BREAST+IMAGING+MODALITIES

__Breast screening and imaging modalities __


 * Mammography
 * MRI
 * Scintimammography-Nuclear Medicine
 * Ultrasound

__Mammography __



Ø Gold standard for breast imaging Ø Used as a diagnostic for symptomatic patients or as a screening tool for asymptomatic women ages 40 and over Ø The goal is early detection of breast cancer Ø Proven to reduce mortality rate from breast cancer Ø Uses low dose ionizing radiation to create images Ø It can detect tumors long before they can be palpated



Magnetic Resonance Imaging of the Breast (MRI)



Ø Noninvasive test that uses a powerful magnetic field, radiofrequency pulses and a computer to acquire images Ø Provides good contrast between soft tissues and evaluation of dense breasts Ø <span style="font-family: 'Arial','sans-serif';">Used as follow up to other breast imaging modalities Ø <span style="font-family: 'Arial','sans-serif';">Used to stage the extent of breast cancer Ø <span style="font-family: 'Arial','sans-serif';">May be used as a screening tool for women with very high risk of developing breast cancer __<span style="font-family: 'Arial','sans-serif';">Disadvantages __ · <span style="font-family: 'Arial','sans-serif';">Increased cost · <span style="font-family: 'Arial','sans-serif';">Increased exam time · <span style="font-family: 'Arial','sans-serif';">Differentiation between benign and malignant tumors



__<span style="color: #008000; font-family: 'Arial','sans-serif'; font-size: 120%; line-height: 115%; margin: 0in 0in 10pt;">Scintimammography- Nuclear Medicine Test __

Ø <span style="font-family: 'Arial','sans-serif';">Used to detect cancer cells in the patients with abnormal mammograms Ø <span style="font-family: 'Arial','sans-serif';">Not used for screening or in the place of a mammogram Ø <span style="font-family: 'Arial','sans-serif';">Uses a small amount of a radioactive substance called technetium 99, a tracer injected into the patients vein, which is then taken up by cancer cells Ø <span style="font-family: 'Arial','sans-serif';">Improved evaluation of dense breasts and lesions difficult to identify with mammography Ø <span style="font-family: 'Arial','sans-serif';">Radiation is a great diadvantage

__<span style="font-family: Arial,Helvetica,sans-serif;">Ultrasound __


 * Typically used for further evaluation of masses found on mammography or for palpable masses
 * Allows us to obtain images in almost any orientation
 * Especially usefull in patients with dense breasts.( common in younger women)
 * Masses in patients with dense breasts are difficult to detect on mammograms
 * Guided interventional procedures of the breast

<span style="color: #000080; font-family: 'Arial','sans-serif'; font-size: 130%; line-height: 200%; margin-left: 22.5pt;">Used as screening tool for women ages 30 and under that have a high risk for developing breast canner or for in patients presenting with: § <span style="font-family: 'Arial','sans-serif';">palpable breast lump § <span style="font-family: 'Arial','sans-serif';">dense breasts § <span style="font-family: 'Arial','sans-serif';">pregnant or lactating patients § <span style="font-family: 'Arial','sans-serif';">breast augmentation

//<span style="font-family: Arial,Helvetica,sans-serif;">Innovation in Breast Ultrasound Imaging //

__<span style="color: #800080; font-family: Arial,Helvetica,sans-serif; font-size: 150%; line-height: 200%; margin: 0in 0in 10pt;">Automated Breast Volume Scanner - ABVS –Ultrasound System __ o <span style="color: #800080; font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Acquires full volume images of the breast o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Offers a more comprehensive representation of the global anatomy of the breast o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Ideal for dense breasts o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Can distinguish between fatty and dense tissue o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Diagnostic confidence is significantly increased o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Allows us to aquire coronal view images ( view from nipple line to the breast wall) o <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%;">Improved comfort and significantly reduced examination time <span style="color: #800080; font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 200%; margin: 0in 0in 10pt 0.25in; text-indent: -0.25in;">

<span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 0px; margin: 0in 0in 10pt 0.25in; overflow: hidden; text-indent: -0.25in;"> <span style="font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 0px; margin: 0in 0in 10pt 0.25in; overflow: hidden; text-indent: -0.25in;">media type="youtube" key="4Z5iLLDXHa0" height="390" width="640"

__<span style="font-family: 'Arial','sans-serif';">Elastography __

v <span style="font-family: 'Arial','sans-serif';">New and invaluable screening tool v <span style="font-family: 'Arial','sans-serif';">Real time scanning technique v <span style="font-family: 'Arial','sans-serif';">Looks at the mechanical properties of tissue v <span style="font-family: 'Arial','sans-serif';">Determines the stiffness of the tissue by measuring the degree of distortion un external force application v <span style="font-family: 'Arial','sans-serif';">Provides further insight into potential pathology v <span style="font-family: 'Arial','sans-serif';">Has a good sensitivity for distinguishing benign vs. malignant lesion v <span style="font-family: 'Arial','sans-serif';">Reproducible, more accurate diagnosis v <span style="font-family: 'Arial','sans-serif';">Provides better care and management of the patient

//__ Breast lesions appearance with Elastography vs.B Mode __// Stiff Masses( tissue) =Anechoic Non-stiff(soft) tissue= Echogenic

//__ CYSTS __// //__ Appearance __// Target Sign lesion Posterior enhancement Cyst looks smaller that what it looks like on B Mode US

//__ Benign Lesions- Fibroadenoma __// //__ Appearance __// Benign lesion usually look similar or smaller than on B-Mode Images

//__ Suspicious (Malignant Lesions) __// //__ Malignant Lesions -Appearance __// Larger than on B- Mode due to Desmoplastic reactiona around the mass. On B Mode this reaction appears as normal tissue but at a microscopic level this tissue is in fact stiffer.

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