Mammogram

乳房 X 线照片
  • 文章类型: Case Reports
    Rosai-Dorfman-Destombes(RDD)疾病也被称为伴有大量淋巴结病的窦组织细胞增生症。它是儿童和年轻人罕见的异质性疾病。大多数RDD患者通常表现为无痛性淋巴结病,而结外和多系统表现的疾病是不寻常的。诊断基于影像学与临床病理相关性。Flourine-18氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描对于RDD病变的初始分期很有用,具有类似的外观和亲和力,如中度和高度淋巴瘤。这里,我们介绍了一例55岁女性患者的左乳腺肿块,结果是结外Rosai-Dorfman病.
    Rosai-Dorfman-Destombes (RDD) disease is also known as sinus histiocytosis with massive lymphadenopathy. It is an uncommon heterogeneous disease of children and young adults. Most of the patients with RDD generally present with painless lymphadenopathy, while extranodal and multisystem manifestation of the disease is unusual. The diagnosis is based on the imaging with clinicopathological correlation. Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography is useful for the initial staging of the RDD lesions, which have similar appearance and avidity like intermediate and high-grade lymphomas. Here, we present the case of a 55-year-old female presented with left breast mass that turned out to be the extranodal Rosai-Dorfman disease.
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  • 文章类型: Journal Article
    乳房X光检查的比较解释变得越来越重要,发展乳房X线照片的减法处理和配准方法至关重要。然而,非刚性图像配准很少应用于仅用软组织构造的受试者,比如乳房X线照片.我们检查了是否可以使用非刚性图像配准来执行用于乳房X线照片比较解释的减法处理。作为一项初步研究,我们通过将非刚性图像配准应用于正常乳房X光检查来评估减法处理的结果,假设左乳和右乳之间的比较解释。中外侧斜视乳房X线照片取自非癌症患者,并分为1000例进行训练,100例用于验证,和500个案例进行测试。应用非刚性图像配准以将水平翻转的左乳房乳房X线照片与右乳房X线照片对齐。我们比较了在应用和不应用非刚性图像配准的情况下,双边图像(DifferenceImage)差异的绝对差异之和(SAD)。统计上,应用非刚性图像配准后的平均SAD显著低于未应用非刚性图像配准的平均SAD(无:0.0692;有:0.0549(p<0.001)).在使用乳房区域的四个亚组中,乳腺密度,压缩乳房厚度,和没有非刚性图像配准的差异图像,在非刚性图像配准的情况下,差异图像的平均SAD也显著低于无刚性图像配准的情况(p<0.001)。发现非刚性图像配准在对齐双侧乳房X线照片中足够有用,预计它将成为开发乳房X线照片比较解释支持系统的重要工具。
    A comparative interpretation of mammograms has become increasingly important, and it is crucial to develop subtraction processing and registration methods for mammograms. However, nonrigid image registration has seldom been applied to subjects constructed with soft tissue only, such as mammograms. We examined whether subtraction processing for the comparative interpretation of mammograms can be performed using nonrigid image registration. As a preliminary study, we evaluated the results of subtraction processing by applying nonrigid image registration to normal mammograms, assuming a comparative interpretation between the left and right breasts. Mediolateral-oblique-view mammograms were taken from noncancer patients and divided into 1000 cases for training, 100 cases for validation, and 500 cases for testing. Nonrigid image registration was applied to align the horizontally flipped left-breast mammogram with the right one. We compared the sum of absolute differences (SAD) of the difference of bilateral images (Difference Image) with and without the application of nonrigid image registration. Statistically, the average SAD was significantly lower with the application of nonrigid image registration than without it (without: 0.0692; with: 0.0549 (p < 0.001)). In four subgroups using the breast area, breast density, compressed breast thickness, and Difference Image without nonrigid image registration, the average SAD of the Difference Image was also significantly lower with nonrigid image registration than without it (p < 0.001). Nonrigid image registration was found to be sufficiently useful in aligning bilateral mammograms, and it is expected to be an important tool in the development of a support system for the comparative interpretation of mammograms.
