarette smoking, respiratory problems before the exposure to SM gas, cardiovascular problems, surgery of the lung, and exposure to occupational toxic chemicals were excluded from the study. Results of all chest HRCTs were evaluated by a radiologist. Results: HRCT findings showed that bronchiectasis involved 53 patients (19.34%) of all cases. Varicose bronchiectasis and cystic bronchiectasis was observed in 10 (18.9%) and 6 cases (11.3%) respectively. Among patients with bronchiectasis, the involvement rate of different lobes was as follows: Right upper lobe (RUL) 7.5%, right middle lobe (RML) 11.3%, left upper lobe (LUL) 15.1%, left lower lobe (LLL) 26.4% and right lower lobe (RLL) 39.6%. Discussion and conclusion: Findings of chest HRCT demonstrated tubular bronchiectasis was the most frequent type of this disease that involve the chemically injured patients and RLL had been the most frequently involved lobe of the lung with bronchiectasis