DDx Breast
Terms
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- Benign Lesions with Typical Appearances
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Lipoma
Fibroadenoma
Intramammary Lymph Node
Lipid Cyst - Single wellfefined soft Tissue Opacit
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Benign Cyst
fibroadenoma
Intrammamary lymph node
skin lesion
Papilloma
galactocele
hamartoma
nipple not in prophile
Malignant
Cystosarcoma phylloides
carcinoma - Multiple Well Defined Soft Tissue opacities
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cysts
fibroadenomas
skin lesions
silicone injections
Intramammary lymph nodes
Mets - Large > 5cm well Defined Opacity
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giant cyst
giant fibroadenoma
sebaceous cyst
cystosarcoma phylloides - Benigh Conditions that Mimic Malignancy
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Microcalcification (sclerosing adenosis (one/both breasts widely seperated opacities)
Suspcious soft tissue opacity
i)fibroadenoma when 1 marnin ill defined
ii) fat necrosi ill defined, sometimes radiolucen t center
iii) post biopsy scar
iv) radial scar
v) plasma cell mastitis
vi) hematoma
vii) summation of norman tissues
viii) irregular skin lesion - Carcinoma
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Primary features
1)Opacity ill defined, spiculated outline, comet tail, usually dense
2) Microcalcificaton mixture of sizes and shapes; linear branching, punctate cluster arrangement. Eccentric to/or outside soft tissue opacity
Secondary Feature
1) Distortion adjacent tissues, obliteration syncutaneous retromammary spaces
2) skin, nipple retraction
edema
halo
Duct dilation
Venous engorgement - Edematous Breast
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Signs on Mamography
diffuse incraesed density
skin thickening
Course reticular apttern
promint Cooper's ligament
Causes
Inflammatory carcinoma
Rx
Lymphatic obstruction
Venous obstruction
recent surgery
breast Abcess -
Ultrasound in Breast Disease
Uses and indication -
Dense parechyma
breast tenderness
breat implant
equivical mamography
biopsy, localization guidance -
Ultrasound in Breast Disease
Typical appearances of Carcinoma -
poorly reflective mass
ill defined mass
heterogenous internal pattern
absent 'far wall' echo
posterior acoustic shadowing -
Ultrasound in Breast Disease
Typical appearances of Cysts -
round, oval in shape
well defined
anechoic
posterior wall enhancement
posterior acoustic enhancement -
Ultrasound in Breast Disease
Typical appearances of Fibroadenoma -
Rounded or Oval (may be lobulated)
poorly reflective
homogenous wcho pattern
variable posterior echo pattern