SUMMARY Sentinel lymph node is defined as the first lymph node or group of first nodes to which cancer cells are likely to spread from the primary tumor. Cancer cells are often found in sentinel lymph node(s) before metastasizing to other nodes or organs. Therefore, sentinel lymph node biopsy plays an important role in identification and management of metastasis lesions, especially in breast cancer, testicular cancer and melanoma. Sentinel lymph node scintigraphy with SPECT/CT using 99mTechnetiumnanocolloid is a useful imaging technique for nodal determination and localization. With negative histopathological results of sentinel lymph node dissection, axillary lymph node dissection can be avoided for patients thereby reducing the risk of lymphedema and other complications. In this article, two patients in Vinmec Health Care System, Times City with breast cancer who underwent SPECT/CT sentinel lymph node scintigraphy were reported. Keywords: breast cancer, sentinel lymph node, SPECT/CT, 99mTc-nanocolloid

SUMMARY Objective: To describe the results of ultrasound- guided needle aspiration in the treatment of lactational breast abscesses. Subjects and methods of study: this study was conducted in Bach Mai Hospital, from 6/2020 to 1/2021. Patients with lactating breast abscesses underwent ultrasound- guided aspiration followed by antibiotics therapy. Results: In 34 patients with 46 lactating breast abscesses, most of the abscesses had heterogeneous echogenic, no capsule and size smaller than 5cm. The smallest size of abscesses was 13x24x14mm (equivalent to volume of 2ml), the largest one occupied most of the mammary gland, equivalent to a volume of 540ml. Bacterial culture results showed that 84,8% of cases were methicillin-resistant staphylococcus aureus. The average number of aspirations was 2. The average treatment length was 16 days. Success rate was 91,2% and in these cases, 4 patients (9,3%) had galactocele complication after treatment. 3 cases (8,8%) were converted to the traditional incision and drainage. Conclusion: Ultrasound- guided needle aspiration is an effective and minimally invasive treatment option for lactating breast abscess with a high rate of success and good cosmetic results. Keywords: lactating breast abscess, ultrasound- guided needle aspiration.

SUMMARY Objective: The aims of this study were to determine the value of the semi-quantitative parameters obtained by dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) in differentiation between benign and malignant breast lesions. Methods: A retrospective study was performed on 63 females (with 72 breast lesions) underwent DCE-MRI before treatment at Cho Ray hospital from Jan 2019 to Feb 2020. The value of semi-quantitative parameters (signal intensity slope (SIslope), maximum slope of increase (MSI), percentage of peak enhancement (Epeak)) were evaluated. The diagnostic value of the time intensity curve according to 5th edition ACR (2013) was compared with the value based on semi-quantitative methods. The results of each DCE-MRI parameter were correlated with histopathology. Results: There were 63 patients with 72 breast lesions including 40 benign lesions and 32 malignant lesions. The area under the ROC curve of SIslope, MSI and Epeak were 0,908; 0,702 and 0,734, respectively. The sensitivity, specificity and accuracy of the time intensity curve according to ACR and semi-quantitative methods were 68,8% and 87,5%; 87,5% and 85%; 79,2% and 86,1%, respectively. Conclusion: Our study reinforces the importance of the semi-quantitative parameters of DCE-MRI in distinguishing between benign and malignant breast lesions. Semi-quantitative analysis of the time intensity curve helps to increase the diagnostic accuracy compared with the methods of ACR. Key words: breast lesions; semi-quantitative parameters; time intensity curve.

The role of digital breast tomosynthesis in diagnosis of breast cancer SUMMARY The purpose of this study is to describe some imaging findings and evaluate the role of digital breast tomosynthesis (DBT) in diagnosis of breast cancer. The study was conducted on 59 breasts of 59 patients with clinical signs or abnormal imaging findings. The malignant or benign nature of the lesions was established by histologic analysis of biopsied lesions or FNA with follow-up. Result : The common manifestations of cancer noted at DBT include ill-defined mass, speculated margins, architectural distortion and microcalcifications. DBT improved diagnostic sensitivity for patients with mass and architectural distortion, and allows a reclassification of the degree of BI-RADS. There was slight to fair agreement for lesion type (k= 0 - 0.25) and BI-RADS final assessment (k = 0.285 - 0.396). DBT improved diagnostic performance compared to MMG, with Se = 94.9%, Sp = 75%, PPV = 88.1%, NPV = 88.2%, Vg = 88.1%. Conclusion: Our study showed fair agreement in lesion detection and characterization between MMG and DBT images. Our findings also demonstrated that DBT is a novel technique that superior in detecting and diagnosing breast cancer compared to MMG, especially in mass and architectural distortion. Keywords : Digital breast tomosynthesis (DBT), mammography (MMG), breast cancer.