ABSTRACT
OBJECTIVE: The objective of this study was to describe the mammographic appearance with pathologic correlation of solitary peripheral papillomas of the breast. CONCLUSION: Solitary peripheral papillomas of the breast are benign lesions that may present mammographic features suggestive of carcinoma. Solitary peripheral papilloma is a variant related to the solitary central duct papilloma but has a different mammographic appearance because of its location and histologic architecture. The associated risk of malignancy is unclear.
Subject(s)
Breast Neoplasms/diagnostic imaging , Papilloma/diagnostic imaging , Aged , Aged, 80 and over , Breast/pathology , Breast Neoplasms/pathology , Diagnosis, Differential , Female , Humans , Mammography , Middle Aged , Papilloma/pathology , Papilloma, Intraductal/diagnostic imaging , Papilloma, Intraductal/pathologySubject(s)
Breast Neoplasms/diagnostic imaging , Calcinosis/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Radiation Injuries/diagnostic imaging , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Breast Neoplasms/radiotherapy , Calcinosis/complications , Calcinosis/etiology , Carcinoma, Ductal, Breast/complications , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Ductal, Breast/radiotherapy , Female , Humans , Mammography , Middle Aged , Neoplasm Recurrence, Local/complications , Neoplasm Recurrence, Local/diagnosis , Radiation Injuries/complications , Radiotherapy/adverse effects , Tomography, X-Ray ComputedSubject(s)
Breast Diseases/diagnostic imaging , Calcinosis/diagnostic imaging , Fibrocystic Breast Disease/diagnostic imaging , Adult , Biopsy , Breast/pathology , Breast Diseases/pathology , Breast Neoplasms/diagnostic imaging , Calcinosis/pathology , Diagnosis, Differential , Female , Fibrocystic Breast Disease/pathology , Humans , MammographyABSTRACT
PURPOSE: To evaluate the clinical utility of dynamic gadolinium-enhanced magnetic resonance (MR) imaging of the breast with commercially available techniques in patients scheduled for excisional biopsy. MATERIALS AND METHODS: A total of 91 breast abnormalities, 70 benign and 21 malignant, were evaluated. Thin-section three-dimensional gradient-echo images were obtained before and 2, 4, and 7 minutes after injection of contrast material. Three radiologists prospectively evaluated the mammograms and MR images. RESULTS: The areas under the receiver operating characteristic curves were 0.820 for mammography and 0.893 for MR imaging (P = .67). Sensitivity of MR imaging was 82.5%, compared with 74.6% for mammography. Specificity of MR imaging was 82.5%, compared with 79.1% for mammography. Enhancement profiles showed early intense enhancement in malignancies but considerable overlap with enhancement of benign disease. CONCLUSION: Breast MR imaging is a slightly more sensitive modality than mammography but not a highly specific technique for evaluating breast lesions. It has utility in several clinical situations but should not be used as a substitute for biopsy or general screening.
Subject(s)
Breast Diseases/diagnosis , Magnetic Resonance Imaging , Adult , Biopsy , Breast/pathology , Breast Diseases/diagnostic imaging , Breast Diseases/pathology , Carcinoma/diagnosis , Carcinoma in Situ/diagnosis , Contrast Media , Female , Fibroadenoma/diagnosis , Fibrocystic Breast Disease/diagnosis , Gadolinium DTPA , Humans , Mammography , Middle Aged , Organometallic Compounds , Pentetic Acid/analogs & derivatives , Prospective Studies , ROC Curve , Sensitivity and SpecificityABSTRACT
Lobular carcinoma in situ (LCIS) was diagnosed in 165 surgical specimens (119 patients) at our institution between 1974 and 1987. LCIS was seen more often in younger women (mean age, 49 years) than other breast carcinomas were (mean age, 58 years). Sampling of a single breast revealed multifocal disease in 70% (96/138). When both breasts were sampled, bilateral foci were found in 50% (41/82). Of 165 breasts with foci of LCIS, 37% (61/165) had simultaneously occurring invasive cancers in the same breast. Direct mammographic-pathologic correlation of foci of LCIS was possible in 73 breasts (67 patients). Microcalcifications were an indication for biopsy in 49% (20/41) of breasts with a mammographic abnormality, but were a nonspecific finding often found in tissues adjacent to foci of LCIS. The mammogram was normal in 44% (32/73) of breasts with foci of LCIS. The mammograms of patients with LCIS and those from a group of age-matched control subjects were compared by using a modified form of Wolfe's criteria and the percentage of fibroglandular elements. LCIS was seldom found in an N1 breast (1% vs 29%) or in a breast with less than 25% of its parenchymal area occupied by fibroglandular density (3% vs 33%). Compared with the control group, breasts with LCIS had more than 50% fibroglandular density (85% vs 45%) and a much higher frequency of the DY pattern (56% vs 36%). More fibroglandular density was seen in the LCIS group at all ages. Postmenopausally, the frequencies of the DY pattern and fibroglandular density greater than 50% in LCIS patients were nearly double those in the control group. LCIS patients have disease of the entire breast parenchyma, characterized by multifocality and bilaterality of various forms of lobular disease. Their mammograms reveal a higher rate of the DY pattern and higher percentages of fibroglandular or parenchymal density than those of age-matched controls. In LCIS patients, persistence of the DY pattern, or large amounts of fibroglandular density postmenopausally supports the concept that mammographically dense breasts are a marker for increased cancer risk in women 50 years old and older.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma in Situ/diagnostic imaging , Mammography , Adult , Aged , Aged, 80 and over , Breast/pathology , Breast Neoplasms/pathology , Carcinoma in Situ/pathology , Female , Humans , Middle AgedSubject(s)
Breast Neoplasms/pathology , Mammography/methods , Mass Screening/standards , Age Factors , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/epidemiology , Female , Health Planning , Humans , Mammography/standards , Mass Screening/organization & administration , Prevalence , Risk FactorsABSTRACT
The mammographic features of hidradenitis suppurativa axillaris, a common clinical entity, are described for the first time in this report. Lucent axillary masses with a small central density appear to be a pathognomonic radiographic finding. Other entities seen on mammography such as lipomas, lucent galactoceles, traumatic oil cysts, axillary hibernomas and benign lymph nodes, should not be confused with hidradenitis suppurative axillaris.
