Presentation

1. Breast
Imaging &
Jars
By: Ahmed Nasr
Assistant lecturer of general surgery

2. Breast imaging
Mammography Ultrasound MRI
Galactography C.T
Bone scan/ PET
scan

3. Case
scenario
• A 37-year-old (gravida 1, para 0)
premenopausal, married woman presents with
a painless left breast mass that she has noticed
for the past 3 to 4 months.
• She is otherwise healthy and without any prior
history of breast-related symptoms or family
history of breast cancer.
• On physical examination, there is a 2-cm
nontender, indiscrete, hard mass in the upper
outer quadrant of her left breast. There is no
skin abnormality over the breast and no
adenopathy in the axilla or supraclavicular
region. The remainder of her physical
examination is otherwise normal.
• What are your next steps?

4. Mammography

5. Mammography
technique

6. Mammography
advantages
• Safety
• Availability
• Sensitivity
• Specificity
• Digital mammography
• Tomo-mammography

7. Mammography
Disadvantages
•5 % error
•Young females
•Implants

8. Mammography
Indications
• Screening
• Diagnosis
• Follow up
• Guided biopsy

9. Mammography
Findings
Mass ( size , location , margins )
Microcalcifications
Spiculations
Architecture distortion
BIRADS score

14. Ultrasound
Advantages
Disadvantages
Indications
Findings

15. Ultrasound
Advantages
Safe
Available
Informative
Young females
Guided biopsy
Cheap
Less radiation
Pregnancy and lactation

16. Ultrasound
disadvantages
• Operator dependent
• Lesion less than 1 cm

17. Ultrasound
indications
• Mostly in all breast lesions
• Pregnancy and lactation
• Young females

18. Ultrasound
Findings

23. MRI
• Breasts with Implants
• Follow up postoperative (scar / recurrence )
• Screening of high-risk group
• Lesions not identified by US and
mammography
• Pregnancy

24. • Costly
• Non available
• Not sensitive to premalignant
lesions
• not accurate if done within 9
months of the radiotherapy for
carcinoma breast.
MRI
disadvantages

26. Ductography
Nipple discharge
Unilateral serous or
bloody
Especially from single
duct

28. Jars

32. Fibroadenoma

33. Breast cancer

34. Paget disease

35. Thanks