Diagnostic Imaging Breast, 4th Edition

Diagnostic Imaging: Breast 4th ed delivers a comprehensive guide for breast imaging specialists with essential details for everyday breast imaging and the potential to positively impact the delivery of breast care and optimized patient outcomes. Because breast imagers consider a wide range of factors in their work with every patient they see, this book’s wide range of topic coverage is invaluable as it provides a one-stop resource. Increasingly, breast imaging is a patient-centered and individualized practice, and breast screening, formerly the domain of mammography alone, is now performed or augmented with other imaging modalities including digital mammography, hand-held ultrasound, dynamic contrast-enhanced MR, digital breast tomosynthesis, and other methods depending on individual patient characteristics. DI Breast begins with substantial anatomy coverage and provides the anatomy of, and normal variants of, breast anatomy. Additional content on the daily practice of breast imagers is included in each of the book’s 15 sections, with content on physical principles of breast MRI, techniques for performing image-guided biopsies, radioactive seed localization, and a wealth of clinical images to help evaluate breast symptoms such as breast lumps, nipple discharge, and axillary adenopathy. Helpful chapters detail the role of imaging in determining the extent of disease and principles of breast cancer treatment with surgery, plastic surgery, radiation therapy, and chemotherapy as well as expanded chapters on incidence during pregnancy, general infections and inflammations, and male breast disease.

• Provides comprehensive, expert information on breast anatomy and normal variants, physical principles of breast MR, techniques for performing image-guided biopsies and preoperative localization, the role of imaging in determining the extent of disease, and principles of breast cancer treatment with surgery, oncoplastics, radiation therapy, and chemotherapy
• Discusses updated and standard imaging protocols, treatment plans, and image-guided and surgical procedures with an eye toward trending topics in frontline breast imaging
• Contains new BI-RADS details across all relevant chapters, as well as updated information from American College of Radiology, American Society of Breast Surgeons, and National Comprehensive Cancer Network on evolving medical, surgical, and radiation treatment of breast cancer patients, along with discussion of ongoing trials and future directions in patient care
• Includes details on 2024 federal screening guidelines that ensure equity and access
• Features more than 8,300 high-quality print and online-only images and illustrations to help evaluate breast symptoms, such as palpable lumps, nipple discharge, and axillary adenopathy
• Uses a bulleted, image-rich layout with short chapters designed for quick access to critical content on terminology, characteristics seen in various imaging studies on the same anatomic location, differential diagnoses, pathological and clinical issues to consider, and more
• Provides a diagnostic checklist and updated references with each chapter
• Includes an eBook version that enables you to access all text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Any additional digital ancillary content may publish up to 6 weeks following the publication date.

SECTION 1: ANATOMY AND NORMAL VARIANTS
ANATOMY
Breast Overview
Embryology and Normal Development
Segmental Anatomy
Nipple-Areolar Complex and Skin
Neurovascular Supply
Lymph Nodes and Lymphatics
Axilla
Pectoralis Muscle and Chest Wall
NORMAL VARIANTS
Axillary Breast Tissue
Pectoralis Muscle and Chest Wall Variants
Sternalis Muscle

SECTION 2: IMAGING
BREAST IMAGING OVERVIEW
Approach to Screening
Screening Mammography
Diagnostic Mammography
Mammography Positioning
Tomosynthesis
Breast Density
Ultrasound
Magnetic Resonance Imaging
Interval Cancers
Missed Cancers
SPECIAL TOPICS IN SCREENING AND DIAGNOSTIC IMAGING
Screening at Age Extremes (< 40, > 70 Years)
Screening in 5th Decade (40-49 Years)
Screening Intervals: Annual vs. Biennial
Screening Ultrasound
Automated Breast Ultrasound
Elastography
Risk Assessment Models
Indications and Management of Genetic Testing
BRCA1 and BRCA2 Mutation Carriers
Screening MR
Abbreviated Breast MR
Diffusion-Weighted Imaging (MR)
MR Spectroscopy
CAD and Double Reading: Mammography and Tomosynthesis
Contrast-Enhanced Mammography Overview
Contrast-Enhanced Mammography Lexicon and Usage
Contrast-Enhanced Mammography-Directed Core Needle Biopsy
Molecular Breast Imaging (MBI and BSGI)
Dedicated Breast PET (PEM)
PET/CT

SECTION 3: INTERPRETIVE CRITERIA
Approach to Lexicons of Breast Imaging
Mammography BI-RADS Lexicon and Usage
Probably Benign Lesions
Ultrasound BI-RADS Lexicon and Usage
MR BI-RADS Lexicon and Usage
Molecular Breast Imaging Lexicon (Includes BSGI)
Breast PET Lexicon and Usage

