Ultrasonography, mammary Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):434-439
DOI 10.1590/SO100-720320150005368
To evaluate breast ultrasonographic features and hemodynamic indexes of the internal mammary arteries in normal pregnant women, and their correlation with the gestational periods.
Observational and cross-sectional, epidemiological, study, conducted between August 2013 and February 2015, with 93 women divided into three groups: first trimester, second trimester and third trimester. The dependent variables were thickness of the skin, of subcutaneous tissue, fibroglandular tissue, and retrommamary adipose tissue, the diameter of the ducts, as well as the pulsatility and resistance indexes of the internal mammary arteries. Independent variables were the three periods of gestation. Repeated measures ANOVA with the multiple comparison Tukey test and a test of contrasts were used for statistical analysis. The Levene test was used to test the homogeneity of variances between periods of gestation. Student's t-test was used to evaluate the difference between nulliparous and non -nulliparous women, and Pearson's correlation coefficient was used for correlation analysis between the two breasts. The level of significance was set at 5%.
Mean age was 26.6±4.6 years, with no significant difference among groups. Breast location (right/left) and gestational period had no significant effect on the thickness of the skin, of subcutaneous tissue and adipose retromammary tissue. However, the thickness of fibroglandular tissue and the diameter of the ducts showed a significant difference according to gestational period (p<0.001), i.e., from the first to the second and to the third trimesters. Doppler flowmetry of the internal mammary arteries showed a difference between breasts and between gestational periods, i.e., the measurements of the right breast were greater than those of the left, and these values decreased throughout pregnancy (p<0.001).
The average thickness of fibroglandular tissue and the diameter of the ducts showed significant differences from the first to the second and to the third trimesters, with no differences being observed between the two breasts. The pulsatility and resistance indexes of the internal mammary arteries decreased progressively throughout pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(3):107-112
DOI 10.1590/S0100-72032008005000005
PURPOSE: to evaluate which method is the best to determine pre-surgically the size of breast cancer: clinical examination, mammography or ultrasonography, using as a reference the anatomopathological exam. METHODS: this study has included 184 patients with palpable-or-not breast lesions, detected by mammography and ultrasonography, that were submitted to surgical resection of the tumor, with histopathological diagnosis of breast cancer. The same examiner evaluated clinically the largest tumoral diameter, through clinical examination, mammography and ultrasonography, and the measurements obtained by each method were correlated with the maximum diameter obtained by the anatomopathological exam. The comparative analysis has been done by Pearson's correlation coefficient (r). RESULTS: Pearson's correlation coefficient between the anatomopathological and the clinical exams was 0.8; between the anatomopathological exam and the mammography, 0.7; and between anatomopathological exam and ultrasonography 0.7 (p<0.05). Pearson's correlation coefficients among the methods evaluated were also calculated and r=0.7 was obtained between clinical exam and mammography, r=0.8 between clinical examination and utrasonograhy, and r=0.8 between mammography and ultrasonography (p<0.05). CONCLUSIONS: clinical examination, mammography and ultrasonography have presented high correlation with the anatomopathological measures, besides high correlations among themselves, what seems to show that they may be used as equivalent methods in the pre-surgical evaluation of the breast tumoral size. Nevertheless, due to specific limitations of each method, clinical examination, mammography and ultrasonography should be seen as complementary to each other, in order to obtain a more accurate measurement of the breast cancer tumor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(3):107-112
DOI 10.1590/S0100-72032008005000005
PURPOSE: to evaluate which method is the best to determine pre-surgically the size of breast cancer: clinical examination, mammography or ultrasonography, using as a reference the anatomopathological exam. METHODS: this study has included 184 patients with palpable-or-not breast lesions, detected by mammography and ultrasonography, that were submitted to surgical resection of the tumor, with histopathological diagnosis of breast cancer. The same examiner evaluated clinically the largest tumoral diameter, through clinical examination, mammography and ultrasonography, and the measurements obtained by each method were correlated with the maximum diameter obtained by the anatomopathological exam. The comparative analysis has been done by Pearson's correlation coefficient (r). RESULTS: Pearson's correlation coefficient between the anatomopathological and the clinical exams was 0.8; between the anatomopathological exam and the mammography, 0.7; and between anatomopathological exam and ultrasonography 0.7 (p<0.05). Pearson's correlation coefficients among the methods evaluated were also calculated and r=0.7 was obtained between clinical exam and mammography, r=0.8 between clinical examination and utrasonograhy, and r=0.8 between mammography and ultrasonography (p<0.05). CONCLUSIONS: clinical examination, mammography and ultrasonography have presented high correlation with the anatomopathological measures, besides high correlations among themselves, what seems to show that they may be used as equivalent methods in the pre-surgical evaluation of the breast tumoral size. Nevertheless, due to specific limitations of each method, clinical examination, mammography and ultrasonography should be seen as complementary to each other, in order to obtain a more accurate measurement of the breast cancer tumor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):515-523
DOI 10.1590/S0100-72032005000900003
PURPOSE: the technological improvements in image quality have increased the importance of ultrasound as an imaging method in the study of breast pathologies. The need for a standardized method for lesion characterization, description and reporting in image analysis motivated the development of a breast sonographic report classification system. METHODS: the classification grouped the breast sonographic images in five classes: I - normal; II - benign; III - indeterminate, IV - suspect, and V - highly suspect. The used morphologic ultrasound features were shape, border, contour, echogenicity, echotexture, sound transmission, orientation, and secondary signals. The gold standard test, in the study of 450 lesions, considered sonographic follow-up of the lesions for a period from 6 to 24 months and the histopathology of surgical cases. RESULTS: breast sonographic classification for the diagnosis of breast cancer showed a sensitivity of 90.2% (CI: 82.8-94.9%), a specificity of 96.2% (CI: 94.0-97.6%), a positive predictive value of 84.1% (CI: 76.0-89.9%), and a negative predictive value of 97.8% (CI: 95.9-98.9%), obtaining an accuracy of 95.1%. CONCLUSIONS: the adoption of a sonographic classification system results in the standardization and optimization of the reports. It also aids the comparison with clinical findings, histopathological tests and breast images, avoiding unnecessary procedures and therefore leading to more adequate therapeutical management.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):515-523
DOI 10.1590/S0100-72032005000900003
PURPOSE: the technological improvements in image quality have increased the importance of ultrasound as an imaging method in the study of breast pathologies. The need for a standardized method for lesion characterization, description and reporting in image analysis motivated the development of a breast sonographic report classification system. METHODS: the classification grouped the breast sonographic images in five classes: I - normal; II - benign; III - indeterminate, IV - suspect, and V - highly suspect. The used morphologic ultrasound features were shape, border, contour, echogenicity, echotexture, sound transmission, orientation, and secondary signals. The gold standard test, in the study of 450 lesions, considered sonographic follow-up of the lesions for a period from 6 to 24 months and the histopathology of surgical cases. RESULTS: breast sonographic classification for the diagnosis of breast cancer showed a sensitivity of 90.2% (CI: 82.8-94.9%), a specificity of 96.2% (CI: 94.0-97.6%), a positive predictive value of 84.1% (CI: 76.0-89.9%), and a negative predictive value of 97.8% (CI: 95.9-98.9%), obtaining an accuracy of 95.1%. CONCLUSIONS: the adoption of a sonographic classification system results in the standardization and optimization of the reports. It also aids the comparison with clinical findings, histopathological tests and breast images, avoiding unnecessary procedures and therefore leading to more adequate therapeutical management.
