1. Breast cancer risk assessment and risk distribution in 3,491 Slovenian women invited for screening at the age of 50 : a population-based cross-sectional studyKatja Jarm, Vesna Zadnik, Mojca Birk, Miloš Vrhovec, Kristijana Hertl, Žan Klaneček, Andrej Studen, Cveto Šval, Mateja Krajc, 2023, original scientific article Abstract: Background. The evidence shows that risk-based strategy could be implemented to avoid unnecessary harm in mammography screening for breast cancer (BC) using age-only criterium. Our study aimed at identifying the uptake of Slovenian women to the BC risk assessment invitation and assessing the number of screening mammographies in case of risk-based screening.Patients and methods. A cross-sectional population-based study enrolled 11,898 women at the age of 50, invited to BC screening. The data on BC risk factors, including breast density from the first 3,491 study responders was col-lected and BC risk was assessed using the Tyrer-Cuzick algorithm (version 8) to classify women into risk groups (low, population, moderately increased, and high risk group). The number of screening mammographies according to risk stratification was simulated. Results. 57% (6,785) of women returned BC risk questionnaires. When stratifying 3,491 women into risk groups, 34.0% were assessed with low, 62.2% with population, 3.4% with moderately increased, and 0.4% with high 10-year BC risk. In the case of potential personalised screening, the number of screening mammographies would drop by 38.6% com-pared to the current screening policy. Conclusions. The study uptake showed the feasibility of risk assessment when inviting women to regular BC screen-ing. 3.8% of Slovenian women were recognised with higher than population 10-year BC risk. According to Slovenian BC guidelines they may be screened more often. Overall, personalised screening would decrease the number of screening mammographies in Slovenia. This information is to be considered when planning the pilot and assessing the feasibility of implementing population risk-based screening. Keywords: breast cancer screening, personalised screening, risk assessment, mammography Published in DiRROS: 25.07.2024; Views: 117; Downloads: 138
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2. Outcome of MRI-guided vacuum-assisted breast biopsy - initial experience at Institute of Oncology Ljubljana, SloveniaMarta Zebič, Kristijana Hertl, Maksimiljan Kadivec, Miha Čavlek, Gašper Podobnik, Marko Snoj, 2012, original scientific article Abstract: Background. Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to surgical excision and to investigate the outcome of MRI-guided breast biopsy as a function of the MRI features of the lesions. Patients and methods. In 14 women (median age 51 zears) with 14 MRI-detected lesions, MRI-guided vacuum-assisted breast biopsy was performed. We evaluated the MRI findings that led to biopsy and we investigated the core and postoperative histology results and follow-up data. Results. The biopsy was technically successful in 14 (93%) of 15 women. Of 14 biopsies in 14 women, core histology revealed 6 malignant (6/14, 43%), 6 benign (6/14, 43%) and 2 high-risk (2/14, 14%) lesions. Among the 6 cancer 3 were invasive and 3 were ductal carcinoma in situ (DCIS). The probability of malignancy in our experience was higher for non-mass lesion type and for washout and plateau kinetics. Conclusions. Our initial experience confirms that MRI-guided vacuum-assisted biopsy is fast, safe and accurate alternative to surgical biopsy for breast lesions detected at MRI only. Published in DiRROS: 21.03.2024; Views: 276; Downloads: 104
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5. Mamografska tehnika - projekcije in kompresijaKristijana Hertl, Miljeva Rener, 1999, review article Abstract: Vsaka od različnih projekcij pri slikanju dojk doda svoj pomemben delež k prepoznavanju začetnega karcinoma dojke. Zelo pomembna je tudi pravilna in zadostna kompresija pri slikanju dojk. Nepravilno izvedena projekcija in kompresija lahko že ob prvem slikanju zavedeta radiologa k lažno negativnem izvidu, kar pa za ženo pomeni zakasnitev terapije in bistveno poslabša prognozo. Radiološki inženir in radiolog se morata zavedati, da z določeno projekcijo dobro prikažemo samo določene dele dojke. Pogoj za optimalen prikaztkiva dojke je prepoznavanje anatomskih odnosov med prsno steno, pektoralno mišico in žleznim tkivom. Published in DiRROS: 08.12.2023; Views: 440; Downloads: 107
