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OBJECTIVES: To validate the performance of Mirai, a mammography-based deep learning model, in predicting breast cancer risk over a 1-5-year period in Mexican women. METHODS: This retrospective single-center study included mammograms in Mexican women who underwent screening mammography between January 2014 and December 2016. For women with consecutive mammograms during the study period, only the initial mammogram was included. Pathology and imaging follow-up served as the reference standard. Model performance in the entire dataset was evaluated, including the concordance index (C-Index) and area under the receiver operating characteristic curve (AUC). Mirai's performance in terms of AUC was also evaluated between mammography systems (Hologic versus IMS). Clinical utility was evaluated by determining a cutoff point for Mirai's continuous risk index based on identifying the top 10% of patients in the high-risk category. RESULTS: Of 3110 patients (median age 52.6 years ± 8.9), throughout the 5-year follow-up period, 3034 patients remained cancer-free, while 76 patients developed breast cancer. Mirai achieved a C-index of 0.63 (95% CI: 0.6-0.7) for the entire dataset. Mirai achieved a higher mean C-index in the Hologic subgroup (0.63 [95% CI: 0.5-0.7]) versus the IMS subgroup (0.55 [95% CI: 0.4-0.7]). With a Mirai index score > 0.029 (10% threshold) to identify high-risk individuals, the study revealed that individuals in the high-risk group had nearly three times the risk of developing breast cancer compared to those in the low-risk group. CONCLUSIONS: Mirai has a moderate performance in predicting future breast cancer among Mexican women. CRITICAL RELEVANCE STATEMENT: Prospective efforts should refine and apply the Mirai model, especially to minority populations and women aged between 30 and 40 years who are currently not targeted for routine screening. KEY POINTS: The applicability of AI models to non-White, minority populations remains understudied. The Mirai model is linked to future cancer events in Mexican women. Further research is needed to enhance model performance and establish usage guidelines.

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BACKGROUND: Fibroadenoma (FA) is the most common tumor found in young women, although it can occur in any age group. Ductal carcinoma in situ (DCIS) that is confined in a FA is rare; it is most frequently reported as an incidental finding. CASE SUMMARY: We report a case of DCIS within a FA in a 46-year-old female without cancer-related personal and family histories. The patient was diagnosed with a breast conglomerate of nodules and was followed for 1 year. In the current control image study, we found suspicious microcalcification, as a new finding, within one of the nodules. Consequently, a core biopsy of the tumor, which appeared hypoechoic, oval, and circumscribed, was performed. The pathological diagnosis was ductal carcinoma in situ within a fibroepithelial lesion. The patient underwent breast-conserving surgery and received radiotherapy as well as endocrine therapy (tamoxifen). CONCLUSION: We recommend a multidisciplinary approach for adequate treatment and follow-up.

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INTRODUCTION: Mucinous carcinoma is a variant of invasive breast carcinomas that accounts for 2% of them and has a better prognosis in contrast to the non-specific invasive carcinoma. They regularly are positive for estrogen and progesterone receptors and, generally, they do not overexpress HER2. When HER2 is positive, the first line treatment is trastuzumab; although the resistance is 52-89% for the non-specific carcinoma, it has been described just once in mucinous carcinoma. CASE SUMMARY: A 48-year-old female presented with a lump in her right breast and after a biopsy, it was diagnosed as mucinous carcinoma in the core biopsy and surgical resection, with positive hormone receptors and HER2 positive (3+) in 100% of the tumor cells. She was treated with neoadjuvant chemotherapy based on trastuzumab and pertuzumab with no pathological response. DISCUSSION: There are few pure mucinous carcinomas positive for HER2. Mucinous carcinomas are positive for HER2 account for less than 5% of invasive ductal carcinoma. Furthermore, our case was resistance to chemotherapy. Most mucinous carcinomas test negative for HER2, so they usually would not be treated with trastuzumab, in this case because the expression of HER2 in the biopsies we initiated it. CONCLUSION: It's important to know that cases of mucinous carcinoma positive for HER2 exist and to be aware of the clinical problems that they may present: resistance to trastuzumab. Also, we need to understand the responsible mechanisms of this resistance and use immunohistochemistry for MUC which may predict it.

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BACKGROUND: Early detection of lobular cancer has for long implied a challenge for diagnostic imaging due to the peculiar histology it presents that makes clinical and radiology detection rather difficult. OBJECTIVE: The aim of our study was to compare the sensitivity and specificity of mammography and ultrasound for the diagnosis of invasive breast lobular carcinoma. MATERIAL AND METHODS: This is a retrospective study of women with histopathological diagnosis of invasive breast lobular carcinoma in the period between September 2006 and August 2009. All patients underwent mammography and ultrasound. The final pathology report was used as reference standard and the sensitivity and specificity of mammography and ultrasound were evaluated statistically using chi-square test (chi2). RESULTS: The analysis included 654 patients who underwent biopsy. Among them, 148 (22.62%) were positive and 506 (77.37%) negative for cancer. The average age was 48 years (range 18-89). The sensitivity of ultrasound was higher in the group of invasive lobular cancer (ILC) in 14/14 (100%) cases, in contrast to 87/111 (78%) cases of invasive ductal carcinoma (IDC) and 9/18 (50 %) cases of ductal carcinoma in situ (DCIS). The mammography showed greater sensitivity in the group of DCIS in 17/18 (94%) cases, unlike 9/14 (64%) cases of ILC and 89/111 (80%) cases of IDC. CONCLUSIONS: Ultrasound improves the detection of ILC with sensitivity up to 100% compared to 64% by mammography. The combination of both diagnostic tests showed sensitivity equal to the ultrasound, but it decreased 30% the specificity in this group.

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Los autores valoran la eficacia del Ultrasonido para el diagnóstico y etapificación de lesiones del manguito rotador. El estudio se llevó cabo en forma prospectiva y longitudinal, en pacientes con diagnóstico de hombro doloroso, en quienes realizaron un examen pasivo y lo compararon con el hombro contralateral. Se estudiaron 42 pacientes, en 29 de los cuales se comparó el resultado con el de la cirugía y en 24 con la Resonancia Magnética. Las lesiones se clasificaron de acuerdo a los criterios de Wiener y Seitz, la que permite el conocimiento de la extensión del daño y correlacionarlo con el encontrado en la cirugía. Los resultados de Ultrasonido concordaron con los de la cirugía en 28/29 pacientes, obteniendo valores de significancia 0.0001, lo que demuestra que el ultrasonido es un método confiable y seguro para el abordaje del paciente con hombro doloroso

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Se practicó RM a 35 pacientes con diagnóstico de disrrafismo espinal en los cuales se logró determinar la localización exacta de los defectos como espina bifida o meningocele, además se definió su extensión y las patologías asociadas como el lipoma, la siringomielia, la distematomielia, médula anclada, así como la malformación de Arnold Chiari. Se considera que la RM es el método de elección en los pacientes con disrrafismo espinal, debido a que es un método no invasivo, multiplanar y que permite delimitar los defectos de la línea media de manera precisa

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El síndrome de Gorlin se caracteriza por la presencia de múltiples carcinomas nevoides de células basaloides, quistes mandibulares y displasias vertebrales y costales múltiples. Se hace una revisión de los hallazgos radiológicos y los aspectos clínicos más importantes de esta enfermedad

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