B-Mode Ultrasound Imaging, Doppler Imaging, and Real-Time Elastography in Cutaneous Malignant Melanoma and Lymph Node Metastases

Examination by ultrasonography (US) is a rapid, sensitive, cost-effective, and even portable technique for confirming the presence of tumors. However, US is not routinely used worldwide for the diagnostic work-up of cutaneous malignant melanoma. High-resolution US using a 6–14 MHz or 5–13 MHz linear transducer enables the preoperative assessment of tumor size and thickness. Compared with physical examination, US is also very effective in the early detection of lymph node metastases. It can be easily repeated for the follow-up of cutaneous malignant melanoma and lymph node metastases. Ultrasonographic appearance of some lymph nodes may overlap, thus producing diagnostic pitfalls. In such cases with overlapping findings, Doppler imaging and elastography may additionally facilitate the evaluation of cutaneous malignant melanoma and lymph node metastases. US-guided fine needle aspiration cytology (FNAC) finally helps to confirm ultrasonographic results, thus improving the specificity and sensitivity in difficult situations in which US alone gives unclear results in lymph node assessment

B-Mode Ultrasound Imaging, Doppler Imaging, and Real-Time Elastography in Cutaneous Malignant Melanoma and Lymph Node Metastases

Examination by ultrasonography (US) is a rapid, sensitive, cost-effective, and even portable technique for confirming the presence of tumors. However, US is not routinely used worldwide for the diagnostic work-up of cutaneous malignant melanoma. High-resolution US using a 6–14 MHz or 5–13 MHz linear transducer enables the preoperative assessment of tumor size and thickness. Compared with physical examination, US is also very effective in the early detection of lymph node metastases. It can be easily repeated for the follow-up of cutaneous malignant melanoma and lymph node metastases. Ultrasonographic appearance of some lymph nodes may overlap, thus producing diagnostic pitfalls. In such cases with overlapping findings, Doppler imaging and elastography may additionally facilitate the evaluation of cutaneous malignant melanoma and lymph node metastases. US-guided fine needle aspiration cytology (FNAC) finally helps to confirm ultrasonographic results, thus improving the specificity and sensitivity in difficult situations in which US alone gives unclear results in lymph node assessment

Overcoming the limitations of screening mammography in Japan and Korea: a paradigm shift to personalized breast cancer screening based on ultrasonography

Screening mammography programs have been implemented in numerous Western countries with the aim of reducing breast cancer mortality. However, despite over 20 years of population-based screening mammography, the mortality rates in Japan and Korea continue to rise. This may be due to the fact that screening mammography is not as effective for Japanese and Korean women, who often have dense breasts. This density decreases the sensitivity of mammography due to a masking effect. Therefore, the early detection of small invasive cancers requires more than just mammography, particularly for women in their 40s. This review discusses the limitations and challenges of screening mammography, as well as the keys to successful population-based breast cancer screening in Japan and Korea. This includes a focus on breast ultrasonography techniques, which are based on histopathologic anatomical knowledge, and personalized screening strategies that are based on risk assessments measured by glandular tissue components