Columnar cell lesions of the breast: mammographic findings with histopathologic correlation.

Because of advances in mammography and a concomitant rise in the number of breast biopsies being performed for mammographically detected abnormalities, increasing numbers of columnar cell lesions (CCLs) are being described by pathologists. However, these lesions can be challenging to manage, since their classification has changed over time and only limited research has been conducted regarding their clinical significance. CCLs may be characterized by a single layer of columnar cells (columnar cell change [CCC]), multiple layers with stratification and apical tufting (columnar cell hyperplasia [CCH]), or monomorphic cells with cytologic atypia (flat epithelial atypia [FEA]).

Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy.

Purpose: To retrospectively determine the degree of underestimation of breast carcinoma diagnosis in papillary lesions initially diagnosed at core-needle biopsy.

Materials And Methods: Institutional review board approval and waiver of informed consent were obtained for this HIPAA-compliant study. Mammographic database review (1994-2003) revealed core biopsy diagnoses of benign papilloma (n=38), atypical papilloma (n=15), sclerotic papilloma (n=6), and micropapilloma (n=4) in 57 women (mean age, 57 years).

Nonmammographic evaluation of the extent of breast carcinoma.

The role of the breast imager has evolved beyond detecting breast cancer. With emphasis on management with breast conservation therapy, it has become imperative to image the patient preoperatively to adequately determine tumor size and to establish the presence or absence of multifocal, multicentric, or contralateral malignancy. The focus of this article was to provide a review of the current literature examining nonmammographic modalities available to the radiologist to thoroughly evaluate the newly diagnosed breast cancer patient.

Fibrous lesions of the breast: imaging-pathologic correlation.

Fibroepithelial lesions of the breast are commonly seen in clinical practice. The masses are composed of a combination of prominent stroma and varying glandular elements. Fibroadenomas, benign lesions that derive from the terminal duct lobular unit, are the most common and are often identified at clinical examination or mammography as circumscribed masses.

Gail model risk assessment and risk perceptions.

Patients can benefit from accessible breast cancer risk information. The Gail model is a well-known means of providing risk information to patients and for guiding clinical decisions. Risk presentation often includes 5-year and life-time percent chances for a woman to develop breast cancer.

Missed breast carcinoma: pitfalls and pearls.

Mammography is the standard of reference for the detection of breast carcinoma, yet 10%-30% of breast cancers may be missed at mammography. Possible causes for missed breast cancers include dense parenchyma obscuring a lesion, poor positioning or technique, perception error, incorrect interpretation of a suspect finding, subtle features of malignancy, and slow growth of a lesion. Recent studies have emphasized the use of alternative imaging modalities to detect and diagnose breast carcinoma, including ultrasonography (US), magnetic resonance imaging, and nuclear medicine studies.

Focal asymmetric densities seen at mammography: US and pathologic correlation.

The American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) defines four different types of asymmetric breast findings: asymmetric breast tissue, densities seen in one projection, architectural distortion, and focal asymmetric densities. These lesions are frequently encountered at screening and diagnostic mammography and are significant because they may indicate a neoplasm, especially if an associated palpable mass is present. Once these lesions are detected at standard mammography, supplementary breast imaging with additional mammographic views and ultrasonography (US) can be a key aspect of work-up.

Imaging and Management of Breast Masses During Pregnancy and Lactation.

Detection and management of breast abnormalities that develop during pregnancy and lactation is difficult for both the clinician and the radiologist. This article reviews the hormonal and physiologic effects on the breast during pregnancy and lactation. Breast masses that occur in pregnant or lactating patients, including pregnancy-associated breast cancer, are discussed and the corresponding ultrasound and mammographic findings are presented.