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  • 文章类型: Journal Article
    男性乳腺癌占所有乳腺癌病例的不到1%。男性乳腺癌发生发展的重要危险因素是家族史,基因突变,肥胖,肝病,酗酒,外源性雌激素给药,和胸部区域的辐射暴露。尽管它很罕见,许多研究已经调查了成像考虑因素的数据(乳房X线照片,超声,和磁共振成像(MRI)),但只涉及男性乳腺癌的某些方面。关于成像特性的综合方法,成像的定时,基于成像特征的预测,男性乳腺癌的随访策略仍然缺乏。这篇综述文章的目的是提供对影像学发现的全面概述,获得成像的最佳时机,以及男性乳腺癌幸存者的适当随访策略。本文还描述了成像方式如何帮助确定预后。通过解决这一知识差距,这篇文章为临床医生治疗这种罕见但具有临床意义的疾病提供了有价值的见解.
    Male breast cancer accounts for less than 1% of all breast cancer cases. The important risk factors for the development of male breast cancer are family history, genetic mutations, obesity, liver disease, alcoholism, exogenous estrogen administration, and radiation exposure to the chest area. Despite its rarity, numerous studies have investigated the data on imaging considerations (mammogram, ultrasound, and magnetic resonance imaging (MRI)), but have addressed only certain aspects of male breast cancer. A comprehensive approach on the imaging characteristics, timing of imaging, prognostication based on imaging characteristics, and follow-up strategies in male breast cancer are still lacking. The purpose of this review article was to provide a comprehensive overview of the imaging findings, optimal timing to obtain imaging, and the appropriate follow-up strategies in male breast cancer survivors. This article also describes how imaging modalities can aid in determining prognosis. By addressing this knowledge gap, the article provides valuable insights for clinicians managing this uncommon yet clinically significant disease.
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  • 文章类型: Journal Article
    乳腺动脉钙化(BAC)是一种通常在乳房X线照片上观察到的钙化,通常被认为是良性的,与乳腺癌无关。然而,越来越多的观察证据表明BAC与心血管疾病之间存在关联,女性死亡的主要原因。我们提出了一种深度学习方法,可以帮助放射科医生在合成的2D乳房X线照片中检测和量化BAC。我们提出了一个循环注意力U-Net模型,该模型由编码器和解码器模块组成,其中包括多个块,每个块都使用循环机制,一种反复出现的机制,和他们之间的注意模块。该模型还包括编码器和解码器之间的跳过连接,类似于U形网络。注意模块用于增强对远程依赖关系的捕获,并使网络能够从背景中有效地对BAC进行分类,而循环块确保了更好的特征表示。使用包含2,000个合成的2D乳房X线照片图像的数据集评估模型。我们获得了99.8861%的总体准确率,69.6107%灵敏度,66.5758%F-1得分,和59.5498%的Jaccard系数,分别。与相关模型相比,提出的模型取得了有希望的性能。
    Breast arterial calcifications (BAC) are a type of calcification commonly observed on mammograms and are generally considered benign and not associated with breast cancer. However, there is accumulating observational evidence of an association between BAC and cardiovascular disease, the leading cause of death in women. We present a deep learning method that could assist radiologists in detecting and quantifying BAC in synthesized 2D mammograms. We present a recurrent attention U-Net model consisting of encoder and decoder modules that include multiple blocks that each use a recurrent mechanism, a recurrent mechanism, and an attention module between them. The model also includes a skip connection between the encoder and the decoder, similar to a U-shaped network. The attention module was used to enhance the capture of long-range dependencies and enable the network to effectively classify BAC from the background, whereas the recurrent blocks ensured better feature representation. The model was evaluated using a dataset containing 2,000 synthesized 2D mammogram images. We obtained 99.8861% overall accuracy, 69.6107% sensitivity, 66.5758% F-1 score, and 59.5498% Jaccard coefficient, respectively. The presented model achieved promising performance compared with related models.
