BREAST IMAGING
Author: Daniel Kopans, MD, FACR
Publisher: Lippincott Williams & Wilkins
Publication Date: 2007
Publisher: Lippincott Williams & Wilkins
Publication Date: 2007
ISBN 10: 0781747686
ISBN 13: 9780781747684
Edition: 3rd
ISBN 13: 9780781747684
Edition: 3rd
Description:
Dr. Kopans' best-selling text and reference on breast imaging is now in its thoroughly revised, updated Third Edition. The author combines a complete, superbly illustrated atlas of imaging findings with a comprehensive text that covers all imaging modalities and addresses all aspects of breast imaging--including breast anatomy, histology, physiology, pathology, breast cancer staging, and preoperative localization of occult lesions. This edition includes state-of-the-art information on a new modality, digital breast tomosynthesis, as well as on digital mammography, MRI, ultrasound, and percutaneous breast biopsy. The book contains more than 2,100 images obtained with the latest technology, including many new mammograms and scans using other imaging modalities.
Table of Contents
Front Matter
Introduction
Breast Anatomy and Basic Histology, Physiology, and Pathology
A Pathologist’s Overview of the Pathology of Breast Disease
Epidemiology, Etiology, Risk Factors, and Survival from Breast Cancer
Screening for Breast Cancer
- INTRODUCTION
- SCREENING FOR CANCER: FUNDAMENTAL CONCEPTS AND THEIR APPLICATION TO MAMMOGRAPHY
- THE MAJOR FACTORS INVOLVED IN DETERMINING WHETHER A SCREENING TEST IS EFFICACIOUS
- PRINCIPLES AND PROBLEMS WITH RANDOMIZED CONTROLLED TRIALS
- SCREENING FOR BREAST CANCER: AN HISTORICAL PERSPECTIVE
- THE RANDOMIZED CONTROLLED TRIALS OF BREAST CANCER SCREENING
- THE MAMMOGRAPHY SCREENING CONTROVERSIES
- INTRODUCTION
- THE RANDOMIZED CONTROLLED TRIALS WERE NOT DESIGNED TO EVALUATE WOMEN AGED 40 TO 49 SEPARATELY
- OTHER EVIDENCE THAT SUPPORTS SCREENING FOR WOMEN IN THEIR FORTIES
- MISLEADING DATA GROUPING
- CONCLUSION
- CLINICAL BREAST EXAMINATION AND BREAST SELF-EXAMINATION AS COMPLEMENTS TO MAMMOGRAPHY
- WHEN TO STOP SCREENING: AT WHAT AGE DOES SCREENING BECOME INEFFECTIVE?
- SUMMARY
- RECOMMENDATIONS
- LEARNING FROM THE PAST
- A FINAL COMMENT
- REFERENCES
Radiation Risk
- IONIZING RADIATION AS A CARCINOGEN
- EVIDENCE OF INCREASED RISK OF BREAST CANCER FROM HIGH-DOSE RADIATION EXPOSURE
- GENETIC ABNORMALITIES
- SIGNIFICANCE OF RADIATION RISK
- LOW-DOSE RISK ESTIMATES AND RELATIONSHIP TO AGE AT EXPOSURE
- FILM/SCREEN MAMMOGRAPHY AND RADIATION RISK
- RISK FROM A MAMMOGRAM TO A DEVELOPING FETUS
- CONCLUSION
- REFERENCES
Staging Breast Cancer
Ductal Carcinoma In Situ and Early-Stage Breast Cancer: Detection, Diagnosis, and Prognostic Indicators
- DOES DCIS PROGRESS TO INVASIVE CANCER?
- DCIS IS NOT A SINGLE LESION
- WHAT IS BREAST CANCER? SURVIVAL FROM EVEN INVASIVE CANCERS IS BETTER THAN MOST REALIZE
- WHAT IS THE APPROPRIATE BIOLOGIC MODEL FOR DCIS?
- BREAST CANCER AND ITS SUBCATEGORIES
- MIGHT SOME LESIONS THAT LOOK LIKE DCIS ACTUALLY REPRESENT INVASIVE CANCERS THAT ARE FORMING WHAT LOOK LIKE DUCTS?
- LOBULAR CARCINOMA IN SITU
- MAYBE IT’S THE CALCIFICATIONS
- THE NATURAL HISTORY OF BREAST CANCER
- DOES BREAST CANCER ORIGINATE FROM A STEM CELL?
- METASTATIC SPREAD
- WHERE DOES DCIS END?
