Female Breast Examination: A Theoretical and Practical Guide to Breast Diagnosis

ISBN-13: 9783540163022 / Angielski / Miękka / 1986 / 228 str.

Claude Annonier; Richard Chambers

Opis

While radiology only reveals one aspect of the entire ana tomical picture, a certain diagnostic precision can be at tained by skillfully combining different techniques. The re sulting images often uncover the hidden reality. This near perfection is most clearly seen - and is also most essential - in the study of the breast. One must remember that in the western world, one woman in fifteen develops breast can cer. It follows that the key to effective treatment is early and precise diagnosis. An understanding of the various breast tissues and of benign pathology is also indispensable in determining local risk. How to achieve this goal of early and precise diagnosis is the problem addressed in this well-documented text demonstrating the considerable experience of Dr. CLAUDE ANNONIER. A fresh look at the technical aspects and a com plete clinical analysis together show the successes and limi tations of modern methods and the need to combine different techniques in most cases. Evaluation of the various methods provides justification, if still needed, for the author's con tention that mammography alone is insufficient. Progress in the field is making it possible to detect smaller and smaller lesions, whose malignancy cannot be determined without needle or surgical biopsy. More generally, the author un derlines the necessity for complete cooperation between diagnostician and therapist. Follow-up for the "treated" breast is largely in the hands of the radiologist, who must, however, work together with other specialists."

