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:
- invasives lobuläres Karzinom
- breast lumps
- Metastasen bei Mammakarzinom
- intraductales Papillom der Mamma
- Morbus Paget der Mamille
- Mammakarzinom beim Mann
- Fibromatose der Mamma
- Lymphom der Mamma
- Phylloidestumor
- duktales in situ Karzinom der Mamma
- tubular carcinoma of breast
- Sarkom der Mamma
- Granularzelltumor der Mamma
- inflammatorisches Mammakarzinom
- adenoid cystic carcinoma of the breast
- artifacts that mimic breast calcification
- Liposarkom der Mamma
- lobular carcinoma in situ (LCIS)
- Malignitätskriterien Sonographie Mamma
- komplizierte Zyste Mamma
- Kontrastmittel in der Magnetresonanztomographie
- apocrine carcinoma of the breast
- extraskelettales Osteosarkom der Mamma
- tubulolobular carcinoma of breast
- Mamma MRT Kontrastmitteldynamik
- papilläre Neoplasien der Mamma
- Angiosarkom der Mamma
- papilläres Mammakarzinom
- medullary breast carcinoma
- Mammakarzinom Sonographie
- metaplastic carcinoma of the breast
- metastasis to the breast
- Atypische duktale Hyperplasie (ADH)
- Mamma-MRT
- invasives muzinöses Mammakarzinom
- comedo type
- breast screening
- terminal duct lobular unit (TDLU)
- atypische lobuläre Hyperplasie (ALH)
- metastasis(es) to breast
- Nicht-Komedo duktales in situ Karzinom der Mamma
- Juvenile Papillomatose der Mamma
- maligner Phylloidestumor
- Mammakarzinom Staging
- Fibrosarkom der Mamma
und weiter:
- Tumoren der Schädelkalotte
- osteoblastische Knochenmetastasen
- Kerley-Linien
- solitäre lytische Läsion des Schädels
- Superscan Szintigraphie
- cancer
- tree in bud-Muster
- breast curriculum
- miliare Lungenherde
- Metastasen in der Orbita
- bilaterale axilläre Lymphadenopathie
- metastases to the pituitary gland
- Krukenberg-Tumor
- hyperdenser Lymphknoten
- chronische abakterielle Mastitis
- Mondor disease
- breast ultrasound
- fibroadenomatoid mastopathy
- ultrasound appearances of liver metastases
- verkalkte Metastasen
- ivory vertebra sign
- differential diagnosis of unilateral axillary lymphadenopathy
- miliary nodules in the exam
- Cowden-Syndrom
- diabetische Mastopathie
- Somatostatin-Rezeptor-Szintigrafie
- FIGO-Klassifikation
- tubular carcinoma of the breast
- seltene Mammatumoren
- hyperechoic breast lesions
- metastatic axillary lymphadenopathy of unknown primary
- architectural distortion in mammography
- einfache Zyste Mamma
- microglandular adenosis of the breast
- Galaktozele
- LCIS
- breast screening programmes
- medullary carcinoma of the breast
- postoperative Narben Mamma
- triple receptor negative breast cancer
- differential diagnosis of calcific axillary lymphadenopathy
- Brachytherapie
- ductal adenoma of breast
- lobular breast carcinoma
- pregnancy associated breast cancer
- Mammakarzinom in einer Zyste
- intracystic papillary carcinoma of the breast
- multi-focal breast cancer
- bilateral lobular carcinoma of the breast
- multi-centric breast cancer
- Brustdichte in der Mammographie
- gemischt osteolytisch osteoblastische Knochenmetastasen
- differential diagnosis of dilated mammary veins
- breast self-examination
- differential diagnosis of dilated ducts on breast imaging
- idiopathische granulomatöse Mastitis
- Abszess der Mamma
- granulomatöse Mastitiden allgemein
- sklerosierende Adenose der Mamma
- eingeblutete Metastasen
- radiäre Narbe der Mamma
- Senologie
- scirrhous carcinoma of the breast
- hyperdense pulmonale Raumforderungen
- Lungenmetastasen bei Mammakarzinom
- Metastasen in der Cervix uteri
- asymmetrische mammographische Dichte