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  • 文章类型: Journal Article
    目标:2020年4月,标准的二维全视场数字乳房X线照片(FFDM)被数字乳腺断层合成术(DBT)取代,并为有症状的乳腺诊所合成了2D视图。本研究旨在评估DBT检测到的建筑失真(AD)中恶性肿瘤的阳性预测值。
    方法:在2020年4月至2022年10月期间评估了所有带有“变形”字样的乳房X线照片报告。有458张乳房X线照片,上面写着“变形”。排除乳房X线照片后,没有变形(n=128),术后变形(n=173),质量失真(n=33),和不变的失真(n=14),有111例纯变形患者。在可能的情况下获得与组织病理学的相关性。所有患者随访至少两年。
    结果:111例AD患者中有42例(37.84%)的超声(US)正常并出院。55例(49.5%)患者有与畸变相对应的超声相关性,导致美国引导活检。13例(23.6%)进行断层合成引导活检,还有一个做了皮肤活检.恶性肿瘤的阳性预测值(PPV)为42.34%。美国引导活检的恶性诊断高于断层合成引导活检。78.1%和30%,分别。
    结论:总恶性率为42.34%,DBT检测到的建筑扭曲具有足够高的PPV,用于恶性肿瘤,如果存在超声相关性或可疑的乳房X线照片,则可以进行选择性组织采样。当存在对应于AD的超声相关性时,恶性肿瘤的机会更高。
    结论:症状性乳腺门诊患者DBT/SM观点的结构失真证明了选择性采样的合理性。
    OBJECTIVE: In April 2020, standard two-dimensional (2D) full-field digital mammograms were replaced with digital breast tomosynthesis (DBT) and synthesised 2D views for symptomatic breast clinics. This study aimed to evaluate the positive predictive value (PPV) for malignancy in DBT-detected Architectural distortion (AD).
    METHODS: All mammogram reports with the word \"distortion\" were assessed between April 2020 and October 2022. There were 458 mammograms with the word \"distortion.\" After excluding mammograms with no distortion (n = 128), post-surgical distortion (n = 173), distortion with mass (n = 33), and unchanged distortion (n = 14), there were 111 patients with pure distortion. Correlation with histopathology was obtained where possible. All patients were followed for a minimum of 2 years.
    RESULTS: Forty-two out of 111 patients (37.84%) with AD had a normal ultrasound (US) and were discharged. Fifty-five (49.5%) patients had sonographic correlation corresponding to the distortion, leading to US-guided biopsy. Thirteen (23.6%) had tomosynthesis-guided biopsy, and one had a skin biopsy. The PPV for malignancy was 42.34%. Malignancy diagnoses were higher with US-guided biopsies than tomosynthesis-guided biopsies, 78.1% and 30%, respectively.
    CONCLUSIONS: With a total malignancy rate of 42.34%, DBT-detected AD has a high enough PPV for malignancy to justify selective tissue sampling if a sonographic correlate is present or with suspicious mammograms. The chances of malignancy are higher when a sonographic correlate corresponding to AD is present.
    CONCLUSIONS: AD on DBT/synthesized mammograms views in symptomatic breast clinic patients justifies selective sampling.
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  • 文章类型: Journal Article
    目的:乳腺癌是印度死亡的重要原因之一,在女性中仅次于宫颈癌。每年,该国目睹了20万例新病例的发现,在早期阶段发现了60%。这项研究旨在评估旨在提高卡纳塔克邦农村妇女对乳腺癌知识的健康教育干预计划的有效性。
    方法:采用描述性研究设计,通过多阶段抽样选择了320名女性。教育干预涉及调查员的PowerPoint演示文稿,随后进行了小组讨论,最后举行了全体会议,以澄清受访者的疑虑。在每次教育会议结束时,预先设计,预先测试,和经过验证的问卷,由结构化和半结构化问题组成,作为后测的一部分,由受访者完成。结果:在参与者中,受过小学教育的占44.7%,多数(64.1%)受雇,大多数(90.3%)已婚。此外,56.9%的人报告月收入低于3000印度卢比,大多数人(86.3%)低于贫困线(BPL)类别。与乳房健康相关的知识有统计学上的显着改善(p=0.0001),乳房自我检查,临床乳房检查,与预测试相比,在干预后阶段观察到乳房X线照相术。86.2%的受访者对乳房健康的知识水平有所提高(从差到中度或从中度到良好),乳房自我检查的实践从4.7%(测试前)增加到60.3%(测试后)。结论:实施健康教育干预方案后,女性知识水平显著提高。这些发现强调了健康教育策略在提高人们对生活方式疾病的认识方面的重要性,尤其是乳腺癌,在女性中。
    OBJECTIVE: Breast cancer is one of the significant causes of mortality in India, ranking second only to cervical cancer among women. Annually, the country has witnessed the detection of 200,000 new cases, with 60% identified in the early stages. This study aimed to assess the effectiveness of a health education intervention program designed to enhance knowledge about breast cancer among women in rural Karnataka.
