Ebook Atlas of mammography (3/E): Part 2
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Ebook Atlas of mammography (3/E): Part 2
Prominent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2 vascular shadows and ducts.Lactiferous ducts are linear, slightly nodular densities that radiate back from the nipple into the breast. Ute nor mal lactiferous ducts are thin, measuring 1 to 2 mm in diameter, and often are not evident as separate structures on mammography. Enlarged ducts may occur i Ebook Atlas of mammography (3/E): Part 2n benign and malignant conditions. When ducts are enlar ged, correlation with clinical examination as to the presence of discharge is important. GalacEbook Atlas of mammography (3/E): Part 2
tography is of help in providing further information in the evaluation of a nipple discharge, with or without dilated ducts being seen on mammography.Prominent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2ng the patient al higher-than-average risk for developing breast cancer. According to Wolfe, the breast parenchyma was classified into four patterns: N1 or fatty replaced, and Pl, P2, or DY with increasing amounts of ductal or glandular tissue. Because of surrounding collagen, individual ducts may n Ebook Atlas of mammography (3/E): Part 2ot be identified; instead, a dense, triangular fanshaped density is present beneath the areola (3). The association between a prominent ductal patternEbook Atlas of mammography (3/E): Part 2
and breast cancer incidence has been debated, with some authors (4.5) agreeing with the association and others (6-8) finding no reliable indicator ofProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2 have dense breasts and a prominent ductal pattern and that breast parenchymal pattern may be related to other risk factor's. Funkhouser et al. (10) found a twofold increase in breast cancer risk in women with a P2 or DY Wolfe pattern in comparison with an N1 pattern (fatty breasts). Andersson et al Ebook Atlas of mammography (3/E): Part 2. (11) also found an increased frequency of the dense ductal patterns with advancing age at first pregnancy and with nulliparity. Brisson et al. (12)Ebook Atlas of mammography (3/E): Part 2
assessed breast cancer risk as related to parenchymal pattern in a study of 3,412women and found that parenchymal pattern was strongly correlated withProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2tissue than in women who had no density on mammography.DUCT ECTASIAAnother cause of bilateral ductal prominence is duct ectasia (Figs. 7.2-7.5). Haagenson (13) described the condition as beginning with bilateral dilation of the main lactiferous ducts in postmenopausal women. Amorphous debris within Ebook Atlas of mammography (3/E): Part 2the ducts is irritating and causes periductal inflammation and fibrosis without epithelial proliferation. Retraction of the nipple may occur secondaryEbook Atlas of mammography (3/E): Part 2
to fibrosis in the periductal space. In a more recent study. Dixon et al. (14) found that periductal inflammation around nondilated ducts occurred inProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2ologic factor in this condition (14).Dilated ductal structures may also be associated with inflammatory or infectious etiologies (Fig. 7.6). In a patient with a breast abscess or with chronic mastitis, there may be intraductal extension of the infection. This may appear as dilated ducts ar ound an i Ebook Atlas of mammography (3/E): Part 2ndistinct mass or as dilated subareolar ducts with overlying skin thickening. Sonography may depict the abscess cavity and the extension of fluid intoEbook Atlas of mammography (3/E): Part 2
ducts surrounding the cavity.PAPILLOMATOSISIntraductal papillomatosis is a benign lesion characterized by a papillary proliferation of tire epitheliuProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2 throughout the parenchyma and is within the339340 Atlas of MammographyFigure 7.1HISTORY: A 74-yvaix»ld gravida 4, para 4 patient for screening.MAMMOGRAPHY: Bilateral MLO (A) and cc IB) views show heterogeneously dense breasts. These arc diffuse small areas of nodularity and linear structures consis Ebook Atlas of mammography (3/E): Part 2tent with a prominent ductal pattern.IMPRESSION: Prominent ductal pattern bilaterally, within normal limits.Figure 7.2HISTORY: A 64-year-old patient wEbook Atlas of mammography (3/E): Part 2
ho is status post-right breast biopsy, for routine screening of the right breast.MAMMOGRAPHY. Right cc view shows extensive ductal dilatation extendinProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2many years and is consistent with duct ectasia.IMPRESSION Duct ectasia.Chapter 7 • Prominent Ductal Patterns 341Figure 7.3HISTORY; A 58-ycar-old gravida 8. para 8 unman for screening mammography.MAMMOGRAPHY: Left (A) and right (Bl cc views show (he breasts to contain scattered fibrogkm-dular densiti Ebook Atlas of mammography (3/E): Part 2es. There are prominent ducts present bilaterally (arrows!. appearing as tubular nodular structures extending bock from the nipples.IMPRESSION BilaterEbook Atlas of mammography (3/E): Part 2
al ductal ectasia.spectrum of fibrocystic change. Sometimes papillomatosis is also called intraductal hyperplasia of the common type. On mammography, Prominent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2ect or multiple filling defects are found (Fig. 7.7).Papillary duel hyperplasia is an unusual lesion that occurs in children and young adults (16). Three patterns have been described: a solitary papilloma, papillomatosis, and sclerosing papillomatosis. The condition causes a distention of the duct o Ebook Atlas of mammography (3/E): Part 2r ducts.Solitary or Focally Dilated DuctsWhen asymmetrically dilated ducts or a solitary duct are found on mammography, the possibility of ductal maliEbook Atlas of mammography (3/E): Part 2
gnancy must be considered. Huynh el al. (17), in a review of 46 women with asymmetrically dilated ducts, found that 24% had ductal carcinoma. Factors Prominent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Ebook Atlas of mammography (3/E): Part 2. The benign causes for the appearance of dilated ducts include a solitary papilloma, multiple papillomas, papillomatosis, ductal hyperplasia, and ductal adenoma.342 Atlas of MammographyFigure 7.4HISTORY: A 62-year-old woman for screening.MAMMOGRAPHY. Bilateral MLO (A) and cc views show scattere Ebook Atlas of mammography (3/E): Part 2d fibroglan-dular densities. There are prominent tubular densities in both subareolar areas, radiating back from (he nipple.IMPRESSION. Bilateral ductEbook Atlas of mammography (3/E): Part 2
ectasia.NOTE: Because the ducts are evident as discrete tubular structures, and because of their widened diameter, the finding represents dilated ducProminent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion between Prominent Ductal PatternsLinear densities on (he mammogram may represent arteries, veins, and lactiferous ducts. There should be no confusion betweenGọi ngay
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