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Fulltext Comparison of low-contrast detectability of computed radiography and screen/film mammography systems

Noriah Jamal, Ng, Kwan-Hoong, McLean, Donald

Journal of Nuclear and Related Technologies, 2008;2008(2):1-8.
MyJurnal

The objective of this study is to compare low-contrast detectability of computed radiography (CR) and screen/film (SF) mammography systems. The Nijimegen contrast detail test object (CDMAM type 3.4) was imaged at 28 kV, in automatic exposure control mode separately. Six medical imaging physicists read each CDMAM phantom image. Contrast detail curves were plotted to compare lowcontrast detectability of CR (soft copy and hard copy) and SF mammography systems. Effect of varying exposure parameters, namely kV, object position inside the breast phantom, and entrance surface exposure (ESE) on the contrast detail curve were also investigated using soft copy CR. The significance of the difference in contrast between CR and SF, and for each exposure parameter, was tested using non-parametric Kruskal-Wallis test. The low- contrast detectability of the CR (soft copy and hard copy) system was found to be not significantly different to that of the SF system (p>0.05, Kruskal-Wallis test). For CR soft copy, no significant relationship (p>0.05, Kruskal-Wallis test) was seen for variation of kV, object position inside the breast phantom and ESE. This indicates that CR is comparable with SF for useful detection and visualization of low-contrast objects such as small lowcontrast areas corresponding to breast pathology.

Matched MeSH terms: Mammography
Fulltext Comparison of Image Quality Criteria between Digital Storage Phosphor Plate in Mammography and Full-Field Digital Mammography in the Detection of Breast Cancer

Thevi Rajendran P, Krishnapillai V, Tamanang S, Kumari Chelliah K

Malays J Med Sci, 2012 Jan;19(1):52-9.
PMID: 22977375 MyJurnal

Digital mammography is slowly replacing screen film mammography. In digital mammography, 2 methods are available in acquiring images: digital storage phosphor plate and full-field digital mammography. The aim of this study was to compare the image quality acquired from the 2 methods of digital mammography in the detection of breast cancer.

Matched MeSH terms: Mammography
Improvement of digital mammogram images using histogram equalization, histogram stretching and median filter

Langarizadeh M, Mahmud R, Ramli AR, Napis S, Beikzadeh MR, Rahman WE

J Med Eng Technol, 2011 Feb;35(2):103-8.
PMID: 21204610 DOI: 10.3109/03091902.2010.542271

Breast cancer is one of the most important diseases in females worldwide. According to the Malaysian Oncological Society, about 4% of women who are 40 years old and above are involved have breast cancer. Masses and microcalcifications are two important signs of breast cancer diagnosis on mammography. Enhancement techniques, i.e. histogram equalization, histogram stretching and median filters, were used to provide better visualization for radiologists in order to help early detection of breast abnormalities. In this research 60 digital mammogram images which includes 20 normal and 40 confirmed diagnosed cancerous cases were selected and manipulated using the mentioned techniques. The original and manipulated images were scored by three expert radiologists. Results showed that the selected methods have a positive significant effect on image quality.

Matched MeSH terms: Mammography/methods*
Impact of age and breast thickness on mean glandular dose of standard digital mammography and digital breast tomosynthesis

Norsuddin NM, Mei Sin JG, Ravintaran R, Arasaratnam S, Abdul Karim MK

Appl Radiat Isot, 2023 Feb;192:110525.
PMID: 36436228 DOI: 10.1016/j.apradiso.2022.110525

This study compares the mean glandular dose (MGD) across 2D, 3D projection and Contrast-Enhanced Digital Mammography (CEDM) mammographic techniques. The important metadata were extracted from the digital mammography console. 650 subjects were clustered based on projections, age and CBT. The MGD of 2D, 3D, and CEDM was positively correlated with CBT but inversely correlated with the age factor. This study indicate MGD of CEDM was 16% and 22% lower compared to 2D and 3D techniques, respectively.

Matched MeSH terms: Mammography/methods
Assessment of male patients' average glandular dose during mammography procedure

Sulieman A, Salah H, Rabbaa M, Abuljoud M, Alkhorayef M, Tahir D, et al.

