Breast Cancer

László Tabar, Tibor Tot, Peter B Dean

In "Breast Cancer: The Art and Science of Early Detection with Mammography-Perception, Interpretation, Histopathologic Correlation," László Tabár, one of the world?s most renowned mammographers, has shared his decades of experience in presenting the fundamentals of perception and interpretation of mammographic images. This is the second volume in a series of books written by the team of Tabár, Tot, and Dean describing breast cancer in its earliest phase according to the imaging findings and correlating these findings with sophisticated histopathologic images and patient outcome. This volume covers a particularly troublesome subtype of breast cancer characterized by casting type calcifications.


Highlights:



Extensive coverage of the morphology and outcome of this deceptive breast cancer subtype

Nearly 1000 illustrations of stunning quality showing the full range of manifestations

Photomicrographs of large, thin-section pathology slides and unique 3D pathology images which are carefully correlated with mammographic images to explain why mammograms appear as they do

Stereoscopic images that demonstrate normal breast structures and the distortion caused by this unique malignant process

Presentation of an original theory of neoductgenesis to explain the surprising disease outcome all too frequently observed

Scientific rationale for using individualized treatment methods which include the mammographic prognostic features

This is a volume in a series of books written by the team of Tabar, Tot, and Dean describing breast cancer in its earliest phase according to the imaging findings and correlating these findings with sophisticated histopathologic images and patient outcome. This volume covers a particularly troublesome subtype of breast cancer characterized by casting type calcifications.

Introduction Chapter 1: Description of calcifications localized within the ducts Anatomic background Secretory disease-type, plasma-cell-mastitis type calcifications Casting-type calcifications Fragmented and dotted casting type calcifications Fragmented casting type calcifications on the mammogram Dotted casting type calcifications on the mammogram Fragmentted casting-type calcifications Mammographic display of widespread fragmented casting type calcifications in five separate cases Macroscopic and subgross histologic correlation when fragmented casting type calcifications fill an entire lobe Characteristic mammographic and histologic presentation of fragmented casting type calcifications on the mammogram Example 1.1 Mammographic-histologic correlation when both fragmented and dotted casting type and dotted casting type calcifications are present Example 1.2 Fragmented casting-type calcifications, differential diagnostic problems Fragmented casting-type calcifications which bear a resemblance to benign secretory disease type calcifications Example 1.3 Fragmented casting-type calcifications may be deceptive, particularly when presenting as a small cluster Examples 1.4, 1.5 Dotted casting-type calcifications Mammographic display of widespread dotted casting type calcifications in five separate cases Mammographic-histologic correlation of dotted casting type calcifications on the mammogram Examples 1.6-1.9 Mammographic-histologic correlation of dotted casting type calcifications caused by Grade 1 DCIS, a rare event Examples 1.10, 1.11 Chapter 2: The evolution of casting-type calcifications Introduction No apparent abnormality on the previous mammogram Example 2.1 Cluster of calcifications as the earliest sign Examples 2.2-2.9 Subtle casting type calcifications as the earliest sign Examples 2.10, 2.11 Chapter 3: The theory of neoductgenesis Introduction Comparison of benign and malignant intraductal calcifications Proposal of the theory of neoductgenesis Morphologic demonstration of neoductgenesis A) Unnaturally high concentration of duct-like structures B) Desmoplastic reaction and extensive lymphocytic infiltration C) Disorganized architecture D) Pathologic ducts, contorted and crowded closely together Histologic demonstration of multiple newly formed ducts Examples 3.1-3.3 E) Tenascin overexpression Examples 3.4, 3.5 Neoductgenesis with asymmetric density and very subtle, associated calcifications Example 3.6 Neoductgenesis without associated calcifications Examples 3.7, 3.8 Chapter 4: The deviant nature of the breast cancer subtype with castings Introduction The use of mammographic tumor features to study breast cancer Relative frequency of breast cancer occurrence by mammographic tumor features Long-term outcome by mammographic tumor features Proportion of breast cancer death by mammographic tumor features Demonstration of fatal cases with casting type calcifications Examples 4.1-4.3 Poor correlation of outcome with mode of therapy Demonstration of local recurrence following radiotherapy Examples 4.4, 4.5 Axillary node status and mammographic tumor features Histologic malignancy grade and mammographic tumor features Outcome of 1-14 mm casting cases compared with advanced cancers Chapter 5: Recognition of the unpredictable, often fatal nature of the breast cancer subtype presenting with casting type calcifications on the mammogram Examples with fatal outcome Examples 5.1-3 Frequent recurrence with casting type calcifications Examples 5.4-5.7 Distant metastases with casting type calcifications Example 5.8 Suggestion for use of the mammographic prognostic features in clinical practice