Learning objectives
-To illustrate the spectrum of clinical,
mammographic,
ultrasound,
and magnetic resonance imaging findings of breast cancer presenting with non-aggressive imaging features with pathological correlation.
-To identify the distinguishing imaging features
-To emphasize pitfalls,
diagnostic difficulties and differential diagnosis.
Background
Most breast cancers appear as suspicious lesions at imaging,
and most well-circumscribed breast masses are benign lesions.
Breast cancers usually appear at mammography,
ultrasound (US),
and magnetic resonance (MR) as irregular non-circumscribed masses,
with or without microcalcifications.
However,
in 10 to 20% of all cases breast malignancies may present with a non-aggresive benign-looking appearance.
Features of benign lesions,
such as well-circumscribed breast masses,
cystic or hyperechoic lesionsmay be the initial findings depicted in certain breast cancers.
Therefore,
it is important to learn the imaging features...
Findings and procedure details
A.-FINDINGS IN DIFFERENT LESIONS.
RADIO-PATHOLOGIC CORRELATION.
1.- MUCINOUS/COLLOID CARCINOMA.
Fig. 1 ,
Fig. 2 Fig. 3
Mucinous breast carcinoma accounts for 1-6% of primary breast carcinomas,
with higher prevalence in older women,
usually older than 55-60 years at diagnosis,
and better prognosis than usual breast carcinoma.
The hystopathologic definition is a tumor with a mucinous component of 50% or more. According to World Health Organization (WHO) two subtypes may be found: pure and mixed mucinous breast carcinoma.
The mixed type contains 50-90% of mucinous component...
Conclusion
TAKE HOME POINTS
- REMEMBER THE MAIN POINT. Breast malignancies may present with non-agressive features.
All breast masses should be carefully assessed,
some of them may be tricky and be malignant in spite of a benign-looking appearance.
- BE ALWAYS ALERT.
Subtle findings on mammograms,
or aditional details such as a new mass in spite of its innocent appearance may hide a malignancy.
- US is useful in cathegorizing breast masses.
Simple cysts are usually benign,
but complex masses,
cystic lesions with solid component,
thick...
References
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MR imaging of medullary carcinoma of the breast.
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2.Jeong SJ,
Lim HS,
Lee JS,
Park MH,
Yoon JH,
Park JG,
Kang HK.
Medullary carcinoma of the breast: MRI findings.
AJR Am J Roentgenol.
2012 May;198(5):W482-7.
3. Zhang L,
Jia N,
Han L,
Yang L,
Xu W,
Chen W.
Comparative Analysis of Imaging and Pathology Features of Mucinous Carcinoma of the Breast.
Clin Breast Cancer.
2014;18: S1526-8209(14)00263-8.
4. Jalaguier-Coudray A,
Thomassin-Piana J.
Solid...