Appl Radiat Isot, 2023 Mar;193:110626.
PMID: 36640699 DOI: 10.1016/j.apradiso.2022.110626

Breast cancer is a common malignancy for females (25% of female cancers) and also has low incidence in males. It was estimated that 1% of all breast malignancies occur in males with mortality rate about 20%, with annual increase in incidence. Risk factors include age, family history, exposure to ionizing radiation and high estrogen and low of androgens hormones level. Diagnosis and screening are challenging due to limiting effectiveness of breast cancer screening. Therefore, patients may expose to ionizing radiation that may contribute in breast cancer incidence in males. In literature, limited studies were published regarding radiation exposure for males during mammography. The objective of this research is to quantify patient doses during male mammogram and to estimate the projected radiogenic risk during the procedure. In total, 42 male patients were undergone mammogram for breast cancer diagnosis during two consecutive years. The mean and range of patient age (years) is 45 (23-80). The mean and standard deviation (SD) of the peak tube potential and tube current time product are 28.64 ± 2. and 149 ± 35.1, respectively. The mean, and range of patients' entrance surface air kerma (ESAK, mGy) per single breast procedure was 5.3 (0.47-27.5). Male patient's received comparable radiation dose per mammogram compared to female procedures. With increasing incidence of male breast cancer, proper guidelines are necessary for the mammographic procedure are necessary to reduce unnecessary radiation doses and radiogenic risk.

Matched MeSH terms: Mammography/methods
Evaluation of physical properties and image of polyvinyl chloride as breast tissue equivalence for dual-modality (mammography and ultrasound)

Hariyanto AP, Budiarti NT, Suprijanto, Ng KH, Haryanto F, Endarko

Phys Eng Sci Med, 2023 Sep;46(3):1175-1185.
PMID: 37253939 DOI: 10.1007/s13246-023-01283-y

TMP is gradually becoming a fundamental element for quality assurance and control in ionizing and non-ionizing radiation imaging modalities as well as in the development of different techniques. This study aimed to evaluate and obtain polyvinyl chloride tissue mimicking material for dual-modality breast phantoms in mammography and ultrasound. Breast tissue equivalence was evaluated based on X-ray attenuation properties, speed of sound, attenuation, and acoustic impedance. There are six samples of PVC-plasticizer material with variations of PVC concentration and additives. The evaluation of X-ray attenuation was carried out using mammography from 23 to 35 kV, while the acoustic properties were assessed with mode A ultrasound and a transducer frequency of 5 MHz. A breast phantom was created from TMP material with tissue equivalence and was then evaluated using mammography as well as ultrasound to analyze its image quality. The results showed that samples A (PVC 5%, DOP 95%), B (PVC 7%, DOP 93%), C (PVC 10%, DOP 90%), E (PVC 7%, DOP 90%, graphite 3%), and F (PVC 7%, DOP 90%, silicone oil 3%) have the closest equivalent to the ACR breast phantom material with a different range of 0.01-1.39 in the 23-35 kV range. Based on the evaluation of the acoustic properties of ultrasound, A had high similarity to fat tissue with a difference of 0.03 (dB cm- 1 MHz- 1) and 0.07 (106 kg m- 2 s- 1), while B was close to the glandular tissue with a difference of 9.2 m s- 1. Multilayer breast phantom images' results showed gray levels in mammography and ultrasound modalities. Therefore, this study succeeded in establishing TMP material for mammography and ultrasound. It can also be used for simple quality assurance and control programs.

Matched MeSH terms: Mammography*
Estimation of breast radiation dose in a mammographic system

Lee KH, Kandaiya S

Appl Radiat Isot, 1996 Mar;47(3):361-3.
PMID: 8935969
Matched MeSH terms: Mammography/instrumentation*; Mammography/methods*; Mammography/standards
Fulltext Optimization of exposure parameters in automatic optimization of exposure parameters of (AOP) mode of full field digital mammography (FFDM) system breast phantom study

Hairenanorashikin Sharip, Rafidah Supar

Journal of Academia Universiti Teknologi MARA Negeri Sembilan, 2020;8(1):18-23.
MyJurnal

This experimental study investigated the significant different in image quality and dose between different
automatic exposure of exposure parameter (AOP) mode in full field digital mammography (FFDM) system.
CIRS012A and PMMA breast phantom (4cm, 5cm and 6 cm thickness) were used as subject using
Senographe Essential FFDM system. TLD chip was used as dose measurement tool. Exposures were taken
in cranio-caudal projection. 2 radiographers with more than 10 years of working experience in performing
mammography scored the image independently. Kappa finds a good agreement between raters (kappa
value=0.9, p0.05). DOSE mode is the preferred selection in optimizing between dose and image quality.

