Diagnostic Imaging: Breast

1. Cover image - p. Cover 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iii 5. Dedications - p. iii 6. Contributing Authors - p. v 7. Foreword - p. v 8. Preface - p. ix 9. Acknowledgments - p. x 10. Sections - p. xi 11. Abbreviations Index - p. xv 12. SECTION 1: ANATOMY AND NORMAL VARIANTS - p. xxviii 13. ANATOMY - p. xxviii 14. Chapter 1: Breast Overview - p. xxviii 15. Chapter 2: Embryology and Normal Development - p. 7 16. Chapter 3: Segmental Anatomy - p. 15 17. Chapter 4: Nipple-Areolar Complex and Skin - p. 19 18. Chapter 5: Neurovascular Supply - p. 25 19. Chapter 6: Lymph Nodes and Lymphatics - p. 33 20. Chapter 7: Axilla - p. 41 21. Chapter 8: Pectoralis Muscle and Chest Wall - p. 47 22. NORMAL VARIANTS - p. 53 23. Chapter 9: Axillary Breast Tissue - p. 53 24. Chapter 10: Pectoralis Muscle and Chest Wall Variants - p. 57 25. Chapter 11: Sternalis Muscle - p. 61 26. SECTION 2: IMAGING - p. 67 27. BREAST IMAGING OVERVIEW - p. 67 28. Chapter 12: Approach to Screening - p. 67 29. Chapter 13: Screening Mammography - p. 75 30. Chapter 14: Diagnostic Mammography - p. 81 31. Chapter 15: Mammography Positioning - p. 87 32. Chapter 16: Tomosynthesis - p. 91 33. Chapter 17: Breast Density - p. 97 34. Chapter 18: Ultrasound - p. 103 35. Chapter 19: Magnetic Resonance Imaging - p. 109 36. Chapter 20: Interval Cancers - p. 115 37. Chapter 21: Missed Cancers - p. 121 38. SPECIAL TOPICS IN SCREENING AND DIAGNOSTIC IMAGING - p. 127 39. Chapter 22: Screening at Age Extremes (< 40, > 70 Years) - p. 127 40. Chapter 23: Screening in 5th Decade (40-49 Years) - p. 131 41. Chapter 24: Screening Intervals: Annual vs. Biennial - p. 135 42. Chapter 25: Screening Ultrasound - p. 139 43. Chapter 26: Automated Breast Ultrasound - p. 145 44. Chapter 27: Elastography - p. 149 45. Chapter 28: Risk Assessment Models - p. 153 46. Chapter 29: Indications and Management of Genetic Testing - p. 157 47. Chapter 30: *BRCA1* and *BRCA2* Mutation Carriers - p. 161 48. Chapter 31: Screening MR - p. 167 49. Chapter 32: Abbreviated Breast MR - p. 171 50. Chapter 33: Diffusion-Weighted Imaging (MR) - p. 175 51. Chapter 34: MR Spectroscopy - p. 179 52. Chapter 35: CAD and Double Reading: Mammography and Tomosynthesis - p. 181 53. Chapter 36: Contrast-Enhanced Mammography - p. 185 54. Chapter 37: Molecular Breast Imaging (MBI and BSGI) - p. 189 55. Chapter 38: Dedicated Breast PET (PEM) - p. 195 56. Chapter 39: PET/CT - p. 201 57. SECTION 3: INTERPRETIVE CRITERIA - p. 205 58. Chapter 40: Approach to Lexicons of Breast Imaging - p. 205 59. Chapter 41: Mammography BI-RADS Lexicon and Usage - p. 213 60. Chapter 42: Probably Benign Lesions - p. 217 61. Chapter 43: Ultrasound BI-RADS Lexicon and Usage - p. 223 62. Chapter 44: MR BI-RADS Lexicon and Usage - p. 227 63. Chapter 45: Molecular Breast Imaging Lexicon (Includes BSGI) - p. 231 64. Chapter 46: Breast PET Lexicon and Usage - p. 237 65. SECTION 4: LESION IMAGING CHARACTERISTICS - p. 243 66. MASSES - p. 243 67. Chapter 47: Circumscribed and Obscured Margins - p. 243 68. Chapter 48: Fat-Containing Mass - p. 251 69. Chapter 49: High-Density Mass - p. 257 70. Chapter 50: Indistinct Margins - p. 261 71. Chapter 51: Intramammary Lymph