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Original Report
Characterization of invisible breast cancers in digital mammography and tomosynthesis: Radio-pathological correlation
Caracterización de cánceres de mama sintomáticos invisibles en mamografía digital y tomosíntesis: correlación radiopatológica
P.M. Aguilar Anguloa,
Corresponding author
elaguilapm@gmail.com

Corresponding author.
, C. Romero Castellanoa, J. Ruiz Martínb, M.P. Sánchez-Camacho González-Carratoa, L.M. Cruz Hernándeza
a Sección de Radiología Mamaria, Servicio de Radiodiagnóstico, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain
b Servicio de Anatomía Patológica, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain
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it is not a perfect modality and although it allows us to assess areas where possible lesions may be misdiagnosed in the digital mammograms &#40;DM&#41;&#44; at times&#44; breast cancer can remain invisible in the DM and the TS&#46; Since it is more and more widely used&#44; we need to know more about the advantages and limitations of TS &#40;information on true false negatives in both modalities in medical literature is scarce&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The goal of this work was to analyze the radiopathological characteristics of lesions with histologic diagnosis of breast cancer &#40;detected in patients with breast symptoms&#41; hidden in the DM and the TS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">It is a retrospective study approved by our hospital ethics committee and focused on the descriptive analysis of hidden lesions in the DM and the TS with a histological diagnosis of breast cancer in patients with clinical suspicion&#46; Out of the 387 female patients &#40;both from the early detection program of our hospital and those with breast symptoms&#41; with a diagnosis of breast cancer who were studied using DMs and TS as initial tests in the Breast Radiology Unit between Nov&#46; 2011 and Dec&#46; 2015&#44; 160 patients with symptoms were selected &#40;symptoms such as palpable nodules or indurations&#59; changes in breast size or morphology&#59; retraction or sinking of the nipple skin&#59; nipple discharges&#44; skin abnormalities&#59; presence of axillary adenopathies&#59; and even persistent mastodynia&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patients were studied using the Selenia Dimensions system &#40;Hologic&#44; Bedford&#44; MA&#44; USA&#41;&#46; The protocol used was the COMBO mode capable of acquiring 2D images and one tomosynthesis in one single compression&#59; craniocaudal and mediolateral oblique projections were taken for every breast&#46; As part of the diagnostic process&#44; all cases underwent ultrasound scans with a 12<span class="elsevierStyleHsp" style=""></span>MHz linear probe &#40;Aplio MX&#44; Toshiba Medical Systems&#44; Tokyo&#44; Japan&#41;&#59; MRIs &#40;RM de 1&#46;5 T Avanto&#44; Siemens&#44; Erlangen&#44; Germany&#41;&#59; the acquisition of images included T1 and T2-weighted enhanced sequences&#44; and diffusion and dynamic studies after the administrations of gadolinium&#59; and percutaneous biopsies &#40;low ultrasonography with a 14<span class="elsevierStyleHsp" style=""></span>G tru-cut needle&#41; as additional tests prior to surgical exeresis&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The images acquired and anonymized were part of a database that was reviewed by three &#40;3&#41; different radiologists with exclusive dedication &#40;professional experience of 2&#8211;15 years&#41; and a computed assisted detection system was used&#46; Information such as age&#59; clinical presentation&#59; type of breast density&#59; the BI-RADS category&#44; and the number and type of lesions was gathered as well&#44; and the lesions hidden in the DMs and TS were identified &#40;true false negatives&#41; having&#44; as a reference point&#44; the anatomopathological findings and the MRI findings &#40;misreadings or technical mistakes were discarded&#41;&#46; Eventually&#44; the imaging findings of the lesions selected were consistent with their respective histopathological diagnoses&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">Overall&#44; 169 neoplastic lesions were found in the symptomatic group&#44; and out of all these lesions&#44; seven &#40;7&#41; were selected &#40;4 per cent&#41; in which breast cancer was not visible through the DM or the TS &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; Appendix B video 1&#8211;2&#41;&#46; Two &#40;2&#41; lesions of our series were found in different quadrants of the same breast &#40;multicentric affectation&#41;&#46; The patients&#8217; average age was 47 years old &#40;range&#58; 32&#8211;61 years old&#41;&#44; and the associated symptoms were self-palpation of an area with greater consistency&#44; or a nodule <span class="elsevierStyleItalic">de novo</span>&#46; When it comes to breast density&#44; four &#40;4&#41; lesions were found in high-density breasts &#40;types c and d&#41;&#44; and the rest in type b density breasts &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">When it comes to the remaining imaging modalities&#44; six &#40;6&#41; carcinomas were seen in the ultrasound scan &#40;looking as hypoechogenic masses of irregular BI-RADS 4 morphology&#41;&#44; and in the MRI &#40;mass enhancement with type 2 uptake curves&#44; and average ADC map of 0&#46;68<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;3</span><span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&#47;s &#91;they varied from 0&#46;61 to 0&#46;78<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;3</span><span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&#47;s&#93;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Only one &#40;1&#41; lesion was not detected in the ultrasound scan&#44; but it was identified in the MRI as segmental enhancement &#40;this case was the aforementioned multicenter affectation&#41;&#46; In the MRI tumor size was close to 1<span class="elsevierStyleHsp" style=""></span>cm in three &#40;3&#41; cases &#40;43 per cent&#41;&#44; and &#62;3<span class="elsevierStyleHsp" style=""></span>cm in the remaining cases &#40;57 per cent&#41;&#46; In two &#40;2&#41; small lesions&#44; conservative surgery was performed&#44; and the size of the final piece had a minimal variation &#40;1&#8211;2<span class="elsevierStyleHsp" style=""></span>mm&#41; with respect to the size measure through the MRI&#59; the rest of the group received neoadjuvant therapy prior to exeresis&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">All neoplasms were infiltrating ductal carcinomas &#40;IDC&#41;&#44; four &#40;4&#41; of them were grade 2 tumors according to the Nottingham grading system &#40;moderately differentiated&#41; and two &#40;2&#41; were grade 3 tumors &#40;poorly differentiated&#41;&#46; All biopsies &#40;except for one lesion&#41; confirmed high percentages of tumor stroma with respect to neoplastic cellularity &#40;55&#8211;70 per cent&#41;&#46; With respect to the molecular subtypes surrogate to immunohistochemical markers&#44; only one &#40;1&#41; of the cases was triple negative and the rest were luminal category tumors &#40;5 were luminal B like tumors&#44; and 1 was a luminal A like tumor&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Finally&#44; the tumor margins of the two &#40;2&#41; lesions were intervened without prior chemotherapy&#46; Both were moving masses that did not infiltrate the adjacent breast parenchyma &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Lesions were surrounded by fibrous tissue&#44; or benign proliferative changes &#40;sclerosing adenosis&#41; without direct contact with neighboring fat&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The TS is a modality that&#44; when combined with mammograms&#44; contributes to the detection and characterization of breast cancer&#46; However&#44; this modality has some limitations&#44; and some lesions still do not differentiate breast parenchyma from the rest&#46; According to the medical literature&#44; the rate of false negatives in conventional mammograms goes from 8 to 10 per cent up to 35 per cent&#44;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">8&#44;9</span></a> and some of the causes may be high breast density&#59; a poor technique&#59; perception errors&#59; or incorrect interpretations&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> One of the great contributions of TS is that it helps reduce the effect of structure overlapping&#44; improves visualization and reveals new findings&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Yet despite all these advantages&#44; in our series we found a small percentage &#40;4 per cent&#41; of false negative lesions in the DM and the TS in the group of symptomatic patients after ruling out all possible interpretation errors&#44; and technical mistakes due to our study inclusion criteria&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">When it comes to breast density&#44; 57 per cent of the lesions occurred in high-density breasts&#44; and the remaining ones in low-density breasts &#40;type b&#41;&#46; This was probably due to the fact that there are several factors that may have influenced tumor visualization&#44; such as the presence of a fat plane separating the lesion from the neighboring parenchyma<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a>&#59; the location of the tumor in an area of higher density with respect to the rest of the parenchyma that eclipses the lesion<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a>&#59; or the presence of other signs of suspicion associated with the lesions&#44; such as distortions or microcalcifications&#44; that are necessary for their identification&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">11&#44;13</span></a> Not a single carcinoma showed other signs suggestive of malignancy&#44; and 86 per cent of the masses were undistinguishable from breast tissue in the DMs and TS&#44; with BI-RADS 4 semiological data in the ultrasound scan and the MRI&#46; In our own experience&#44; small size would not be a characteristic of false negatives in DMs and TS with associated clinical presentations&#44; since the size of most of these false negatives &#40;57 per cent&#41; was &#8805;3<span class="elsevierStyleHsp" style=""></span>cm&#44; and all cases &#40;except for one lesion only detected through an MRI&#41; were clinically evident&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">With respect to the anatomopathological findings&#44; all neoplasms of our series were infiltrating ductal carcinomas &#40;most hidden carcinomas were poorly or moderately differentiated&#41;&#46; With respect to the molecular classification&#44; only one &#40;1&#41; lesion was categorized as a triple negative carcinoma and the rest were luminal neoplasms &#40;most luminal B tumors&#41;&#44; something that we also saw in our series&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> This finding would indicate