Amorphous/Indistinct Calcifications (Regional/Diffuse)

2018 ◽  
Author(s):  
Lilian Wang
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Morphological Classification ◽  
Imaging Protocols ◽  
Fibrocystic Change ◽  
Perimenopausal Women ◽  
Risk Of Malignancy ◽  
Management Recommendations ◽  
Sclerosing Adenosis ◽  
Diffuse Distribution

Amorphous calcifications are calcifications that are sufficiently small and/or hazy that a more specific morphological classification cannot be made. Historically, such calcifications were referred to as “indistinct” calcifications. The likelihood of malignancy and the management of amorphous calcifications largely depend on their distribution. The majority of amorphous calcifications are benign, most often due to fibrocystic change (60%). Sclerosing adenosis commonly occurs in perimenopausal women and is associated with a 1.5–2.1x relative risk for development of breast cancer. This chapter, appearing in the section on calcifications, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnosis, and management recommendations for amorphous/indistinct calcifications in a regional or diffuse distribution. Topics discussed include influence of distribution on risk of malignancy and pathological entities, including sclerosing adenosis.

Mass in Lactating Female

2018 ◽  
Author(s):  
Nina Woldenberg ◽  
Melissa M. Joines
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Screening Mammography ◽  
Accurate Diagnosis ◽  
Comprehensive Understanding ◽  
Palpable Mass ◽  
Imaging Protocols ◽  
Fibrocystic Change ◽  
Lactating Breast ◽  
Management Recommendations

Timely and accurate diagnosis of a mass in the lactating patient requires comprehensive understanding of the indicated imaging workup. During lactation it is not uncommon for patients to present with a palpable mass that requires evaluation. In patients with a palpable abnormality, diagnostic evaluation should not be delayed due to pregnancy or lactation. In addition, a mass that requires further evaluation may be identified at the time of screening mammography in lactating patients. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for a mass in the lactating patient. Topics discussed include differential considerations of benign and malignant masses in the lactating breast including cysts, focal lobular hyperplasia (focal fibrocystic change), galactocele, abscess, fibroadenoma, lactating adenoma, and pregnancy-associated breast cancer.

Amorphous/Indistinct Calcifications (Group)

2018 ◽  
Author(s):  
Lilian Wang
Keyword(s):  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Atypical Ductal Hyperplasia ◽  
Morphological Classification ◽  
Imaging Protocols ◽  
Fibrocystic Change ◽  
Ductal Hyperplasia ◽  
Management Recommendations

Amorphous calcifications are calcifications that are sufficiently small and/or hazy that a more specific morphological classification cannot be made. Historically, such calcifications were referred to as “indistinct” calcifications. The likelihood of malignancy and the management of amorphous calcifications largely depend on their distribution. This chapter, appearing in the section on calcifications, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnosis with radiology–pathology correlation, and management recommendations for amorphous/indistinct calcifications in a group. Topics discussed include spot magnification views for characterization, role of distribution in BI-RADS assessment, and pathological entities, including fibrocystic change, milk of calcium, atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS).

Non-Mass Enhancement on MRI

2018 ◽  
Author(s):  
Diana L. Lam ◽  
Habib Rahbar
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Morphological Features ◽  
Post Contrast ◽  
Imaging Protocols ◽  
Background Parenchymal Enhancement ◽  
Management Recommendations ◽  
Normal Background ◽  
Mass Enhancement ◽  
Parenchymal Enhancement

Breast cancer presents on MRI as an enhancing finding on post-contrast T1-weighted images that is distinct from normal background parenchymal enhancement (BPE), and these enhancing lesions can be further described as a focus, mass, or non-mass enhancement (NME). Each enhancing lesion, with the exception of a focus, can be described further with specific morphological features that are defined by the ACR BI-RADS Atlas. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations of a focus of enhancement and non-mass enhancement on MRI. Topics discussed include distinguishing a focus from normal BPE, benign versus suspicious features of a focus, NME characterization, and kinetic enhancement curves.