Matched MeSH terms: Mammography
Fulltext Perbandingan dos glandular purata payudara berdasarkan kombinasi anod/penuras tungsten/rhodium dan tungsten/argentum pada mamografi digital

Chelliah, Kanaga Kumari, Lumin, Felecia

Jurnal Sains Kesihatan Malaysia, 2012;10(1):53-56.
MyJurnal

Mamografi adalah cara paling efektif untuk mengesan keabnormalan payudara di kalangan wanita. Namun, mamografi dipercayai boleh menyebabkan karsinogenesis aruhan sinaran. Justeru pengukuran dos adalah penting untuk menganggar risiko dan mengawal kualiti imej. Kajian ini dijalankan untuk membandingkan dos glandular purata (AGD) yang diperolehi fantom payudara berdasarkan dua kombinasi anod/penuras yang berbeza iaitu tungsten/rhodium (W/Rh) dan tungsten/argentum (W/Ag). Fantom payudara CIRS 012A didedahkan pada projeksi kraniokaudal (CC) menggunakan sistem mamografi digital Hologic Selenia. Kerma udara kemasukan permukaan (ESAK) diukur menggunakan dosimeter pendar cahaya terma (TLD). AGD diperolehi daripada pengiraan asas ESAK dengan faktor penukaran berdasarkan formula Euref. Ujian t tak bersandar menunjukkan perbezaan bererti dalam purata AGD yang diperolehi. Purata AGD W/Rh adalah lebih tinggi berbanding purata AGD W/Ag (p = 0.002, 95% CI: 0.22, 0.53). Kesimpulannya, penggunaan W/Ag menyumbang kepada pengurangan dos semasa pemeriksaan mamografi.

Matched MeSH terms: Mammography
Fulltext Optimization of exposure parameters in full field digital mammography using figure of merit. [Pengoptimuman parameter dedahan dalam mamografi digital medan penuh menggunakan rajah merit]

Laila Suryani Elias, Eng M, Ang W, Chelliah K, Abd Aziz Tajuddin, Arasaratnam S, et al.

Sains Malaysiana, 2010;39:299-303.

Mammography is used as a screening tool for early detection of breast cancer. However, the radiation dose used should be as low as possible to minimize any effects on asymptomatic woman while maintaining the diagnostic value of the image as mammography is done annually. This study was done to determine the optimum exposure parameter in exposure control mode (AEC) for two combinations of anode/filter which were molybdenum/molybdenum (Mo/Mo) and molybdenum/rhodium (Mo/Rh) using the Lorad Selenia digital mammography system at the Women’s Breast Clinic, National Cancer Society (NCS). A CIRS012A mammography research of phantom 4 cm thickness with 50% glandularity was exposed in the cranio-caudal projection. TLD 100H was used to measure the entrance surface air kerma (ESAK). The AGD values were then calculated from the ESAK values, incorporating three correction factors (g, c and s) according to Euref protocol. Image quality was evaluated using signal to noise ratio (SNR). Figure of Merit (FOM) which is the ratio of the square of SNR to the AGD shows that 30 kVp is the optimum exposure parameter for a 4 cm thickness phantom with the use of Mo/Rh and Mo/Mo anode/filter combination. Non-parametric Spearman correlation test showed a negative linear relationship between AGD and SNR with increasing tube voltage for both anode/filters.
Keywords: Average glandular dose; CIRS012A phantom; exposure; full field digital mammography
Study site: Women’s Breast Clinic, National Cancer Society (NCS), Kuala Lumpur, Malaysia

Matched MeSH terms: Mammography
Fulltext The role of ductography in patients with nipple discharge

Zulfiqar MA, Nair S, Lily M, Norizan MA, Samad SA

Med J Malaysia, 1996 Dec;51(4):457-61.
PMID: 10968034

The main objective of this study is to illustrate the role of ductography in the management of nipple discharge. Thirty-six patients had ductography for the investigation of blood-stained or serous nipple discharge. The ductogram findings were reviewed. Ductography showed an intraductal lesion in 13 patients, duct ectasia in 16 and normal ducts in 7. Fourteen patients had surgery. Eight had preoperative ductography using a mixture of methylene blue and contrast media. Histology revealed 5 cases of duct papilloma, 2 cases of epithelial hyperplasia, 4 cases of fibrocystic change and 3 cases of duct ectasia. Twenty had follow-up without surgery and of these, the nipple discharge ceased in 11 patients. Two patients did not come for follow-up. Ductography has a significant role in the management of nipple discharge. Firstly, surgery might be averted in patients with normal ducts or duct ectasia on ductography. Secondly, intraductal methylene blue will demonstrate the abnormal ductal system to the surgeon and allow for a less radical surgery.

