Breast Imaging: The Core Requisites

Description

Focusing on high-yield information, Breast Imaging: The Core Requisites, 4th Edition emphasizes the basics to help you establish a foundational understanding of breast imaging during rotations, prepare for the core and certifying exams, refresh your knowledge of key concepts, and learn strategies to provide “value-added” reports to referring clinicians. This completely rewritten and reorganized edition emphasizes the essential knowledge you need in an easy-to-read format, with thorough updates that cover new imaging modalities, the latest guidelines, and integration of physics information throughout. Emphasizes the essentials in a templated, quick-reference format that includes numerous outlines, tables, pearls, boxed material, and bulleted content for easy reading, reference, and recall.   Prioritizes and explains the key information that you will be tested on to help you efficiently and effectively prepare for board exams.   Helps you build and solidify core knowledge to prepare you for clinical practice with critical, up-to-date information on mammography, breast ultrasound, digital breast tomosynthesis, and breast MRIs, as well as special chapters on lymph node evaluation in breast imaging, augmented and reconstructed breast, and special populations in breast imaging.   Features hundreds of high-quality images, including correlations of ultrasound, mammography, digital breast tomosynthesis and MRI.   Published as part of the newly reimagined Core Requisites series, an update to the popular Requisites series aimed at radiology trainees and today’s busy clinicians.  Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.  Front Cover Breast Imaging Copyright Page Contributors Foreword Preface Contents 1 Introduction to Mammography: The Basics How Is a Mammogram Performed? Compression Standard Views Standardized Labeling What Is Acceptable Quality? Image Quality Appropriate Positioning Special Views and Additional Views Spot Compression View Magnification View Additional Views The Normal Mammogram Anatomy Radiologic Anatomy of the Breast Image Contrast Screening Versus Diagnostic Mammograms Suggested Readings 2 Why BI-RADS?: Overview of Breast Imaging Reporting and Data System (BI-RADS) Introduction History of BI-RADS The BI-RADS Lexicon Special Considerations for Other Imaging Modalities BI-RADS Final Assessment Categories The Structured Breast Imaging Report BI-RADS FAQs Quality Assurance Tool BI-RADS and Beyond/Conclusion Implications for Research Beyond BI-RADS The Art of Breast Imaging Suggested Readings References 3 Mammographic Masses, Asymmetries, and Distortion Overview Breast Masses Breast Mass Descriptors Specific to Ultrasound Asymmetries Asymmetry Global Asymmetry Focal Asymmetry Developing Asymmetry Assessment of Asymmetry at Screening Mammography Assessment of Asymmetry at Diagnostic Mammography Architectural Distortion Assessment of Architectural Distortion on Diagnostic Mammography Workup References Suggested Readings 4 Mammographic Analysis of Breast Calcifications Pathogenesis Screening and Diagnostic Assessment Typically Benign Calcifications Skin Calcifications Vascular Coarse “Popcorn-Like” Large Rod-Like Rim Dystrophic Milk of Calcium Suture Round Probably Benign Calcifications (BI-RADS 3) and Their Management Suspicious Calcifications Distribution Diffuse Regional Grouped Linear Segmental Morphology Coarse Heterogeneous Amorphous Fine Pleomorphic Fine Linear/Linear Branching Management of Suspicious Calcifications Summary Suggested Reading 5 Breast Ultrasound Indications and Interpretation Indications Supplemental Screening in Addition to Mammography Technique Diagnostic Evaluation Ultrasound Evaluation of Mammographic Finding Targeted Ultrasound