that&#44; when it comes to immunophenotyping&#44; neoplasms misdiagnosed in the DM and the TS would have worse prognosis&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Our study has some limitations such as the low number of hidden lesions&#44; which makes it hard to draw definitive conclusions&#44; the group selected for the analysis &#40;symptomatic neoplasms where the findings reported could only be compared to this group&#41;&#44; and the type of study &#40;retrospective&#44; without case follow-up&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In sum&#44; false negative symptomatic carcinomas in the DM and TS of our small series were basically masses&#59; all lesions were diagnosed as infiltrating ductal carcinomas &#40;predominantly immunophenotype luminal B tumors&#41;&#59; and they were identified in breasts with densities types b&#44; c&#44; and d&#46; We need further studies to specifically analyze the impact of false negatives in diagnostic and screening programs of breast cancer that use digital mammograms and TS&#44; with a special attention to their possible causes&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Ethical disclosures</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Protection of human and animal subjects</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Confidentiality of data</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Right to privacy and informed consent</span><p id="par0195" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Authors</span><p id="par0080" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Manager of the integrity of the study&#58; PMAA&#44; CRC&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Study idea&#58; PMAA&#44; CRC&#44; JRM&#44; MPSCGC&#44; LMCH&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Study design&#58; PMAA&#44; CRC&#44; JRM&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Data mining&#58; PMAA&#44; JRM&#44; MPSCGC&#44; LMCH&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Data analysis and interpretation&#58; PMAA&#44; CRC&#44; JRM&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Statistical analysis&#58; PMAA&#44; CRC&#44; JRM&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Reference&#58; PMAA&#44; MPSCGC&#44; LMCH&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8&#46;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Writing&#58; PMAA&#44; CRC&#44; JRM&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9&#46;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually relevant remarks&#58; PMAA&#44; CRC&#44; JRM&#44; MPSCGC&#44; LMCH&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Approval of final version&#58; PMAA&#44; CRC&#44; JRM&#44; MPSCGC&#44; LMCH&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflict of interests</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests associated with this article whatsoever&#46;</p></span></span>"
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          "clase" => "keyword"
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            0 => "Occult breast carcinoma"
            1 => "False negative"
            2 => "Digital mammography"
            3 => "Digital breast tomosynthesis"
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            0 => "Carcinoma de mama oculto"
            1 => "Falso negativo"
            2 => "Mamograf&#237;a digital"
            3 => "Tomos&#237;ntesis mamaria digital"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To review the radio-pathologic features of symptomatic breast cancers not detected at digital mammography &#40;DM&#41; and digital breast tomosynthesis &#40;DBT&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis of 169 lesions from symptomatic patients with breast cancer that were studied with DM&#44; DBT&#44; ultrasound &#40;US&#41; and magnetic resonance &#40;MR&#41;&#46; We identified occult lesions &#40;true false negatives&#41; in DM and DBT&#46; Clinical data&#44; density&#44; US and MR findings were analyzed as well as histopathological results&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We identified seven occult lesions in DM and DBT&#46; 57 per cent &#40;4&#47;7&#41; of the lesions were identified in high-density breasts &#40;type c and d&#41;&#44; and the rest of them in breasts of density type b&#46; Six carcinomas were identified at US and MR &#40;BI-RADS 4 masses&#41;&#59; the remaining lesion was only identified at MR&#46; The tumor size was larger than 3<span class="elsevierStyleHsp" style=""></span>cm at MRI in 57 per cent of the lesions&#46; All tumors were ductal infiltrating carcinomas&#44; six of them with high stromal proportion&#46; According to molecular classification&#44; we found only one triple-negative breast cancer&#44; the other lesions were luminal-type&#46; We analyzed the tumor margins of two resected carcinomas that were not treated with neoadjuvant chemotherapy&#44; both lesions presented margins that displaced the adjacent parenchyma without infiltrating it&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Occult breast carcinomas in DM and DBT accounted for 4 per cent of lesions detected in patients with symptoms&#46; They were mostly masses&#44; all of them presented the diagnosis of infiltrating ductal carcinoma &#40;with predominance of the luminal immunophenotype&#41; and were detected in breasts of density type b&#44; c and d&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Material and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Revisar las