Matched MeSH terms: Mammography*
Comparison of two-dimensional synthesized mammograms versus original digital mammograms: a quantitative assessment

Tan M, Al-Shabi M, Chan WY, Thomas L, Rahmat K, Ng KH

Med Biol Eng Comput, 2021 Feb;59(2):355-367.
PMID: 33447988 DOI: 10.1007/s11517-021-02313-1

This study objectively evaluates the similarity between standard full-field digital mammograms and two-dimensional synthesized digital mammograms (2DSM) in a cohort of women undergoing mammography. Under an institutional review board-approved data collection protocol, we retrospectively analyzed 407 women with digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) examinations performed from September 1, 2014, through February 29, 2016. Both FFDM and 2DSM images were used for the analysis, and 3216 available craniocaudal (CC) and mediolateral oblique (MLO) view mammograms altogether were included in the dataset. We analyzed the mammograms using a fully automated algorithm that computes 152 structural similarity, texture, and mammographic density-based features. We trained and developed two different global mammographic image feature analysis-based breast cancer detection schemes for 2DSM and FFDM images, respectively. The highest structural similarity features were obtained on the coarse Weber Local Descriptor differential excitation texture feature component computed on the CC view images (0.8770) and MLO view images (0.8889). Although the coarse structures are similar, the global mammographic image feature-based cancer detection scheme trained on 2DSM images outperformed the corresponding scheme trained on FFDM images, with area under a receiver operating characteristic curve (AUC) = 0.878 ± 0.034 and 0.756 ± 0.052, respectively. Consequently, further investigation is required to examine whether DBT can replace FFDM as a standalone technique, especially for the development of automated objective-based methods.

Matched MeSH terms: Mammography*
A comparative study of computed radiography-based mammography using digital phosphor storage plate and full field digital mammography

Chelliah KK, Tamanang S, Bt Elias LS, Ying KY

Indian J Med Sci, 2013 11 2;67(1-2):23-8.
PMID: 24178338

BACKGROUND: Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM).
AIMS: The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles.
MATERIALS AND METHODS: This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists.
STATISTICAL ANALYSIS: Wilcoxon Signed Rank Test and Weighted Kappa.
RESULTS: FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact.
CONCLUSION: FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.

Matched MeSH terms: Mammography/instrumentation; Mammography/methods*
Fulltext Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach

Mahmud A, Aljunid SM

PLoS One, 2018;13(2):e0191764.
PMID: 29389972 DOI: 10.1371/journal.pone.0191764

Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who lived in sub-urban and rural areas. In summary, availability of mammogram facilities was good in the central and west coast of the peninsula. The overall provider-to-population ratio was lower than recommended. Based on the travel impedance approach used, accessibility to subsidised mammogram screening among the respondents was good in urban areas but deprived in other areas. This study was a preliminary study with limitations. Nonetheless, the evidence suggests that actions have to be taken to improve the accessibility to opportunistic mammogram screening in Malaysia in pursuit of universal health coverage.

Matched MeSH terms: Mammography/economics; Mammography/utilization*
Positron emission mammography is a useful adjunct in assessment of dense breasts

Kumar SK, Trujillo PB, Ucros GR

Med J Malaysia, 2017 04;72(2):138-140.
PMID: 28473683

Worldwide breast cancer remains as the most common malignancy in women and the numbers who form a subgroup with dense breast parenchyma are substantial. In addition to mammography, the adjuncts used for further evaluation of dense breasts have been anatomically based modalities such as ultrasound and magnetic resonance imaging. The practice of functionally based imaging of breasts is relatively new but has undergone rapid progress over the past few years with promising results. The value of positron emission mammography is demonstrated in patients with dense breasts and mammographically occult disease.

Matched MeSH terms: Mammography/methods*
Options for Addressing the Dilemma of Managing Dense Breasts

Newman LA, Yip CH

JAMA Surg, 2020 04 01;155(4):279-280.
PMID: 32096827 DOI: 10.1001/jamasurg.2020.0280
Matched MeSH terms: Mammography*
Fulltext Efficient Breast Cancer Diagnosis from Complex Mammographic Images Using Deep Convolutional Neural Network

Rahman H, Naik Bukht TF, Ahmad R, Almadhor A, Javed AR

Comput Intell Neurosci, 2023;2023:7717712.
PMID: 36909966 DOI: 10.1155/2023/7717712

