Summary

This article provides an overview of different minimally invasive biopsy (MIB) methods for preoperative assessment of suspicious and indeterminate breast lesions. Accuracy depends on the choice of method and on lesion characteristics. An additional aspect deals with the question whether or not MIB is a suitable therapeutic approach in selected lesions.

New recommendations on screening for breast cancer in the USA recently presented by the US Preventive Services Task Force (USPSTF) and the Society of Breast Imaging and American Council of Radiologists (ACR) provoke some concerns about the optimal screening strategy for breast cancer. USPSTF recommendations published in November 2009 do not recommend screening mammography in women younger than 50 years old because of high false-positive rates and low effects on mortality and vote against self examination of the breast because of lacking evidence for survival benefit from randomized trials. Nevertheless, the ACR guidelines published two months later strongly support the beginning of screening mammography by the age of 40.

We asked Dr. Kettritz whether the new recommendation from the USA might have impact on the clinical routine in Europe?

Oleg Gluz and Cornelia Liedtke

Backround

Advancements in immunosuppressive therapy have significantly improved patient and graft survival following renal transplantation. This is paralleled by an increasing occurrence of posttransplantation malignancy.

Case presentation

We report on a patient who presented with a history reminding of colon cancer seven years after receiving a kidney transplant. Initial diagnostic imaging seemed to confirm this diagnosis showing a constricting colonic lesion. To our surprise, colonoscopy findings were unremarkable. Review of the imaging studies revealed that the tumor-like picture was caused by the renal graft impressing the intestine. The following search for malignancy in other locations resulted in the diagnosis of glioblastoma multiforme of which the patient died several weeks later.

Conclusion

Follow-up of renal transplant patients must include screening tests directed at tumor detection. Imaging studies and other tests in this patient group should be interpreted by physicians who are familiar with transplant related peculiarities.