Post on 16-Jul-2015
Antonio Pio MasciotraCampobasso – Molise – Italy
antoniomasciotra@yahoo.it
Website
www.masciotra.net
YouTube Channel
https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ
Breast cancer clinical cases and Shear Wave Elastography
Woman 35 years old
Feature (kPa) Nodule
Mean stiffness 21-35
Maximum stiffness 77-199
Minimum stiffness 0,1-0,2
Standard Deviation 18-38
Woman 55 years old2010 2011 2012 2013 2014
Woman 55 years old
Feature (kPa) Nodule
Mean stiffness 72-237
Maximum stiffness 99-199
Minimum stiffness 5-139
Standard Deviation 16-39
Woman 43 years old
Woman 44 years old
Woman 43 years old
Woman 43 years old
Feature (kPa) Right Nodule Left Nodule
Mean stiffness 6 79-180
Maximum stiffness 21 58-223
Minimum stiffness 0 35-139
Standard Deviation 1-5 18-22
Woman 65 years old
Woman 65 years old
Feature (kPa) Nodule Ax. Nod.
Mean stiffness 10-196 29-36
Maximum stiffness 38-300 65-70
Minimum stiffness 2-139 0-4
Standard Deviation 5-90 12-17
Woman 85 years old with verydense breasts and retroareolar
IDC in May 2013.Then the treatment
with Exemestane was started.Initial and 10 months later
follow up exams are showed.
Feature (kPa) Exam1
Exam2
Mean stiffness 101 67
Maximum stiffness 130 74
Minimum stiffness 66 60
Standard Deviation 14 4
Woman 65 years oldOperated of left breast fibroadenoma in 20002 mammographies of left breast in comparison(March 2012 and April 2014) and US with SWE in April 2014
Feature (kPa) Nodule Fat
Mean stiffness 25,8 50,2
Maximum stiffness 33,1 64,7
Minimum stiffness 21,2 38,7
Standard Deviation 2,6 6,5
Woman 45 years old.She felt 1 months before a lump in her leftbreast becoming very painful in the last week.
Woman 45 years oldShe felt 1 months before a lump in her leftbreast becoming very painful in the last week.
Woman 79 years old
Woman 79 years old
Feature (kPa) Nodule
Mean stiffness 42-201
Maximum stiffness 67-300
Minimum stiffness 1-81
Standard Deviation 8-77
Woman 65 years old
Feature (kPa) Nodule
Mean stiffness 21-196
Maximum stiffness 47-295
Minimum stiffness 12-139
Standard Deviation 5-62
Woman 65 years old
2008 2013 2014
Woman 78 years old with very dense breasts
Woman 78 years old with very dense breasts
Woman 78 years old with very dense breasts.Actually she feels a little nodule in right upper outer quadrant.
Feature (kPa) Right breast Left breast
Mean FG stiffness 42 40
Maximum FG stiffness 47 47
Minimum FG stiffness 37 31
FG Standard Deviation 3 2
Woman 78 years old with very dense breasts
Feature (kPa) Probe 10-2 Probe 15-4 Probe 16-5
Mean stiffness 25-33 22-116 16-77
Maximum stiffness 30-43 30-137 38-94
Minimum stiffness 18-28 11-85 0-37
Standard Deviation 3-4 5-18 7-13
Woman 48 years old feeling a little painin upper quadrants of her right breast. Only mammography performed at the
first exam.
9 months later she feels a nodulebetween the upper quadrants of the
same breast.
27/08/2013
12/05/2014
27/08/2013 12/05/2014 27/08/2013 12/05/2014
Only right breast images in comparison are showed with closeup details.Very dense breast far to offerwell valuable signs.
Maybe the only differencesperceivable are in retromammaryfat area that in the second examseems to host ‘something new’at least in CC view (arrows).
Then US exam was performedshowed in next slides.
Woman 48 years old
Woman 48 years old
Feature (kPa) Nodule
Mean stiffness 86-118
Maximum stiffness 135-299
Minimum stiffness 0,1-95
Standard Deviation 9-64
Hypoechoic area 0,42 cm²
Stiffest area 1,17 cm²
The tumor area tracedaccording echogenicity is far smaller than the area traced
according the stiffness
Woman 48 years old
Feature Echogenicitybased data
Stiffnessbased data
Perimeter 5,42 cm 6,63 cm
Area 1,52 cm² 2,45 cm²
Diameter 1 1,48 cm 2,19
Diameter 2 1,45 cm 1,88
The tumor area traced according echogenicity is large smaller than the area traced according the stiffness.
Woman 48 years oldPlane Feature Echogenicitybased data
Stiffnessbased data
Difference(%)
CoronalPerimeter 5,89 cm 5,78 cm -1,87%
Area 1,47 cm² 2,06 cm² 40,1%
AxialPerimeter 3,03 cm 6,48 cm 80,9%
Area 0,47 cm² 1,35 cm² 187,2%
Sagittal Perimeter 4,06 cm 5,39 cm 32,8%
Area 0,69 cm² 1,71 cm² 147,8%
The tumor’s dimensions traced according echogenicity are always smaller than the ones traced according the stiffness in all planes.Breast cancer is staged by the TNM System : Tumor Size, node status, and metastasis. Tumor Size is divided into four classes based on the maximum diameter:
T-1 is from 0 to 2 centimeters.
T-2 is from 2 to 5 cm. T-3 is greater than 5 cm .T-4 is a tumor of any size that has broken through (ulcerated) the skin, or is attached to the chest wall.
So it would be wise to check which is the most reliable imaging technique of measurement of the ‘T’ parameterrelating it to the more accurate prognostic significance and to the right choice in the therapeutic approach.
T1mi Tumor ≤1 mm in greatest dimension.
T1a Tumor >1 mm but ≤5 mm in greatest dimension.
T1b Tumor >5 mm but ≤10 mm in greatest dimension.
T1c Tumor >10 mm but ≤20 mm in greatest dimension.
Woman 41 years old
Woman 41 years old
Woman 41 years old
Woman 41 years old
Woman 41 years old
2008 2010 Woman 58 years old 2011 2014
2008 2010 Woman 58 years old 2011 2014
Woman 58 years old
2012 2014 Woman 68 years old DCIS 2012 2014
Woman 68 years old DCIS
Antonio Pio MasciotraCampobasso – Molise – Italy
antoniomasciotra@yahoo.it
Website
www.masciotra.net
YouTube Channel
https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ
Breast cancer clinical case
Woman with right breast IDC had quadrantectomy followed by radiotherapy 10 years ago, at age of 60
Then she was well and in the following slides you can see the MLO and CC views done since 2008
uptodate
2008 2009 2010 2011 2012 2014
2008 2010 2012 2014
2008 2010 2012 2014
2012 2014
2012 2014
Compared to the exam of 2 years ago the last show a diffuse thickening of the skin and the retinacula cutis associated to an overallincrease in density
2012
2012
2014
2014
22/09/2014
12/11/2014
22/09/2014
12/11/2014
12/11/2014
12/11/2014