Hungarian Radiology

[Results of breast cancer screening and clinical mammography at the Kenezy Breast Center, Debrecen between 2002-2003]


MARCH 20, 2007

Hungarian Radiology - 2007;81(01-02)

[INTRODUCTION - Breast cancer screening has been started in January 1. 2002. in Hungary in the course of the National Health Program. Breast cancer is the main cause of death among women’s malignant tomors, and the aim of the project is to reduce this mortality. The chance of survival is highly increased by the early detection of the disease. Kenezy Breast Center was connected to this project. PATIENTS AND METHODES - Females between 45-65 years without symptoms participated in the project. Paralel to this women with symptoms, sometimes with palplable masses were clinically examined. Screening mammography films were read by two radiologists and the complementary examinations of the breast and the axillary lymph nodes - ultrasonography, guided biopsy (FNAB, core biopsy) - were performed always by the same doctor. Results of the two projects were compared. RESULTS - The incidence of malignant breast cancer was 4‰ in the screening and 1,5% in the clinical group. 46.5% of the malignant breast cancers revealed by the clinical examinations was diagnosed in the group of women between the age of 45 to 65 years. This is the age when most women are involved in the screening program. 7.3% of the tumors was diagnosed in the 40- 44 year age-group and 11.3% among women aging 66-77 years. The rate of malignant tumors smaller than 1.5 cm was 49.1% according to screening records and 36% in the clinical trial. In both groups, tumor size of 1.5 cm proved to be a critical limit regarding to the development of metastases, mainly in the axillary region. Above this size, metastases were more frequent. CONCLUSIONS - Both breast screening program and clinical exams are of great significance. Based on the data obtained during two years, authors found that women below the age of 40 and above the age of 65 should also be involved in the screening program. Detection of breast tumor is possible at an early stage by screening. In the case of small tumors (smaller than 1.5 cm) the development of axillary metastases is less likely than in the case of larger ones. The lack of metastases in the axillary lymph nodes offers better prognosis according to the published scientific data, which reinforces the importance and necessity of the screening programs.]



Further articles in this publication

Hungarian Radiology

[Transcranial Doppler monitoring of distal embolism during of carotid stenting]


[INTRODUCTION - Reducing the risk of embolisation during endovascular treatment of internal carotid artery stenosis is very important. The rate of embolisation is affected by the different steps of stenting manipulation. Using transcranial Doppler equipment we studied the embolic signals during the different phases of carotid dilatation and stenting. MATERIAL AND METHOD - 50 patients (33 male, 17 female; mean age 64 years) were intraproceduraly monitorized with transcranial Doppler. Predilatation was necessary in nine cases, postdilatation was performed in 39 cases. The number of emboli were measured in seven different steps of endovascular treatment of carotid stenosis. Different type of commercial available endovascular devices were used. RESULTS - Intraprocedural embolisation was observed in every case. In different phases of carotid stenting the rate of embolisation showed marked differences in each phase of carotid stenting. Crossing the stenosis with stent delivery system were accompanied by a low rate of embolism (5.3) compared to the level during stent opening (9.16) and balloon dilatation (9.96). The highest level of embolisation was observed during predilatation (15.9) without the protection of the stent. CONCLUSIONS - We detected embolisation in all of the cases, however the number of embolic signals varied in different phases of carotid artery stenting. Embolisation can be reduced if the most dangerous steps (i.e. pre- and postdilatation) are avoided. Using TCD monitorisation the physician can be informed by the degree of embolisation that may alarm the interventionalist to perform the procedure more carefully, furthermore it can be employed during the training of carotid stenting.]

Hungarian Radiology

[2nd National Meeting of the Radiology Residents]

NAGY Endre, PALKÓ András, LOMBAY Béla

Hungarian Radiology

[The emperor’s new cloth]


Hungarian Radiology

[Az emlődaganatok radiológiai vizsgálatának újdonságai Onco Update, 2007]


[Experiences about the breast diagnostic methods are accumulating year-to-year, rapidly. Therefore the current examination algorithm is changing continuously. New diagnostic and therapeutic modalities are entering into the daily practice. Some of them became obsolete, so far their application is becoming a faulty decision. Some other methods become obligatory steps in the diagnostics. These are the reasons why the up-to-date knowledge of the literature is mandatory. Systematic review of the most recent articles of the last two years (January 2005-December 2006) of breast radiological diagnostics and the actual place of the imaging and interventional methods are presented. The following topics are summarized: breast cancer screening with conventional and digital mammography, computer assisted diagnostics (CAD), high risk patients' screening, US, MRI, MSCT, PET/CT, diagnostic interventions, differential diagnostics, percutaneous tumour ablation, therapy-related questions in the diagnostic work up.]

