breast neoplasms


















Breast neoplasms consist of a wide spectrum of pathologies from benign proliferations, high-risk lesions, precursor lesions, to invasive malignancies. This article provides an overview for radiologists, with a focus on breast cancer. For a summary article for medical students and non-radiologists, see breast cancer (summary).
Epidemiology
Breast cancer is the most common nonskin malignancy in women. In the affluent populations of North America, Europe, and Australia, 6% of women develop invasive breast cancer before age 75, compared to a 2% risk in developing regions of Africa and Asia . The difference has been attributed to risks associated with a Westernized lifestyle, including high-calorie diet rich in fat and protein and physical inactivity .
Risk factors
- increasing age
- reproductive lifestyle factors increasing unopposed estrogen load
- early menarche
- nulliparity, infertility, or, if parous, few children with late age at first delivery
- lack of breastfeeding
- late menopause
- unopposed estrogen hormone replacement therapy
- personal history of breast cancer or a high risk breast lesion
- first degree relative with breast cancer
- genetic mutations
- thoracic radiation therapy
- alcohol consumption
Pathology
Classification
The main pathological classification of breast neoplasms is published by the World Health Organization: WHO classification of tumors of the breast.
The vast majority of breast cancers are adenocarcinomas (99%). The most common types are :
- invasive carcinoma of no special type (ductal carcinoma not otherwise specified): 40-75%
- ductal carcinoma in situ: 20-25%
- invasive lobular carcinoma: 5-15%
Categories of benign epithelial neoplasms include:
Nonepithelial malignancies are uncommon and include:
Immunophenotype
Three molecular biomarkers are routinely evaluated in invasive breast cancers because they have therapeutic implications:
- estrogen receptor (ER)
- progesterone receptor (PR)
- human epidermal growth factor receptor 2 (HER2; protooncogene Neu; receptor tyrosine-protein kinase erbB-2)
Staging
Staging of breast tumors is performed according to the TNM system published by the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC): breast cancer (staging).
Radiographic appearance
Dedicated evaluation of the breast involves multiple imaging modalities to detect and localize lesions for biopsy. In all modalities, regional metastasis can be suspected by the presence of axillary adenopathy.
Mammography
Neoplasms have varied appearances, including masses, asymmetries, calcifications, or architectural distortions.
Ultrasound
Neoplasms can appear as masses or architectural distortions. Calcifications can sometimes be seen.
MRI
Neoplasms can manifest as masses with or without enhancement, nonmass enhancement, or foci of enhancement.
CT
Breast masses may be incidentally identified but CT is not the preferred modality for dedicated breast evaluation. If calcifications are visualized on CT, they are nearly all benign .
Radiology report
The use of a standard lexicon is recommended to enhance communication with referrers and audit performance: breast imaging-reporting and data system (BI-RADS).
Siehe auch:
- Metastasen bei Mammakarzinom
- breast lumps
- invasives lobuläres Karzinom
- atypical ductal hyperplasia
- Morbus Paget der Mamille
- Sarkom der Mamma
- Fibromatose der Mamma
- artifacts that mimic breast calcification
- intraductales Papillom der Mamma
- Mammakarzinom beim Mann
- atypical lobular hyperplasia
- inflammatorisches Mammakarzinom
- Granularzelltumor der Mamma
- Lymphom der Mamma
- adenoid cystic carcinoma of the breast
- lobular carcinoma in situ (LCIS)
- apocrine carcinoma of the breast
- malignant phyllodes tumour
- Malignitätskriterien Sonographie Mamma
- Liposarkom der Mamma
- breast cancer staging
- komplizierte Zyste Mamma
- comedo type
- tubulolobular carcinoma of breast
- breast screening
- tubular carcinoma of breast
- non comedo type ductal carcinoma in situ
- metaplastic carcinoma of the breast
- extraskelettales Osteosarkom der Mamma
- mucinous (colloid) carcinoma
- terminal duct lobular unit (TDLU)
- metastasis to breast
- medullary carcinoma of breast (MCB)
- juvenile papillomatosis of breast
- fibrosarcoma of breast
- metastasis(es) to breast
- duktales in situ Karzinom der Mamma
- Mammakarzinom Sonographie
- papilläres Mammakarzinom
- Zystosarkoma phylloides
- Angiosarkom der Mamma
- papilläre Neoplasien der Mamma
und weiter:
- Tumoren der Schädelkalotte
- solitäre lytische Läsion des Schädels
- Kerley-Linien
- osteoblastische Knochenmetastasen
- cancer
- miliare Lungenherde
- breast curriculum
- tree in bud-Muster
- hyperdenser Lymphknoten
- Metastasen in der Orbita
- ultrasound appearances of liver metastases
- bilaterale axilläre Lymphadenopathie
- breast ultrasound
- differential diagnosis of unilateral axillary lymphadenopathy
- nodular pleural thickening
- Somatostatin-Rezeptor-Szintigrafie
- Krukenberg-Tumor
- Mondor disease
- lung mass with calcification
- ivory vertebra sign
- FIGO-Klassifikation
- miliary nodules in the exam
- hyperechoic breast lesions
- microglandular adenosis of the breast
- seltene Mammatumoren
- metastases to the pituitary gland
- sclerosing adenosis
- chronische abakterielle Mastitis
- breast screening programmes
- diabetische Mastopathie
- metastatic axillary lymphadenopathy of unknown primary
- ADH
- einfache Zyste Mamma
- architectural distortion in mammography
- fibrosarcoma of the breast
- asymmetrical density in mammography
- tubular carcinoma of the breast
- haemorrhagic metastases (mnemonic)
- metastases to the cervix
- ALH
- mucinous carcinoma of the breast
- differential diagnosis of calcific axillary lymphadenopathy
- fibroadenomatoid mastopathy
- postoperative Narben Mamma
- medullary carcinoma of the breast
- LCIS
- lobular breast carcinoma
- ductal adenoma of breast
- triple receptor negative breast cancer
- Brachytherapie
- pregnancy associated breast cancer
- Cowden-Syndrom
- intracystic papillary carcinoma of the breast
- Aschoff's proliferative centre
- multi-focal breast cancer
- differential diagnosis of dilated ducts on breast imaging
- multi-centric breast cancer
- breast self-examination
- bilateral lobular carcinoma of the breast
- differential diagnosis of dilated mammary veins
- Galaktozele
- Mammakarzinom in einer Zyste
- Superscan Szintigraphie
- Abszess der Mamma
- Senologie
- scirrhous carcinoma of the breast
- Brustdichte in der Mammographie
- gemischt osteolytisch osteoblastische Knochenmetastasen
- verkalkte Metastasen
- idiopathische granulomatöse Mastitis
- granulomatöse Mastitiden allgemein