- GROWTH RATE OF BREAST CANCER
- SURVIVAL AND PROGNOSTIC FACTORS
- EARLY-STAGE BREAST CANCER
- SUMMARY
- REFERENCES
Mammography: Equipment and Basic Physics
- BASIC PRINCIPLES OF X-RAY MAMMOGRAPHY
- FILM/SCREEN DETECTORS
- X-RAY PRODUCTION
- X-RAY GENERATORS
- FOCAL SPOT SIZE AND GEOMETRIC CONSIDERATIONS
- RECIPROCITY LAW FAILURE
- FOCAL SPOT COMPOSITION AND FILTERS
- BREAST COMPRESSION
- SCATTER RADIATION
- GRIDS
- FILM/SCREEN MAMMOGRAPHY
- CHOOSING A FILM/SCREEN COMBINATION
- FILM PROCESSING
- DOSE MEASUREMENT
- MAGNIFICATION MAMMOGRAPHY
- SUMMARY
- REFERENCES
Quality Assurance and Quality Control
- INTRODUCTION
- QUALITY CONTROL AND ASSURANCE FOR FILM/SCREEN MAMMOGRAPHY
- QUALITY ASSURANCE
- QUALITY CONTROL
- EQUIPMENT ACCEPTANCE TESTING
- ESTABLISHING THE COMPONENTS OF QUALITY IMAGING: AN OPTIMIZED BASELINE
- MAMMOGRAPHY EQUIPMENT
- BREAST IMAGING TEAM
- QUALITY ASSURANCE PROGRAM
- QUALITY CONTROL TESTS
- QUALITY ASSURANCE COMPLIANCE PROGRAMS
- AMERICAN COLLEGE OF RADIOLOGY ACCREDITATION
- SUMMARY
- REFERENCES
Mammographic Positioning
- SCREENING MAMMOGRAPHY
- ROUTINE MAMMOGRAPHIC PROJECTIONS
- MAMMOGRAPHY AID TO POSITIONING
- IDENTIFICATION MARKERS
- PHYSICAL EXAMINATION
- MAMMOGRAPHY FOR THE INDIVIDUAL WITH A SIGN OR SYMPTOM THAT COULD INDICATE BREAST CANCER
- ADDITIONAL PROJECTIONS: EXAGGERATED VIEWS
- POSITIONING THE MALE BREAST
- TRIANGULATION TRICKS
- FINDINGS ON THE SKIN AND SKIN LESIONS
- SPOT COMPRESSION OF NONPALPABLE LESIONS
- MAGNIFICATION
- REFERENCES
A Systematic Approach to Breast Imaging
- BASIC PRINCIPLES: DETECTION VERSUS DIAGNOSIS
- PERCEPTION AND DOUBLE READING
- DIAGNOSTIC MAMMOGRAPHY
- SCREENING TERMINOLOGY
- GAUGING THE SUCCESS OF A SCREENING PROGRAM
- STANDARDIZED REPORTING AND OUTCOME MONITORING
- USE AN ORGANIZED APPROACH
- A SYSTEMATIC APPROACH
- MANAGEMENT
- COMMUNICATION OF BREAST IMAGING RESULTS
- THE AUDIT
- SUMMARY
- REFERENCES
Mammography and the Normal Breast
- MAMMOGRAPHY
- GENERAL PRINCIPLES
- THE MAMMOGRAM AND THE MENSTRUAL CYCLE
- THE NORMAL MAMMOGRAM
- DEVELOPMENTAL VARIATIONS
- ACCESSORY AND ECTOPIC BREAST TISSUE
- ASYMMETRIC BREASTS
- BREAST SIZE AND CANCER RISK
- BREAST COMPOSITION
- BREAST VARIATION WITH AGE
- BREAST DENSITY AND AGE
- CLINICAL ASSESSMENT OF THE BREAST DOES NOT PREDICT ITS RADIOGRAPHIC DENSITY
- BREAST TISSUE (PARENCHYMAL) PATTERNS
- TISSUE PATTERNS AND BREAST CANCER RISK
- LOCATION OF BREAST CANCERS
- INCREASING BREAST TISSUE DENSITY
- THE RADIOGRAPHICALLY DENSE BREAST
- CONCLUSIONS
- REFERENCES
Interpreting the Mammogram
Benign Lesions
Probably Benign Findings Appropriately Managed with Short-Interval Follow-up
