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    Radiology Approach to Invasive Breast Lobular Carcinoma – Initial Experience
    (Walter de Gruyter GmbH, 2025-11-01)
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    Bozinovska, Biljana
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    Prvulovic Bunovic Natasa
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    It is well known that invasive lobular carcinoma (ILC) accounts for approximately 5-15 % of invasive breast cancers that remain one of the most common malignancies among women globally. ILC is distinguished from the more common invasive ductal carcinoma (IDC) by characteristics histopathology features. The aim of the study was to emphasize the need of more specified diagnostic imaging approach in order to detect breast ILC, based on our institution experience. We describe a number of 17 female cases (58±7 years) who presented: breast fullness/asymmetry – 11 patients (64.7 %), pain – 2 patients (11.7 %), and the rest 4 patients (23.5 %) were asymptomatic. Diagnostic modalities used in this study were: 2D Mammography, Ultrasound, Digital Breast Tomosynthesis (DBT), and core biopsy in guidance by Ultrasound. On 2D Mammography, visible mass was found in 8 patients (47 %), and architectural distortion was found in 4 patients (23.5 %). On DBT additional 5 patients were examined from the total number of patients, and additional lesions were found such as occult lesions and additional architectural distortion. Using DBT, occult lesion was found in 3 patients (17.6 %) and architectural distortion was found in 2 patients (11.7%). Due to these inconclusive findings, DBT was carried out to improve visualization especially in those with more glandular tissue. The occult lesions were seen in 3 patients, which showed as false negative on 2D, as well as an architectural distortion in 2 patients, additionally seen on DBT. This multimodality approach, including DBT, holds promise for more reliable detection of occult lesions and distortions especially in denser breast, and for better clinical outcomes in patients with ILC, respectively.
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    ESSR Consensus Document for Detection, Characterization, and Referral Pathway for Tumors and Tumorlike Lesions of Bone
    (Georg Thieme Verlag KG, 2017-11)
    Lalam, Radhesh
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    Bloem, Johan L
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    Noebauer-Huhmann, Iris M
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    Wörtler, Klaus
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    Tagliafico, Alberto
    Benign bone tumors are rare but are more common than primary malignant bone tumors. The early accurate diagnosis and reliable differentiation of these rare benign tumors and tumor mimickers from the even rarer malignant tumors with subsequent appropriate treatment or watchful waiting is crucial for the clinical outcome. Bone tumors are often a source of diagnostic and therapeutic uncertainty. Thus this European Society of Musculoskeletal Radiology consensus document is intended to help radiologists in their decision making and support discussion among clinicians who deal with patients with suspected or proven bone tumors. Evaluating these tumors starts with a patient history and physical examination. Radiography is the principal imaging modality and often can reliably diagnose a benign bone tumor by providing information about localization, matrix, aggressiveness, size, and (potential) multiplicity. In a significant number of cases, additional imaging is not necessary. Potentially malignant entities recognized by radiography should be referred for magnetic resonance imaging, which also serves as a preoperative local staging modality, with specific technical requirements. Indeterminate tumors, or tumors in which therapy depends on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist regional sarcoma treatment center (RSTC), where a multidisciplinary tumor team, including a specialist pathologist, radiologist, and sarcoma surgeon, are involved. Additional staging modalities are entity specific and should be performed according to the recommendations of the RSTC.