Publications by authors named "Federica Di Naro"

Purpose: The purpose of this study was to assess the diagnostic performance of CEM in the preoperative staging of breast cancer in a large cohort of patients.

Materials And Methods: A retrospective review of preoperative staging CEM exams was conducted at our centre between June 2016 and June 2021. We evaluated cases where CEM influenced the type of surgery, necessitated additional biopsies or imaging, and identified additional lesions.

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Background/objectives: The aim of this study is to evaluate the impact of tumor characteristics on lesion conspicuity in contrast-enhanced mammography (CEM) and identify factors associated with different levels of conspicuity.

Methods: In this retrospective study, we analyzed 552 patients with breast cancer who underwent CEM. Lesion conspicuity was categorized into three levels: 1 (low), 2 (moderate), and 3 (high).

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Background: This study evaluates the procedural efficacy and patient experience of Contrast Enhanced Mammography (CEM)-guided biopsies performed in a prone position using the Giotto Class 30,000 system. The emphasis is on the procedural advantages and clinical outcomes for "enhancing-only lesions" (EOLs).

Methods: A retrospective analysis of 524 CEM examinations conducted from December 2023 to June 2024 at a tertiary referral center was performed.

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Article Synopsis
  • Melanoma in situ of the nipple is rare and not well-documented, making diagnosis difficult due to various potential conditions affecting the nipple-areola area.
  • A case is presented of a patient with cosmetic bilateral breast implants who reported eczema on her left nipple-areola complex and had suspicious microcalcifications found on a mammogram.
  • The patient was ultimately diagnosed with nipple melanoma and also had ductal carcinoma in situ in the same breast.
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Neoadjuvant chemotherapy (NAT) plays a crucial role in breast cancer (BC) treatment, both in advanced BC and in early-stage BC, with different rates of pathological complete response (pCR) among the different BC molecular subtypes. Imaging monitoring is mandatory to evaluate the NAT efficacy. This study evaluates the diagnostic performance of Contrast-Enhanced Mammography (CEM) in BC patients undergoing NAT.

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Background: To assess contrast-enhanced mammography (CEM) in the management of BI-RADS3 breast architectural distortions (AD) in digital breast tomosynthesis (DBT).

Methods: We retrospectively reviewed 328 women with 332 ADs detected on DBT between 2017 and 2021 and selected those classified as BI-RADS3 receiving CEM as problem-solving. In CEM recombined images, we evaluated AD's contrast enhancement (CE) according to its presence/absence, type, and size.

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Background: Reconstructive options that can be used following conservative mastectomy, skin-, nipple-sparing and skin-reducing mastectomies, allow a remarkable variety of safe methods to restore the natural shape and aesthetics of the breast mound. In case of two-stage breast reconstruction, tissue expanders (TEs) are usually placed in a subpectoral position. The purpose of this retrospective cohort study is to evaluate the feasibility and safety of two-step reconstruction with TE in pre-pectoral position covered by acellular dermal matrix (ADM).

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Breast lesions of uncertain malignant potential (B3) are frequently diagnosed in the era of breast cancer (BC) screening and their management is controversial. They are generally removed surgically, but some international organizations and guidelines for breast research suggest follow-up care alone or, more recently, propose vacuum-assisted excision (VAE). The risk of upgrade to BC is known, but very little data exist on its role as risk factor for future BC development.

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Purpose: In recent years vacuum-assisted excision (VAE) has been described as an alternative treatment for some B3 lesions. This study aims to assess the effectiveness of using VAE to manage selected B3 lesions by quantifying the number of B3 lesions undergoing VAE, the malignant upgrade rate, and the complications encountered.

Materials And Methods: Our department evaluated all B3 lesions diagnosed between January 2019 and October 2021 and treated them with VAE.

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(1) Purpose: The latest Breast Imaging Reporting and Data System (BI-RADS) lexicon for CEM introduced a new descriptor, enhancing asymmetries (EAs). The purpose of this study was to determine which types of lesions were correlated with EAs. (2) Methods: A total of 3359 CEM exams, executed at AOUC Careggi in Florence, Italy between 2019 and 2021 were retrospectively assessed by two radiologists.

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Background And Purpose: Preoperative partial breast irradiation (PBI) has got the advantage of treating a well-defined target. We report the results of the phase II ROCK trial (NCT03520894), enrolling early breast cancer (BC) patients treated with preoperative robotic radiosurgery (prRS), in terms of acute and early late toxicity, disease control, and cosmesis.

Material And Methods: The study recruited between 2018 and 2021 at our Radiation Oncology Unit.

