Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

49 results found
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Abscess

Abscesses are focal confined collections of suppurative inflammatory material and can be thought of as having three components 1: a central core consisting of necrotic inflammatory cells and local tissue peripheral halo of viable neutrophils surrounded by a 'capsule' with dilated blood vessel...
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Adenosis of the breast

Adenosis of the breast is a benign lobulocentric proliferative process in which lobules are enlarged and increased in number in addition to an increased number of glands within each lobule. Pathologically subclassified into three main subtypes which include: sclerosing adenosis of the breast ...
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Altered breast density between two mammograms

Mammographic screening detects early breast cancers and thereby reduces potential mortality. However, its sensitivity is inversely related to breast density 1.  Altered density between two mammograms can arise in a number of situations: Affecting both breasts: interval commencement/cessation ...
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Amorphous calcification within breast

Amorphous or indistinct calcifications are a morphological descriptive term for breast calcification and are defined as having small, hazy, faint calcifications with no clearly defined shape or form.  Radiographic features 80-200 micrometer in diameter small, hazy calcification often magnifi...
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Asymmetrical density in mammography

Asymmetrical mammographic density, or more simply asymmetries, is a spectrum of morphological descriptors for a unilateral fibroglandular-density finding seen on one or more mammographic projections that does not meet criteria for a mass. The criteria for an asymmetry includes that it is seen o...
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Asymmetry in breast size

Asymmetry in breast size can arise from a number of factors. Pathology Breasts are rarely absolutely the same size or volume. Normal variation is common. Most females have slight discrepancies in breast size. Asymmetric progressive breast enlargement is unusual but known. The role of the breas...
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Bilateral axillary lymphadenopathy (differential)

Bilateral axillary lymphadenopathy can result from a number of causes and generally implies a systemic process. They include: autoimmune diseases, e.g.: rheumatoid arthritis scleroderma dermatomyositis 5 systemic lupus erythematosus (SLE) psoriasis Sjögren syndrome lymphoma leukemia di...
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Borderline breast disease

Borderline breast disease (BBD) refers to a group of conditions while being not completely malignant are still concerning. Usually an excision biopsy is recommended if entities falling into borderline breast disease is detected on core biopsy. These entities include: atypical ductal hyperplasi...
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Brachytherapy

Brachytherapy, also known as sealed source radiotherapy or endocurietherapy, is a form of radiotherapy where a radioactive source is placed, under the guidance of imaging, within or next to the area requiring treatment. Brachytherapy has been used to treat: prostate cancer breast cancer (ofte...
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Breast architectural distortion

Breast architectural distortion is a descriptive term in breast imaging (mammography, ultrasound, and MRI) to indicate that the breast parenchyma is tethered or indented. The finding per se is not a mass. Pathology Architectural distortion is often due to a desmoplastic reaction in which there...
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Breast calcifications

Breast calcifications are deposits of calcium salts in the breast, which are radio-opaque on mammography. The majority are benign, but they can be associated with cancer. The ability to diagnose and appropriately manage the significant microcalcifications and differentiate them from innocuous fi...
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Breast cancer metastases

Metastases from breast cancer can be a frequent finding in routine onco-radiological practice. Clinical presentation With the universal use and acceptance of screening mammography, the isolated clinical presentation from metastases from breast carcinoma has become rare in clinical practice. Hi...
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Breast cyst

Breast cysts are a common mammographic and sonographic finding, and can be of different types: simple breast cyst: typically is a well-defined, anechoic lesion with imperceptible wall and posterior acoustic enhancement 1 complicated breast cyst: contains intracystic echoes or debris with other...
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Breast density

Breast density refers to the amount of fibroglandular tissue in a breast relative to fat. It can significantly vary between individuals and within individuals over a lifetime. Classification There are four descriptors for breast density on mammography in the 5th edition of BI-RADS 1-2: a: the...
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Breast implants

Breast implants are increasingly common in general breast radiology practice. Classification Location Breast implants may be placed behind the glandular tissue but in front of the pectoral muscle: subglandular submammary retroglandular retromammary The second position of breast implants ...
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Breast lumps

Breast lumps have different characteristics that allow simplification of differential diagnosis by breaking down the vast list into sections. Consider whether the lump fits into one of these categories. Spiculated lesion Spiculation is a feature of neoplasms and all masses that display spicula...
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Calcific axillary lymphadenopathy (differential)