Spis treści

1 Sources of Information.- 1.1 History of the Disease.- 1.1.1 Chief Complaint.- 1.1.2 Past Medical History.- 1.1.3 Characteristics of the Menstrual Cycle.- 1.1.4 Medical and Psychologic Background.- 1.1.5 Social and Family Background.- 1.1.6 Family History.- 1.2 The Clinical Picture.- 1.2.1 Functional Signs.- 1.2.1.1 Pain.- 1.2.1.2 Galactorrhea.- 1.2.1.3 Sectorial Discharge.- 1.2.2 Physical Examination.- 1.2.2.1 Inspection.- 1.2.2.2 Palpation.- 1.2.2.3 Combined Palpation.- 1.3 Transillumination.- 1.3.1 Diaphanoscopy.- 1.3.1.1 Principle.- 1.3.1.2 Material.- 1.3.1.3 Technique.- 1.3.1.4 Interpretation.- 1.3.2 Diaphanometry.- 1.3.2.1 Principle.- 1.3.2.2 Material.- 1.3.2.3 Technique.- 1.3.2.4 Interpretation.- 1.3.2.5 Somanetics.- 1.4 Ultrasonography.- 1.4.1 A Mode.- 1.4.1.1 Principle.- 1.4.1.2 Material.- 1.4.1.3 Technique.- 1.4.1.4 Interpretation.- 1.4.2 B Mode (Echotomography).- 1.4.2.1 Principle.- 1.4.2.2 Material.- 1.4.2.3 Technique.- 1.4.2.4 Interpretation.- 1.4.3 TM Mode (Time Motion).- 1.4.3.1 Principle.- 1.4.3.2 Material.- 1.4.3.3 Technique.- 1.4.3.4 Interpretation.- 1.4.4 C Mode.- 1.4.5 Transsonography.- 1.5 Roentgenographic Diagnosis.- 1.5.1 Mammography.- 1.5.1.1 Principle.- 1.5.1.2 Material.- 1.5.1.3 Technique.- 1.5.1.4 Interpretation of the Overall Structure.- 1.5.1.5 Interpretation of Abnormalities.- 1.5.2 Galactography.- 1.5.2.1 Technique.- 1.5.2.2 Interpretation.- 1.5.3 Cystography.- 1.5.3.1 Technique.- 1.5.3.2 Interpretation.- 1.5.4 Tomography.- 1.5.4.1 Mechanical Tomography.- 1.5.4.2 Computed Tomography.- 1.6 Cytodiagnosis.- 1.6.1 Needle Biopsy.- 1.6.1.1 Principles.- 1.6.1.2 Biopsy Material.- 1.6.1.3 Biopsy Technique.- 1.6.2 Cytodiagnosis of a Discharge.- 1.6.3 Cytodiagnosis of Cystic Fluid.- 1.7 Thermography.- 1.7.1 Principles of Thermography.- 1.7.1.1 Physiopathologic Findings.- 1.7.1.2 Clinical Findings.- 1.7.2 Physical Principles and Materials.- 1.7.2.1 Physical Principles of Contact Thermography.- 1.7.2.2 Physical Principles of Telethermography.- 1.7.3 Thermographic Techniques.- 1.7.3.1 Special Aspects of Contact Thermography.- 1.7.3.2 Special Aspects of Telethermography.- 1.7.3.3 Some Easily Avoided Pitfalls.- 1.7.4 Thermographic Interpretation.- 1.7.4.1 Basic Signs.- 1.7.4.2 Diagnostic Classification.- 1.7.4.3 Prognostic Classification.- 1.7.4.4 Interpretation and Follow-up.- 1.8 Invasive Examination.- 1.8.1 Nonsurgical Biopsy.- 1.8.2 Open Biopsy.- 1.8.2.1 Preoperative Mammographie Localization.- 1.8.2.2 Pathologic Study.- 1.8.2.3 Specimen Radiography.- 1.9 Magnetic Resonance Imaging.- 2 Normal Breasts.- 2.1 Breast Tissue and Examination Findings.- 2.1.1 Lactiferous-Connective Tissue Network.- 2.1.2 “Passive” Mesenchyma.- 2.1.3 Blood Vessels, Lymphatic System, Nerves.- 2.1.3.1 Arteries.- 2.1.3.2 Veins.- 2.1.3.3 Lymphatics.- 2.1.3.4 Nerves.- 2.1.4 Areolar-Nipple Area.- 2.1.4.1 Nipple.- 2.1.4.2 Areola.- 2.1.4.3 Retroareolar Region.- 2.1.5 Skin.- 2.2 Organic-Functional Variations Related to Normal Sex Hormone Activity.- 2.2.1 Prepuberty.- 2.2.2 Puberty.- 2.2.3 Period of Regular Menstrual Cycles.- 2.2.3.1 First Phase of the Cycle.- 2.2.3.2 Second Phase of the Cycle.- 2.2.4 Pregnancy and Lactation.- 2.2.4.1 Pregnancy.- 2.2.4.2 Lactation.- 2.2.5 Premenopause and Menopause.- 2.2.6 Postmenopause.- 3 Abnormalities and Breast Disease.- 3.1 Local Congenital Abnormalities.- 3.1.1 Embryologic Review.- 3.1.2 Anomalies by Deficiency.- 3.1.2.1 Hypoplasia.- 3.1.2.2 Aplasia.- 3.1.2.3 Amastia.