Escolar Documentos
Profissional Documentos
Cultura Documentos
Index
Breast Injuries Breast abscess Normal anatomy & mammography Fibrocystic disease Simple cysts Mammary duct ectasia Breast neoplasms (Classification) Duct papilloma Breast lipoma Fibroadenoma Phylloides tumour Cancer Breast Ductal CA (Path) Lobular CA (Path) Pagets disease Triple assessment Mammography Isotope bone scan Staging of CA breast
Clinical
Imaging
Histopathology
Index
Breast Injuries
Blunt breast trauma can produce
1-Breast Hematoma 2-Traumatic Fat Necrosis Following blunt trauma Trauma Fat Necrosis or breast surgery . Release of Fatty Acids F.A. + Ca Ca Soaps (FBG) Old organized Hematoma without Painless irregular hard mass overlying skin bruising with no LN in the axilla with skin is difficult to diagnose tethering and even nipple correctly except by retraction biopsy. Trauma history is a trap, DD cancer breast Mammography is not conclusive DD cancer breast
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Index
Stages:
Milk engorgement: Dull ache pain, shivering, low grade fever wedge shaped tender induration no signs of inflammation Cellulites: Burning pain, high grade persistent fever diffuse swelling with tender red induration Pus formation: Throbbing pain ,Hectic fever local signs localized to one sector& overlying skin pitting oedema
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Breast Abscess
Etiology: Organisms: Predisposing factors: Routes of infect:
Index
A thin skin margin with no retraction of either skin or nipple. The glandular tissue is interspersed with fat and there are relatively regular bands of suspensory ligaments known as Cooper's ligaments. Note that the radiograph shows no dominant or irregular mass and no evidence of any microcalcifications, Breast diseases 2007 8 both are findings which may be observed in carcinomas. Index
The normal mammography image shows a thin, regular skin line with a diffuse, even, soft tissue density of the general glandular tissue and fatty structures organized in a Breast diseases 2007 9 relatively regular way by Cooper's ligaments Index
Normal variations
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Fatty breast
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Dense breast
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Index
Fibrocystic Disease
Index
Simple cysts
Multiple circumscribed low soft tissue dense lesions seen in both breasts
Ultrasound showing the typical features of a simple cyst: a well defined, anechoic (black) lesion with posterior echoic accentuation (white)
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Index
Benign Epithelial
Duct Papilloma Mesenchymal Lipoma Fibroma
Mixed Fibroadenoma
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Malignant
CARCINOMA Lymphoma, Sarcoma
Index
Duct Papilloma
Pathology Situated in one of the major ducts near its orifice usually single but may be multiple and peripheral (Multiple Papillomatosis) Clinical Picture young adult female (30-45) presenting with blood discharge from the nipple, on examination a fresh drop of
blood is seen on pressure at a certain point or a palpable small fusiform retroareolar mass is felt (retention cyst due to obstruction of the duct by clotted blood) pressure on it produces the discharge.
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Fibroadenoma
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Index
Fibroadenoma
A benign fibroadenoma of the breast is distinguished by its sharp margins and lack of microcalcifications. There is no skin retraction or extensions into the parenchymal tissue.
19 Breast diseases 2007
Index
Fibroadenoma
Mammography showed 9 mm solid nodule Ultrasound showed oval, hypoechoic and homogeneous mass, suggesting a benign lesion
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Index
Phylloides Tumour
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Index
Cancer Breast
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Index
Pathology
Ductal Carcinoma
In situ ductal carcinoma Invasive ductal carcinoma
Inflammatory carcinoma
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Index
Pathology
Lobular carcinoma
Lobular Carcinoma In Situ (LCIS) RR10
premenoposal 1% in biopsies Multicenteric, bilateral
Index
Pathology
Pagets Disease
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Index
MRI (Indications)
Bone scan (Indications)
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Index
Histopathological assessment:
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Index
Radiological assessment:
Breast US
Breast ultrasound is used as the initial method for evaluating the following symptomatic patients: The young patient under 30 years of age. The pregnant patient. Follow-up of patients with fibrocystic disease (3-6 month intervals).
Breast ultrasound is used as a complementary examination to mammography in the following situations: Evaluation of dense breast tissue. Evaluation of a mass demonstrated on mammography. Breast diseases 2007 28 Guidance of biopsy needle or needle localization (see cyst aspiration image) Index
Radiological assessment:
Mammography
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Index
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Breast diseases Invasive duct carcinoma giving a speculate mass on mamography 2007 Index
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Index
Mammography demonstrating a focal area of soft tissue density measuring 0.8 x 2.0 cm.
Architectural distortion and microcalcifications are also noted. The mass is categorized as 'highly suspicious' for malignancy
Index
Malignant masses are often characterized by irregular tented boundaries with retraction of other Breast diseases 2007 33 fibrous structures and may be accompanied by local skin thickening or microcalcifications Index
Close-up view
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Cranio-codal view
Medio-lateral view
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Ductal carcinoma insitu (high grade comedo type) Irregular linear branching microcalcification
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Index
Cluster of very small microcalcifications with or without increased local density of the breast is an important image finding indicating malignancy. The36 finding merits specific attention even if it is not accompanied by any other of the 2007 Breast diseases Index typical findings in carcinoma such as skin retraction or irregular mass boundary
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Manchester Classification
Stage I Mass confined to the breast, skin involvement over and smaller
Breast carcinoma
Peau d'orange"
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Breast carcinoma
This is an old specimen and the adipose tissue has become rather dark
It shows an ill defined grayish tumour in the breast, through which run yellow streaks of necrosis.
The nipple is retracted & the tumour is infiltrating the underlying pectoral muscle.
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Index
Breast carcinoma
Pectoralis muscle
Axillary LNs
Tumour
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