Neoplasien der Mamma






























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

