Erin . Gundersen. MS IV. Breast Cancer . Main Types. In Situ- tumor cells confined to ducts and lobules with no invasion. Ductal. Calcifications. Palpable mass. Lobular. Not palpable, no mammographic appearance. ID: 333448
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In Situ- tumor cells confined to ducts and lobules with no invasion
Not palpable, no mammographic appearance
Increase risk of invasive cancerSlide5
Invasive Carcinoma- invade breast stroma, can spread or metastasize
Infiltrating ductal — 76 percent
Invasive lobular — 8 percent
Ductal/lobular — 7 percent
Mucinous (colloid) — 2.4 percent
Tubular — 1.5 percent
Medullary — 1.2 percent
Papillary — 1 percentSlide6
Spiculated soft tissue mass
Most specific- 90% are invasive CA
Clustered microcalcifications- 0.1 to 1 mm in diameter, and numbering more than 4 to 5 per cubic centimeter
Intraductal necrotic tumor
Benign- vascular, skin, rim-like, coarse, smooth round or ovalSlide7
BIRADS diagnostic categories
0- need additional testing
2- benign finding
3- probably benign finding
5- highly suggestive of malignancy
6- biopsy proven carcinomaSlide8
Limitations of Mammography
Technique and positioning error
Density of breast tissue
Error in reading
Slow growing tumorSlide9
Cystic from solid lesions
U/S guided biopsy
Not see microcalcification
Miss part of breast tissueSlide10
Applications of MRI
Screening tool in patients with genetic or familial predisposition
Staging of breast cancer
Determination of recurrent/residual disease
Determination of occult diseaseSlide11
Limitations of MRI
Enhancement during luteal phase
Enhancement with hormone therapy
Difficulty distinguishing benign from malignant
May miss DCIS or invasive lobularSlide12
Mammography, ultrasound, and MRI can be used to evaluate breast cancer
Each modality has advantages and limitations
MRI is an evolving diagnostic toolSlide13
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