Breast Cancer Screening and Diagnosis: A Synopsis
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This book presents the current trends and practices in breast imaging. Topics include mammographic interpretation; breast ultrasound; breast MRI; management of the symptomatic breast in young, pregnant and lactating women; breast intervention with imaging pathological correlation; the postoperative breast and current and emerging technologies in breast imaging. It emphasizes the importance of fostering a multidisciplinary approach in the diagnosis and treatment of breast diseases. Featuring more than 800 high-resolution images and showcasing contributions from leading authorities in the screening, diagnosis and management of the breast cancer patient, Breast Cancer Screening and Diagnosis is a valuable resource for radiologists, oncologists and surgeons.
9.4 Demonstration of different margins of masses 185 186 Fig. 9.5 Demonstration of different internal enhancement patterns of masses Fig. 9.6 A T2 or STIR bright mass demonstrates dark and non-enhancing septations (arrows), a benign sign that is highly correlated with a fibroadenoma. STIR (short T1 inversion recovery) and SUB (post-contrast subtraction) images Fig. 9.7 Examples of patterns of distribution of NMLE lesions R.H. El Khouli et al. 187 9 Breast MRI for Diagnosis
2005;103(1):44–51. 81. Narod SA, et al. Tamoxifen and risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers: a case-control study. Hereditary Breast Cancer Clinical Study Group. Lancet. 2000;356(9245):1876–81. 82. Gronwald J, et al. Tamoxifen and contralateral breast cancer in BRCA1 and BRCA2 carriers: an update. Int J Cancer. 2006;118(9): 2281–4. 83. Phillips KA, et al. Tamoxifen and Risk of Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. J Clin Oncol.
systematic search and review of studies involving mammography and ultrasound performed for screening of breast cancer found 6 cohort studies, of which only two had followup on patients with negative or benign findings. Screening ultrasound performed in women with American College of Radiology breast density types 2–4 identified primarily invasive cancers in 0.32 % of women. The mean tumor size was 9.9 mm, and 90 % of the cancers were node negative. Biopsy rate was high at 2.3–4.7 %, with positive
a solid hypoechoic mass with ill-defined and microlobulated borders suggestive of malignancy 97 (Fig. 5.5a, b). Architectural distortion when unassociated with other findings such as masses or clustered calcifications can be often subtle and accounts for a significant number of missed breast cancers; a discussion on missed cancers appears later. Architectural distortion is less common than a mass as a mammographic sign of breast cancer but is highly predictive of breast cancer both at screening
of six descriptors in the BI-RADS-US lexicon for a mass that is visible in two projections (Table 7.1). The shape of a mass is described as being oval, round, or when neither as irregular. The orientation of the lesion is noted as being parallel to the skin surface indicating a horizontal orientation or as being not parallel, meaning in a M.K. Shetty, MD, FRCR, FACR, FAIUM Department of Radiology, Baylor College of Medicine, Houston, TX, USA Woman’s Center for Breast Care and MRI, Woman’s