After MRI and Other Imaging Postsurgical Breast Neoadjuvant Treatment Breast Implants Interventional Procedures Technical Parameters Image Quality Artifacts Image Optimization Image Resolution Tissue Harmonics Compound Imaging Doppler Imaging Additional Ultrasound Techniques Strain Elastography Shear Wave Elastography Breast Anatomy Female Hormonal Phases Male Breast Ultrasound BI-RADS and Interpretation Tissue Composition Masses Shape Orientation Margin Echo Pattern Posterior Features Calcifications Associated Features Special Cases Cysts: Simple versus Complicated versus Complex Cystic and Solid Mass Benign versus Probably Benign Masses Round Mass Additional Features of Malignancy BI-RADS Final Assessment for Ultrasound Suggested Reading 6 Basics of Digital Breast Tomosynthesis Acquisition of Images Methods of Acquiring DBT Images Dose of DBT Compared With DM Imaging With DBT in One View Only Synthetic Imaging Images Available for Interpretation DBT Terminology DBT Display Advantages of DBT Reasons for Increase in Cancer Detection Reasons for Decrease in Recall Vessel Turns Lymph Nodes Superimposed Tissue Decrease in Technical Recalls Grouped Skin Calcifications Incident Versus Prevalent Screening With DBT Special Considerations Suggested Readings 7 Mammographic and Ultrasound-Guided Breast Biopsy Procedures Image-Guided Breast Biopsy Prebiopsy Patient Workup Breast Lesion Labeling Informed Consent and Procedural Risks Complications—Specific Scenarios Skin Sterilization, Local Anesthesia, and Skin Nicks Fine-Needle Aspiration and Core Biopsy Techniques Fine Needle Aspiration Automated Core Biopsy Vacuum-Assisted Core Biopsy Cyst Aspiration Palpation-Guided Percutaneous Needle Biopsy Ultrasound-Guided Percutaneous Needle Biopsy Stereotactic and Tomosynthesis-Guided Percutaneous Needle Biopsy Core Specimen Radiography Placement of Biopsy Site Markers Carbon Breast Tissue Marking and Tattoo Ink Marking of Axillary Lymph Nodes Patient Safety and Comfort after Biopsy Radiologic-Pathologic Correlation after Breast Biopsy Preoperative Needle Localization With Hookwire or Wireless Methods 2D Mammographic–Guided Needle/Hookwire or Wireless Localization Tomosynthesis-Guided Needle/Hookwire or Wireless Localization Stereotactic-Guided Needle/Hookwire or Wireless Localization Ultrasound-Guided Needle/Hookwire or Wireless Localization Types of Wireless Fiducial Devices Specimen Radiography References 8 Breast MRI Indications, Interpretation, and Interventions Indications Screening Diagnostic Imaging in Women With Known Breast Cancer Evaluation of Response to Neoadjuvant Therapy Problem Solving: Evaluation of Suspicious Nipple Discharge Evaluation of Silicone Implant Integrity Technical Considerations and MRI Artifacts Technical Considerations Key Pulse Sequences Artifacts Breast MRI Interpretation and Reporting Approach to MRI Interpretation MRI BI-RADS Lexicon Amount of Fibroglandular Tissue Amount of Background Parenchymal Enhancement Lesion Type, Morphology, and Internal Enhancement Characteristics Contrast Kinetic Features Assigning BI-RADS Assessments on MRI Malignant MRI Findings Invasive Carcinoma Ductal Carcinoma in Situ Features Associated with Malignancy Benign MRI Findings MRI-Guided Breast Interventions Pulse Sequences for MRI-Guided Biopsy Approach Planning Basic Steps of MRI-Guided Biopsy Radiology-Pathology Concordance and Follow-Up Suggested Reading 9 Breast Pathology and Radiologic–Pathologic Correlation Overview of Normal Breast Anatomy Anatomy Breast Embryology and Development Menstrual Cycle and Menopause Radiologic–Pathologic Correlation and Recommendations Appearance and Management of Benign Lesions Benign Breast Masses Generally Not Requiring Additional Management Fibroadenoma Lipoma Hamartoma Pseudoangiomatous