Second Edition
Dr Col. CS PantVSM MD FICRI
Consultant Radiologist Col. Pant's Imaging Center
A-22, Green Park (Main), New Delhi, India
Headquarter
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Email: jaypee@jaypeebrothers.com
Overseas Offices
J.P. Medical Ltd.
83 Victoria Street, London
SW1H 0HW (UK)
Phone: +44-2031708910
Fax: +02-03-0086180
Email: info@jpmedpub.com
Jaypee-Highlights Medical Publishers Inc.
City of Knowledge, Bld. 237, Clayton
Panama City, Panama
Phone: + 507-301-0496
Fax: + 507-301-0499
Email: cservice@jphmedical.com
Website: www.jaypeebrothers.com
Website: www.jaypeedigital.com
© 2012, Jaypee Brothers Medical Publishers
All rights reserved. No part of this book may be reproduced in any form or by any means without the prior permission of the publisher.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
This book has been published in good faith that the contents provided by the author contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the author specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the author. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Atlas of Breast Imaging with Mammography, Ultrasound and MRI Correlation
First Edition: 2002
Second Edition: 2012
9789350251874
Printed at
4Dedicated to
Little Angel Anya
After a long gap of seven years, I am happy to present the second edition of Atlas of Breast Imaging with Mammography, Ultrasound and MRI Correlation which is a major revision.
I am pleased to provide a new update as most of the previous images have been replaced by digital images now and the volume has almost increased to double the size of the previous edition. There are approximately 1000 images as compared to the previous edition having half of this. A word of caution, with the introduction of CR systems for routine radiography work in this part of the world in a big way, there has been tendency on the part of radiologists to use it for mammography as well with disastrous results as shown by a few examples in the atlas. It is my earnest request to my fellow colleagues to use only dedicated CR system for mammography.
I am pleased to announce that many new authors have joined and helped me in this edition; Dr Ritu Vinayak Arora in compiling the substantial section on case studies and Dr Taneja and Dr Jena on comprehensive section on MRI breast.
Though we have two excellent books available on breast imaging, one a textbook by Dr Kopans and another an atlas by L Tabar, however, Kopans' textbook is very elaborate and Tabar's atlas primarily deals with mammography with pathological correlation; our attempts have been to bridge the gap between the two. The atlas provides a crisp and comprehensive information about mammography and ultrasound, correlating them with proven FNAC/biopsy results. It also touches upon the basics of MRI breast which is fast emerging as an important tool in evaluation of breast pathologies.
Another major addition/revision is the inclusion of 111 case studies with excellent mammography and USG images as well as the description of the pathologies. The case studies and images all reflect the spectrum of mammography and sonographic changes that may occur in a given disease instead of the most common manifestation only.
The atlas format has been redesigned in such a way that the case studies extensively cover most pathologies which will be a must read and an excellent teaching atlas of breast imaging for postgraduate residents of radiology, practicing radiologists with interest in breast radiology, breast surgeons and oncosurgeons.
Dr Col. CS Pant vsm
6Preface to the First Edition
With 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 approximately Rs 8,000 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 approximately 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 color 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 localization in palpable/nonpalpable lesions. This being my maiden efforts there will be many deficiencies I hope you will overlook them.
Dr Col. CS Pant vsm
7Acknowledgments
I am extremely grateful to my authors for their dedication and timely submission of the manuscript. I would like to acknowledge the contribution of my colleague Dr Ritu Vinayak Arora for meticulously compiling the 111 cases in the section on case studies and in finishing this marathon. I look forward to her contribution in our future endeavors. Dr Taneja and Dr Jena of Rajiv Gandhi Cancer Hospital for their crisp and comprehensive section of MRI breast; Dr A Chaturvedi, Head of the Department of Radiology, Rajiv Gandhi Cancer Institute, Delhi, for his inputs on core biopsy. My special thanks to Dr Bishwajit Sen of Dr Dang's Lab for his outstanding contribution in providing highly accurate cytological correlation. My sincere thanks to Ms T Monica, Deepali and Monika Singh for their technical support, Seema for her hardwork in preparing and correcting the manuscript and Dharam for his logistic support. My sincere thanks to the staff of our publisher M/s Jaypee Brothers Medical Publishers (P) Ltd for their unstinted support. last but not least to my dear wife Dr Geeta Pant for her valuable support and encouragement.