    METHODS: A descriptive study design was employed and a total of 320 women were selected through multi-stage sampling. The educational intervention involved a PowerPoint presentation by the investigator, which was followed by group discussions that culminated with plenary sessions for clarifying the doubts of respondents. At the end of every educational session, pre-designed, pre-tested, and validated questionnaires, comprising a mix of structured and semi-structured questions, were completed by the respondents as part of the post-test.  Results: Among the participants, 44.7% were educated up to the primary level, a majority (64.1%) were employed, and most (90.3%) were married. Additionally, 56.9% reported a monthly income below 3000 Indian rupees (₹), with the majority (86.3%) falling below the poverty line (BPL) category. A statistically significant improvement (p = 0.0001) in knowledge related to breast health, breast self-examination, clinical breast examination, and mammography was observed in the post-intervention phase when compared to the pre-test. 86.2% of the respondents showed an increase in knowledge level about breast health (either from poor to moderate or from moderate to good) and the practice of breast self-examination increased from 4.7% (pre-test) to 60.3% (post-test).  Conclusion: The study demonstrated a significant enhancement in women\'s knowledge levels after implementing the health education intervention program. These findings underscore the importance of health education strategies in raising awareness of lifestyle diseases, particularly breast cancer, among women.
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  • 文章类型: Journal Article
    乳房X线照相术是乳腺癌筛查的首选方式。然而,一些乳腺癌病例仅通过超声检查确诊,在乳房X线照相术上没有发现或出现良性发现(在此称为不可视).因此,这项研究旨在根据使用人工智能(AI)根据患者年龄和压缩乳房厚度(CBT)估算的乳腺含量比,确定表明存在不可视可能性的因素.
    我们使用我们先前开发的AI来估算乳腺含量比,并对26,232个对照和150个不可视的进行定量分析。首先,我们根据平均估计的乳腺含量比评估了对照组和非可见者之间的差异趋势,以确保按年龄和CBT进行分析的重要性.接下来,我们评估了乳腺含量比率≥50%组会影响对照组和非可见组之间差异的可能性,以明确确定表明非可见组可能性的因素.对于估计的乳腺含量比率,将图像分为两组,阈值为50%,在对照组和非可见者之间进行逻辑回归分析。
    当整体样本时,非可见者的平均估计乳腺含量比率显着高于对照组,患者年龄≥40岁,CBT≥40mm(p<0.05).总体样本的对照和不可见的平均估计乳腺含量比率的差异为7.54%,40-49岁、50-59岁和≥60岁患者的差异为6.20%,7.48%,4.78%,分别,CBT为40-49、50-59和≥60mm的差异为6.67%,9.71%,和16.13%,分别。在评估乳腺含量比率≥50%组时,我们还发现,当对照被用作总体样本的基线时,非可见性呈正相关,在40-59岁的患者中,以及CBT≥40mm的患者(p<0.05)。相应的比值比≥2.20,最大值为4.36。
    研究结果强调,年龄在40-59岁的患者或CBT≥40mm的患者中,乳腺含量的估计比例≥50%可能是不可视的指示因素。
    UNASSIGNED: Mammography is the modality of choice for breast cancer screening. However, some cases of breast cancer have been diagnosed through ultrasonography alone with no or benign findings on mammography (hereby referred to as non-visibles). Therefore, this study aimed to identify factors that indicate the possibility of non-visibles based on the mammary gland content ratio estimated using artificial intelligence (AI) by patient age and compressed breast thickness (CBT).
    UNASSIGNED: We used AI previously developed by us to estimate the mammary gland content ratio and quantitatively analyze 26,232 controls and 150 non-visibles. First, we evaluated divergence trends between controls and non-visibles based on the average estimated mammary gland content ratio to ensure the importance of analysis by age and CBT. Next, we evaluated the possibility that mammary gland content ratio ≥50% groups affect the divergence between controls and non-visibles to specifically identify factors that indicate the possibility of non-visibles. The images were classified into two groups for the estimated mammary gland content ratios with a threshold of 50%, and logistic regression analysis was performed between controls and non-visibles.
