TEACHING ATLAS OF MAMMOGRAPHY PDF
Teaching Atlas of Mammography, 4th Edition () - Ebook download as PDF File .pdf), Text File .txt) or read book online. Teaching Atlas of Mammography. Editorial Reviews. From the Back Cover. The names Tabar and Dean are associated with In this fourth edition of the bestselling Teaching Atlas of Mammography, readers are again invited to share in the authors experience of analyzing and. The names Tabar and Dean are associated with high-quality mammography worldwide. In this fourth edition of the bestselling Teaching Atlas of Mammography.
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Teaching atlas of Mammography. Stuttgart. Thieme Verlag Svane G, Potchen EJ, Sierra A, Azavedo E. Stellate lesions. In: Patterson A. ed. Screening . Request PDF on ResearchGate | On Feb 1, , L Tabár and others published Teaching Atlas of Mammography. Teaching atlas of mammography. Laszlo Tabar, Peter B. Dean. × mm. Pp. + viii. Illustrated. Stuttgart: Georg Thieme Verlag. DM
The tumor is seen at coordinate A1. Magnification view in the MLO projection. First screening examination. Follow-up The woman died 8 years and 5 months later from colon cancer. A stellate tumor is seen in the upper inner quadrant.
At the time of death. Maximum dia- meter 7 mm. Conclusion This tumor has the typical mammographic appearance of a malignant stellate breast tumor: Centrally located, large 5 cm dia- meter stellate tumor. The nipple and areola are retracted. The skin is thickened and re- tracted over the lower and outer portions of the breast. Comment This is an illustrative example of an ad- vanced stellate malignant breast tumor with a large central tumor mass and radiat- ing spicules that retract the areola and skin.
The tumor in- filtrates the lymph vessels. Right breast, CC projection. Right a and left b breasts, Fig. Right breast, microfocus magnifi- MLO projections. Compare the lower halves cation view, MLO projection. Compare of the right and left breasts.
In the lower half Fig. Observe how the of the right breast there is architectural dis- lesion has a different appearance in each A year-old asymptomatic woman. First tortion centered at coordinate A1.
Conclusion This mammographic appearance is typical Fig. The diagnosis is supported by the lack of palpatory findings. No further diagnostic procedures are indicated. In fact, needle biopsy is contraindicated see p.
The next step should be open surgi- cal biopsy followed by careful histologic ex- amination. A large area with architectural distortion is seen 4 cm from the nipple. The mammographic appearance of the lesion changes with the projection. The two hollow, benign-type calcifications are not associated with the lesion. Analysis An invasive ductal carcinoma of this size would have a large, solid central tumor mass.
Instead, there are central radiolucen- Fig. The radiating structure consists of long, thick, drooping linear densities inter- vening with radiolucencies. The mammo- graphic image is unlike the straight specu- lations of an invasive breast cancer. Unlike large breast cancers, this lesion was not pal- pable, nor was there skin thickening or re- traction.
Conclusion Typical mammographic and clinical picture of a radial scar. Complete surgical removal is recommended without preoperative needle biopsy see p. Operative specimen photograph. Comment An invasive ductal carcinoma similar in size to Cases 61—64 would be palpable and would have a large, dense, homogeneous central tumor mass dominating the picture compare Case 60 with Cases 61— Left breast, detailed view of the MLO projection.
There is a large radiating structure in the upper half of the breast. Analysis Best from the Microfocus Magnifi- cation Views No solid tumor center is demonstrable in this radiating structure. The radiating struc- ture consists of thick collections of linear Fig. Alternating with them are radiolucent linear structures parallel to these strands. Comment Even with such a large, superficial lesion, no tumor could be palpated. This supports the diagnosis of a radial scar. Right breast, MLO projection.
A Fig. The radiating structure is seen at coordinate A1. Right breast, enlarged view of the lateromedial LM projection. Analysis No solid tumor center. The appearance of the lesion changes remarkably with the pro- jection.
The radiating structure consists of thick linear radiopaque densities alternat- ing with linear translucencies. Complete surgical removal is the treatment of choice. Overview of the tumor. Spot microfocus magnification im- age in the CC projection. Detailed view of the tubular carci. Histology Tubular carcinoma. Conclusion This is a typical mammographic picture of a small infiltrating carcinoma: Ultrasound-guided core biopsy a single shot through the lesion provides sufficient preoperative information for treatment planning.
