Diagnostic Breast Imaging and Breast Cancer Staging

Abstract

This review is geared to provide surgeons practical insight on breast imaging, intended to improve breast cancer detection and staging. Breast cancer is a leading cause of death in women in the United States. The American Joint Committee on Cancer staging system provides a tumor-node-metastasis classification that helps in determining prognosis and patient treatment. There is an increasing role of radiologists in ascertaining the correct cancer stage. Screening mammography is the basic tool and most widely used modality to detect breast cancer. The diagnostic work-up of a patient recalled from screening is the next step in assessing the artifacts and benign findings from more suspicious lesions. Additional mammographic views, tomosynthesis, and ultrasonography play an important role in determining if the finding represents a true lesion and if so, to localize and determine its level of suspicion to be cancer. Breast MRI is used both as a screening tool and a diagnostic modality to help in cancer detection and treatment planning. Recognizing patterns of benign masses, malignant calcifications, architectural distortion, and masses via a multimodality approach is the essential first step in further diagnosis. A quick overview of common interventional breast procedures may serve as a practical reference for the readers. This review contains 10 figures, 8 tables, and 39 references. Key Words: breast cancer, breast MRI, breast ultrasonography, fibroadenoma, invasive ductal staging, male breast, mammograms, postoperative breast, screening