Type:
Educational Exhibit
Keywords:
Mammography, Breast, Ultrasound, Biopsy, Dilatation, Cancer
Authors:
V. J. Ayres1, E. F. C. Fleury2, L. Ramalho3, L. D. M. Pompei1; 1Santo André/BR, 2Sao Paulo/BR, 3Bg/BR
DOI:
10.26044/ecr2019/C-1663
Background
Mammography is proved to be the unique exam that can reduce breast cancer mortality.
Mammography is recommended exam to women over 40 years old and should be done annually for screening and,
when women present any symptoms - palpable mass,
hemorrhages discharge or inflammatory signals - the diagnostic mammography should be performed.
The correct mammographic interpretation and the valorization of some aspects allow reduce false negative or false positive results in order to reduce women anxiety.
BI-RADS® is the guideline for the uniformization of reading through has being updated with new papers.
Since last edition of BI-RADS®,
solitary dilated duct,
previously classified only as "special cases" without relevance to the suspicion or association with breast cancer,
if now classified at category 4 with recommendation for histological analysis based on a retrospective paper that demonstrated an association of solitary dilated duct with mammary carcinoma.
Solitary dilated duct is a rare event and there is no literature consensus on which diameter it should be considered as dilated,
however,
its morphology is recognized: tubular or branched structure at mammary retroareolar region.
Performing a second look US at the retroareolar area,
where the solitary dilated had been found by mammography,
allows:
- to capture the presence of a single dilated duct;
- to evaluate the presence of intraductal contents: homogeneous or heterogeneous;
- to guide percutaneous biopsy when suspected findings.
The elastography performed at the moment of the second look US can help forecasting the malignancy suspicious of heterogenous intraductal content.