Calcific axillary lymphadenopathy is in general, more concerning than axillary lymphadenopathy alone and is particularly so if it contains microcalcifications. While this is concerning for malignancy, it can also occur from occasional nonmalignant causes Causes include metastatic axillary lymp...
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CEA

Serum CEA (carcinoembryonic antigen) is a cell-adhesive glycoprotein that was discovered in colorectal cancer in 1965, and is hence one of the oldest and most used tumor markers. Its name derives from its normal expression in fetoembryonic liver, gut and pancreas tissue. Normal range of CEA is ...
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Coarse macrocalcifications within the breast

Coarse macrocalcifications within the breast are a morphological descriptive term for a type of breast calcification.  Associations   involuting fibroadenomas ( classical popcorn calcification ) chronic renal disease with hypercalcemia 1  rarely seen in malignancy  2 invasive breast carcin...
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Cutaneous calcifications in breast imaging

Cutaneous calcifications in breast imaging can form in dermal sweat glands after low grade folliculitis and inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. The vast majority of calcifications are coincidental findings on mammography. Radiographi...
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Cystic breast mass

A cystic breast mass is a mass that contains both solid and fluid components. This can occur from both benign and malignant causes. Benign complex breast hematoma complex breast abscess breast cyst with associated inflammation and hemorrhage galactocoele fibrocystic changes and oil cysts 2...
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Dilated ducts on breast imaging (differential)

Dilated ducts on breast imaging may be seen on many breast imaging modalities and can arise from a number of causes which can be both benign or malignant. physiological lactational changes mammary duct ectasia breast neoplasm 2-3
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Fat containing breast lesions

Fat containing breast lesions generally have some radiolucent component on mammography. Pathology They are generally classified at BIRADS II lesions. Common breast lipoma breast hamartoma fat necrosis within the breast/oil cyst intramammary lymph node: classically has a central fatty hilu...
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Free silicone breast injections

Free silicone breast injections (silicone mastopathy) are an alternative form of breast augmentation to breast implants, although they have serious adverse effects and are banned in many countries.  Radiographic features There are similar features to that of free silicone from breast implant r...
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Grouped calcifications

The term grouped calcifications is used in mammography when relatively few breast microcalcifications reside within a small area. At the least, there must be at least five calcifications are present within 1 cm of each other 4. At the most, it may refer to a larger number of calcifications prese...
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Gynecomastia

Gynecomastia refers to a benign excess of the male breast tissue, that is usually reversible. It is not a risk factor per se for developing male breast cancer. Epidemiology While it can occur at any age, it tends to have greater prevalence in two groups: adolescent boys and older men (some pub...
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High risk breast lesion

The term high-risk breast lesion is given to a breast lesion that carries an increased risk for the future development of breast cancer or carries suspicion of a more sinister pathology around or in association with the lesion. The term has some overlap with borderline breast disease. Many radio...
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Hyperechoic breast lesions

There are a number of lesions that appear hyperechoic on ultrasound. Such lesions can be either completely or partly hyperechoic and include both benign and malignant entities. Benign fat containing breast lesions lipoma of the breast fibroadenolipoma (hamartoma) of the breast focal regions...
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Male breast disease

Male breast disease includes a wide spectrum of conditions. Many conditions and entities that affect the female breast may also affect the male breast.  Pathology Malignant male breast cancer lymphoma dermatofibrosarcoma Benign gynecomastia pseudogynecomastia: fat deposition within the b...
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Mastitis

Mastitis refers to inflammation of the breast parenchyma, of which there are a number of subtypes: acute mastitis puerperal mastitis: occurs usually from infection with Staphylococcus during lactation non-puerperal mastitis: not related to lactation, and occurs usually in older women plasma ...
Article

Medical devices in the thorax

Medical devices in the thorax are regularly observed by radiologists when reviewing radiographs and CTs. Extrathoracic devices tubing, clamps, syringes lying on or under the patient rubber sheets, foam mattresses, clothing, hair braids, nipple piercings etc. may also be visible These devices...
Article

Metachronous breast cancer

Metachronous breast cancers are two breast cancers that occur in either breast in two different time periods. Treatment and prognosis The survival rate of women with metachronous breast cancers diagnosed within 2 years of the original primary is worse than those with unilateral disease 4.
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Metastatic intramammary lymph node

A metastatic intramammary lymph node refers to an intramammary lymph node involved with metastatic or malignant disease. Radiographic features Breast ultrasound Sonographic features that suggest metastatic involvement include 4: disappearance or loss of central echogenic hilar region marked...
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Milk of calcium (disambiguation)

