OBJECTIVE: Vacuum-assisted biopsy is the percutaneous technique of breast biopsy with the lowest underestimation rate. However, the cost of such procedure is high and currently there is a considerable interest in developing less expensive techniques. The present study was aimed at testing a less expensive device for vacuum-assisted biopsy of breast microcalcifications. MATERIALS AND METHODS: Thirty-five patients with clustered microcalcifications classified as BI-RADS® 4 or 5 were submitted to biopsy. Collected specimen appropriateness, difficulties in the reinsertion of the cannula and number of biopsy passes were evaluated. RESULTS: Successful specimens collection was achieved in all of the patients. Histo-radiological disagreement, difficulties in the cannula reinsertion or severe complications were not observed. CONCLUSION: The authors conclude that the method is effective in terms of specimens appropriateness and cost-benefit ratio as compared with of biopsy techniques for breast microcalcifications. Such findings are compatible with data reported in the literature.

Keywords: Breast biopsy, Vacuum-assisted biopsy, Mammotomy, Mammography, Microcalcifications, Vacora

The author presents a critical analysis of the recently published BI-RADS TM system. The first recommendation is to always determine if BI-RADS TM is being used for mammography, ultrasound or magnetic resonance by using the term BI-RADS TM-US or a similar term. The advantages of using the BI-RADS TM-US including reproducibility, standardization, auditing, basis of echogenicity are also considered. In addition, some drawbacks of the system are identified: the omission of statistically significant proven descriptors such as marked hypoechogenicity and number of lobulations, the use of non-recognized descriptors such as the Cooper ligament, and the lack of data on the positive predictive value of some very common breast lesions such as hypoechoic nodules. Finally, a suggestion is presented: to classify the descriptors according to its importance as predictors in order to determine the positive predictive value of the lesions.

Keywords: BI-RADS™, Mammography, Breast cancer

OBJECTIVE: To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. MATERIALS AND METHODS: We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. RECOMMENDATIONS: Annual mammography screening is recommended for women 40–74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.

Keywords: Breast cancer screening; Mammography; Ultrasound; Magnetic resonance imaging.

OBJECTIVE: To evaluate background parenchymal enhancement (BPE) and its characteristics, as well as its behavior before and after neoadjuvant chemotherapy (NAC), in both breasts of patients with unilateral breast cancer. MATERIALS AND METHODS: This was a retrospective, cross-sectional observational study involving a consecutive sample of women with invasive breast cancer who underwent breast magnetic resonance imaging (MRI) between July 2007 and July 2017, as well as undergoing dynamic contrast-enhanced MRI before and after NAC. In both breasts, we evaluated the BPE in accordance with the Breast Imaging Reporting and Data System. We applied logistic regression analysis, and values of p < 0.05 were considered significant. RESULTS: We evaluated 150 women. The mean age was 45.2 years (range, 20–74 years). The variables correlating independently with a high pre-NAC BPE, in the affected and contralateral breasts, were being under 50 years of age (odds ratio [OR] = 6.55; 95% confidence interval [95% CI]: 2.32–18.46, for both breasts) and a post-NAC BPE reduction (OR = 17.75; 95% CI: 4.94–63.73 and OR = 18.47; 95% CI: 5.19–66.49, respectively). CONCLUSION: Patients with invasive unilateral breast cancer who have a high pre-NAC BPE in both breasts tend to be under 50 years of age and to show a post-NAC reduction in BPE.

Keywords: Breast neoplasms/diagnostic imaging; Magnetic resonance imaging/methods; Antineoplastic agents/therapeutic use; Neoadjuvant treatment; Treatment outcome; Parenchymal tissue/diagnostic imaging.