Medical image analysis places a significant focus on breast cancer, which poses a significant threat to women's health and contributes to many fatalities. An early and precise diagnosis of breast cancer through digital mammograms can significantly improve the accuracy of disease detection. Computer-aided diagnosis (CAD) systems must analyze the medical imagery and perform detection, segmentation, and classification processes to assist radiologists with accurately detecting breast lesions. However, early-stage mammography cancer detection is certainly difficult. The deep convolutional neural network has demonstrated exceptional results and is considered a highly effective tool in the field. This study proposes a computational framework for diagnosing breast cancer using a ResNet-50 convolutional neural network to classify mammogram images. To train and classify the INbreast dataset into benign or malignant categories, the framework utilizes transfer learning from the pretrained ResNet-50 CNN on ImageNet. The results revealed that the proposed framework achieved an outstanding classification accuracy of 93%, surpassing other models trained on the same dataset. This novel approach facilitates early diagnosis and classification of malignant and benign breast cancer, potentially saving lives and resources. These outcomes highlight that deep convolutional neural network algorithms can be trained to achieve highly accurate results in various mammograms, along with the capacity to enhance medical tools by reducing the error rate in screening mammograms.

Matched MeSH terms: Mammography/methods
Fulltext Comparative Study of Digital Breast Tomosynthesis (DBT) with and without Ultrasound versus Breast Magnetic Resonance Imaging (MRI) in Detecting Breast Lesion

Goh JHL, Tan TL, Aziz S, Rizuana IH

Int J Environ Res Public Health, 2022 Jan 11;19(2).
PMID: 35055581 DOI: 10.3390/ijerph19020759

Digital breast tomosynthesis (DBT) is a fairly recent breast imaging technique invented to overcome the challenges of overlapping breast tissue. Ultrasonography (USG) was used as a complementary tool to DBT for the purpose of this study. Nonetheless, breast magnetic resonance imaging (MRI) remains the most sensitive tool to detect breast lesion. The purpose of this study was to evaluate diagnostic performance of DBT, with and without USG, versus breast MRI in correlation to histopathological examination (HPE). This was a retrospective study in a university hospital over a duration of 24 months. Findings were acquired from a formal report and were correlated with HPE. The sensitivity of DBT with or without USG was lower than MRI. However, the accuracy, specificity and PPV were raised with the aid of USG to equivalent or better than MRI. These three modalities showed statistically significant in correlation with HPE (p < 0.005, chi-squared). Generally, DBT alone has lower sensitivity as compared to MRI. However, it is reassuring that DBT + USG could significantly improve diagnostic performance to that comparable to MRI. In conclusion, results of this study are vital to centers which do not have MRI, as complementary ultrasound can accentuate diagnostic performance of DBT.

Matched MeSH terms: Mammography*
Fulltext Image quality of two full field digital mammography using a female breast phantom

Chelliah, Kanaga Kumari, Ang, Wee Chin, Abd Aziz Tajuddin, Arasaratnam, Shantini A., Suraya Aziz, Laila Suryani Elias

Jurnal Sains Kesihatan Malaysia, 2009;7(1):65-72.
MyJurnal

Digital mammography has been progressively introduced in screening centers and the concern is to achieve an image of diagnostic value which would be able to detect early changes in the breast tissue. The aim of this study was to evaluate the image quality of mammograms using quantitative and qualitative methods of two FFDM systems with variations in breast thickness and anode/filter combination. This study was done from January to April 2008 with two FFDM systems; Siemens Mammomat NovationDR at Diagnostic Imaging Department, Hospital Kuala Lumpur and Hologic Lorad Selenia at Breast Clinic, National Cancer Society. A CIRS012A tissue equivalent breast phantom (4, 5 and 6 cm) thickness was used to obtain images in the craniocaudal plane with 26-32 kVp and a combination of molybdenum/molybdenum (Mo/Mo) and molybdenum/rhodium (Mo/Rh) anode/filter. For the qualitative evaluation, two independent radiologist with a minimum of five years experience was used to score the images. Wilcoxon Sign Rank Test showed that there are no significant differences (p > 0.05) in image quality between both the FFDM systems. Kappa analysis had a poor agreement between the scores given by the two radiologists. The quantitative analysis using Mann-Whitney test showed that there are significant differences (p < 0.05) between the SNR values of both FFDM systems. Although the qualitative evaluation was similar, the study showed that Lorad Selenia had a significantly superior SNR value, hence would be a better tool to detect early changes in the breast tissue. This study also demonstrated that a lower kVp is more suitable with molybdenum filter and as the breast thickness is increased rhodium filter with higher kVp displayed better quality images.

Matched MeSH terms: Mammography
Fulltext Imaging and histopathology correlation of solid papillary carcinoma of the breast : a review of four cases.

Sharifah, M.I.A.

International Medical Journal Malaysia, 2015;14(1):93-97.
MyJurnal

Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.

Matched MeSH terms: Mammography

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