Medical Lecture Note: Bassett: Breast Imaging (Expert Radiology Consult Series)

The editors of Breast Imaging are very excited about the introduction of this new and unique textbook for many reasons, including:

It has been designed to be the most up-to-date and comprehensive product for health care professionals who deal with breast diseases and especially physicians who interpret breast imaging exams.
It will provide an in-depth review on all aspects of breast imaging, including the newest technologies. The chapter authors are acknowledged as leading experts in the field.
It offers unique learning opportunities, including the ability to access the textbook for information on-line at a computer near the interpreting physician's workstation. For example, if the interpreting physician has questions about a breast imaging examination they are interpreting they can immediately access this textbook on-line for help.

Section 1 begins with a chapter on the history of the origins and development of the subspecialty of breast imaging. The next chapter, overseen by the lead author of the American Cancer Society Guidelines for Breast Cancer Screening, provides an opportunity to learn the newest information on the epidemiology of breast cancer and the impact of early detection on patient survival. The final chapter addresses controversies about breast cancer screening with mammography. The authors are acknowledged international experts in this arena. They provide evidence-based data that supports annual screening beginning at age 40, and this information will be important for interpreting physicians and other health care providers responding to questions from referring physicians and patients concerning screening mammography.

Section 2 encompasses comprehensive updates on breast imaging technologies. Leading experts in these technologies offer the current status of digital mammography, computer-aided detection, positioning, clinical image evaluation, and quality control in mammography. Experts in breast ultrasound and breast MRI have contributed additional chapters with thorough reviews and updates on these modalities. This section ends with a chapter that provides the most recent version of the American College of Radiology's Breast Imaging Reporting and Data System, authored by the overall Chair of the ACR BI-RADS Committee and Subcommittee Chairs for Mammography, Ultrasound, and MRI.

Sections 3, 4, and 5Sections 3 4 5 are focused on imaging-pathology correlation. The authors of these chapters are pathologists and radiologists who specialize in breast diseases. Today the majority of breast biopsies are imaging guided, and the pathology results will determine subsequent patient management. We are confident that this publication provides the most comprehensive review of correlated imaging-pathology findings.

Section 3 presents the imaging and histology of the normal breast. We believe that this is fundamental to understand the imaging and histology of benign and malignant breast lesions.

Section 4 focuses on the Imaging of Benign Breast Diseases. The breast pathology and imaging authors worked together to provide a comprehensive review of the majority of benign lesions with histology and imaging correlates. There are chapters addressing both cystic and solid benign entities. In addition, proliferative lesions and benign calcifications are reviewed. Importantly, there is a review of high-risk benign breast lesions that may require excisional biopsy after an imaging-guided core needle biopsy.

Section 5 follows with a comprehensive review of the pathology and imaging of breast malignancies, ranging from ductal carcinoma-in-situ and invasive carcinomas to rare malignancies. There is also information about the role of imaging with neoadjuvant chemotherapy.

Section 6 introduces the current status of “Appropriateness Criteria” for the breast imaging workup. We are entering the era of “evidence-based medicine”, which will require justification of our imaging protocols in the future health care system. The American College of Radiology Appropriateness Criteria were developed to identify appropriate workup protocols, justified by evidence in the scientific literature, for breast imaging findings associated with clinical findings or recalled from a screening mammogram. The authors of these chapters have been members of the ACR Appropriateness Criteria committee for breast imaging.

Section 7 presents the status of current imaging-guided interventional procedures. It also presents the pathologist's evaluation of the biopsy specimens and how they are processed. Finally, it addresses the breast imager's role in determining post-biopsy management.

Section 8 reviews the imaging findings in the surgically altered breast. Evaluating imaging studies after major surgery can be a challenge. However, the authors of these chapters are known experts in evaluating the post-surgical breast.

Section 9 is a comprehensive update on the current regulations in breast imaging. Like it or not, breast imaging is the most regulated field in radiology, and one of the most regulated in all of medicine. We are fortunate to have recruited the most authoritative contributors for each of these chapters that address MQSA and Accreditation Programs, The Medical Audit, Coding and Billing, and Medico-legal Issues.

Section 10 introduces Emerging Technologies in breast imaging. Each of the authors of these chapters is actively involved in research studies on these new and promising technologies of the future. It is an exciting venture.

We wish to thank our contributing authors for their excellent submissions to this book. We also want to thank our patients, families, friends, and coworkers for their help and patience in this endeavor. In summary, after our hard work we are proud to provide this new and unique textbook to you.