Spiculated Masses

2018 ◽  
Author(s):  
Liva Andrejeva ◽  
Jaime L. Geisel ◽  
Malini Harigopal
Keyword(s):  
Differential Diagnosis ◽  
Tumor Cells ◽  
Clinical Features ◽  
Clinical Management ◽  
Normal Tissue ◽  
Clinical History ◽  
Benign Lesions ◽  
Imaging Protocols ◽  
Malignant Lesions ◽  
Management Recommendations

A spiculated mass is a centrally dense lesion seen on mammography with sharp lines radiating from its margin. The spicules can vary greatly in length, from a few millimeters to several centimeters. In malignant lesions, spicules represent a mixture of tumor cells and fibrosis invading the normal tissue surrounding the lesion. Although a spiculated mass is thought of as a classic finding of malignancy on mammography, ultrasound, and MRI, its differential diagnosis includes benign lesions. However, unless clinical history strongly supports a benign diagnosis, a spiculated mass on any modality typically will require additional workup and biopsy. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, radiology–pathology correlations, and clinical management recommendations for a spiculated mass. Topics discussed include both malignant and benign masses.

Mass in Male (Gynecomastia, Cancer)

2018 ◽  
Author(s):  
Eric Foo ◽  
Bonnie N. Joe
Keyword(s):  
Breast Cancer ◽  
Breast Tissue ◽  
Nipple Discharge ◽  
Male Breast ◽  
Differential Diagnoses ◽  
Benign Condition ◽  
Imaging Protocols ◽  
Management Recommendations

Gynecomastia is a benign condition manifesting as enlarged breasts in men and boys. This increased breast tissue is caused by excess fibroglandular deposits and is caused by hormonal imbalances, commonly due to estrogen excess or from various drugs, such as spironolactone, ketoconazole, cimetidine, ranitidine, and specific HIV therapies. Patients generally present with bilateral subareolar enlarged breasts (however, unilateral gynecomastia also occurs), which commonly exhibit tenderness on palpation, swelling, palpable lumps, or nipple discharge. This chapter reviews the important imaging protocols, pitfalls, differential diagnoses, radiology–pathology correlation, and management recommendations for gynecomastia and cancer of the male breast. Topics discussed include gynecomastia, breast cancer, pseudogynecomastia, hypogonadism, and lymphangioma.

Coarse Heterogeneous Calcifications

2018 ◽  
Author(s):  
Cheryce Poon Fischer
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Differential Diagnoses ◽  
Intermediate Risk ◽  
Imaging Protocols ◽  
Prior Surgery ◽  
Management Recommendations

Coarse heterogeneous calcifications are irregular calcifications that are between 0.5 mm and 1 mm in size. They are usually in a group and are smaller in size than dystrophic calcifications. Although they are of intermediate risk for breast cancer (most commonly, DCIS), they are also associated with benign entities, such as hyalinized/degenerating fibroadenoma, areas of fibrosis, papilloma, and evolving dystrophic calcifications from prior surgery or trauma. Generally, numerous bilateral groups of coarse heterogeneous calcifications may be considered benign. However, baseline magnification views may be helpful to confirm the morphology of the calcifications and to exclude more suspicious pleomorphic morphology. Coarse heterogeneous calcifications in a linear or segmental distribution are suspicious. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for coarse heterogeneous calcifications.

Sclerosing adenosis as a predictor of breast cancer bilaterality and multicentricity

2015 ◽  
Vol 467 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Mikinao Oiwa ◽  
Tokiko Endo ◽  
Shu Ichihara ◽  
Suzuko Moritani ◽  
Masaki Hasegawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sclerosing Adenosis

Qualitative Diagnosis of Solid Breast Mass by Blood Flow in Solid Breast Mass Based on Color Doppler Ultrasound

