Dr. masciotra breast swe clinical cases

Antonio Pio MasciotraCampobasso – Molise – Italy

Email

[email protected]

Website

www.masciotra.net

YouTube Channel

https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ

Breast cancer clinical cases and Shear Wave Elastography

mailto:[email protected]

http://www.masciotra.net/


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




Minimum stiffness 5-139


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 65 years old

2008 2013 2014

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


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




Minimum stiffness 0,1-95


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.

http://breastcancer.about.com/od/diagnosis/a/bc_stages.htm

Woman 41 years old

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

Email

[email protected]

Website

www.masciotra.net

YouTube Channel


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

mailto:[email protected]

http://www.masciotra.net/


2008 2009 2010 2011 2012 2014

2008 2010 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

Dr. masciotra breast swe clinical cases

Healthcare

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