Node - p. 265 72. Chapter 52: Microlobulated Margins - p. 269 73. Chapter 53: Spiculated Margins - p. 273 74. CALCIFICATIONS, TYPICALLY BENIGN - p. 277 75. Chapter 54: Typically Benign Calcifications - p. 277 76. Chapter 55: Round Calcifications - p. 283 77. Chapter 56: Milk of Calcium - p. 287 78. CALCIFICATIONS, NOT TYPICALLY BENIGN - p. 291 79. Chapter 57: Punctate Calcifications - p. 291 80. Chapter 58: Amorphous Calcifications - p. 295 81. Chapter 59: Coarse Heterogeneous Calcifications - p. 299 82. Chapter 60: Fine Pleomorphic Calcifications - p. 303 83. Chapter 61: Fine Linear Calcifications - p. 307 84. CALCIFICATION DISTRIBUTION - p. 313 85. Chapter 62: Diffuse Distribution of Calcifications - p. 313 86. Chapter 63: Grouped Distribution of Calcifications - p. 317 87. Chapter 64: Regional Distribution of Calcifications - p. 323 88. Chapter 65: Linear Distribution of Calcifications - p. 329 89. Chapter 66: Segmental Distribution of Calcifications - p. 335 90. ADDITIONAL FINDINGS - p. 341 91. Chapter 67: Architectural Distortion - p. 341 92. Chapter 68: Asymmetries - p. 347 93. Chapter 69: Developing Asymmetry - p. 353 94. Chapter 70: Duct Ectasia - p. 357 95. Chapter 71: Multiple Bilateral Similar Findings - p. 361 96. Chapter 72: One-View-Only Findings - p. 367 97. Chapter 73: Solitary Dilated Duct - p. 373 98. Chapter 74: Trabecular Thickening, Edema - p. 377 99. ULTRASOUND LESION CHARACTERISTICS - p. 383 100. Chapter 75: Calcifications (US) - p. 383 101. Chapter 76: Clustered Microcysts (US) - p. 389 102. Chapter 77: Complex Cystic and Solid Masses (US) - p. 395 103. Chapter 78: Complicated Cyst With Debris (US) - p. 401 104. Chapter 79: Cyst, Simple (US) - p. 407 105. Chapter 80: Echogenicity: Anechoic (US) - p. 411 106. Chapter 81: Echogenicity: Hyperechoic (US) - p. 415 107. Chapter 82: Echogenicity: Hypoechoic (US) - p. 421 108. Chapter 83: Echogenicity: Isoechoic (US) - p. 425 109. Chapter 84: Echogenic Rim (US) - p. 429 110. Chapter 85: Echogenicity: Heterogeneous/Mixed (US) - p. 433 111. Chapter 86: Intraductal Mass (US) - p. 437 112. Chapter 87: Lesion Orientation (US) - p. 443 113. Chapter 88: Margins, Not Circumscribed (US) - p. 449 114. Chapter 89: Posterior Features (US) - p. 453 115. MR FINDINGS - p. 459 116. Chapter 90: Background Parenchymal Enhancement (MR) - p. 459 117. Chapter 91: Kinetic Assessment (MR) - p. 463 118. Chapter 92: T2 Hyperintensity (MR) - p. 469 119. Chapter 93: Dark Internal Septations (MR) - p. 475 120. Chapter 94: Focus (MR) - p. 479 121. Chapter 95: Focal Area, Regional, and Diffuse Enhancement (MR) - p. 483 122. Chapter 96: Clumped and Clustered Ring Enhancement (MR) - p. 489 123. Chapter 97: Linear Enhancement (MR) - p. 495 124. Chapter 98: Segmental Enhancement (MR) - p. 499 125. Chapter 99: Rim Enhancement (MR) - p. 503 126. SECTION 5: HISTOPATHOLOGIC DIAGNOSES - p. 509 127. Chapter 100: Approach to Histopathologic Diagnoses - p. 509 128. Chapter 101: Imaging-Histopathologic Discordance - p. 519 129. BENIGN LESIONS - p. 525 130. Chapter 102: Adenosis, Sclerosing Adenosis, Microglandular Adenosis - p. 525 131. Chapter 103: Apocrine Metaplasia - p. 531 132. Chapter 104: Columnar Cell Lesions - p. 537 133. Chapter 105: Cyst, Ruptured/Inflamed - p. 541 134. Chapter 106: Fat Necrosis, Oil Cyst - p. 545 135. Chapter 107: Fibroadenoma - p. 551 136. Chapter 108: Fibroadenomatoid Change - p. 557 137. Chapter 109: Fibrocystic Change - p. 561 138. Chapter 110: Fibrosis - p. 567 139. Chapter 111: Hamartoma (Fibroadenolipoma) - p. 571 140. Chapter 112: Hematoma - p. 577 141. Chapter 113: Lipoma and Angiolipoma - p. 583 142. Chapter 114: Papilloma, Benign - p. 589 143. Chapter 115: PASH - p. 593 144. Chapter 116: Radial Scar, Radial Sclerosing Lesions - p. 597 145. Chapter 117: Tubular Adenoma and Nipple Adenoma - p. 603 146. RISK LESIONS - p. 607 147. Chapter 118: Atypical Ductal Hyperplasia - p. 607 148. Chapter 119: Atypical Lobular Hyperplasia - p. 613 149. Chapter 120: Atypical Papilloma - p. 617 150. Chapter 121: Flat Epithelial Atypia - p. 621 151. Chapter 122: Lobular Carcinoma In Situ, Classic - p. 623 152. Chapter 123: Lobular Carcinoma In Situ, Pleomorphic - p. 629 153. Chapter 124: Mucocele-Like Lesions - p. 633 154. LOCALLY AGGRESSIVE LESIONS - p. 635 155. Chapter 125: Fibromatosis - p. 635 156. Chapter 126: Granular Cell Tumor - p. 641 157. Chapter 127: Myoepithelial Neoplasms - p. 645 158. Chapter 128: Myofibroblastoma - p. 649 159. Chapter 129: Phyllodes Tumor: Benign - p. 653 160. Chapter 130: Phyllodes Tumor: Borderline and Malignant - p. 659 161. MALIGNANT LESIONS - p. 665 162. Chapter 131: Adenoid Cystic Carcinoma - p. 665 163. Chapter 132: Apocrine Carcinoma - p. 669 164. Chapter 133: DCIS, General - p. 673 165. Chapter 134: DCIS, Low Grade - p. 677 166. Chapter 135: DCIS, Intermediate Grade - p. 681 167. Chapter 136: DCIS, High Grade - p. 685 168. Chapter 137: DCIS, Micropapillary - p. 689 169. Chapter 138: Encapsulated Papillary Carcinoma - p. 693 170. Chapter 139: HER2-Positive Cancer - p. 697 171. Chapter 140: Invasive Ductal Carcinoma NST, Grade 1, 2, 3 - p. 703 172. Chapter 141: Invasive Lobular Carcinoma, Classic - p. 709 173. Chapter 142: Invasive Lobular Carcinoma, Pleomorphic - p. 715 174. Chapter 143: Invasive Micropapillary Carcinoma - p. 719 175. Chapter 144: Luminal A and B Cancers - p. 723 176. Chapter 145: Lymphoma, Primary Breast - p. 729 177. Chapter 146: Medullary Carcinoma - p. 735 178. Chapter 147: Metaplastic Carcinoma - p. 739 179. Chapter 148: Mixed Invasive Ductal and Lobular Carcinoma - p. 745 180. Chapter 149: Mucinous Carcinoma - p. 749 181. Chapter 150: Papillary Carcinoma, Invasive - p. 755 182. Chapter 151: Sarcomas - p. 759 183. Chapter 152: Triple-Negative and Basal-Like Breast Cancer - p. 765 184. Chapter 153: Tubular and Tubulolobular Carcinoma - p. 769 185. SECTION 6: SIGNS AND SYMPTOMS - p. 775 186. Chapter 154: Approach to Signs and Symptoms of Disease - p. 775 187. NIPPLE - p. 781 188. Chapter 155: Nipple Discharge - p. 781 189. Chapter 156: Nipple Retraction and Inversion - p. 787 190. Chapter 157: Paget Disease of Nipple - p. 791 191. SKIN - p. 797 192. Chapter 158: Epidermoid Cyst - p. 797 193. Chapter 159: Erythema - p. 801 194. Chapter 160: Sebaceous Cyst - p. 805 195. Chapter 161: Skin Lesions, Other - p. 809 196. Chapter 162: Skin Retraction - p. 813 197. Chapter 163: Skin Thickening - p. 815 198. AXILLA - p. 819 199. Chapter 164: Axillary Adenopathy - p. 819 200. Chapter 165: Axillary Nodal Calcification - p. 825 201. Chapter 166: Metastatic Node, Unknown Primary - p. 829 202. BREAST - p. 833 203. Chapter 167: Pain - p. 833 204. Chapter 168: Palpable Lump or Thickening - p. 837 205. VASCULAR ENTITIES - p. 843 206. Chapter 169: Benign Lesions of Vascular Origin - p. 843 207. Chapter 170: Mondor Disease - p. 847 208. SECTION 7: SPECIAL TOPICS - p. 851 209. HORMONAL CHANGES - p. 851 210. Chapter 171: Hormonal Supplementation - p. 851 211. Chapter 172: Hormone Blocking: Endocrine Therapy - p. 857 212. GENDER REASSIGNMENT - p. 861 213. Chapter 173: Transgender Patients: Terminology and Normal Appearances - p. 861 214. Chapter 174: Transgender Patients: Surveillance and Cancer - p. 865 215. PREGNANCY - p. 869 216. Chapter 175: Galactocele - p. 869 217. Chapter 176: Lactating Adenoma - p. 873 218. Chapter 177: Lactation - p. 879 219. Chapter 178: Pregnancy-Associated Breast Cancer - p. 883 220. INFECTIONS AND INFLAMMATION - p. 889 221. Chapter 179: Abscess - p. 889 222. Chapter 180: Granulomatous Mastitis - p. 895 223. Chapter 181: Mastitis - p. 899 224. Chapter 182: Unusual Infections - p. 903 225. BREAST MANIFESTATIONS OF SYSTEMIC CONDITIONS - p. 907 226. Chapter 183: Amyloid - p. 907 227. Chapter 184: Breast Manifestations of Organ Failure - p. 911 228. Chapter 185: Collagen Vascular Disease - p. 915 229. Chapter 186: Diabetic Mastopathy/Lymphocytic Lobulitis - p. 919 230. Chapter 187: Leukemia - p. 923 231. Chapter 188: Lymphoma, Secondary - p. 929 232. Chapter 189: Metastases to Breast - p. 935 233. Chapter 190: Sarcoid - p. 939 234. Chapter 191: Weight Fluctuations - p. 943 235. TRAUMA - p. 945 236. Chapter 192: Trauma - p. 945 237. MALE BREAST - p. 949 238. Chapter 193: Gynecomastia - p. 949 239. Chapter 194: Male, Breast Cancer - p. 953 240. Chapter 195: Male, Other Neoplasms - p. 957 241. ARTIFACTS - p. 963 242. Chapter 196: Artifacts: Mammography and Tomosynthesis - p. 963 243. Chapter 197: Artifacts: MR - p. 969 244. Chapter 198: Artifacts: Nuclear Medicine - p. 973 245. Chapter 199: Artifacts: Ultrasound - p. 977 246. IMAGING SAFETY - p. 983 247. Chapter 200: Contrast Reactions - p. 983 248. Chapter 201: Gadolinium Safety - p. 987 249. Chapter 202: Radiation Dose and Safety: Mammography and Tomosynthesis - p. 991 250. SECTION 8: TREATMENT - p. 995 251. PRINCIPLES IN TREATMENT - p. 995 252. Chapter 203: Approach to Breast Cancer - p. 995 253. Chapter 204: Oncology Overview (Adjuvant and Neoadjuvant) - p. 999 254. Chapter 205: Pathology Overview - p. 1005 255. Chapter 206: Radiation Therapy Overview - p. 1011 256. Chapter 207: Staging: Breast - p. 1017 257. Chapter 208: Surgery Overview - p. 1027 258. FOCUSED ISSUES IN TREATMENT - p. 1031 259. Chapter 209: Approach to Treatment Planning - p. 1031 260. Chapter 210: Breast Cancer in Young Patients (< 40 Years) - p. 1035 261. Chapter 211: Contralateral Breast Cancer - p. 1039 262. Chapter 212: Extensive Intraductal Component - p. 1043 263. Chapter 213: Inflammatory Breast Carcinoma - p. 1047 264. Chapter 214: Internal Mammary Adenopathy - p. 1053 265. Chapter 215: Locally Advanced Breast Cancer - p. 1057 266. Chapter 216: Metastatic Breast Cancer - p. 1063 267. Chapter 