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TÜRELİ, DERYA

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TÜRELİ

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DERYA

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2016 - 201912020 - 20211
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Subject: BREAST ×

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    Outcomes of unconventional utilization of BI-RADS category 3 assessment at opportunistic screening
    (SAGE PUBLICATIONS LTD, 2016) TÜRELİ, DERYA; Altas, Hilal; Tureli, Derya; Cengic, Ismet; Kucukkaya, Fikret; Aribal, Erkin; Kaya, Handan
    Background An important difficulty regarding the Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment is the need for extensive diagnostic workup and an additional 6-month follow-up study. Purpose To evaluate the feasibility of the BI-RADS category 3 assessments at opportunistic screening. Material and Methods Mammography charts of 9062 screening patients in a major teaching hospital situated in an urban setting of a developing country were evaluated retrospectively (1997-2010). BI-RADS category 3 patients, called for a 6-month follow-up, which comprised a single-view spot or magnification mammogram. The length of follow-up period, compliance to periodic mammographic surveillance, cancer detection rate, and negative predictive values of category 3 assessments were calculated. Results Of the screened population, 9.2% were assigned BI-RADS category 3, and 31.2% of these cases were lost to follow-up. The mean follow-up period for 606 patients was 36.9 months. The negative predictive values for 6-month, 12-month, and final control studies were 90.9%, 87.5%, and 100%, respectively. Patient compliance for 6 months, 12 months, and any control evaluations beyond 12 months was low (50.0%, 29.8%, and 47.5%, respectively). Cancer detection rate was 0.8%. Conclusion Results of the study supports the feasibility of the BI-RADS category 3 assessments at opportunistic screening without any additional diagnostic workup. The practice of category 3 assessment following screening mammograms may be a more cost-effective method for developing countries with high recall rates and low resources in eliminating the maximum risk with minimum cost within the limits of available resources.
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    PublicationOpen Access
    Ultrasound shear-wave elasticity and magnetic resonance diffusion coefficient show strong inverse correlation in small fibroadenomas
    (MARMARA UNIV, FAC MEDICINE, 2021-01-22) TÜRELİ, DERYA; Andac Baltacioglu, Nurten; Tureli, Derya
    Objective: Stiffness of breast lesions helps distinguish malignant from benign solid masses. Stiffness can he quantitatively measured by magnetic resonance and ultrasound imaging using apparent diffusion coefficient (ADC) and shear-wave elastography (SWE) techniques, respectively. This study aims to analyze correlations between SWE and ADC in biopsy-proven small fibroadenomas. Patients and Methods: Shear-wave elastography and ADC measurements of 50 fibroadenomas were evaluated retrospectively. Mean patient age was 41 +/- 13 years (range 27-63). All lesions had maximum diameters of <= 20 millimeters. Correlations between intralesional ADC, lesion-parenchyma ADC ratio, intralesional SWE, SWE heterogeneity index and lesion volume were analyzed. Results: Mean values of lesions were as follows: ADC=1.71 +/- 0.22 x10-3mm2/s, ADC ratio=1.04 +/- 0.09, maximum SWE=73.4 +/- 28.8 kPa, minimum SWE=43.9 +/- 21.8 kPa and SWE heterogeneity index =29.4 +/- 12.7 kPa. There was a strong inverse correlation between fibroadenoma ADC and SWE values (rho - 0.746, p <0.01). Significant correlations were also found between fihroadenoma volume and ADC (rho = - 0.525, p <0.05) and SWE (rho = 0.840, p <0.01). Conclusion: Apparent diffusion coefficient and SWE values show strong inverse correlation in small fibroadenomas. If proven threshold values for lesion characterization are revealed, ultrasonographic SWE and diffusion-weighted MRI have potential to be used interchangeably.