Diagnostic Imaging: Breast

Anatomy and Normal Variants
Anatomy
Breast Overview
Embryology and Normal Development
Nipple-Areolar Complex and Skin
Segmental Anatomy
Pectoralis Muscle and Chest Wall
Neurovascular Supply
Lymph Nodes and Lymphatics
Axilla
Normal Variants
Axillary Breast Tissue
Pectoralis Muscle and Chest Wall Variants
Sternalis Muscle
Imaging
Modalities
Mammography: Positioning
Mammography: Diagnostic
Tomosynthesis
Contrast-Enhanced Mammography/Tomosynthesis
Ultrasound
Elastography
Automated Breast Ultrasound
Magnetic Resonance Imaging
Diffusion-Weighted Imaging (MR)
MR Spectroscopy
Molecular Breast Imaging (MBI and BSGI)
Dedicated Breast PET (PEM)
PET/CT
Interpretive Criteria
Approach to the Lexicons of Breast Imaging
Mammography BI-RADS Lexicon and Usage
Ultrasound BI-RADS Lexicon and Usage
MR BI-RADS Lexicon and Usage
Probably Benign Lesions
Molecular Breast Imaging Lexicon (Includes BSGI)
Breast PET Lexicon and Usage
Lesion Imaging Characteristics
Masses
Circumscribed and Obscured Margins
Intramammary Lymph Node
Fat-Containing Mass
Microlobulated Margins
Indistinct Margins
Spiculated Margins
High-Density Mass
Calcifications, Typically Benign
Typically Benign Calcifications
Round Calcifications
Milk of Calcium
Calcifications, Not Typically Benign
Punctate Calcifications
Coarse Heterogeneous Calcifications
Amorphous Calcifications
Fine Pleomorphic Calcifications
Fine Linear Calcifications
Calcification Distribution
Diffuse Distribution of Calcifications
Regional Distribution of Calcifications
Grouped Distribution of Calcifications
Linear Distribution of Calcifications
Segmental Distribution of Calcifications
Additional Findings
One-View-Only Findings
Asymmetries
Developing Asymmetry
Architectural Distortion
Trabecular Thickening, Edema
Multiple Bilateral Similar Findings
Duct Ectasia
Solitary Dilated Duct
Ultrasound Lesion Characteristics
Margins, Not Circumscribed (US)
Echogenic Rim (US)
Lesion Orientation (US)
Posterior Acoustic Features: Enhancement & Shadowing (US)
Posterior Shadowing (US)
Echogenicity: Anechoic (US)
Echogenicity: Isoechoic, Hypoechoic, and Mixed (US)
Echogenicity: Hyperechoic (US)
Heterogeneous Internal Echogenicity (US)
Simple Cyst (US)
Complicated Cyst With Debris (US)
Clustered Microcysts (US)
Intraductal Mass (US)
Complex Cystic and Solid Masses
Calcifications (US)
MR Findings
Background Parenchymal Enhancement (MR)
T2 Hyperintensity (MR)
Kinetic Assessment (MR)
Dark Internal Septations (MR)
Rim Enhancement (MR)
Focus (MR)
Focal Area, Regional, and Diffuse Enhancement (MR)
Linear Enhancement (MR)
Segmental Enhancement (MR)
Clumped and Clustered Ring Enhancement (MR)
Clustered Ring Enhancement (MR) [DELETE AFTER WENDIE DONE WITH IT]
Histopathologic Diagnoses
Approach to Histopathologic Diagnoses
Benign Lesions
Tubular Adenoma and Nipple Adenoma
Adenosis, Sclerosing Adenosis, Microglandular Adenosis
Apocrine Metaplasia
Columnar Cell Lesions
Cyst, Ruptured/Inflamed
Fat Necrosis, Oil Cyst
Hamartoma (Fibroadenolipoma)
Fibroadenoma
Fibroadenomatoid Change
Fibrocystic Changes
Fibrosis
Hematoma
Lipoma and Angiolipoma
Myoepithelial Neoplasms
Myofibroblastoma
Papilloma, Benign
PASH
Risk Lesions
Radial Scar, Radial Sclerosing Lesions
Atypical Ductal Hyperplasia
Atypical Lobular Hyperplasia
Flat Epithelial Atypia
Lobular Carcinoma In Situ (Classic)
Mucocele-Like Lesions
Atypical Papilloma
Locally Aggressive Lesions
Fibromatosis
Granular Cell Tumor
Phyllodes Tumor: Benign
Malignant Lesions
DCIS, General
DCIS, Low Grade
DCIS, Intermediate Grade
DCIS, High Grade
DCIS, Micropapillary
Invasive Ductal Carcinoma NOS, General
Invasive Ductal Carcinoma NOS, Grade 1, 2, 3
Invasive Lobular Carcinoma
Invasive Lobular Carcinoma, Pleomorphic
Lobular Carcinoma In Situ, Pleomorphic
Mixed Invasive Ductal and Lobular Carcinoma
Apocrine Carcinoma
Invasive Micropapillary Carcinoma
Luminal A and B Cancers
HER2-Positive Cancer
Triple-Negative and Basal-Like Breast Cancer
Adenoid Cystic Carcinoma
Medullary Carcinoma
Metaplastic Carcinoma
Mucinous Carcinoma
Tubular Carcinoma
Tubulolobular Carcinoma
Encapsulated Papillary Carcinoma
Papillary Carcinoma, Invasive