caracter&#237;sticas radiopatol&#243;gicas de carcinomas mamarios sintom&#225;ticos ocultos en mamograf&#237;a digital &#40;MD&#41; y tomos&#237;ntesis &#40;TS&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo de 169 lesiones provenientes de pacientes sintom&#225;ticas con diagn&#243;stico histol&#243;gico de c&#225;ncer de mama y que fueron estudiadas con MD&#44; TS&#44; ecograf&#237;a y resonancia magn&#233;tica &#40;RM&#41;&#46; Se identificaron las lesiones ocultas &#40;falsos negativos verdaderos&#41; en MD y TS&#46; Se analizaron datos cl&#237;nicos&#44; de densidad&#44; los hallazgos con ecograf&#237;a y RM&#44; y la histopatolog&#237;a de las lesiones&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se detectaron siete lesiones neopl&#225;sicas ocultas en MD y TS&#46; El 57&#37; &#40;4&#47;7&#41; se present&#243; en mamas densas &#40;tipo c y d&#41;&#44; y las restantes en mamas de densidad b&#46; Se identificaron seis de los carcinomas por ecograf&#237;a y RM &#40;masas BI-RADS 4&#41;&#59; la lesi&#243;n restante solo se visualiz&#243; en RM&#46; En el 57&#37; de las neoplasias&#44; el tama&#241;o medido con RM fue mayor de 3<span class="elsevierStyleHsp" style=""></span>cm&#46; Todas fueron carcinomas ductales infiltrantes&#44; seis de ellos con alta proporci&#243;n estromal&#46; En cuanto a los subtipos moleculares&#44; solo una fue triple negativo y las dem&#225;s fueron de tipo luminal&#46; Se analizaron los m&#225;rgenes tumorales de dos carcinomas intervenidos sin quimioterapia previa&#44; y ambos presentaban m&#225;rgenes que desplazaban sin infiltrar el par&#233;nquima adyacente&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los carcinomas ocultos en MD y TS representaron el 4&#37; de las lesiones detectadas en pacientes sintom&#225;ticas&#44; fueron mayoritariamente masas&#44; todas tuvieron diagn&#243;stico de carcinoma ductal infiltrante &#40;con predominio del inmunofenotipo luminal&#41; y se detectaron en mamas de densidad tipo b&#44; c y d&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Aguilar Angulo PM&#44; Romero Castellano C&#44; Ruiz Mart&#237;n J&#44; S&#225;nchez-Camacho Gonz&#225;lez-Carrato MP&#44; Cruz Hern&#225;ndez LM&#46; Caracterizaci&#243;n de c&#225;nceres de mama sintom&#225;ticos invisibles en mamograf&#237;a digital y tomos&#237;ntesis&#58; correlaci&#243;n radiopatol&#243;gica&#46; Radiolog&#237;a&#46; 2017&#59;59&#58;511&#8211;515&#46;</p>"
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            "apendice" => "<p id="par0145" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Video 1&#8211;2&#46; Tomosynthesis in craniocaudal and lateral projections of the patient from <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#59; there are no suspicious signs or other significant findings in either of the two &#40;2&#41; cases&#46;<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0040"
          ]
        ]
      ]
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Fifty &#40;50&#41; year old female with indurated area in the outer quadrants of her right breast&#46; 2D digital mammogram of her breast in &#40;a&#41; craniocaudal and &#40;b&#41; lateral projections&#44; of heterogeneous density without findings &#40;BI-RADS 1&#41;&#46;</p>"
        ]
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Ultrasound scan showing one &#40;1&#41; hypoechogenic nodule of poorly established edges close to the patient&#39;s right breast external quadrant juncture&#46; &#40;b&#41; Breast MRI&#58; coronal image showing mass enhancement &#40;15<span class="elsevierStyleHsp" style=""></span>mm&#41; consistent with the nodule described by the ultrasounds scan&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Histology of the studied lesion &#40;after surgical exeresis&#41;&#44; with a diagnosis of well-differentiated infiltrating adenocarcinoma mixed with non-neoplastic ducts and lobules&#44; with presence of well-established fibrous edge&#44; and pushing margins &#40;arrows&#41; separating the fat &#40;HE&#44; 2&#215;&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">IDC&#58; infiltrating ductal carcinoma&#59; NA&#58; non applicable&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lesion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Breast density&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ultrasound finding&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">MRI enhancement&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Size in the MRI &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Anatomopathological diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Histologic grade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stroma&#47;cellularity ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">d&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">d&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nodule&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mass&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;triple negative&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Segmental&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IDC &#40;luminal B&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 per cent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                    0 => array:2 [
                      "titulo" => "Effectiveness of digital breast tomosynthesis compared with digital mammography&#58; outcomes analysis from 3 years of breast cancer screening"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;S&#46; McDonald"