2021 ◽  
Vol 11 (6) ◽  
pp. 1608-1615
Author(s):  
Ding Zuopeng ◽  
Liu Weiyong ◽  
Hu Chunmei ◽  
Wang Tao ◽  
Wang Mingming
Keyword(s):  
Breast Cancer ◽  
Blood Flow ◽  
Differential Diagnosis ◽  
Color Doppler ◽  
Flow Characteristics ◽  
Flow Distribution ◽  
Color Doppler Ultrasound ◽  
Blood Flow Distribution ◽  
Breast Masses ◽  
Malignant Breast

The incidence of breast cancer ranks first among female malignant tumor. With the increase of the sensitivity of color Doppler ultrasound blood flow, the blood flow distribution in and around the tumor can be clearly displayed, and the analysis of hemodynamic parameters is provided, which provides convenience for the study of tumor blood flow characteristics. Studies have shown that tumor cells can secrete a substance called angiogenesis factor, which makes the tumor site form a rich vascular network to promote tumor growth and metastasis. The tumor has many new blood vessels, abnormal structure, thin wall, lack of muscle layer, and is prone to form arteriovenous rash. These characteristics provide a pathological basis for color Doppler flow imaging (CDFI) for the diagnosis of breast cancer. This article discusses the role of two-dimensional sonographic features in the differential diagnosis of benign and malignant breast masses, CDFI was used to study the blood flow distribution and hemodynamic characteristics in benign and malignant breast masses; explore the value of blood flow characteristics and blood flow parameters in the differential diagnosis of breast masses. The experimental results show that the detection rate of blood flow signals and the classification of blood flow signals in the malignant group are higher than those in the benign group, mainly level II and III blood flow, and the irregular branched blood flow is more common, especially when the tumor appears penetrating blood flow supports the diagnosis of malignancy. PSV, RI and PI have a certain differential meaning in the diagnosis of benign and malignant breast masses. PSV, RI and PI of malignant masses are higher than benign masses. For tumors without obvious necrosis, the larger the tumor diameter, the richer the blood flow and the higher the blood flow grade is. The malignant tumors have more blood flow than the benign ones.

scholarly journals Features of the decidualized endometriosis diagnosis and course during pregnancy

2021 ◽  
Author(s):  
AA Gerasimova ◽  
LA Asyrafyan ◽  
IB Manuchin ◽  
MV Shamarakova ◽  
MS Miryasova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pregnant Women ◽  
Ultrasound Imaging ◽  
Imaging Data ◽  
Surgical Interventions ◽  
Rational Treatment ◽  
Borderline Tumors ◽  
Results Of Treatment ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Currently, surgical treatment aimed to exclude the malignant ovarian tumors is performed in almost 90% of patients with decidualized endometrial cysts (DEC). However, unnecessary surgical interventions increase the risk to maternal and fetal health. The study was aimed to perform a differential diagnosis of DEC in pregnant women in order to define the rational treatment. A total of 82 female patients were included in the study: 63 had endometrial cysts (EC), 16 had DEC, 3 had rare forms of endometriosis, and 10 had ovarian serous papillary borderline tumors. When performing the diagnostic ultrasound, our proposed model was used. The ultrasound imaging data obtained were juxtaposed with the concentration of the protein tumor markers (СА-125), the risk of malignancy index (RMI) was calculated, and the morphological assessment of the masses was performed. The ultrasound imaging parameters, being the most valuable for differential diagnosis of EC, DEC, and serous borderline tumors, were as follows: the altered mass wall thickness, the existence and shape of papillary masses, avascular echogenic inclusions with blurry contour, blood circulation and arrangement of blood vessels, ascites. The frequency analysis revealed the differences between groups based on the ultrasound imaging data (in 60–100% of observations). Histological examination revealed the differences between groups in 100% of observations. Our findings have made it impossible to prolong pregnancy in patients with DEC without performing surgery. The results of treatment provided to patients with DEC during pregnancy were worse compared to those in patients with no prominent decidualization in ovarian EC. Today, the diagnosis of DEC and the treatment of patients during pregnancy remain unsophisticated. Further clinical observation and the search for more reliable methods of the diagnosis and rational treatment of pregnant women with DEC are required.

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