BACKGROUND Lesions of breast imaging reporting and data system(BI-RADS)4 at mammography vary from benign to malignant,leading to difficulties for clinicians to distinguish between them.The specificity of magnetic reso...BACKGROUND Lesions of breast imaging reporting and data system(BI-RADS)4 at mammography vary from benign to malignant,leading to difficulties for clinicians to distinguish between them.The specificity of magnetic resonance imaging(MRI)in detecting breast is relatively low,leading to many false-positive results and high rates of re-examination or biopsy.Diffusion-weighted imaging(DWI),combined with perfusion-weighted imaging(PWI),might help to distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.AIM To evaluate the value of DWI and PWI in diagnosing BI-RADS 4 breast lesions.METHODS This is a retrospective study which included patients who underwent breast MRI between May 2017 and May 2019 in the hospital.The lesions were divided into benign and malignant groups according to the classification of histopathological results.The diagnostic efficacy of DWI and PWI were analyzed respectively and combinedly.The 95 lesions were divided according to histopathological diagnosis,with 46 benign and 49 malignant.The main statistical methods used included the Student t-test,the Mann-Whitney U-test,the chi-square test or Fisher’s exact test.RESULTS The mean apparent diffusion coefficient(ADC)values in the parenchyma and lesion area of the normal mammary gland were 1.82±0.22×10^(-3)mm^(2)/s and 1.24±0.16×10^(-3)mm^(2)/s,respectively(P=0.021).The mean ADC value of the malignant group was 1.09±0.23×10^(-3)mm^(2)/s,which was lower than that of the benign group(1.42±0.68×10^(-3)mm^(2)/s)(P=0.016).The volume transfer constant(Ktrans)and rate constant(Kep)values were higher in malignant lesions than in benign ones(all P<0.001),but there were no significant statistical differences regarding volume fraction(V_(e))(P=0.866).The sensitivity and specificity of PWI combined with DWI(91.7%and 89.3%,respectively)were higher than that of PWI or DWI alone.The accuracy of PWI combined with DWI in predicting pathological results was significantly higher than that predicted by PWI or DWI alone.CONCLUSION DWI,combined with PWI,might possibly distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.展开更多
BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform...BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform,and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer.MGA may progress to atypical MGA and carcinoma arising in MGA.Among various invasive carcinomas from MGA,AdCC has been rarely reported.Here,we report a case of AdCC arising in MGA.CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram.The density was similar to or slightly lower than that of the breast parenchyma.Sonography showed an irregular mass with a slightly higher echo than that of fat.Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma.The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern.Microscopically,the tumor was composed of invasive AdCC,in situ AdCC,and MGA.AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets,or haphazardly scattered small cribriform or tubular glands.MGA showed small glands with a single epithelial lining and retained lumen.S-100 staining was strongly positive in MGA area.The patient underwent breast-conserving surgery with sentinel lymph node biopsy.CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.展开更多
The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Informat...The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.展开更多
<span style="font-family:Verdana;">The breast is a rare localization of extra-pulmonary tuberculosis, even in highly endemic countries. It is most often primitive. The clinical and radiological feature...<span style="font-family:Verdana;">The breast is a rare localization of extra-pulmonary tuberculosis, even in highly endemic countries. It is most often primitive. The clinical and radiological features are sometimes misleading. It poses diagnostic problems especially with cancer. We report a case of breast tuberculosis having clinical and radiological presentations as a breast carcinoma. Through this observation and a review of the literature, we provide an update on the epidemiological characteristics and the means of diagnosis of this lesion. It was a 52-year-old woman with inflammatory lump of the left breast, adherent to the skin. Ultrasonography and mammography revealed a homogeneous, poorly demarcated nodule of approximately 4 cm of diameter, classified ACR4. Surgical excision was performed. The histological diagnosis was breast tuberculosis. The diagnosis of tuberculous mastitis is made on bacteriological and pathological examinations. Histological examination helps for diagnostic confirmation while excluding a malignant lesion of the breast.</span>展开更多
Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reprod...Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.展开更多
In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and respo...In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.展开更多
Background:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions.In China,breast masses are divided into four categories according to the treatment m...Background:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions.In China,breast masses are divided into four categories according to the treatment method:inflammatory masses,adenosis,benign tumors,and malignant tumors.These categorizations are important for guiding clinical treatment.In this study,we aimed to develop a convolutional neural network(CNN)for classification of these four breast mass types using ultrasound(US)images.Methods:Taking breast biopsy or pathological examinations as the reference standard,CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers.The patients were randomly divided into training and test groups(n=1810 vs.n=1813).Separate models were created for two-dimensional(2D)images only,2D and color Doppler flow imaging(2D-CDFI),and 2D-CDFI and pulsed wave Doppler(2D-CDFI-PW)images.The performance of these three models was compared using sensitivity,specificity,area