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6. Klinična presoja kakovosti mamogramovMiljeva Rener, Kristijana Hertl, 1999, review article Abstract: Kakovosten mamogram prikaže kar največ tkiva dojke, je primerno ekponiran, kontrasten, ni zabrisan, z nizkim šumom, brez artefaktov in je narejen s sprejemljivo dozo sevanja. Končni videz mamograma je skupek raznih dejavnikov,od katerih so najpomembnejši sodoben mamografski aparat z optimalnonaravnano fotocelico in s sodobnim priborom; posebna pozornost velja postopku razvijanja. Dobro usposobljeno, posebej za to delo izobraženo osebje mora vzdrževati visoko kakovost, to pa pripomore k čim manjšemu številu zgrešenih in zapoznelih diagnoz. Published in DiRROS: 08.12.2023; Views: 411; Downloads: 105
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8. Bolečina pri mamografijiZvonko Krajnc, Brigita Hudales, Andreja Kokot, Kristijana Hertl, Maksimiljan Kadivec, Elizabeta Jokan, 2004, published scientific conference contribution Abstract: Izhodišča. Bolečina pri mamografiji je neprijetrna čutnaa in čustvena izkušnja, povezana z dejansko ali možno okvaro tkiva. Nanjo vplivajo različni dejavniki. Metode. Pri preiskovankah, ki so na Onkološkem inštitutu in po vsejSloveniji opravile mamografijo, smo naredili anketno raziskavo o bolečini pri tej preiskavi. Rezultati. Asimptomatske preiskovanke občutijo manjšo jakost bolečine kot simptomatske. `lečina preiskovank v Sloveniji ne zaužije premedikacije pred mamografijo. Zaključki. Informiranje preiskovank o poteku preiskave in vnaprejšne pričakovanje bolečine je pomembno pri zmanjševanju bolečine. velik vpliv na občutenje bolečine ima tudi radiološki inženir, ki jepo mnenju preiskovank pomembno vplival na zmanjševanje bolečine pri mamografiji. Published in DiRROS: 01.12.2023; Views: 377; Downloads: 121
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9. Intervencijski posegi v dojkahTomaž Vargazon, Miljeva Rener, Kristijana Hertl, 2004, published scientific conference contribution Abstract: Izhodišča. Intervencijske posege v dojkah na Onkološkem inštitutu v Ljubljani opravljajo izključno radiologi. Tako je tudi v drugih ustanovah v svetu. Radiolog-mamolog je osrednja in ključna osebnost multidisciplinarne mamološke strokovne skupine, v kateri so še klinik, patolog, citolog in kirurg. Zaključki. Pri benignih lezijah je danes kirurški poseg odveč. Dokončno diagnozo lahko postavimo že s pravilno izbranim intervencijskim posegom ter sodelovanjem citologa ali patologa. Tudi pred načrtovano operacijo verjetnega malignoma je nujna verifikacija. Published in DiRROS: 01.12.2023; Views: 361; Downloads: 101
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10. Rentgenska in ultrazvočna anatomija dojkeMaja Marolt-Mušič, Kristijana Hertl, Maksimiljan Kadivec, Maja Podkrajšek, Simona Jereb, 2004, published scientific conference contribution Abstract: Izhodišča. Mlečna žleza je parna žleza, ki ima modificirane značilnosti žleze znojnice in se razvije v podkožnem tkivu zgornje sprednje strani prsnega koša.Skupaj s kožo jo imenujemo dojka. Zaključki. V mamografskem izvidu ni pomembno, da natančno opredelimo, kakšne strukturne spremembe so v dojki prisotne, saj te predstavljajo histološko opredelitev. Pomembno je, da v izvidu opišemo, kako gosta je struktura dojke in s tem klinika opozorimo, s kakšno verjetnostjo smo izključili patološke spremembe v smislu malignega obolenja. Pri UZ preiskavi je pomemben standarden položaj preiskovanke, kar omogoča ponovljivost preiskave. Pregledovati moramo vse dele dojke, paziti moramo, da ne izpustimo določenega predela. Pomembno je, da v izvidu označimo lego lezije: kvadrant, ura in oddaljenost od mamile. Published in DiRROS: 01.12.2023; Views: 439; Downloads: 129
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