Hungarian Radiology

[Zsófia Farbaky: Basics of musculoskeletal ultrasound]

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LÁNG István, HITRE Erika

[Modern biological oncotherapy of solid tumours means targeting various kinase inhibitor pathways either by specific monoclonal antibodies against extracellular receptors or ligands (trastuzumab, cetuximab, panitumumab, bevacizumab) or by small molecular weight oral kinase inhibitors that interfere with intracellular signal transduction (imatinib, sunitinib, lapatinib, erlotinib, gefitinib, sorafenib). Here we review the clinical use of targeted biological agents in breast and colorectal cancer.]

Clinical Oncology

[Gene-expression profiles in adjuvant treatment of early breast cancer]


[Breast cancer is a heterogeneous disease with different subtypes having a distinct biological, molecular, and clinical course. Assessments of standard clinical and pathological features have traditionally been used to determine the use of adjuvant systemic therapy in early-stage breast cancer; however, the ability to identify those who will benefi t from adjuvant chemotherapy remains a challenge, leading to over treatment of some patients. Risk stratifi cation of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of seven multi-gene classifi ers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test’s analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.]

Clinical Oncology

[Neoadjuvant therapy in breast cancer – an update]

KAHÁN Zsuzsanna, RUSZ Orsolya, UHERCSÁK Gabriella, NIKOLÉNYI Alíz

[Traditionally, neoadjuvant systemic therapy (NST) serves as treatment of advanced breast cancer to achieve technical operability by resulting in tumor regression. Nowadays, NST is advantageous in all cases if adjuvant systemic therapy is needed, since the in vivo study of its effect provides possibility for the estimation of prognosis, the treatment may be modifi ed according to the therapeutic response, the systemic therapy starts earlier as compared to adjuvant therapy, and fi nally, it may result in the reduction of surgical and radiotherapeutical radicality. The type of NST should be selected on the basis of tumor features refl ecting treatment sensitivity. In case of chemosensitive cancers, chemotherapy is taxane- and anthracycline-based, and the planned dose should be delivered prior to surgery. In HER2-positive cancers, the addition of an anti-HER2 agent doubles the rate of pathological complete regressions. In hormone-sensitive tumors, the standard neoadjuvant endocrine therapy consists of an aromatase inhibitor (postmenopause), or tamoxifen or an aromatase inhibitor combined with an LHRH analog (premenopause) for 4-8 months that is continued following the surgery in the adjuvant setting. For the early evaluation of the effect of NST, serial tumor biopsy or imaging studies (MRI, PET) seem promising. Sentinel lymph node biopsy around the NST should be practiced with prudence; it may warrant the avoidance of axillary blockdissection in some cases. For the design of radiotherapy, the initial stage and the degree of regression are considered.]

Hungarian Radiology

[Breast malignancies: review of the year 2008/2009 radiological diagnostics and therapy news - Onco Update, 2010]


[Systematic review of the recent articles of the years 2008/2009 about breast tumours’ radiological diagnostics and guided therapy, the actual place of the imaging and interventional methods are presented.]

Hungarian Radiology

[Breast core needle biopsies yielding uncertain results - Experience at the complex mammographic screening unit in Kecskemét]


[INTRODUCTION - On occasion core biopsies yield an inconclusive (B3 or B4) result in the triple diagnostics of breast lesions. These cases may turn to be malignant in the operation specimen. This study evaluates the value of B3 and B4 diagnoses and the consequences of these diagnoses. MATERIALS AND METHODS - Core needle biopsies were generally taken under imaging guidance with an automatic gun using G14 gauge needles. They were evaluated using internationally and nationally accepted categories from B1 to B5. The analysis was based on data collected between 2000 and March 2005. RESULTS - Of the 663 core needle biopsy specimens 31 (4.7%) were classified as B3 and 22 (3.3%) as B4. Specimens were more often fragmented in the latter category (a rate of 0.64 as compared with a rate of 0.26). Patients with a B3 diagnosis were operated on in 23 cases, eight of which turned to be malignant (0.35). B4 diagnoses were followed by operations in 21 cases and were found to be malignant on 19 occasions (0.9). Whenever a B4 diagnosis was associated with radiological findings of malignancy (category 5 on mammography and/or ultrasound) the cases unanimously proved to be malignant. The same association with B3 diagnoses yielded malignancy in a rate of only 0.67. CONCLUSION - Both B3 and B4 diagnoses represent an indication for operation. Our experience suggests that B4 diagnoses when coupled with a radiological opinion of malignancy can be candidates for definitive (therapeutic breast conserving) surgery whereas B3 diagnoses require diagnostic excisions.]