under receiver operating characteristic curve(AUC),positive(PPV)and negative predictive values(NPV),positive(LR+)and negative likelihood ratios(LR-),and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators,between images from different hospitals with AUC,and with the performance of 37 radiologists.Results:The accuracies of the 2D,2D-CDFI,and 2D-CDFI-PW models on the test set were 87.9%,89.2%,and 88.7%,respectively.The AUCs for classification of benign tumors,malignant tumors,inflammatory masses,and adenosis were 0.90,0.91,0.90,and 0.89,respectively(95%confidence intervals[CIs],0.87-0.91,0.89-0.92,0.87-0.91,and 0.86-0.90).The 2D-CDFI model showed better accuracy(89.2%)on the test set than the 2D(87.9%)and 2D-CDFI-PW(88.7%)models.The 2D model showed accuracy of 81.7%on breast masses≤1 cm and 82.3%on breast masses>1 cm;there was a significant difference between the two groups(P<0.001).The accuracy of the CNN classifications for the test set(89.2%)was significantly higher than that of all the radiologists(30%).Conclusions:The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registration:Chictr.org,ChiCTR1900021375;http://www.chictr.org.cn/showproj.aspx?proj=33139.展开更多
This study aimed to describe the clinicopathologic characteristics of non-puerperal mastitis and to investigate spectrum of organisms causing it in the population of Southern China.We retrospectively registered 364 fe...This study aimed to describe the clinicopathologic characteristics of non-puerperal mastitis and to investigate spectrum of organisms causing it in the population of Southern China.We retrospectively registered 364 female patients with histological confirmation of inflammatory disease of the breast in the non-lactational phase,who were admitted to our institution over an 11-year period(2005–2016).Clinical,laboratory,and radiographic imaging features,as well as their bacteriological etiology,were analyzed in detail.In this study,117 patients were diagnosed with periductal mastitis(PDM)/mammary duct ectasia(MDE)and 247 patients were diagnosed with idiopathic granulomatous mastitis(IGM).There were significant differences in terms of mean age of onset,menstruation period,and menstruation history.Nipple discharge,inverted nipple,and the ratio of abscess and fistula were more spontaneous in women with PDM/MDE compared to IGM.The inflammatory biomarkers including leukocyte count,neutrophil percentage,and highsensitivity C-reactive protein in PDM/MDE group were significantly higher than IGM group.For bacteriological etiology,the most commonly isolated organism was Corynebacterium kroppenstedtii(C kroppenstedtii)in the IGM group and Staphylococcus in the PDM/MDE group.The study shows that the combination of demographic characteristics and clinicopathological characteristics was helpful in differential diagnosis of PDM/MDE and IGM.IGM can be associated with C kroppenstedtii,providing a possible effective therapeutic and preventive method by targeting this kind of bacilli.展开更多
文摘BACKGROUND Lesions of breast imaging reporting and data system(BI-RADS)4 at mammography vary from benign to malignant,leading to difficulties for clinicians to distinguish between them.The specificity of magnetic resonance imaging(MRI)in detecting breast is relatively low,leading to many false-positive results and high rates of re-examination or biopsy.Diffusion-weighted imaging(DWI),combined with perfusion-weighted imaging(PWI),might help to distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.AIM To evaluate the value of DWI and PWI in diagnosing BI-RADS 4 breast lesions.METHODS This is a retrospective study which included patients who underwent breast MRI between May 2017 and May 2019 in the hospital.The lesions were divided into benign and malignant groups according to the classification of histopathological results.The diagnostic efficacy of DWI and PWI were analyzed respectively and combinedly.The 95 lesions were divided according to histopathological diagnosis,with 46 benign and 49 malignant.The main statistical methods used included the Student t-test,the Mann-Whitney U-test,the chi-square test or Fisher’s exact test.RESULTS The mean apparent diffusion coefficient(ADC)values in the parenchyma and lesion area of the normal mammary gland were 1.82±0.22×10^(-3)mm^(2)/s and 1.24±0.16×10^(-3)mm^(2)/s,respectively(P=0.021).The mean ADC value of the malignant group was 1.09±0.23×10^(-3)mm^(2)/s,which was lower than that of the benign group(1.42±0.68×10^(-3)mm^(2)/s)(P=0.016).The volume transfer constant(Ktrans)and rate constant(Kep)values were higher in malignant lesions than in benign ones(all P<0.001),but there were no significant statistical differences regarding volume fraction(V_(e))(P=0.866).The sensitivity and specificity of PWI combined with DWI(91.7%and 89.3%,respectively)were higher than that of PWI or DWI alone.The accuracy of PWI combined with DWI in predicting pathological results was significantly higher than that predicted by PWI or DWI alone.CONCLUSION DWI,combined with PWI,might possibly distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.
文摘BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform,and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer.MGA may progress to atypical MGA and carcinoma arising in MGA.Among various invasive carcinomas from MGA,AdCC has been rarely reported.Here,we report a case of AdCC arising in MGA.CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram.The density was similar to or slightly lower than that of the breast parenchyma.Sonography showed an irregular mass with a slightly higher echo than that of fat.Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma.The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern.Microscopically,the tumor was composed of invasive AdCC,in situ AdCC,and MGA.AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets,or haphazardly scattered small cribriform or tubular glands.MGA showed small glands with a single epithelial lining and retained lumen.S-100 staining was strongly positive in MGA area.The patient underwent breast-conserving surgery with sentinel lymph node biopsy.CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.