- The Editors -

Key Features

Confidently interpret breast imaging findings by looking at how various radiologic presentations correlate with pathology studies.
Make the best imaging decisions with comprehensive coverage of the appropriateness criteria for various imaging modalities.
Comply with accepted reporting standards thanks to in-depth information on Breast Imaging-Reporting and Data System.
Enhance your interventional radiology skills with detailed guidance of these techniques.
View breast pathology clearly with full-color images throughout.

Website Features

Consult the book from any computer at home, in your office, or at any practice location.
Instantly locate the answers to your clinical questions via a simple search query.
Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.

Contents

SECTION ONE - Introduction

CHAPTER 1 - History of Breast Imaging
CHAPTER 2 - Epidemiology of Breast Cancer
CHAPTER 3 - Screening Results, Controversies, and Guidelines

SECTION TWO - Imaging Technologies

CHAPTER 4 - Mammography and Digital Equipment
CHAPTER 5 - Computer-Aided Detection
CHAPTER 6 - Positioning in Mammography
CHAPTER 7 - Clinical Image Evaluation
CHAPTER 8 - Mammography Quality Control: Digital and Screen-Film
CHAPTER 9 - Ultrasound Equipment
CHAPTER 10 - Ultrasound Indications and Interpretation
CHAPTER 11 - Magnetic Resonance Equipment and Techniques
CHAPTER 12 - Magnetic Resonance Imaging: Indications and Interpretation
CHAPTER 13 - BI-RADS, Reporting, and Communication

SECTION THREE - Imaging of the Normal Breast

CHAPTER 14 - The Normal Breast

SECTION FOUR - Imaging of the Benign Breast Disease

CHAPTER 15 - Benign Cystic Lesions of the Breast
CHAPTER 16 - Solid Benign Lesions of the Breast
CHAPTER 17 - Proliferative Lesions
CHAPTER 18 - Typical Benign Calcifications
CHAPTER 19 - High-Risk Breast Diseases
CHAPTER 20 - Infectious and Inflammatory Diseases of the Breast

SECTION FIVE - Imaging of the Breast Malignancies

CHAPTER 21 - Ductal Carcinoma in Situ and Paget's Disease
CHAPTER 22 - Invasive Ductal Carcinomas
CHAPTER 23 - Invasive Lobular Carcinoma
CHAPTER 24 - Other Malignant Breast Diseases
CHAPTER 25 - The Effect of Neoadjuvant Chemotherapy and Radiation Therapy on Breast Tissue

SECTION SIX - Appropriateness Criteria for Breast Imaging Workup

CHAPTER 26 - American College of Radiology Appropriateness Criteria
CHAPTER 27 - Appropriate Management of Masses
CHAPTER 28 - Appropriate Management of Calcifications

SECTION SEVEN - Interventional Approaches

CHAPTER 29 - Image-Guided Percutaneous Biopsy
CHAPTER 30 - Galactography
CHAPTER 31 - Presurgical Needle Localization
CHAPTER 32 - Specimen Processing in Pathology
CHAPTER 33 - Post-Biopsy Management

SECTION EIGHT - The Surgically Altered Breast

CHAPTER 34 - The Conservatively Treated Breast
CHAPTER 35 - The Augmented Breast
CHAPTER 36 - Reduction Mammoplasty

SECTION NINE - Regulations in Breast Imaging

CHAPTER 37 - The Mammography Quality Standards Act and Accreditation
CHAPTER 38 - The Medical Audit: Statistical Basis of Clinical Outcomes Analysis
CHAPTER 39 - Coding and Billing in Breast Imaging
CHAPTER 40 - Medical-Legal Aspects of Breast Imaging and Intervention

SECTION TEN - Emerging Technologies

CHAPTER 41 - Emerging X-Ray-Based and Nuclear Technologies
CHAPTER 42 - Ultrasound-Based Technologies Including Elastography and Automated Whole Breast Scanning
CHAPTER 43 - Recent Advances in Magnetic Resonance Spectroscopy in the Breast
CHAPTER 44 - Minimally Invasive Percutaneous Breast Cancer Ablation

About the Authors

Lawrence W. Bassett, MD, FACR, Iris Cantor Professor of Breast Imaging, Vice Chair for Academic Affairs, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California.
Mary Catherine Mahoney, MD, FACR, Director of Breast Imaging, Barrett Cancer Center, Professor of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio.
Sophia Kim Apple, MD, Director of Breast Pathology, Associate Professor, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
Carl J. D'Orsi, MD, FACR, Professor of Radiology, Oncology/Hematology, Director of Breast Imaging Research, Emory University Hospital, Atlanta, Georgia.

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