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IMAGING OF THE BREAST –
TECHNICAL ASPECTS AND
CLINICAL IMPLICATION
Edited by Laszlo Tabar
Imaging of the Breast – Technical Aspects and Clinical Implication
Edited by Laszlo Tabar
Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia
Copyright © 2012 InTech
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Publishing Process Manager Bojan Rafaj
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team
First published March, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechopen.com
Imaging of the Breast – Technical Aspects and Clinical Implication,
Edited by Laszlo Tabar
p. cm.
ISBN 978-953-51-0284-7
Contents
Preface IX
Part 1 New, Innovative Breast Imaging Modalities 1
Chapter 1 Magnetic Resonance Imaging of the Breast 3
Marc Lobbes and Carla Boetes
Chapter 2 The Application of Breast MRI
on Asian Women (Dense Breast Pattern) 17
Ting Kai Leung
Chapter 3 Scintimammography - Molecular Imaging:
Value and New Perspectives with
99m
Tc(V)-DMSA 61
Vassilios Papantoniou, Pipitsa Valsamaki and Spyridon Tsiouris
Chapter 4 Digital Mammography 81
Cherie M. Kuzmiak
Chapter 5 Image Quality Requirements
for Digital Mammography in Breast Cancer Screening 115
Margarita Chevalier, Fernando Leyton, Maria Nogueira Tavares,
Marcio Oliveira, Teogenes A. da Silva and João Emilio Peixoto
Chapter 6 Contrast Enhancement
in Mammography Imaging Including K Edge Filtering 133
George Zentai
Chapter 7 Standards for Electrical
Impedance Mammography 159
Marina Korotkova and Alexander Karpov
Chapter 8 The Role of Molecular Imaging Technologies
in Breast Cancer Diagnosis and Management 179
Anne Rosenberg, Douglas Arthur Kieper, Mark B. Williams,
Nathalie Johnson and Leora Lanzkowsky
VI Contents
Part 2 Clinical Implications 197
Chapter 9 Suspicious Nipple Discharge Diagnostic Evaluation 199
Yukiko Tokuda and Yoshinori Kodama
Chapter 10 Radiotherapy After Surgery
for Small Breast Cancers of Stellate Appearance 217
Laszlo Tabar, Nadja Lindhe, Amy M.F. Yen, Tony H.H. Chen,
Sherry Y.H. Chiu, Jean C.Y. Fann, Sam L.S. Chen, Grace H.M. Wu,
Rex C.C. Huang, Judith Offman, Fiona A. Dungey, Wendy Y.Y. Wu,
Robert A. Smith and Stephen W. Duffy
Preface
Early detection of breast cancer combined with targeted therapy offers the best
outcome for breast cancer patients. The development of low-dose screen-film
mammography made the early detection of breast cancer a reality. This technology
was successfully implemented in the population-based screening trials, which proved
that the early detection of breast cancer through mammography screening can prevent
at least 40% of the deaths from breast cancer in participating women. Additionally,
these smaller and less advanced cancers do not need as extensive therapy as the larger,
palpable cancers.
The heterogeneity of benign and malignant breast diseases has necessitated the
development of supplementary imaging methods for their improved detection and
differential diagnosis. The optimum preoperative diagnosis and mapping of the full
disease extent has become an important prerequisite for adequate management of the
disease. This volume deal with a wide range of new technical innovations for
improving breast cancer detection, diagnosis and therapy. There is a special focus on
improvements in mammographic image quality, image analysis, magnetic resonance
imaging of the breast and molecular imaging. A chapter on targeted therapy explores
the option of less radical postoperative therapy for women with early, screen-detected
breast cancers.
Laszlo Tabar, M.D., F.A.C.R.
Department of Mammography
Falun Central Hospital
Falun,
Sweden
[...]... inform the patient that lying comfortly and motionless is important for succesfull imaging of the breast They should be instructed that administration of the contrast agent can result in various physical sensations, which may cause patient anxiety (and motion) when not properly instructed 4 Imaging of the Breast – Technical Aspects and Clinical Implication A dedicated breast coil should be used for breast. .. of diagnostic problems Proper indications for performing breast MRI (as supported by the European Society of Breast Cancer Specialists and the European Society of Breast Imaging) are: inconclusive findings in conventional imaging, preoperative staging, unknown primary cancer, evaluation of therapy response in neoadjuvant chemotherapy, imaging of the breast after conservative therapy, screening of the. .. biopsy 10 Imaging of the Breast – Technical Aspects and Clinical Implication However, both studies have some limitations For example, the COMICE trial recruited patients from 45 centres, resulting in a large variation of radiologic experience when evaluating the breast MRI exams The MONET trial only evaluated non-palpable breast tumors and a subanalysis of their results showed that the volume of the lumpectomy... United States, Canada, Italy, and Germany, the American Cancer Society (ACS) and European Society of Breast Imaging (EUSOBI) recommended annual MR evaluation of the breasts for 12 Imaging of the Breast – Technical Aspects and Clinical Implication all women with a lifetime risk for breast cancer of more than 20-25% (Saslow et al., 2007, Mann et al., 2008) These women include known BRCA gene mutation... Despite the considerably smaller proportion of non-dense areas, the overall proportion of dense breast tissue in the breasts of Chinese and Japanese women is 20 % higher than in Caucasian women in the same age group (Huang et al., 2001; Maskarineca et al., 2001) Irrespective of race, women with lower mammographic densities have a lower risk of breast cancer 26 Imaging of the Breast – Technical Aspects and. .. lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy J Comput Assist Tomogr Vol 35, No 3, May/June 2011, pp 361- 366 20 Imaging of the Breast – Technical Aspects and Clinical Implication Berg et al (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer Radiology Vol 233,... al., 2009) By 2009, there is still no significant survival benefit could be demonstrated in the country, in the meanwhile, rapid increase of breast cancer incidence was reported Singapore government choose for longer period of 24 Imaging of the Breast – Technical Aspects and Clinical Implication follow-up, expect for the benefit of mortality reduction in the population resulted from their mass mammography... this might influence breast perfusion, and thus contrast enhancement pharmacokinetics In premenopausal women, the enhancement of the fibroglandular tissue after contrast administration is dependent of the menstrual cycle MR imaging of the breast in the wrong phase of the menstrual cycle can result in strong glandular enhancement, complicating the interpretation of the images Elective breast MRI is ideally... months after the last irradiation of the breast Nonetheless, Morakkabati et al demonstrated that the detection and characterization of breast lesions can be performed with comparible diagnostic accuracies in irradiated breasts (when compared with nonirradiated breasts, Morakkabati et al., 2003) Finally, the risk of local recurrence is dependent on the age of the patient at the time of the diagnosis... New, Innovative Breast Imaging Modalities 1 Magnetic Resonance Imaging of the Breast Marc Lobbes and Carla Boetes Maastricht University Medical Center The Netherlands 1 Introduction Magnetic resonance imaging (MRI) of the breast was first performed in the late 1980s At first, differentiation between benign and malignant breast lesions was primarily based on their differences in T1 and T2 relaxations . IMAGING OF THE BREAST – TECHNICAL ASPECTS AND CLINICAL IMPLICATION Edited by Laszlo Tabar Imaging of the Breast – Technical Aspects and Clinical Implication Edited. properly instructed. Imaging of the Breast – Technical Aspects and Clinical Implication 4 A dedicated breast coil should be used for breast MRI. These coils usually consist of a multichannel. by Yau et al., who reviewed Imaging of the Breast – Technical Aspects and Clinical Implication 8 3001 MRI exams and found 204 MRI exams that were performed for ‘problem solving’. Of these
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