文摘The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X<sup>2</sup>-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.
文摘<span style="font-family:Verdana;">The breast is a rare localization of extra-pulmonary tuberculosis, even in highly endemic countries. It is most often primitive. The clinical and radiological features are sometimes misleading. It poses diagnostic problems especially with cancer. We report a case of breast tuberculosis having clinical and radiological presentations as a breast carcinoma. Through this observation and a review of the literature, we provide an update on the epidemiological characteristics and the means of diagnosis of this lesion. It was a 52-year-old woman with inflammatory lump of the left breast, adherent to the skin. Ultrasonography and mammography revealed a homogeneous, poorly demarcated nodule of approximately 4 cm of diameter, classified ACR4. Surgical excision was performed. The histological diagnosis was breast tuberculosis. The diagnosis of tuberculous mastitis is made on bacteriological and pathological examinations. Histological examination helps for diagnostic confirmation while excluding a malignant lesion of the breast.</span>
文摘Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.
文摘In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.
基金This study was supported by the grants from the National Key Research and Development Program of China(No.2016YFC0104801)National Natural Science Foundation of China(No.81730050)。
文摘Background:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions.In China,breast masses are divided into four categories according to the treatment method:inflammatory masses,adenosis,benign tumors,and malignant tumors.These categorizations are important for guiding clinical treatment.In this study,we aimed to develop a convolutional neural network(CNN)for classification of these four breast mass types using ultrasound(US)images.Methods:Taking breast biopsy or pathological examinations as the reference standard,CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers.The patients were randomly divided into training and test groups(n=1810 vs.n=1813).Separate models were created for two-dimensional(2D)images only,2D and color Doppler flow imaging(2D-CDFI),and 2D-CDFI and pulsed wave Doppler(2D-CDFI-PW)images.The performance of these three models was compared using sensitivity,specificity,area under receiver operating characteristic curve(AUC),positive(PPV)and negative predictive values(NPV),positive(LR+)and negative likelihood ratios(LR-),and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators,between images from different hospitals with AUC,and with the performance of 37 radiologists.Results:The accuracies of the 2D,2D-CDFI,and 2D-CDFI-PW models on the test set were 87.9%,89.2%,and 88.7%,respectively.The AUCs for classification of benign tumors,malignant tumors,inflammatory masses,and adenosis were 0.90,0.91,0.90,and 0.89,respectively(95%confidence intervals[CIs],0.87-0.91,0.89-0.92,0.87-0.91,and 0.86-0.90).The 2D-CDFI model showed better accuracy(89.2%)on the test set than the 2D(87.9%)and 2D-CDFI-PW(88.7%)models.The 2D model showed accuracy of 81.7%on breast masses≤1 cm and 82.3%on breast masses>1 cm;there was a significant difference between the two groups(P<0.001).The accuracy of the CNN classifications for the test set(89.2%)was significantly higher than that of all the radiologists(30%).Conclusions:The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registration:Chictr.org,ChiCTR1900021375;http://www.chictr.org.cn/showproj.aspx?proj=33139.
基金This work was supported by grants from the National Natural Science Foundation of China(no.81272897,81772837)the Science Foundation of Guangdong Province(no.2016B030229004)the Sun Yat-Sen Initiative Program for Scientific Research(no.YXQH201701).
文摘This study aimed to describe the clinicopathologic characteristics of non-puerperal mastitis and to investigate spectrum of organisms causing it in the population of Southern China.We retrospectively registered 364 female patients with histological confirmation of inflammatory disease of the breast in the non-lactational phase,who were admitted to our institution over an 11-year period(2005–2016).Clinical,laboratory,and radiographic imaging features,as well as their bacteriological etiology,were analyzed in detail.In this study,117 patients were diagnosed with periductal mastitis(PDM)/mammary duct ectasia(MDE)and 247 patients were diagnosed with idiopathic granulomatous mastitis(IGM).There were significant differences in terms of mean age of onset,menstruation period,and menstruation history.Nipple discharge,inverted nipple,and the ratio of abscess and fistula were more spontaneous in women with PDM/MDE compared to IGM.The inflammatory biomarkers including leukocyte count,neutrophil percentage,and highsensitivity C-reactive protein in PDM/MDE group were significantly higher than IGM group.For bacteriological etiology,the most commonly isolated organism was Corynebacterium kroppenstedtii(C kroppenstedtii)in the IGM group and Staphylococcus in the PDM/MDE group.The study shows that the combination of demographic characteristics and clinicopathological characteristics was helpful in differential diagnosis of PDM/MDE and IGM.IGM can be associated with C kroppenstedtii,providing a possible effective therapeutic and preventive method by targeting this kind of bacilli.