Suspicious Lesions and Lesions with a High Probability of Malignancy
Breast Ultrasound
- ULTRASOUND OF THE BREAST
- ANATOMY OF THE BREAST AS DELINEATED BY ULTRASOUND
- ULTRASOUND FOR BREAST CANCER SCREENING
- DIAGNOSTIC ULTRASOUND
- DOPPLER ULTRASOUND
- INTRAVENOUS ENHANCEMENT OF BREAST LESIONS FOR ULTRASOUND EVALUATION
- ULTRASOUND AND WOMEN WITH RADIOGRAPHICALLY DENSE BREAST TISSUES
- THE APPROPRIATE USE OF BREAST ULTRASOUND
- ULTRASOUND AND IMPLANTS
- ULTRASOUND AND ASYMMETRIC BREAST TISSUE
- EQUIPMENT FOR ULTRASOUND SCREENING IF IT EVER BECOMES EFFICACIOUS
- SONOGRAPHIC EVALUATION OF THE BREAST
- PERFORMING BREAST ULTRASOUND
- ACOUSTIC PROPERTIES OF BREAST TISSUE AND BREAST LESIONS
- THE NORMAL BREAST
- INTERPRETING BREAST SONOGRAPHIC FINDINGS
- GENERAL PRINCIPLES OF BREAST ULTRASOUND INTERPRETATION
- SONOLUCENT LESIONS
- COMPLICATED CYSTS VERSUS COMPLEX MASSES
- DUCT ECTASIA
- FAT NECROSIS
- ABSCESSES AND HEMATOMAS
- CIRCUMSCRIBED HYPOECHOIC MASSES
- L/AP RATIO IN BENIGN AND MALIGNANT LESIONS
- ECHO TEXTURE OF A MASS
- HYPERECHOIC (ECHOGENIC) LESIONS
- VARIABLE COMPRESSION TO HELP DIFFERENTIATE LESIONS
- ILL-DEFINED HYPOECHOIC MASSES
- LESIONS THAT PRODUCE POSTERIOR ACOUSTIC SHADOWING
- ULTRASOUND APPEARANCE OF BREAST CANCER
- ULTRASOUND AND THE CLINICALLY SUGGESTED ABNORMALITY
- NONPALPABLE MAMMOGRAPHICALLY DETECTED MASS
- USE OF ULTRASOUND FOR EVALUATING YOUNGER WOMEN
- ULTRASOUND AND THE FUTURE
- REFERENCES
The Altered Breast: Pregnancy, Lactation, Abscess, Post-Biopsy Changes, Mastectomy, Radiation, and Implants
The Male Breast
Magnetic Resonance Imaging of the Breast
- INTRAVENOUSLY ADMINISTERED CONTRAST IS NEEDED
- BASICS OF BREAST MRI
- TISSUE EFFECTS IN MRI
- MR SPECTROSCOPY
- MAGNETIC RESONANCE
- THREE-DIMENSIONAL LOCALIZATION
- BASIC MRI TECHNOLOGY
- MAGNETIC FIELDS
- SPIN-ECHO IMAGING
- MRI SEQUENCING
- GRADIENT-ECHO IMAGING
- BREAST COILS AND PATIENT POSITIONING
- FAT SUPPRESSION AIDS IN THE APPRECIATION OF CONTRAST ENHANCEMENT
- CONTRAST SUBTRACTION
- DYNAMICS OF CONTRAST ENHANCEMENT
- LESION MORPHOLOGY AND ENHANCEMENT PATTERN ANALYSIS
- BREAST MRI IS SENSITIVE BUT NOT SPECIFIC
- MRI OF THE BREAST AND BREAST LESIONS
- MRI INTERPRETATION
- HOW SHOULD MRI BE USED?
- HISTOLOGIC DIAGNOSIS OF LESIONS FOUND BY MRI
- CONTROVERSIES AND BREAST MRI
- MRI AND THE FUTURE
- REFERENCES
Evaluating Women With Lumps, Thickening, Discharge, or Pain: Imaging Women With Signs or Symptoms That Might Indicate Breast Cancer
Image Sequencing: Problems and Solutions in Breast Evaluation
- BASIC PRINCIPLES
- MAMMOGRAPHIC FLUOROSCOPY
- IS IT REAL?