Stromal Hyperplasia Intramammary Lymph Node Fat Necrosis Fibrocystic Change Benign Masses That May Warrant Surgical Consultation Phyllodes Tumor Stromal Fibrosis Granular Cell Tumor Granulomatous Mastitis Diabetic Mastopathy Desmoid Tumor Benign Calcifications Usual Ductal Hyperplasia Adenosis and Sclerosing Adenosis Columnar Cell Change and Columnar Cell Hyperplasia High-Risk Lesions Atypical Ductal Hyperplasia Lobular Neoplasia (Atypical Lobular Hyperplasia and Classic Lobular Carcinoma In Situ) Pleomorphic LCIS Flat Epithelial Atypia Complex Sclerosing Lesion/Radial Scar Papillary Lesions Mucocele-Like Lesion Breast Malignancies Ductal Carcinoma In Situ Molecular Subtypes of Breast Cancer Invasive Ductal Carcinoma Not Otherwise Specified (IDC NOS) Tubular Carcinoma Medullary Carcinoma Mucinous/Colloid Carcinoma Invasive Papillary Carcinoma Invasive Lobular Carcinoma Adenoid Cystic Carcinoma Metaplastic Carcinoma Other Malignancies Lymphoma Metastasis Sarcoma Suggested Readings 10 Breast Cancer Risk Assessment Definitions: Average Versus Higher-Than-Average Risk Population Subgroups at Higher Risk Genetic Mutation Carriers and Hereditary Syndromes Chest/Mantle Radiation Before Age 30 Family History of Breast Cancer Personal History of Breast Cancer Additional Risk Factors for Breast Cancer General Risk Factors Lobular Neoplasia and Atypical Ductal Hyperplasia Breast Density Background Parenchymal Enhancement Models for Risk Assessment Gail Model BRCAPRO IBIS (Tyrer-Cuzick) Claus BOADICEA Breast Cancer Surveillance Consortium Suggested Readings References 11 Breast Cancer Screening Guidelines and Supplemental Screening Breast Cancer Screening Guidelines Screening Guidelines for Average-Risk Women ACR, SBI, ASBrS, NCCN, and NCBC American Cancer Society USPSTF, AAFP, and ACP Screening Guidelines for Higher-Than-Average-Risk Women Supplemental Screening Incremental Cancer Detection Rate Per Modality Digital Breast Tomosynthesis Screening Breast Ultrasound Breast Magnetic Resonance Imaging Supplemental Breast MRI Screening in High-Risk Women Supplemental Breast MRI Screening in Average-Risk Women Molecular Breast Imaging Contrast-Enhanced Mammography References Suggested Readings 12 Organized Approach to Screening Mammography Why Perform Screening Mammography? (Screening Evidence) Historical Perspective Screening Mammography Reduces Breast Cancer Mortality Screening Guidelines Screening Controversies: Commonly Cited Screening “Harms” (Risks) Radiation Benign-Outcome Recalls and Biopsies (False Positives) Patient Anxiety Overdiagnosis Additional Benefits of Screening Mammography Risk-Based Screening Breast Cancer Incidence by Race How to Interpret Screening Mammography by Following a Systematic Approach General Approach Perform “Overview” and “Close-In” Visual Searches Look for a Second Lesion Annotate and Describe Location of Findings to Help the Next Radiologist Perception Aids for Screening Mammography Interpretation View Right and Left Images “Back-to-Back” as if They Were Mirror Images Concentrate on the Whitest Areas of the Image Search for One Calcification or Tiny Artifact Compare With Two Prior Examinations Interpret in Batches Without Distractions Suggested Readings 13 Organized Approach to Diagnostic Imaging Triangulation Describing the Location of Findings in the Breast Triangulation with Two-Dimensional Mammography Lesion Localization with Tomosynthesis Supplemental Mammographic Views Diagnostic Workup of Masses Workup of Asymmetries Asymmetry (One-View) Workup Shallow Obliques Rolled Views Tomosynthesis Focal Asymmetry workup Developing Asymmetry workup Suggested Reading 14 The Symptomatic Breast Palpable Breast Lump Palpable Lump ≥40 Years Old Palpable Lump in Women 30 to 39 Years Old Palpable Lump in Women