217: Multifocal/Multicentric Breast Cancer - p. 1069 268. Chapter 218: Pectoralis Muscle and Chest Wall Invasion - p. 1073 269. Chapter 219: Skin Invasion - p. 1077 270. Chapter 220: Tumor Genomic Testing: e.g., Oncotype DX, MammaPrint - p. 1081 271. SECTION 9: POSTOPERATIVE AND POSTTREATMENT IMAGING - p. 1085 272. Chapter 221: Approach to Postoperative Imaging Findings - p. 1085 273. RESULTS OF BENIGN INTERVENTION - p. 1091 274. Chapter 222: Benign Surgical Biopsy, Postoperative Imaging - p. 1091 275. Chapter 223: Cosmetic Augmentation Injections - p. 1095 276. Chapter 224: Implant, Saline - p. 1099 277. Chapter 225: Implant, Silicone - p. 1103 278. Chapter 226: Implant With Multiple Lumina - p. 1107 279. Chapter 227: Implants and Cancer - p. 1111 280. Chapter 228: Post-Core Biopsy and Clip Placement Imaging - p. 1115 281. Chapter 229: Reduction Mammoplasty, Imaging - p. 1121 282. Chapter 230: Silicone Granuloma - p. 1127 283. RESULTS FOLLOWING TREATMENT FOR MALIGNANCIES - p. 1131 284. Chapter 231: Accelerated Partial Breast Irradiation - p. 1131 285. Chapter 232: Neoadjuvant Chemotherapy - p. 1137 286. Chapter 233: Positive or Close Margins - p. 1143 287. Chapter 234: Post Breast-Conserving Surgery - p. 1147 288. Chapter 235: Personal History of Breast Cancer Surveillance - p. 1151 289. Chapter 236: Recurrent Breast Carcinoma - p. 1157 290. Chapter 237: Prior Chest Radiation Therapy, Surveillance - p. 1161 291. Chapter 238: Tissue Transfer Reconstruction Imaging - p. 1165 292. SECTION 10: PROCEDURES - p. 1171 293. IMAGE-GUIDED PROCEDURES - p. 1171 294. Chapter 239: Cyst Aspiration - p. 1171 295. Chapter 240: Ductography - p. 1175 296. Chapter 241: Fine-Needle Aspiration Biopsy, Breast - p. 1181 297. Chapter 242: MR-Directed Ultrasound - p. 1183 298. Chapter 243: MR-Guided Vacuum-Assisted Biopsy - p. 1187 299. Chapter 244: Preoperative Lesion Localization, Bracketing - p. 1191 300. Chapter 245: Preoperative Axillary Node Localization - p. 1193 301. Chapter 246: Preoperative Localization, Tomosynthesis - p. 1195 302. Chapter 247: Preoperative Magnetic, Other Nonradioactive Localization - p. 1197 303. Chapter 248: Preoperative Radioactive Seed Localization - p. 1201 304. Chapter 249: Preoperative Wire Localization, Mammography - p. 1205 305. Chapter 250: Preoperative Wire Localization, MR - p. 1207 306. Chapter 251: Preoperative Wire Localization, Ultrasound - p. 1211 307. Chapter 252: Skin Localization - p. 1213 308. Chapter 253: Specimen Imaging - p. 1215 309. Chapter 254: Stereotactic Biopsy, Prone - p. 1219 310. Chapter 255: Stereotactic Biopsy, Upright - p. 1223 311. Chapter 256: Ultrasound-Guided Core Needle Biopsy - p. 1227 312. Chapter 257: Ultrasound-Guided Vacuum-Assisted Biopsy - p. 1231 313. SURGICAL PROCEDURES - p. 1233 314. Chapter 258: Reduction Mammoplasty, Procedure - p. 1233 315. Chapter 259: Sentinel Lymph Node Biopsy - p. 1237 316. Chapter 260: Targeted Axillary Dissection - p. 1241 317. Chapter 261: Axillary Lymph Node Dissection - p. 1245 318. Chapter 262: Breast-Conserving Surgery - p. 1249 319. Chapter 263: Oncoplastic Techniques - p. 1253 320. Chapter 264: Mastectomy - p. 1257 321. Chapter 265: TRAM and Other Flap Procedures - p. 1261 322. INDEX - p. 1265