The term milk of calcium (MOC) is given to dependent, sedimented calcification within a cystic structure or hollow organ. This sort of colloidal calcium suspension layering can occur in various regions: renal: milk of calcium in renal cyst (most common) breast: milk of calcium in breast cyst ...
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Milk of calcium within a breast cyst

Milk of calcium within a breast cyst is a mammographic feature observed when there is dependent calcium layering within breast cysts. It is typically observed as "tea cup" or "crescent shaped" calcifications on a true lateral (LM or ML) view on occasionally on a MLO view. On a CC view, these cal...
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Multicentric breast cancer

A multicentric breast cancer is a term given to a breast cancer where there are two or more breast cancers separated by normal breast tissue (often taken as 5 cm of separation 4). It is related to but distinct from the term multifocal breast cancer. At a pathological level It can also mean 2 t...
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Multifocal breast cancer

Multifocal breast cancer refers to two or more individual breast cancers diagnosed at the same time within the same quadrant of the same breast 1. 
Article

Nipple markers

Nipple markers can be a useful technique in the evaluation of densities overlying the expected position of the nipple on a chest radiograph. Not uncommonly a small round opacity projects over the lower thorax on a chest radiograph (see: solitary pulmonary nodule). Often, especially in women, th...
Article

Papillary lesions of the breast

Papillary lesions of the breast comprise a wide group and range from benign to malignant. Pathology They develop as tufts of epithelium with a fibrovascular core that arborize into branching papillae and protrude into the duct lumen. Benign papilloma of breast / intraductal papilloma of the b...
Article

Post surgical breast scar

Post surgical breast scar is a benign complication that usually occurs following  surgical intervention to breast tissue. It can however be a strong and potentially very confusing mimicker of breast malignancy. Radiographic features Review of the patient's past history and previous mammography...
Article

Pregnancy associated breast cancer

Pregnancy associated breast cancer (PABC) is usually defined as a breast cancer diagnosed during pregnancy or one year following delivery. PABC occurs in one out of every 1500-10,000 pregnancies 5-6 and represents up to 3% of all breast malignancies. The incidence may be increasing due to many w...
Article

Residual breast cancer

A residual breast cancer is a remaining portion of the original primary breast cancer after an incomplete resection or following radiotherapy or chemotherapy. The term is particularly used in assessing patients who have had neo-adjuvant chemo +/- radiotherapy.
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Screening for breast cancer

There are few areas in imaging specifically and in medicine in general, fraught with more controversy than screening for breast cancer. Due to the emotive issues surrounding the diagnosis, the scientific literature on breast screening and its issues reaches the lay press quickly and is sometimes...
Article

Silicone injection and insertion (cosmetic)

Silicone injection into various parts of the body has been used in many countries to achieve what are perceived to be cosmetic improvements. Most common sites for such injections are the breasts, face, and buttocks, although anywhere can be targeted.  This article is a general discussion of the...
Article

Skin thickening on mammography (differential)

The presence of skin thickening on mammography is variably defined, usually being more than 2mm in thickness. It can result from a number of both benign and malignant causes. They include: Malignant inflammatory breast cancer: one of the most concerning causes of skin thickening: this usually ...
Article

Spontaneous nipple discharge

Spontaneous nipple discharge in a non lactating breast can result from many causes which include: papillary lesions of breast: present in ~35-50% of cases with spontaneous nipple discharge intraductal papilloma fibrocystic change ductal carcinoma in situ: 5-21%
Article

Suspicious breast calcifications

Suspicious breast calcifications are calcifications within the breast that have a morphology and/or distribution on mammography indicating a significant probability of malignancy. These merit further workup and biopsy 1. Radiographic features Technique Some calcifications may be more conspicu...
Article

Unilateral axillary lymphadenopathy (differential)

Unilateral axillary lymphadenopathy while being more concerning than bilateral axillary lymphadenopathy can still arise from a various benign as well as malignant causes. Benign mastitis other regional infective causes tuberculosis ipsilateral arm infection, e.g. cellulitis silicone induce...
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Well-defined breast cancers (differential)

Certain well-defined breast cancers tend lack the characteristic spiculation and can give false reassurance of more benign entities on both ultrasound and mammography. These include: certain high grade invasive ductal carcinomas: not enough time for a desmoplastic reaction to form spiculation ...

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