                            1 => "A&#46; Ustinov"
                            2 => "S&#46;P&#46; Weinstein"
                            3 => "M&#46;B&#46; Synnestvedt"
                            4 => "M&#46; Schnall"
                            5 => "E&#46;F&#46; Conant"
                          ]
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                      "doi" => "10.1001/jamaoncol.2015.5536"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Oncol"
                        "fecha" => "2016"
                        "volumen" => "2"
                        "paginaInicial" => "737"
                        "paginaFinal" => "743"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26893205"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0085"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breast cancer screening using tomosynthesis in combination with digital mammography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Friedewald"
                            1 => "E&#46;A&#46; Rafferty"
                            2 => "S&#46;L&#46; Rose"
                            3 => "M&#46;A&#46; Durand"
                            4 => "D&#46;M&#46; Plecha"
                            5 => "J&#46;S&#46; Greenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2014.6095"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2014"
                        "volumen" => "311"
                        "paginaInicial" => "2499"
                        "paginaFinal" => "2507"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25058084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
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              "etiqueta" => "3"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Skaane"
                            1 => "A&#46;I&#46; Bandos"
                            2 => "R&#46; Gullien"
                            3 => "E&#46;B&#46; Eben"
                            4 => "U&#46; Ekseth"
                            5 => "U&#46; Haakenaasen"
                          ]
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                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.12121373"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2013"
                        "volumen" => "267"
                        "paginaInicial" => "47"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23297332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0095"
              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening for dense breasts&#58; digital breast tomosynthesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;V&#46; Destounis"
                            1 => "R&#46; Morgan"
                            2 => "A&#46; Arieno"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/AJR.14.13554"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "2015"
                        "volumen" => "204"
                        "paginaInicial" => "261"
                        "paginaFinal" => "264"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25615747"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0100"
              "etiqueta" => "5"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Digital breast tomosynthesis &#40;DBT&#41;&#58; initial experience in a clinical setting"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "R&#46; Gullien"
                            2 => "H&#46; Bj&#248;rndal"
                            3 => "E&#46;B&#46; Eben"
                            4 => "U&#46; Ekseth"
                            5 => "U&#46; Haakenaasen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/ar.2012.120062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Radiol"
                        "fecha" => "2012"
                        "volumen" => "53"
                        "paginaInicial" => "524"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22593120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0105"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; Zuley"
                            1 => "A&#46;I&#46; Bandos"
                            2 => "M&#46;A&#46; Ganott"
                            3 => "J&#46;H&#46; Sumkin"
                            4 => "A&#46;E&#46; Kelly"
                            5 => "V&#46;J&#46; Catullo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.12120552"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2013"
                        "volumen" => "266"
                        "paginaInicial" => "89"
                        "paginaFinal" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23143023"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tomosynthesis in the diagnostic setting&#58; changing rates of BI-RADS final assessment over time"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Raghu"
                            1 => "M&#46;A&#46; Durand"
                            2 => "L&#46; Andrejeva"
                            3 => "A&#46; Goehler"
                            4 => "M&#46;H&#46; Michalski"
                            5 => "J&#46;L&#46; Geisel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2016151999"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2016"
                        "volumen" => "281"
                        "paginaInicial" => "54"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27139264"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breast Cancer Detection Demonstration Project&#58; five-year summary report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;H&#46; Baker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin"
