الفهرس 
Anatomy of the breastOnly 14 pages are availabe for public view
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Abstract
Despite of the major advance in technology, mammography remains the primary imaging modality for early detection of breast cancer. Breast ultrasonography is indicated in evaluation of questionable or nonspecific mammographic findings as well as evaluation of a patient who presented with breast lump to differentiate solid from cystic lesions. US remains the initial imaging modality for evaluation of symptomatic women who are pregnant and those younger than 35 years.
New imaging modalities have been developed to provide improved detection and management of patients with breast cancer, of these are PET/CT and MRI.
First results using PET/CT imaging in the follow-up of breast cancer patients demonstrate increased specificity compared with FDG PET alone. PET/CT offers to detect recurrent and metastatic breast cancer disease at an early stage and thus continue to demonstrate the efficacy of molecular imaging in patient management.
In primary tumor, FDG PET/CT is of limited use in patients with early-stage disease without nodal or distant metastases, it has poor detection rate for small breast carcinomas.
However, in patients with palpable regional lymphadenopathy, PET/CT scanners have the same sensitivity as (SLN) in detection of metastasis with over advantage of detecting occult metastasis and provide accurately aligned anatomical and functional images of a patient, allowing functional abnormalities to be localized and distinguished from normal uptake of the PET tracer, which increases Physician confidence in arriving at a correct diagnosis.
FDG PET and PET/CT have been shown to be most helpful in staging recurrent or metastatic breast cancer and in evaluating the response of locally advanced and metastatic breast cancer to treatment. Emerging data support the use of FDG PET/CT in advanced axillary disease and evaluation of regional nodal spread in LABC.
Integrated FDG-PET/CT is a sensitive and accurate imaging modality, superior to CT for diagnosis of tumor recurrence and for definition of extent of disease in patients with breast cancer and rising tumor markers. PET/CT appears to have a role in determining the subsequent clinical management of these patients.
MR imaging of the breast provides a cross sectional imaging modality not limited by overlapping structures or by the density or complexity of the fibroglandular pattern.
Contrast enhancing lesions, although associated with malignancy, may commonly be seen in many benign breast lesions.
Some indications for the use of breast MRI include screening program for high-risk women, pre -operative staging of newly diagnosed breast cancer and in monitoring the response to therapy.
Various studies have demonstrated that although the sensitivity of MRI in detection of breast cancer is high, the specificity of this technique varies. In addition, many studies have demonstrated the highest sensitivity and specificity when using a combination approach, i.e. using X ray mammography, ultrasound, and MRI together when evaluating patients, especially for those who are at high risk for breast cancer.
MRI is extremely sensitive in detecting most invasive breast cancers, greater than 90 %. However, its sensitivity in detecting DCIS is low approximately 40% in most studies; and its specificity for malignancy is limited.
Several recent studies have shown that in staging of newly diagnosed breast cancer, MRI can detect additional ipsilateral disease in 27% of cases and can detect additional contralateral disease in 4-5% of cases. In high risk women, MRI can detect mammographically occult breast cancer in 2-8% of patients.