No axil- lary metastases. Physical Examination No palpable tumor in the breasts. A stellate tumor is seen 6 cm from the nip- ple in the lateral half of the breast. Follow-up The patient died 6 years and 9 months later from acute myocardial infarction. Physical Examination No history of trauma. MLO projection: The tumor was excised in toto. Although the mammographic picture is characteristic of a radial scar. There appears to be a hole in the center of the lesion cor- responding to the radiolucent center of the lesion on the mammogram.
In addition. Note the thick radiating tissue strands. Comment The benign lesion and benign-type calcifi- cations are unrelated to each other. Analysis of the Calcifications Distribution: Right breast same case 6 months later. Follow-up The woman died 8 years later of septicemia. A palpable tumor has developed at the site of operation.
At the time of death there was no evidence of breast cancer. This case was reoperated before the advent of percutaneous core needle biopsy. Histology Traumatic fat necrosis. There is a large radiating structure in the upper inner quadrant of the breast. This radiating structure Fig. Analysis The radiating structure consists of collec- tions of thick. No history of trauma. Histology Radial scar sclerosing duct hyperplasia. The associated calcifications are unusually large.
Spot magnification view. At the center of the large lesion. CC pro- jection. Conclusion This large region of architectural distortion did not cause skin changes.
The mammographic image is consistent with a radial scar. Physical Examination A hard. A large radiating structure is seen at the site of operation.
Analysis Center of the lesion Fig. The patient requested surgical removal of the cyst. The radiating structure is smaller. History of repeated aspirations from a large cyst in the right breast. The large circular lesion in the medial half of the breast corresponds to a cyst.
Histology Foreign body granuloma. The history may help in differen. Analysis Central portion of the architectural distor- tion: History of right breast surgery 25 years earlier. The appearance of the tumor changes with the projection Radiating structure: The skin retraction and the thick scar at the site of operation had remained unchanged for many years. There is architec- tural distortion in the lower outer quadrant.
MLO and detailed view of the CC projection. A small tumor is seen at coordinate A1 in these four mammograms. Only the tumor. Follow-up The woman died 13 years later from myo- cardial infarction. Mammo- graphically malignant tumor.
Analysis Central tumor mass with long radiating spi- cules. There was no evidence of breast cancer. No associated calcifications. No axillary lymph node metastases. A Comment There are a number of other radiopaque. The spicules are short. The Fig. Conclusion A palpable tumor was noted in the lateral cations.
Mammographically malignant tumor. Spot compression with micro. Right and left breasts. Best on the spot compression views. At coor. There are no associated calcifi. Stellate tumor with a central tumor mass.
MLO pro. The tumor can be detected on the MLO projection by oblique masking. Retraction of the posterior parenchymal border on the CC projection Fig. At coordinate A1 there is a small stellate tumor with no associated calcifications.
Operative specimen. MLO pro- jections. CC and LM projections. Comment This case represents a problem in percep- tion. Follow-up The woman was still alive 21 years later at the age of 92 years.
Spot compression microfocus magnification views. Normal right breast. There are coarse calcifica- screening study. First tralateral breast. The calcifications With knowledge of the mammogram. Typical mammographic appearance of a Physical Examination Fig.
The cation view. There is a stel- breast parenchymal contour protrudes at late tumor with a distinct central mass. Asymptomatic year-old woman. The tumor. No stellate malignant tumor.
Follow-up The patient was still alive 20 years later. Detailed view of the spiculated contour. More than half of the nuclei express receptor positivity through brown staining. The spicules contain grade 1 ductal carcinoma in situ. Overview of the tumor using an immunohistochemical stain for estrogen re- ceptors.
Follow-up First to the so-called desmoplastic reaction con- screening study. The mographically malignant. Histology nective tissue proliferation in the vicinity of Infiltrating ductal carcinoma. Chapter II p. Physical Examination 10 mm. No palpable tumor in the breasts.
The woman was still alive 19 years later. Oblique masking helps reveal Small. Mammography with no evidence of breast cancer. A small tumor is seen at coordinate A1 in the upper outer quadrant of the left breast.
Mammographic diagnosis: A small. Follow-up Fig. Analysis Lace-like radiating structure. The tumor can mor is seen at coordinate A1. There is a stellate lesion at coordi. Infiltrating ductal carcinoma.
Comment nate A1 in the right breast. First Form: Enlarged view in the Histology mediolateral projection. There was No palpable tumor in the breasts.