                        "fecha" => "1982"
                        "volumen" => "32"
                        "paginaInicial" => "194"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6805867"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Previous mammograms in patients with impalpable breast carcinoma&#58; retrospective vs blinded interpretation&#46; 1993 ARRS President&#39;s Award"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Harvey"
                            1 => "L&#46;L&#46; Fajardo"
                            2 => "C&#46;A&#46; Innis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.161.6.8249720"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "1993"
                        "volumen" => "161"
                        "paginaInicial" => "1167"
                        "paginaFinal" => "1172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8249720"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Missed breast carcinoma&#58; pitfalls and pearls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;S&#46; Majid"
                            1 => "E&#46;S&#46; de Paredes"
                            2 => "R&#46;D&#46; Doherty"
                            3 => "N&#46;R&#46; Sharma"
                            4 => "X&#46; Salvador"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.234025083"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiographics"
                        "fecha" => "2003"
                        "volumen" => "23"
                        "paginaInicial" => "881"
                        "paginaFinal" => "895"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12853663"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital breast tomosynthesis&#58; a better mammogram"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;B&#46; Kopans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2013"
                        "volumen" => "267"
                        "paginaInicial" => "968"
                        "paginaFinal" => "969"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23844423"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital breast tomosynthesis in the diagnostic setting&#58; indications and clinical applications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46;R&#46; Peppard"
                            1 => "B&#46;E&#46; Nicholson"
                            2 => "C&#46;M&#46; Rochman"
                            3 => "J&#46;K&#46; Merchant"
                            4 => "R&#46;C&#46; Mayo 3rd"
                            5 => "J&#46;A&#46; Harvey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.2015140204"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiographics"
                        "fecha" => "2015"
                        "volumen" => "35"
                        "paginaInicial" => "975"
                        "paginaFinal" => "990"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26024062"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0140"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital breast tomosynthesis&#58; lessons learned from early clinical implementation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;G&#46; Roth"
                            1 => "A&#46;D&#46; Maidment"
                            2 => "S&#46;P&#46; Weinstein"
                            3 => "S&#46;O&#46; Roth"
                            4 => "E&#46;F&#46; Conant"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.344130087"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiographics"
                        "fecha" => "2014"
                        "volumen" => "34"
                        "paginaInicial" => "E89"
                        "paginaFinal" => "E102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25019451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0145"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Missed breast cancer by digital mammography and tomosynthesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Pinochet"
                            1 => "E&#46; Horvath"
                            2 => "M&#46;P&#46; Rochels"
                            3 => "C&#46;S&#46; Silva Fuente-Alba"
                            4 => "M&#46; Uchida"
                            5 => "M&#46;P&#46; Duran Caro"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "titulo" => "Scientific presentation at&#58; 2015 Annual Meeting of the Radiological Society of North America"
                        "conferencia" => "Chicago"
                        "serieFecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0150"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular classification of infiltrating breast cancer&#58; toward personalized therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Trop"
                            1 => "S&#46;M&#46; LeBlanc"
                            2 => "J&#46; David"
                            3 => "L&#46; Lalonde"
                            4 => "D&#46; Tran-Thanh"
                            5 => "M&#46; Labelle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/rg.345130049"
                      "Revista" => array:6 [
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                        "fecha" => "2014"
                        "volumen" => "34"
                        "paginaInicial" => "1178"
                        "paginaFinal" => "1195"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25208275"
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