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    Breast Diseases

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    Martin Amores
    This document provides an overview of normal breast anatomy and mammographic views, as well as descriptions of common breast findings seen on mammography. It includes schematics and images showing normal mediolateral oblique and craniocaudal views. Characteristics of heterogeneously dense breast parenchyma are described. The four categories of breast density and types of asymmetries and architectural distortions are outlined. Benign and malignant skin changes are differentiated. Features of breast masses including shape, density and margin characteristics are defined.

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    Breast Diseases

    Uploaded by

    Martin Amores
    24 views41 pages
    This document provides an overview of normal breast anatomy and mammographic views, as well as descriptions of common breast findings seen on mammography. It includes schematics and images showing normal mediolateral oblique and craniocaudal views. Characteristics of heterogeneously dense breast parenchyma are described. The four categories of breast density and types of asymmetries and architectural distortions are outlined. Benign and malignant skin changes are differentiated. Features of breast masses including shape, density and margin characteristics are defined.

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    BREAST-DISEASES

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    This document provides an overview of normal breast anatomy and mammographic views, as well as descriptions of common breast findings seen on mammography. It includes schematics and images showing normal mediolateral oblique and craniocaudal views. Characteristics of heterogeneously dense breast parenchyma are described. The four categories of breast density and types of asymmetries and architectural distortions are outlined. Benign and malignant skin changes are differentiated. Features of breast masses including shape, density and margin characteristics are defined.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views41 pages

    Breast Diseases

    Uploaded by

    Martin Amores
    This document provides an overview of normal breast anatomy and mammographic views, as well as descriptions of common breast findings seen on mammography. It includes schematics and images showing normal mediolateral oblique and craniocaudal views. Characteristics of heterogeneously dense breast parenchyma are described. The four categories of breast density and types of asymmetries and architectural distortions are outlined. Benign and malignant skin changes are differentiated. Features of breast masses including shape, density and margin characteristics are defined.

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    ROUTINE MAMMOGRAPHIC VIEWS

    Normal breast anatomy and correlative mammograms. (A) Schematic of a normal


    mediolateral oblique (MLO) mammogram. Note the normal scalloped edge of
    glandular tissue, retromammary fat, concave pectoralis muscle, and normal lymph
    nodes. (B) Normal MLO mammogram.
    (A) Schematic of a normal craniocaudal (CC) mammogram. Note the normal fat in the
    medial and retroglandular regions and the location of the pectoralis muscles. Most of
    the residual glandular tissue and the sternalis muscle remain in the upper outer
    quadrants. (B) Normal CC mammogram.
    Heterogeneously dense
    breast parenchyma. There
    are no masses, any
    suspicious microcalcifications
    nor architectural distortion.
    Axillary nodes are not visible.
    Heterogeneously dense breast
    parenchyma. There are no
    masses, any suspicious
    microcalcifications nor
    architectural distortion.
    Axillary nodes are not visible.
    Category A: Breasts are almost all fatty
    tissue.
    Category B: There are scattered areas of
    dense glandular and fibrous tissue (seen
    as white areas on the mammogram).
    More of the breast is made of dense
    glandular and fibrous tissue
    (described as heterogeneously dense).
    This can make it hard to see small masses
    in or around the dense tissue, which also
    appear as white areas.
    Category D: Breasts are extremely dense,
    which makes it harder to see masses or
    other findings that may appear as white
    areas on the mammogram.
    ASYMETRY
    • SIZE- difference in the right and left
    breast
    • FOCAL- unilateral, localized area of
    parenchyma
    • GLOBAL – difference in the amount of
    parenchyma between right and left
    breast
    ARCHITECTURAL DISTORTION
    • Focal interruption of the normal mammographic
    pattern of lines (converging at the nipple), usually
    presenting a star shaped pattern
    • MAMMOGRAPHIC FINDINGS: star shaped
    distortion of the normal parenchymal structure,
    center may be radiolucent, occasionally associated
    with microcalcifications, spot compression view is
    recommended
    SKIN CHANGES
    • BENIGN ORIGIN
    -calcifications of the sebaceous glands
    -deodorants containing zinc (radiopaque particles
    containing zinc are on MLO
    -powder particles containing calcium or aluminum
    (inframammary crease)
    -skin thickening (after radiotherapy or acute mastitis)
    -skin retraction ( seen postoperatively or in Mondor
    Disease)
    -nipple retraction (seen postoperatively)
    -skin changes appearing as masses ( moles, warts,
    sebaceous cysts, neurofibromatosis)
    Sebaceous cysts. A: Left MLO view
    photographically coned to upper aspect of the
    image. A round, dense mass (arrow) is imaged
    in the axilla correlating to a “lump” described
    by the patient. B: Spot tangential view. A round
    dense mass with circumscribed margins is
    imaged associated with the dermis, focally
    thickened at this site. This is a nice illustration
    of how useful the spot tangential can be in
    localizing lesions to the skin
    USE OF DEODORANTS
    SKIN CHANGES
    • MALIGNANT ORIGIN
    -skin thickening(inflammatory breast cancer,
    tumor infiltration)
    -skin retraction (pulling in of skin by coppers
    ligaments)
    -nipple retraction (pulling in of skin by coopers
    ligaments)
    -nipple flattening (paget’s disease)
    -enlarged skin pores (may be seen in lymphedema
    or in inflammatory breast CA
    MASS, SHAPE
    • Space occupying lesion seen in two different
    projections
    • Descriptive criteria are: mass, density, margins
    SHAPE
    • Round – spherical, ball shaped (cyst,
    hamartoma)
    • Oval- elliptical or egg shaped (fibroadenoma)
    • Lobulated – mass with undulated contours
    (up to 3)
    • Irregular – shape cannot be characterized
    MARGIN
    • Circumscribed- sharply demarcated, occasional
    halo sign
    • Micro lobulated-lesion margins undulate within a
    short distance of a few millimeters ( medullary
    breast CA)
    • Obscured-superimposed
    • Indistinct – poorly defined, transition between
    lesion and surrounding tissues is gradual
    • Spiculated- lines radiating from the margins of a
    mass (tubular breast CA, post operative scar)
    OBSCURED
    INDISTINCT
    MICROLOBULATED
    SPICULATED

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