Mammography Mammographically malignant tumor. The smaller the stellate tumor. Follow-up tions The woman died 12 years later from myo- Physical Examination Size: Analysis The tumor is lo. Conclusion The overlying dense parenchyma obscures the tiny central tumor mass. At co- ordinate A1 there is parenchymal distortion. The long. Follow-up The woman was still alive 19 years later. Operative specimen radiograph. There is architectural distortion located centrally.
A tion view in the CC projection. Analysis No definite central tumor mass is demons- trable on the preoperative mammograms. The asymmetric density is seen at coordinate A1. A Analysis Form: Physical Examination A No palpable tumor in the breasts. Normal right mammogram. The nonspecific asymmetric density corresponds to a tiny.
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At coordinate A1 in the left breast there is a small. The lesion is seen at coordinate A1. Spot magnification view of the tu- mor in the MLO projection. Follow-up The patient returned to her native country.
Analysis Best on the Spot Compression View Stellate tumor with a central tumor mass surrounded by numerous spicules. Follow-up The patient died 4 years later.
Mam- mographically malignant tumor. Histology Infiltrating ductal carcinoma with axillary lymph node metastases. A Mammography Fig. Low-power view of the invasive tumor. There is architectural distortion at coordinate A1.
XIXa at coordinate A1. Sus- picious for malignancy. There is parenchymal contour retraction see Fig. No associated calci- fications are seen.
Analysis Instead of a solid. The associated calcifications are very faint. The radiating structure is formed by alternating radiopaque and ra- diolucent linear structures. No associated malignancy. A ra- diating structure is seen 8 cm from the nip- ple in the upper half of the breast.
CC projection: Radial scar sclerosing duct hyper- ture is located at coordinate A1. Analysis Comment The radiating structure lacks a central tu. No cation view. A year-old asymptomatic woman. This lesion is difficult to perceive and also Physical Examination mor mass. Oblique masking. There are no associated calcifica. Conclusion jections. At coordinate A1. The occupies most of the right breast. Right a and left b breasts. The right breast is smaller than the left because of a large.
There are nipple—areola complex and skin overlying coarse. Hand-held ul- breast. Photographic magnification of tions.
Neither a distinct tumor mass nor trasound f: The large architectural distortion the upper half of the right breast with the drastically alters the appearance of the right architectural distortion e. Right c and left d CC projec. Ultrasound-guided g core bi- opsy.
First mammography examination. There is an asymmetric density with slight architectural distortion in the upper outer quadrant rectangles. Neither skin changes nor nipple discharge were ob- served. Microfocus magnification views of the asymmetric density on the LM c and CC d projections. Histology showed grade 1 and 2 carcinoma in situ. Specimen radiographs of large- bore needle biopsy containing calcifications. Innumerable powdery and crushed stone-like calcifications are seen within the density.
Operative specimen radiograph with the architectural distortion and micro- calcifications h. Specimen radiograph with the architectural distortion. Specimen radiograph o shows a cluster of discernible calcifications. The corresponding large thick-section subgross. Details of a specimen radiograph slice containing two clusters of discernible microcalcifications. Low-power microphotograph of tightly packed cancer-filled duct-like struc- tures characteristic of neoductgenesis.
The corresponding histology slide shows that some of the microcalcifications are localized within the acini of an ex- tremely distended TDLU. No sign of invasion was demonstrable. The first mammogram at age 64 outer quadrant. First examination. The malignant diagnostic options are Two consecutive mammography screening A nonspecific asymmetric density with ar. At the age of 66 years. The asymmetric asymptomatic.
Analysis the two malignant options remain. Low-power histology image of the outer quadrant. The cancer-filled. Histologic images with increas- ing magnification. Conclusion Asymmetric densities with or without ar- chitectural distortion detected on the mam- mogram require a thorough workup. Micropapillary carcinoma in situ with skipping stone-like calcifications.
Cystically dilated acini with psammoma body-like calcifications. VI Calcifications on the Mammogram Grade 3 ductal carcinoma in situ with casting-type calcifications. These are seen on the ular in form. XXVI or ance is often essential for differential diag. The appearance of these calci- The remaining calcifications are formed gle or multiple clusters. The corre. The malignant cells and nosis. The amorphous calcifi- been determined.
Analyzing the distribution of the cal. Their distribution will eventually break off and fill up the within the arterial walls.
It is the ductal lumen that de. In this subtype of breast cancer.
Teaching Atlas of Mammography, 3rd Ed
Form cer and distending the ducts containing Linear. Unilateral distribution that the pathological process takes place the ducts and their branches. These flat. These are described here in detail. The Despite their wide variation in appearance. The dif. Their location within the distended TDLU will help in distinguishing benign from ma. Differential di. Microfocus magni. The heterogeneity fications is pathognomonic Case The mammographic appearance the malignant cells is predominantly are not malignant type.