- 3.1.3 Anomalies by Excess.- 3.1.3.1 Polythelia and Polymastia.- 3.1.3.2 Hypertrophy.- 3.1.4 Asymmetry.- 3.1.5 Nipple Inversion.- 3.2 From the Slight Hormonal Imbalance to the Organic-Functional Anomaly.- 3.2.1 Endocrine Anomalies.- 3.2.1.1 Estrogen Deficiency.- 3.2.1.2 Excess Estrogen and Progesterone.- 3.2.1.3 Estrogen-Progesterone Imbalance.- 3.2.1.4 Excess Prolactin.- 3.2.2 Diseases Causing Endocrine Anomalies.- 3.3 Mastosis.- 3.3.1 Apparently Isolated Lesions.- 3.3.1.1 Solid, Well-Delineated Masses.- 3.3.1.2 Poorly Delineated Solid Masses.- 3.3.1.3 Dystrophic Cysts.- 3.3.1.4 Lactiferous Ectasia.- 3.3.1.5 Papillary Adenomas.- 3.3.1.6 Galactocele and “Oil Cyst”.- 3.3.2 Diffuse Mastosis.- 3.3.2.1 General Features.- 3.3.2.2 Lobular Dystrophy.- 3.3.2.3 Papillary Adenomatosis.- 3.3.3 The Examining Physician When Confronted with Mastosis.- 3.4 Benign Mesenchymatous Tumors.- 3.4.1 Common Lipoma.- 3.4.2 Fibroadenolipoma (or Hamartoma).- 3.4.3 Leiomyomas.- 3.4.4 Abrikossof’s Tumor.- 3.5 Carcinoma.- 3.5.1 Characteristic Signs of Malignancy.- 3.5.1.1 Clinical.- 3.5.1.2 Transillumination.- 3.5.1.3 Ultrasonography.- 3.5.1.4 Mammography.- 3.5.1.5 Thermography.- 3.5.1.6 Needle Biopsy.- 3.5.2 Determining the Prognosis.- 3.5.2.1 Based on Radiologic-Clinical Findings.- 3.5.2.2 Based on Thermographic Findings.- 3.5.2.3 Based on Cytologic Findings.- 3.5.2.4 Based on Histologie Findings.- 3.5.3 Types of Carcinoma.- 3.5.3.1 Epithelioma.- 3.5.3.2 Sarcoma.- 3.5.3.3 Secondary Malignant Breast Lesions.- 3.5.3.4 Occult Carcinoma.- 3.5.3.5 False Appearances of Carcinoma.- 3.5.3.6 Treated Carcinoma.- 3.5.3.7 Follow-up After Primary Treatment.- 3.6 Cutaneous and Nipple-Areolar Disease.- 3.6.1 Benign Florid Papillomatosis of the Nipple.- 3.6.2 Subareolar Abscess.- 3.6.3 Sebaceous Cysts.- 3.6.4 Other Nonspecific Skin Lesions.- 3.6.5 Primary Melanoma of the Breast.- 3.7 Vascular Disease.- 3.7.1 Mondor’s Disease.- 3.7.2 Breast Infarction.- 3.7.3 Hematoma.- 3.7.4 Fat Necrosis.- 3.8 Breast Trauma.- 3.8.1 Solitary Closed Trauma.- 3.8.2 Microtrauma of the Breast.- 3.8.3 Surgical Trauma and Breast Injury.- 3.8.4 Foreign Bodies.- 3.9 The Surgical Breast.- 3.9.1 Resections.- 3.9.1.1 Open Biopsy.- 3.9.1.2 Extracapsular Mastectomy.- 3.9.1.3 Reduction Mammoplasty.- 3.9.2 Plastic Surgery Not Affecting the Gland.- 3.9.2.1 Treatment for Nipple Inversion.- 3.9.2.2 Suspension Mammoplasty.- 3.9.3 Augmentation Mammoplasty.- 3.10 Mastitis.- 3.10.1 Acute Mastitis.- 3.10.1.1 Confirming the Mastitis.- 3.10.1.2 Determining the Type of Extension.- 3.10.1.3 Determining the Cause of Mastitis.- 3.10.1.4 The Course of Acute Mastitis.- 3.10.2 Chronic Infectious Mastitis.- 3.10.3 Subacute and Chronic Tuberculosis, Cold Abscess.- 3.10.4 Mycosis and Parasitosis.- 3.10.4.1 Actinomycosis.- 3.10.4.2 Echinococcal Infestation.- 3.10.4.3 Filariasis.- 4 Examination Procedure.- 4.1 Cancer Screening.- 4.1.1 Risk of Cancer.- 4.1.2 Carcinoma.- 4.1.2.1 Telethermography.- 4.1.2.2 Ultrasonography.- 4.1.2.3 Mammography.- 4.1.2.4 The Clinical Examination.- 4.2 Examination and Diagnosis of a Breast Disease.- 4.3 Follow-up of a Breast Disease.- 4.4 Diagnosis of Cancer.- 5 Analysis.- 5.1 Detection.- 5.2 Diagnosis of Cancer.- 5.3 Cancer Work-up.- 5.4 Final Analysis.- 5.4.1 Functional Examination.- 5.4.2 Organic Examination.- 5.4.2.1 Types of Breast Tissue.- 5.4.2.2 Is There a Lesion?.- 5.4.2.3 Is the Lesion Malignant?.- 5.4.3 Screening Factors.- 5.4.4 Suggested Plan.