    UNASSIGNED: The average estimated mammary gland content ratio was significantly higher in non-visibles than in controls when the overall sample, the patient age was ≥40 years and the CBT was ≥40 mm (p < 0.05). The differences in the average estimated mammary gland content ratios in the controls and non-visibles for the overall sample was 7.54%, the differences in patients aged 40-49, 50-59, and ≥60 years were 6.20%, 7.48%, and 4.78%, respectively, and the differences in those with a CBT of 40-49, 50-59, and ≥60 mm were 6.67%, 9.71%, and 16.13%, respectively. In evaluating mammary gland content ratio ≥50% groups, we also found positive correlations for non-visibles when controls were used as the baseline for the overall sample, in patients aged 40-59 years, and in those with a CBT ≥40 mm (p < 0.05). The corresponding odds ratios were ≥2.20, with a maximum value of 4.36.
    UNASSIGNED: The study findings highlight an estimated mammary gland content ratio of ≥50% in patients aged 40-59 years or in those with ≥40 mm CBT could be indicative factors for non-visibles.
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  • 文章类型: English Abstract
    目的:放射科医生很难在乳房X线照片上正确检测到微小病变和隐藏在致密乳腺组织上的病变。因此,最近,计算机辅助检测(CAD)系统已广泛用于辅助放射科医生解释图像。因此,在这项研究中,我们的目标是通过使用从眼动追踪设备获得的聚焦图像,在乳房X线照片上高精度地分割肿块。
    方法:我们在DDSM发布的8例异常和8例正常乳房X线照片中获得了两名乳房X线摄影专家和19名乳房X线摄影技术人员的焦点图像。接下来,自动编码器,Pix2Pix,UNIT了解了实际乳房X线照片和焦点图像之间的关系,并生成未知乳房X线照片的焦点图像。最后,我们使用U-Net为自动编码器生成的每个焦点图像在乳房X线照片上分割质量区域,Pix2Pix,和单位。
    结果:单元中的骰子系数为0.64±0.14。单元中的骰子系数高于自动编码器和Pix2Pix中的骰子系数,差异有统计学意义(p<0.05)。提出的方法的骰子系数,它结合了UNIT生成的焦点图像和原始乳房X线照片,为0.66±0.15,相当于使用原始乳房X线照片的方法。
    结论:在未来,有必要增加病例数量并进一步改善分割。
    OBJECTIVE: It is very difficult for a radiologist to correctly detect small lesions and lesions hidden on dense breast tissue on a mammogram. Therefore, recently, computer-aided detection (CAD) systems have been widely used to assist radiologists in interpreting images. Thus, in this study, we aimed to segment mass on the mammogram with high accuracy by using focus images obtained from an eye-tracking device.
    METHODS: We obtained focus images for two mammography expert radiologists and 19 mammography technologists on 8 abnormal and 8 normal mammograms published by the DDSM. Next, the auto-encoder, Pix2Pix, and UNIT learned the relationship between the actual mammogram and the focus image, and generated the focus image for the unknown mammogram. Finally, we segmented regions of mass on mammogram using the U-Net for each focus image generated by the auto-encoder, Pix2Pix, and UNIT.
    RESULTS: The dice coefficient in the UNIT was 0.64±0.14. The dice coefficient in the UNIT was higher than that in the auto-encoder and Pix2Pix, and there was a statistically significant difference (p<0.05). The dice coefficient of the proposed method, which combines the focus images generated by the UNIT and the original mammogram, was 0.66±0.15, which is equivalent to the method using the original mammogram.
    CONCLUSIONS: In the future, it will be necessary to increase the number of cases and further improve the segmentation.
