1、Imaging examinations of breastsDepartment of radiologyQuestionHow to choose a proper examination for screening and diagnosisWhat examinations we could useBreast cancerHigher incident rate of breast cancer for recent yearsRisk factors:procreation,family history,environment,hormone Clinic findings：mas
2、s，skin changes The survival rate based on the stage of breast cancerScreening：ductal carcinoma in situAnatomy 1518 lobes Lobules:Terminal Ductal Lobular Units(TDLUs)Anatomy TDLU：12mm Drained by a terminal duct attached to the main duct system Most breast diseases arise in TDLUImaging methods Mammogr
3、aphy Ultrasound MRIProjection：CC MLO MammographyMammographic characters Calcification MassCalcificationPO43-Calcium phosphatCa+Calcification The main value:detection necrotic tissues Form:Casting type,powderish,granular type Differentiation between malignant and benign:distribution,form,densityCalci
4、ficationCalcificationCalcificationCalcificationMass Proliferation and invasion Stellate lesion with spicules and ill-defined borders Differentiation between malignant and benign is difficultMassMassMassMassCharacteristics of mammography Sensitive to the malignant calcification even microcalcificatio
5、ns Differentiation between benign and malignant mass is difficultCharacteristics of Ultrasound Exam Allows significant freedom in obtaining images from almost any orientation excellent at imaging cysts and solid mass young women at high risk of the disease Guide biopsyLimited of ultrasound Though ul
6、trasound has excellent contrast resolution,it lacks the detail(spatial resolution)Operator and equipment factors unable to image microcalcifications Benefits of MRI Exam Allows breast images to be taken in any plane and from any orientation highly sensitive to small abnormalities,could show multi-fo
7、cal tumor Determining the extent of breast cancer,can help indicate treatment An excellent at imaging the augmented breastLimited of MRI Exam Too expensive Couldnt find the microcalcificationDuctal Carcinoma in Situ Intraductal carcinoma:cancer cells are confined to an intact basementmembrane Appearances:microcalcification(85%)microcalcification and mass(10%)mass or architectural distortion(5%)Screeningphysical exammammographyP+M+operationP+M-ultrasoundFollow upP-Ca+P-T+P-M-Follow upbiopsy