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Objectives: To compare second-look ultrasound (SL-ultrasound) with second-look digital breast tomosynthesis (SL-DBT) in the detection of additional lesions (ALs) with presurgical contrast-enhanced spectral mammography (CESM).

Methods: We retrospectively included 121 women with 128 ALs from patients who underwent CESM for presurgical staging at our centre from September 2016 to December 2018. These ALs underwent SL-ultrasound and a retrospective review of DBT (SL-DBT) performed 1-3 weeks prior to CESM to evaluate the performance of each technique individually and in combination.

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Rationale And Objectives: The aim of this retrospective study is to compare the radiation dose received during CEDM, short and long protocol (CEDM SP and CEDM LP), with dose received during DM and DBT on patients with varying breast thickness, age and density.

Materials And Methods: Between January 2019 and December 2019, patients having 6214 DM, 3662 DBT and 173 CEDM examinations in our department were analyzed. Protocol total single breast AGD has been evaluated for all clinical imaging protocols, extracting AGD values and exposure data from the dose DICOM Structured Report (SR) information stored in the hospital PACS system.

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Breast cancer (BC) is the cancer with the highest incidence in women in the world. In this last period, the COVID-19 pandemic has caused in many cases a drastic reduction of routine breast imaging activity due to the combination of various factors. The survival of BC is directly proportional to the earliness of diagnosis, and especially during this period, it is at least fundamental to remember that a diagnostic delay of even just three months could affect BC outcomes.

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Purpose: The aim of our work is to illustrate a new technique for the histological diagnosis of Paget's disease (PD) using a core needle biopsy with a semiautomated 14-gauge needle called nipple-core needle biopsy (N-CNB). We report 3 years' experience in our senology unit.

Materials And Methods: Twenty-six women with 26 clinical of nipple-areola complex (NAC) changes with suspected PD and subjected to core needle biopsy using our new 14G semiautomated needle technique were included in our study group.

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Background: CEDM has demonstrated a diagnostic performance similar to MRI and could have similar limitations in breast cancer (BC) detection.

Purpose: The aim of our study was to systematically analyze the characteristics of the lesions with the absence of enhancement with CEDMs, called false-negatives (FNs), in order to identify which clinical, radiological, histological and molecular parameters are associated with the absence of enhancement of known BCs with CEDMs, and which types of BC are most likely to cause FNs in CEDMs. We also tried to evaluate which parameters instead increased the probability of showing enhancement in the same context.

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Contrast-enhanced digital mammography (CEDM) is a diagnostic tool for breast cancer detection. Artefacts are observed in about 10% of CEDM examinations. Understanding CEDM artefacts is important to prevent diagnostic misinterpretation.

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The aim of our study was to assess the performance of contrast-enhanced digital mammography (CEDM) in the preoperative loco-regional staging of invasive lobular carcinoma (ILC) patients, about the valuation of the extension of disease and in measurement of lesions. Then, we selected retrospectively, among the 1500 patients underwent to CEDM at the Breast Diagnostics Department of the Careggi University Hospital of Florence and the National Cancer Institute of Milan from September 2016 to November 2018, 31 women (mean age 57.1 aa; range 41-78 aa) with a definitive histological diagnosis of ILC.

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Imaging-guided Core Needle Biopsy (CNB) is a procedure for tissue sampling in case of suspicious findings, such as breast masses and abnormal lymph nodes. It provides definitive diagnosis with a high accuracy rate and generally with no significant complications. To our knowledge, this is the first case report to document a pseudoaneurysm of the axilla after CNB.

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Purpose: The prevalence of invasive lobular carcinoma (ILC), the second most common type of breast cancer, accounts for 5%-15% of all invasive breast cancer cases. Its histological feature to spread in rows of single cell layers explains why it often fails to form a palpable lesion and the lack of sensitivity of mammography and ultrasound (US) to detect it. It also has a higher incidence of multifocal, multicentric, and contralateral disease when compared to the other histological subtypes.

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Synopsis of recent research by authors named "Federica Di Naro"

  • - Federica Di Naro's recent research primarily focuses on the use and effectiveness of Contrast-Enhanced Mammography (CEM) in various clinical contexts, including guided biopsies, monitoring chemotherapy responses, and characterizing breast lesions, illustrating its role in improving diagnostic accuracy and patient management in breast cancer detection and treatment.
  • - Di Naro has also investigated less common conditions like primary nipple melanoma in breast cancer patients and the management of ambiguous breast lesions, contributing to an enhanced understanding of patient outcomes and the necessity for tailored diagnostic approaches.
  • - The studies encompass a variety of methods, including retrospective analyses and evaluations of novel techniques such as pre-pectoral breast reconstruction, indicating a commitment to advancing surgical practices and imaging techniques that could enhance patient safety and treatment efficacy.