Col. CS Pant VSM MD FICRI
Consultant Radiologist Col. Pant's Imaging Centre
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Atlas of Breast Imaging
© 2002, Col. CS Pant VSM
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2002
Publishing Director: RK Yadav
8171799418
9788171799411
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A-14, Sector 60, Noida
5Dedicated tomy loving wife Dr Geeta Pant who has inspired me in writing this book and has been constant source of encouragement
7ForewordThe national burden of diseases for India is still entices the nutritional deficiencies and infections. However, India is competing with well-developed western countries in disorders like hypertension, diabetes and cancer. Cancer of the breast is no exception.
Since “early detection is early cure”, this Atlas of Breast Imaging plays a tremendous role in the recognition of early breast cancer. Clinical examination has its own role but the clinical suspicion should be supported by evidence based practice of medicine. However, a good number of consumer court cases are coming up due to improper interpretation of mammographies. Hence, there is a dire need of atlas like this, which gives descriptions of the findings in greater detail. The understanding of the technique and technology is a basic necessity in the acute diagnosis of breast cancer. The maxim that “one picture is equivalent to 2000 words” holds good in Atlas of Breast Imaging. I am happy that ultrasonic imaging is also included.
Col. Pant has made a mark in the elevation of standards of practice and education of radiology and imaging in India. With his vast and rich experience in this speciality, in the armed forces as well as at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi and with the practical knowledge at his own well-established imaging centre a great deal of authenticity, accuracy and instruction is injected in this atlas.
I was told the illustrations are of international standards and M/s Jaypee Brothers Medical Publishers who have established their name in medical publishing will do a good job. Each of the 512 well-displayed illustrations is instructive by itself. The number of references indicated are reasonable.
I recommend this book strongly to all the radiology and imaging residents, practitioners and teachers. Oncologists, medical, surgical and radiation should have this book on their desk. I also recommend that every medical institution will obtain at least one copy and keep it in their sectional and general libraries.
Padma Shri Prof Kakarla Subbarao mbbs ms frcr facr
Director/Vice-Chancellor
Nizam's Institute of Medical Sciences
(A University Established Under the State Act)
Panjagutta, Hyderabad-500 082
Andhra Pradesh
India
9PrefaceWith increasing awareness about breast cancer among Indian population there has been sudden spurt in Mammography installations all over the country. However, only one Atlas in Mammography by Tabar is available costing appx. Rs 8000 which is unaffordable by many of us. This atlas is outcome of my work in this field for over 20 years. Probably this is the first Atlas of Breast Imaging which has combined both X-ray Mammography and Ultrasound with appx. 512 illustrations. I have tried to cover various aspects of breast diseases with special emphasis on important role played by Ultrasound specially in dense breast and complimentary role of colour Doppler in evaluation of breast masses. I have also touched upon various aspects of interventional procedures available for management of breast lesions, needless to say that Ultrasound plays pivotal role be it FNAC, core biopsy or hookwire localisation in palpable/non-palpable lesions. This being my maiden efforts there will be many deficiencies I hope you will overlook them.
Col. CS Pant vsm
10AcknowledgementsI am extremely grateful to my loving children Shubham, Swati and her husband Vineet who had been constant source of encouragement; my sincere thanks to Seema my secretary who did an excellent job in typing the manuscript many times over. To my other staff members Monica, Suman and Taru for their invaluable help. To Dr Ravi Kashyap of INMAS for his valuable suggestion and guidance. My special thanks to Dr Madhavi Chandra of Ganga Ram Hospital, Dr Biswajit Sen of Dr Dang's Lab, New Delhi, and Dr Suren Kothari of Mumbai for permitting me to use their transparencies. Last but not the least Mr JP Vij, Chairman and Managing Director, the staff of Jaypee Brothers Medical Publishers Pvt Ltd. and specially Mr RK Yadav for his constant support, guidance and encouragement.