Subject(s)
Lymph Nodes/diagnostic imaging , Lymphatic Diseases/diagnostic imaging , Mammography , Adult , Axilla , Female , Humans , InflammationABSTRACT
Radiographic manifestation of intracystic papillary male carcinoma is presented along with its histopathological correlation. The prognosis, differential diagnosis, and natural history as well as possible sites of origin are discussed.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Papillary/diagnostic imaging , Breast Neoplasms/pathology , Carcinoma, Papillary/pathology , Diagnosis, Differential , Humans , Male , Middle Aged , RadiographyABSTRACT
A case-control study was conducted to evaluate the association of body size with morphologic features of breast tissue visible on mammograms, and to analyze the interrelations of these factors with breast cancer risk. The cases were 362 women with newly diagnosed breast cancer identified in 1978-1979 in three large hospital-based xeromammography units in Boston, Massachusetts, and one unit in Livingston, New Jersey. The controls were 686 women referred to these units in the same period for a "routine" mammogram. The parenchymal pattern (N1, P1, P2, DY) and the per cent of the breast showing nodular densities were the principal mammographic features assessed. Among controls, body weight was strongly but inversely associated with the per cent of women who had the high risk P2 or DY patterns and with the mean per cent of the breast showing nodular densities. Body weight and the amount of nodular densities were both directly related to breast cancer risk. The strengths of the relations of body weight and of nodular densities to risk were each increased when the other factor was taken into account.
Subject(s)
Body Height , Body Weight , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Female , Humans , Menopause , Middle Aged , Risk , XeromammographyABSTRACT
Five cases of a benign sclerosing lesion of breast are described. The lesion is characterized by a stellate, indurated zone of sclerosis and elastosis in a region of benign ductal proliferation. Because of the stellate configuration and frequently retracted cut surface, the lesion may grossly resemble scirrhous carcinoma. Microscopically, there is often entrapment of benign but distorted ducts at the sclerotic margin, which may further cause confusion with cancer. Of special interest is the radiographic appearance, which may be indistinguishable from scirrhous carcinoma. The term "indurative mastopathy" is a descriptively valid designation for these lesions.
Subject(s)
Adenocarcinoma, Scirrhous/diagnosis , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Adult , Breast Diseases/diagnostic imaging , Breast Diseases/pathology , Diagnosis, Differential , Female , Humans , Middle Aged , Sclerosis/diagnosis , Sclerosis/diagnostic imaging , Sclerosis/pathology , XeromammographyABSTRACT
Xeromammographic false negatives were analyzed to ascertain the cause of the errors and determine what corrective measures could be taken. Of 52 cancers miscalled, 52% were not visualized and 48% were categorized as misinterpretations. The causes of these errors are discussed. The error rate in all but 8% of the former group appears to be irreducible, yet errors discussed in the latter group are thought to be correctable in a high percentage of cases. Recommendations to reduce the number of false negatives in this group are presented.
Subject(s)
Breast Neoplasms/diagnostic imaging , Mammography , Xeromammography , False Negative Reactions , Female , HumansSubject(s)
Breast Neoplasms/diagnostic imaging , Mammography/methods , Needles , Calcinosis/diagnostic imaging , Female , Humans , Palpation , XeromammographyABSTRACT
Galactography is a quick effective means of evaluating nipple discharge. It is especially indicated when the effluent is bloody. A description of the procedure is discussed. The radiographic findings in both normal and abnormal studies are presented. Abnormal findings include filling defects, duct cut-off, duct encasement, extravasation, and duct ectasia. The radiographic diagnosis corresponded with pathologic findings in 12 of 16 cases (75%), although in two cases no radiographic or pathologic abnormality was found to explain the bloody discharge.