SECTION 4: LESION IMAGING CHARACTERISTICS
MASSES
Circumscribed and Obscured Margins
Fat-Containing Mass
High-Density Mass
Indistinct Margins
Intramammary Lymph Node
Microlobulated Margins
Spiculated Margins
CALCIFICATIONS, TYPICALLY BENIGN
Typically Benign Calcifications
Round Calcifications
Milk of Calcium
CALCIFICATIONS, NOT TYPICALLY BENIGN
Punctate Calcifications
Amorphous Calcifications
Coarse Heterogeneous Calcifications
Fine Pleomorphic Calcifications
Fine Linear Calcifications
CALCIFICATION DISTRIBUTION
Diffuse Distribution of Calcifications
Grouped Distribution of Calcifications
Regional Distribution of Calcifications
Linear Distribution of Calcifications
Segmental Distribution of Calcifications
ADDITIONAL FINDINGS
Architectural Distortion
Asymmetries
Developing Asymmetry
Duct Ectasia
Multiple Bilateral Similar Findings
One-View-Only Findings
Solitary Dilated Duct
Trabecular Thickening, Edema
ULTRASOUND LESION CHARACTERISTICS
Calcifications (US)
Clustered Microcysts (US)
Complex Cystic and Solid Masses (US)
Complicated Cyst with Debris (US)
Cyst, Simple (US)
Echogenicity: Anechoic (US)
Echogenicity: Hyperechoic (US)
Echogenicity: Hypoechoic (US)
Echogenicity: Isoechoic (US)
Echogenic Rim (US)
Echogenicity: Heterogeneous/Mixed (US)
Intraductal Mass (US)
Lesion Orientation (US)
Margins, Not Circumscribed (US)
Posterior Features (US)
MR FINDINGS
Background Parenchymal Enhancement (MR)
Kinetic Assessment (MR)
T2 Hyperintensity (MR)
Dark Internal Septations (MR)
Mass (MR)
Focal Area, Regional, and Diffuse Enhancement (MR)
Clumped and Clustered Ring Enhancement (MR)
Linear Enhancement (MR)
Segmental Enhancement (MR)
Rim Enhancement (MR)

SECTION 5: HISTOPATHOLOGIC DIAGNOSES
Pathology Methods
Approach to Histopathologic Diagnoses
Imaging-Histopathologic Discordance
BENIGN LESIONS
Adenosis, Sclerosing Adenosis, Microglandular Adenosis
Apocrine Metaplasia
Columnar Cell Lesions
Cyst, Ruptured/Inflamed
Fat Necrosis, Oil Cyst
Fibroadenoma
Fibroadenomatoid Change
Fibrocystic Change
Fibrosis
Hamartoma (Fibroadenolipoma)
Hematoma
Lipoma and Angiolipoma
Papilloma, Benign
PASH
Radial Scar, Radial Sclerosing Lesions
Tubular Adenoma and Nipple Adenoma
RISK LESIONS
Atypical Ductal Hyperplasia
Atypical Lobular Hyperplasia
Atypical Papilloma
Flat Epithelial Atypia
Lobular Carcinoma in Situ, Classic
Lobular Carcinoma in Situ, Pleomorphic
Mucocele-Like Lesions

LOCALLY AGGRESSIVE LESIONS
Fibromatosis
Granular Cell Tumor
Myoepithelial Neoplasms
Myofibroblastoma
Phyllodes Tumor: Benign
Phyllodes Tumor: Borderline and Malignant
MALIGNANT LESIONS
Adenoid Cystic Carcinoma
Apocrine Carcinoma
DCIS, General
DCIS, Low Grade
DCIS, Intermediate Grade
DCIS, High Grade
DCIS, Micropapillary
Encapsulated Papillary Carcinoma
HER2-Positive Cancer
Invasive Ductal Carcinoma NST, Grade 1, 2, 3
Invasive Lobular Carcinoma, Classic
Invasive Lobular Carcinoma, Pleomorphic
Invasive Micropapillary Carcinoma
Luminal A and B Cancers
Lymphoma, Primary Breast
Medullary Carcinoma
Metaplastic Carcinoma
Mixed Invasive Ductal and Lobular Carcinoma
Mucinous Carcinoma
Papillary Carcinoma, Invasive
Sarcomas
Triple-Negative and Basal-Like Breast Cancer
Tubular and Tubulolobular Carcinoma

SECTION 6: SIGNS AND SYMPTOMS
Approach to Signs and Symptoms of Disease
NIPPLE
Nipple Discharge
Nipple Retraction and Inversion
Paget Disease of Nipple
SKIN
Epidermoid Cyst
Erythema
Sebaceous Cyst
Skin Lesions, Other
Skin Retraction
Skin Thickening
AXILLA
Axillary Adenopathy
Axillary Nodal Calcification
Metastatic Node, Unknown Primary
BREAST
Pain
Palpable Lump or Thickening
VASCULAR ENTITIES
Benign Lesions of Vascular Origin
Mondor Disease

SECTION 7: SPECIAL TOPICS
HORMONAL CHANGES
Hormonal Supplementation
Hormone Blocking: Endocrine Therapy
GENDER REASSIGNMENT
Transgender Patients: Terminology and Normal Appearances
Transgender Patients: Surveillance and Cancer
PREGNANCY
Galactocele
Lactating Adenoma
Lactation
Pregnancy-Associated Breast Cancer
INFECTIONS AND INFLAMMATION
Abscess
Granulomatous Mastitis
Mastitis
Unusual Infections
BREAST MANIFESTATIONS OF SYSTEMIC CONDITIONS
Amyloid