1、,单击此处编辑母版标题样式,*,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Imaging examinations of breasts,Question,How to choose a proper examination for screening and diagnosis,?,?,What examinations we could use,Breast cancer,Higher incident rate of breast cancer for recent years,Risk factors:procreation,family history,enviro,n,ment,hormone,Clinic findings,：,mass,，,skin changes,The survival rate based on the stage of breast cancer,S,c,reening,：,ductal carcinoma in situ,Anatomy,15,18 lobes,Lobules:Terminal Ductal Lobular Un
2、its(TDLUs),Anatomy,TDLU,：,1,2mm,Drained by a terminal duct attached to the main duct system,Most breast diseases arise in TDLU,Imaging methods,Mammography,Ultrasound,MRI,Projection,：,CC,MLO,Mammography,Mammographic characters,Calcification,Mass,Calcification,PO,4,3-,Calcium phosphat,Ca,+,Calcification,The main value:detection necrotic tissues,Form:Casting type,powderish,granular type,Differentiation between malignant and benign:distribution,form,density,Calcification,Calcification,Calcification,
3、Calcification,Mass,Proliferation and invasion,Stellate lesion with spicules and ill-defined borders,Differentiation between malignant and benign is difficult,Mass,Mass,Mass,Mass,Characteristics of mammography,Sensitive to the malignant calcification even microcalcifications,Differentiation between benign and malignant mass is difficult,Characteristics of Ultrasound Exam,Allows significant freedom in obtaining images from almost any orientation,excellent at imaging cysts and solid mass,young wome
4、n at high risk of the disease,Guide biopsy,Limited of ultrasound,Though ultrasound has excellent contrast resolution,it lacks the detail(spatial resolution),Operator and equipment factors,unable to image microcalcifications,Benefits of MRI Exam,Allows breast images to be taken in any plane and from any orientation,highly sensitive to small abnormalities,could show multi-focal tumor,Determining the extent of breast cancer,can help indicate treatment,An excellent at imaging the augmented breast,Limited of MRI Exam,Too expensive,Couldnt find the microcalcification,Ductal Carcinoma in Situ,Intraductal carcinoma:cancer cells are confined to an intact basementmembrane,Appearances:microcalcification(,85%,),microcalcification and mass(,10%,),mass or architectural distortion(,5%,),Screening,physical exam,mammography,P+M+,operation,P+M-,ultrasound,Follow up,P-Ca+,P-T+,P-M-,Follow up,biopsy,
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