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AUTORES :
Lszl Tabr, MD, es Profesor de Radiologa en la Universidad de
Uppsala yjefe del Departamento de
Mamografa en el Hospital Central Faln, Faln, Suecia.
Tibor Tot, MD, es Profesor Asociado de Patologa en la
Universidad de Uppsala y Presidente delDepartamento de Patologa y
Citologa Clnica de la Universidad de Uppsala, Hospital Central,
Faln,
Suecia.Peter B. Dean, MD, es Profesor en el Departamento de
Radiologa Diagnstica en la Universidad de
Turku, Finlandia, y fue anteriormente Profesor Visitante en el
Brigham and Women's Hospital, Hospital
Mdico de Harvard, Boston, MA, EUA.
CARACTERISTICAS
Los internacionalmente conocidos imagenlogos Lszl Tabr y Peter
B. Dean, y el eminente patlogo de
la mama Tibor Tot, condensan dcadas de experiencia en este nuevo
volumen que cubre las msfrecuentes calcificaciones de tipo maligno
que ocurren: las calcificaciones de tipo piedra triturada
pleomrficas.
El libro presenta un enfoque sistemtico, utilizando las
caractersticas mamogrficas para distinguir los
diferentes subtipos de enfermedad de mama que se originan dentro
de la unidad terminal del lbulo ductal
(UTLD).Ms de 800 imgenes muestran los hallazgos anormales con
magnfica claridad, ofreciendo unareferencia visual vanguardista
para interpretar las mamografas de un grupo clnico de
observaciones.
http://www.slideshare.net/selabg/mamografia-basica
Parenchymal patterns in breast imagingDr Yuranga
WeerakkodyandStefano Pacificiet al.
Mammographic densityis considered a risk factor for breast
cancer, and its important in the way in which
it affects mammographic screening sensitivity. Women with
high-risk density patternsshould be screened
more frequently and / or with additional views per breast.
Pioneers in classification of density was
Leborgne in 1953 and Wolfe in 1967, which described an increased
risk of breast cancer in
radiographically dense breast, but the first qualitative
classification of mammographic density patterns was
described by Wolfe in 1976.
Wolfe Classification
Wolfe assign the mammograms to four parenchymal patterns (N1,
P1, P2 and DY) according to the
distribution of fat and the prominence of the ducts:
N1 : the breast consists mainly of fat (N=normal), corresponding
to ACR 1 (lower risk for breastcancer)
P1 : this pattern includes fat as well as linear densities
(enlarged ducts) occupying no more than25% of the breast,
corresponding to ACR 2 (low risk for breast cancer)
P2 : linear denisities (from enlarged ducts) occupying more than
25% of the breast. They areprominently in the upper outer quadrant
but may be distributed throughout the breast (P=prominent
ducts), corresponding to ACR3 (high risk for breast cancer)
Dy : dense, radiopaque breast (Dy=dysplasia) corresponding to
ACR4 (highest risk for breastcancer) ; these patterns are again
subdivided into low-risk (N1 and P1) and high-risk (P2 and DY)
patterns.
A fifth category has been later added by Wolfe to this four:
Qdy (quasi-dysplasia) : this group consists of young women whose
dense breast have a somewhatspongy texture due to fatty
infiltration
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Boyd Classification
An alternative, quantitative method proposed by Boyd and
collegues (1980) was based on
mammographic density percentage given by radiologists and
divided into six categories of unequal
intervals
A : 0% B : > 0 - 10% C : > 10 - 25% D : > 25 - 50% E :
> 50 - 75% F : > 75%
This method has been updated in 1995 with computer-assisted
technique measuring.
BI-RADS Classification of density
TheBI-RADSsystem too is a quantitative method proposed by the
American College of Radiology (2000)
and used in clinical radiology practice in the USA .BI-RADS
classification is a modification of Wolfes
classification, and is defined using percentages of density
divided into quartiles:
type 1 : extremely fat type 2 : minimal density type 3 :
heterogeneous density type 4 : extremely dense
Tabar Classification
Tabr (1997) classifies the mammograms in five patterns (I to V)
based on an histologic-mammographic
correlation with a three-dimensional, subgross (thick-slice)
technique, and on the relative proportion of four
building blocks (nodular denisties, linear densities,
homogeneous fibrous tissue, radiolucent fat tissue):
I : balanced proportion of all components of breast tissue with
a slight predominance offibrous tissue
II : predominance of fat tissue (fat breast) III : predominance
of fat tissue with retroareolar residual fibrous tissue IV :
predominantly nodular densities V : predominantly fibrous tissue
(dense breast)
Patterns I, II and III are considered low-risk; patterns IV and
V high-risk.
It is important to considere that some therapies may alter the
pattern by increasing
parenchymal density, as in hormone replacement therapy (HRT), or
reducing it as in therapies
with selective estrogen-receptor modulators (SERM).
References
Synonyms & Alternative Spellings
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