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  • 文章类型: Journal Article
    全世界有超过10亿人患有残疾。残疾患者经常面临许多障碍,无法获得医疗保健。特别是预防和筛查服务。1990年的《美国残疾人法》规定,所有人都可以使用与美国医疗保健有关的公共场所;但是,许多医疗设施达不到这一要求。研究表明,由于经济原因,慢性残疾妇女不太可能接受乳腺癌筛查,环境,和物理限制,以及心理障碍。缺乏对行动不便的个人的需求以及他们在获得医疗保健服务时面临的障碍特征的研究,尤其是乳房成像服务。本文的目的是说明行动不便者面临的乳房成像服务的现有障碍,并提供在临床实践中用于乳房护理实践和与行动不便患者一起工作的医务人员的指南列表。
    Over 1 billion people worldwide live with a disability. Patients living with disability are often challenged by many barriers to healthcare access, especially preventive and screening services. The Americans with Disabilities Act of 1990 mandated that access to public accommodations related to medical care in the United States be available to all; however, many healthcare facilities fall short of meeting this requirement. Research studies suggest that women with chronic disabilities are less likely to undergo breast cancer screening due to financial, environmental, and physical limitations, as well as psychological barriers. There is scarcity of research on the needs of individuals with mobility impairments and the features of the barriers they face when accessing healthcare services, especially breast imaging services. The objective of this article is to illustrate the existing barriers to breast imaging services that individuals with mobility impairments face and to provide a list of guidelines to be used in clinical practice for breast care practices and medical staff working with patients who have mobility impairments.
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  • 文章类型: Journal Article
    目的:在诊断为单纯的放射状瘢痕(RSs)和RSs并在经皮芯针乳腺活检中遇到其他相关的高危病变(HRL)后,确定最佳的治疗选择(手术切除与影像学检查)。
    方法:对乳腺影像学报告系统数据库进行了IRB批准的回顾性审查,以识别所有单纯RS或RS加额外HRL(乳头状瘤,非典型,小叶瘤形成)在芯针活检中诊断,从2007年到2016年,在我们机构的四个乳房中心。伴有恶性肿瘤的病例,不一致的放射学-病理学结果,或者那些失去随访的人被排除在外.对其余病例进行评估,以确定后续手术切除或长期随访成像(至少两年)的结果。记录的其他数据包括临床表现,乳腺密度,乳腺癌的个人和家族史,病变影像学特征,和活检方法。
    结果:研究队列包括111例患者,111个病灶:56.8%(63/111)单独使用RS(纯),43.2%(48/111)使用RS加其他HRL(s)。在63个放射学-病理学一致的纯RS中,在51例后续手术切除或12例长期监测病例(0/63,0%)中,未出现恶性升级.在48个RS加上额外的HRL(s)中,有2例升级为恶性肿瘤(2/48,4.2%).
    结论:在芯针活检中诊断为放射学-病理学一致的纯RS的病例不需要手术切除。另一方面,对于在芯针活检中诊断出的RS和其他HRLs,应考虑手术切除.
    OBJECTIVE: To determine the best management option (surgical excision versus imaging surveillance) following the diagnosis of pure radial scars (RSs) and RSs with associated additional high-risk lesions (HRLs) encountered on percutaneous core-needle breast biopsy.
    METHODS: An IRB-approved retrospective review of the breast imaging reporting system database was performed to identify all cases of pure RS alone or RS plus an additional HRL (papilloma, atypia, lobular neoplasia) diagnosed on core-needle biopsy, from 2007 to 2016, at four breast centers in our institution. Cases with associated malignancy, discordant radiologic-pathologic results, or those lost to follow-up were excluded. The remaining cases were evaluated to determine results of either subsequent surgical excision or long-term follow-up imaging (minimum of two years). Additional data recorded included clinical presentation, breast density, personal and family history of breast cancer, lesion imaging characteristics, and biopsy method.
    RESULTS: The study cohort included 111 patients with 111 lesions: 56.8% (63/111) with RS alone (pure) and 43.2% (48/111) with RS plus additional HRL(s). Out of the 63 radiologic-pathologic concordant pure RSs, there were no upgrades to malignancy in 51 subsequent surgical excisions or 12 long-term surveillance cases (0/63, 0%). Out of the 48 RSs plus additional HRL(s), there were 2 upgrades to malignancy (2/48, 4.2%).
    CONCLUSIONS: Cases of radiologic-pathologic concordant pure RS diagnosed at core-needle biopsy do not require surgical excision. On the other hand, surgical excision should be considered for RS plus additional HRLs diagnosed at core-needle biopsy.
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