- BASIC APPROACHES TO POSSIBLE SUPERIMPOSITION OF TISSUES
- LESIONS SEEN ON ONLY ONE PROJECTION
- TRIANGULATION OF BREAST LESIONS
- IMPLANTS
- BE CREATIVE
- MAGNIFICATION MAMMOGRAPHY
- IMAGE SEQUENCING
- IMAGE EVALUATION OF WOMEN WITH SIGNS OR SYMPTOMS OF POSSIBLE BREAST CANCER
- USING MRI
- REFERENCES
Histologic, Pathologic, and Imaging Correlation
- THE NORMAL BREAST
- MAMMOGRAPHIC, SONOGRAPHIC, AND MAGNETIC RESONANCE FEATURES OF PATHOLOGIC PROCESSES
- BENIGN BREAST LESIONS
- BACTERIAL INFECTIONS AND BREAST ABSCESSES
- MALIGNANT LESIONS OF THE BREAST
- CANCER OF THE DUCTAL EPITHELIUM
- DISTINCTIVE CANCERS OF DUCTAL ORIGIN
- TUMORS OF LYMPHOID ORIGIN
- METASTATIC LESIONS TO THE BREAST
- TUMOR MASSES IN PREADOLESCENT FEMALES
- OTHER BREAST PROBLEMS
- REFERENCES
Interventional Procedures in the Breast: Imaging-Guided Needle Placement for Biopsy and the Preoperative Localization of Clinically Occult Lesions
- BREAST BIOPSY: AN HISTORICAL PERSPECTIVE
- IMAGING-GUIDED NEEDLE BIOPSY
- OVERLAP BETWEEN BENIGN AND MALIGNANT LESIONS
- BIOPSY RATES: POSITIVE PREDICTIVE VALUE AND THE HEALTH CARE CONTROVERSY
- SENSITIVITY
- LEAD TIME FOR DETECTION
- EARLY INTERVENTION
- INTERVAL CANCERS AND DETECTION TARGETS
- NEEDLE VERSUS SURGICAL BIOPSY
- IMAGING-GUIDED NEEDLE BIOPSY HAS REPLACED SURGICAL BIOPSY FOR DIAGNOSING BREAST LESIONS
- APPROACHES TO NEEDLE BIOPSY OF BREAST LESIONS
- CORE NEEDLE BIOPSY
- IMAGING GUIDANCE FOR NEEDLE BIOPSY
- INDICATIONS FOR IMAGING-GUIDED NEEDLE BREAST BIOPSY
- CONCORDANCE BETWEEN THE PATHOLOGY RESULT AND THE IMAGING FINDINGS IS CRITICAL
- WHAT IF THE NEEDLE BIOPSY REVEALS A HIGH-RISK BUT BENIGN LESION?
- BENIGN CALCIFICATIONS AND CANCER: A SCIENTIFICALLY UNTESTTED ANECDOTAL OBSERVATION
- ACCURATE NEEDLE POSITIONING
- STANDARD NEEDLE LOCALIZATION AND EXCISIONAL BIOPSY
- INJECTION OF DYES AND RADIOACTIVE TRACERS
- POSITIONING NEEDLES AND GUIDES
- LOCALIZATION PARALLEL TO THE CHEST WALL IS THE SAFEST AND MOST ACCURATE METHOD FOR X-RAY– GUIDED NEEDLE LOCALIZATION
- INTRODUCING GUIDES USING THE PCW TECHNIQUE
- SURGICAL EXCISION OF A NONPALPABLE LESION AFTER PLACEMENT OF A GUIDE
- BRACKETING LARGER LESIONS
- MAMMOGRAPHICALLY GUIDED CYST ASPIRATION OR FINE-NEEDLE ASPIRATION
- ULTRASOUND-GUIDED NEEDLE PROCEDURES
- ULTRASOUND-GUIDED CYST ASPIRATION
- CT-GUIDED LOCALIZATION
- GALACTOGRAPHY AND NEEDLE LOCALIZATION
- CORE NEEDLE BIOPSIES
- SENTINEL LYMPH NODE BIOPSY
- PROBLEMS AND SOLUTIONS IN STEREOTACTICALLY GUIDED CORE NEEDLE BIOPSY
- SOURCES OF ERROR IN STEREOTACTIC DEVICES
- ULTRASOUND-GUIDED CORE NEEDLE BIOPSY
- MRI TO GUIDE PERCUTANEOUS BIOPSY
- SUMMARY
- REFERENCES
The Breast Imaging Report: Data Management and the Breast Imaging Audit
The Medical-Legal Problem and Breast Imaging
Digital Mammography
Digital Breast Tomosynthesis
- THE FIRST “WHOLE BREAST” DIGITAL BREAST TOMOSYNTHESIS SYSTEM
- OTHER WAYS OF ACQUIRING PROJECTION IMAGES FOR DBT
- ADVANTAGES OF DBT
- ANALYZING THE IMAGES
- WHAT ABOUT CALCIFICATIONS?
- DIGITAL BREAST TOMOSYNTHESIS WILL ELIMINATE THE NEED FOR “DIAGNOSTIC” MAMMOGRAPHY
- DBT WILL BECOME THE MULTIMODALITY BREAST IMAGING PLATFORM
- CONCLUSIONS
- REFERENCES