The tips of the ever- ential diagnosis presents few problems. When high. They are largely dependent upon the malignancy calcifications will be seen on the usually easily recognized. Microfocus magnification ferential diagnosis of the fragmented lobule s.
If the cal. They fill out a single breast lobe of malignant cells fragmented or dotted lege of Radiology Breast Imaging-Reporting with a fairly uniform intralobar distribu- casting-type calcifications.
Within this necrosis. They are irreg- analyzing the mammograms alone. Three lateral and restricted to a single breast types of benign. Whereas carcinoma. These calcifi- analysis. Since understanding of the underlying processes 99— Microcalcifications are often formed as a by. Since both the be- needle biopsy can provide the correct di.
Magnification mam- proliferate within the acini of the TDLUs. The number of the mammogram as multiple clusters of These are the dif. Multiple cluster powdery calci.
Multiple clus. Number agnosis. Stereotactic percutaneous sclerosing adenosis. Use of the same term amorphous to describe vastly different Density analysis should include a compari- calcification types that represent dispa.
It is impor- been used by pathologists to describe the of the TDLU s or duct s. XXIV Large-section histology image of a duct distended by grade 3 in situ carcinoma. The individual particles are irregular in size.
XXV Diagram of an extremely distended duct with solid-cell pro- liferation. This is a typical mammographic im- age of malignant-type. Histology also reveals invasion.
A cluster of microcalcifica. Analysis of the Calcifications The de novo. Two consecutive screening examinations. Second screening examination. Mammography First screening examination. No associated tumor mass is demonstrable. No palpable tumor. MLO and craniocaudal CC projections. Operative specimen radiographs.
Analysis of the Clustered Calcifications Distribution: In ad- dition. Practice in Calcification Analysis 87 Asymptomatic year-old woman. MLO projec- tion and specimen radiography. Two clusters of microcalcifications are seen in the upper half of the breast arrow.
The acini from one TDLU filled with malignant cells. Follow-up The woman died 15 years later from myo- cardial infarction.
Practice in Calcification Analysis 88 This year-old woman felt a thickening in the lateral portion of her left breast. The ducts are distended by the fluid pro- duced by the cancer cells. Within this fluid. Higher magnification of the grade 2 micropapillary carcinoma in situ. They are a mixture of the casting-type long. Conclusion Mammographically malignant-type calcifi- cations with an associated ill-defined. Follow-up The woman was still alive 19 years later at the age of 87 years. Innu- merable calcifications of varying form.
No histologic signs of invasion. Practice in Calcification Analysis 89 Mammography Fig. Histology Grade 3 in situ carcinoma with solid-cell proliferation. There are numerous fragmented casting- type calcifications. Look Inside. Table of Contents.
Product Description. Special features: Revised and expanded case studies, based on 40 years of imaging experience, provide instructive long-term follow-up of patients over a period of up to 25 years Offers a unique comparison of imaging findings with the corresponding large thin-section and subgross thicksection 3D histologic images to facilitate an understanding of the pathologic processes and the mammographic appearances they lead to Includes an abundance of coned-down compression views, microfocus magnification views, and specimen radiographs to support the analytic workup Teaching Atlas of Mammography and the Breast Cancer book series by the same authors are essential for residents in radiology and practicing radiologists who need the highest level of training in the radiologic anatomy of the normal breast and the changes associated with benign and malignant lesions.
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Share your thoughts with other customers. Write a customer review. Top Reviews Most recent Top Reviews. There was a problem filtering reviews right now. Please try again later. Hardcover Verified Purchase. For a physician getting back into reading mammograms after several years, this book really helped as part of my review.
I previously owned a prior edition during residency and am glad I updated. Best atlas for mammography I've found.
Short and easy to complete in just a week or so with outstanding pathology slide correlations A must have for those in this field. Might even be a good reference for those who seem to be getting frequent mammograms and just want to "look up" what the reports are saying about them. Great for refresher on mammography. Reviews how to look and diagnose mammographic abnormalities including masses, architectural distortion and calcs.
Good review.The hook localizes the tumor for biopsy.
Analyzing the distribution of the cal. Rather than starting with the diagnosis and demonstrating typical findings, the approach of this atlas is to teach the reader how to analyze the image and reach the correct diagnosis through proper evaluation of the mammographic signs.
Early Detection with Mammography: MLO and CC pro. These are described here in detail.