Phyllodes Tumor: Borderline and Malignant
Sarcomas
Lymphoma, Primary Breast
Signs and Symptoms
Approach to Signs and Symptoms of Disease
Nipple
Nipple Discharge
Nipple Retraction and Inversion
Paget Disease of the Nipple
Skin
Epidermoid Cyst
Sebaceous Cyst
Skin Lesions, Other
Erythema
Skin Retraction
Skin Thickening
Axilla
Axillary Adenopathy
Axillary Nodal Calcification
Metastatic Adenopathy, Unknown Primary
Breast
Palpable Lump or Thickening
Pain
Shrunken Breast
Vascular Entities
Mondor Disease
Benign Lesions of Vascular Origin
Postoperative and Post-Treatment Imaging
Approach to Postoperative Imaging Findings
Results of Benign Intervention
Benign Surgical Biopsy, Postoperative Imaging
Post-Core Biopsy and Clip Placement Imaging
Reduction Mammoplasty, Imaging
Implant, Saline
Implant, Silicone
Implant With Multiple Lumina
Implants and Cancer
Silicone Granuloma
Cosmetic Augmentation Injections
Results Following Treatment for Malignancies
Positive or Close Margins
Post Breast-Conserving Surgery
Recurrent Breast Carcinoma
Neoadjuvant Chemotherapy
Accelerated Partial Breast Irradiation
Tissue Transfer Reconstruction Imaging
Special Topics
Hormonal Changes
Hormonal Manipulation
Gender Reassignment
Terminology and Imaging Appearance
Cancer and Screening in Transgendered Patients
Pregnancy
Galactocele
Lactation
Lactating Adenoma
Pregnancy-Associated Breast Cancer
Infections and Inflammation
Abscess
Idiopathic Granulomatous Mastitis
Mastitis
Unusual Infections
Breast Manifestations of Systemic Conditions
Weight Fluctuations
Diabetic Mastopathy/Lymphocytic Lobulitis
Collagen Vascular Disease
Breast Manifestations of Organ Failure
Sarcoid
Amyloid
Leukemia
Lymphoma, Secondary
Metastases to Breast
Trauma
Trauma
Male Breast
Gynecomastia
Male, Breast Cancer
Male, Other Neoplasms
Artifacts
Artifacts: Mammography and Tomosynthesis
Artifacts: Ultrasound
Artifacts: MR
Artifacts: Nuclear Medicine
Imaging Safety
Radiation Dose and Safety: Mammography and Tomosynthesis
Gadolinium Safety
Contrast Reactions
Screening
Focused Issues in Screening
Approach to Screening
Risk Assessment Models
Screening Mammography
Screening Intervals: Annual vs. Biennial
Screening at Age Extremes (< 40, > 70 Years)
Screening in 5th Decade (40-49 Years)
Interval Cancers
Missed Cancers
CAD and Double Reading
Breast Density
Screening Ultrasound
Screening MR
Abbreviated Breast MR
Personal History of Breast Cancer Surveillance
Prior Chest Radiation Therapy, Surveillance
Genetics
Indications for Genetic Testing
BRCA1 and BRCA2 Mutation Carriers
Li-Fraumeni Syndrome
Gene Mutations Beyond BRCA
Genetic Testing Techniques (e.g., Oncotype, MammoPrint)
Treatment
Principles in Treatment
Approach to Breast Cancer
Staging: Breast
Pathology Overview
Surgery Overview
Radiation Therapy Overview
Oncology Overview (Adjuvant and Neoadjuvant)
Focused Issues in Treatment
Approach to Treatment Planning
Multifocal/Multicentric Breast Cancer
Extensive Intraductal Component
Contralateral Breast Cancer
Locally Advanced Breast Cancer
Pectoralis Muscle and Chest Wall Invasion
Skin Invasion
Inflammatory Breast Carcinoma
Internal Mammary Adenopathy
Metastatic Breast Cancer
Breast Cancer in Young Patients (< 40 Years)
Procedures
Image-Guided Procedures
Ductography
Cyst Aspiration
Fine-Needle Aspiration Biopsy, Breast
Skin Localization
Ultrasound-Guided Core Biopsy
Ultrasound-Guided Vaccum-Assisted Biopsy
Stereotactic Biopsy, Prone
Stereotactic Biopsy, Upright
MR-Guided Vacuum-Assisted Biopsy
MR-Directed Ultrasound
Imaging-Histopathologic Discordance
Preoperative Wire Localization, Mammography
Preoperative Wire Localization, Ultrasound
Preoperative Wire Localization, MR
Preoperative Localization, Tomosynthesis
Preoperative Radioactive Seed Localization
Preoperative Localization in Axilla
Preoperative Lesion Localization, Bracketing
Preoperative Magnetic, Other Nonradioactive Localization
Specimen Imaging
Image-Guided Thermal Ablation (and Cryotherapy)
Surgical Procedures
Sentinel Lymph Node Biopsy
Axillary Lymph Node Dissection
Targeted Axillary Dissection
Breast-Conserving Surgery
Mastectomy
Oncoplastic Techniques
Reduction Mammoplasty, Procedure
TRAM and Other Flap Procedures