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Documentation of the results of a breast examination is extremely important. Without accurate documentation, communication is impossible. Owing to the increased use of mammography and ultrasound, nonpalpable lesions of unknown origin are increasingly being detected. The demands on doctors involved in the diagnostic investigation of nonpalpable lesions have greatly increased (Senofsky et al. 1998;...
The past 30 years have seen dramatic changes in the diagnosis and management of breast problems. Much of this change has been driven by the quest for early diagnosis and by the widespread use of imaging in the diagnosis of symptomatic breast disease and for breast cancer screening. The traditional approach of surgical biopsy for diagnosis has now been replaced by needle biopsy techniques that provide...
Sonographic examination of the breast with state-of-the-art equipment has become an essential part of the clinical work-up of breast lesions and a valuable adjunct to mammographic screening and physical examination (Stavros et al. 1995). The technique is capable of detecting lesions not seen on mammography, allowing differentiation of cystic from solid lesions, and benign from malignant lesions. Because...
Interventional methods such as ultrasonographically, mammographically, or stereotactically targeted/guided core vacuum biopsy or excision biopsy (Aichinger et al. 1999; Bauer et al. 1994; Burbank 1997; D’angelo et al. 1997; Ferzli et al. 1999; Heywang-Köbrunner et al. 1997, 1998; Jackman et al. 1997, 1998; Kelly et al. 1997; Krämer et al. 2002, 1998; Liberman 2000, 1998; Parker et al. 1993, 1994;...
There are different stereotactic systems with different tables for breast biopsy available around the world. In three of the six described methods or tables, the patients are in the prone position, whereas the other techniques use the upright system. The Giotto system: the Mammobed in combination with a digital mammography unit The MultiCare Platinum system: the Lorad table from Hologic The Fischer...
During the last decade, MR mammography has been successfully tested as an adjunct imaging modality to mammography and ultrasound of the breast. Lesions that cannot be detected in mammography and ultrasound are shown with high sensitivity and in realistic extent but specificity is still poor. However, the high sensitivity of MR alone is not satisfactory if histology cannot be obtained. Therefore MR...
Breast cancer is the most common malignancy diagnosed in women in Germany and is the leading cause of cancer death. Recently, it was demonstrated that mammography screening can reduce mortality from breast cancer by 21% (Nystrom et al. 2002). The vast majority of breast cancers originate in the epithelial lining of the ductal system of the breast. Invasive breast cancer is believed to result from...
Over the last decade, minimally invasive biopsies, such as core-needle biopsies (CNB), have gained wide acceptance for the preoperative diagnosis of breast disease. Due to frequent fragmentation of the tissue and lack of architectural orientation, diagnosis based on this type of biopsy poses many problems for pathologists. Minimally invasive biopsy (MIB) in most cases allows for the decision of whether...
The term technical failure may describe either the physical inability to retrieve tissue in a radiologic lesion or the inability to retrieve a tissue sample that explains the features of the radiologic lesion, which is also called a discrepancy or noncorrelation between imaging and histology. While the first is easily identified during the biopsy procedure due to lack of tissue or inability to target...
Breast cancer is the leading malignant disease in women in the Western world. It affects 9–12% of women during their lifetime (Heywang-Köbrunner and Schreer 2003). In the United States breast cancer causes more than 43,000 deaths per year, in the countries of the European Union more than 74,000 (Eurostat Datenbank Newcronos, unpublished data). Early detection and effective treatment of breast cancer...
Only in a few European countries (Switzerland, France, Poland, Belgium, and some local projects in Germany) are minimally invasive breast biopsies (MIBB) reimbursed by health insurance. Public health authorities ask for detailed estimates and calculation of costs as well as laborious, expensive evaluation procedures as the basis for decision making before obliging insurance to provide reimbursement...
With image-guided percutaneous needle biopsy, different procedures are available today to remove tissue samples without surgery. By guiding tissue removal stereotactically with X-ray, ultrasound, or magnetic resonance imaging (MRI), even nonpalpable lesions can be accurately biopsied. None of these methods requires hospitalization and all of them can be carried out with the patient under local anesthesia...
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