Articles
Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.
341 results found
Article
Sappey plexus
Sappey plexus is a network of lymphatics in the areola of the nipple. Sappey plexus assumes considerable importance in the identification of the sentinel lymph node since the subareolar route is the most straightforward to infiltrate with an injected radiotracer/dye and the most suitable in spec...
Article
Scirrhous carcinoma (breast)
Scirrhous carcinoma of the breast is a pathological subtype of breast cancer. It is a subtype of invasive ductal carcinoma not otherwise specified and presents as a hard lump. The proportion of pathologic lymph node metastasis among scirrhous carcinomas is significantly higher than that among ca...
Article
Sclerosing adenosis of the breast
Sclerosing adenosis (SA) is a benign proliferative condition of the terminal duct lobular units characterized by an increased number of acini and their glands. It manifests as multiple small, firm, tender nodules, fibrous tissue, and variable microcysts within the breast. It is sometimes placed ...
Article
Sclerosing lobular hyperplasia of breast
Sclerosing lobular hyperplasia (SLH) of the breast, also known as fibro-adenomatoid mastopathy, is an uncommon benign proliferative breast lesion.
Epidemiology
It tends to occur more often in adolescent and young adult patients (peak age in the thirties). In the United States, there may be a g...
Article
Sclerosing papilloma (breast)
Sclerosing papillomas of the breast are a sub type of intraductal papilloma of breast. It is termed when a papillary lesion form well-defined solid masses with a dominant sclerosed architecture 2. It is usually a histological diagnosis and usually cannot be differentiated from a non sclerosing p...
Article
Screening for breast cancer
Screening for breast cancer includes activities which test members of asymptomatic populations for breast cancer. Many advanced countries have breast screening programs. The most widely adopted method for breast cancer screening is mammography.
There are few areas in imaging fraught with more c...
Article
Sentinel lymph node
The sentinel lymph nodes (SLNs) are defined as those lymph nodes that directly drain a malignancy, or alternatively can be considered as the first node(s) that a tumor metastasizes to.
History and etymology
"Sentinel node" as the initial draining node of a malignancy was first used in a paper ...
Article
Seroma
Seromas are collections of serous fluid that usually occur as a complication of surgery, but can also be seen post-trauma. They are commonly seen as an early complication of breast surgery, where a potential space is left.
Terminology
Seromas are distinct from hematoma as they contain almost n...
Article
Silicone injection and insertion (cosmetic)
Silicone injection into various parts of the body has been used in many countries to achieve what are perceived to be cosmetic improvements. Most common sites for such injections are the breasts, face, and buttocks, although anywhere can be targeted.
This article is a general discussion of the...
Article
Simple breast cyst
Simple breast cysts are a common benign cause of a breast lump in women.
Clinical presentation
Patients may be asymptomatic or present with a breast lump. Some patients may have associated pain or tenderness.
Pathology
Breast cysts are caused by blockage of the terminal acini with resultant ...
Article
Skin calcification in breast
Skin calcifications in the breast usually form in dermal sweat glands after low grade folliculitis and inspissation of sebaceous material. Calcifications may also form in moles and other skin lesions. Often, these calcifications are in groups as they extend into small glands in the skin. Occasi...
Article
Skin thickening on mammography (differential)
The presence of skin thickening on mammography is variably defined, usually being more than 2 mm in thickness. It can result from a number of both benign and malignant causes. They include:
Malignant
inflammatory breast cancer: one of the most concerning causes of skin thickening: this usually...
Article
Skip metastases to the axillary lymph nodes in breast cancer
Skip metastases to the axillary lymph nodes in breast cancer refer to the uncommon phenomenon in which metastases do not follow the conventional stepwise pattern from level I to level II, to level III (infraclavicular), to the supraclavicular fossa, and or internal jugular chain 1-6,9.
Terminol...
Article
Snowstorm sign (disambiguation)
Snowstorm sign may refer to:
snowstorm sign: complete hydatiform mole (ultrasound)
snowstorm sign: extracapsular breast implant rupture (ultrasound)
snowstorm sign: thyroid pulmonary metastases (chest radiograph)
Article
Snowstorm sign (extracapsular breast implant rupture)
Snowstorm sign on breast ultrasound imaging represents the presence of free silicone droplets mixed with breast tissue giving a characteristic heterogeneous echogenic appearance with dispersion of the ultrasound beam. It is considered the most reliable sign of extracapsular breast implant ruptur...
Article
Spence tail
Spence tail is the prolongation of upper outer quadrant of the breast in the axillary direction. It is also called the axillary tail, once it passes through the foramen of Langer, it pierces the axillary fascia. The duct system is seen to extend into the axilla.
If this direct continuity with t...
Article
Spontaneous nipple discharge
Spontaneous nipple discharge in a non lactating breast can result from many causes which include:
papillary lesions of breast: present in ~35-50% of cases with spontaneous nipple discharge
intraductal papilloma
fibrocystic change
mammary duct ectasia
ductal carcinoma in situ: 5-21%
Article
Spot view (mammography)
A spot view (also known as a spot compression view or focal compression view) is an additional mammographic view performed by applying the compression to a smaller area of tissue using a small compression paddle, increasing the effective pressure on that spot. This results in better tissue separ...
Article
Steatocystoma multiplex of the breast
Steatocystoma multiplex is a rare familial hamartomatous malformation that is characterized by the presence of multiple intradermal cysts, and can result in abnormal breast examinations.
Epidemiology
They usually appear during adolescence and progress with age.
Clinical presentation
The dis...
Article
Stellate breast lesions: causes (mnemonic)
A handy mnemonic to recall the causes of a stellate breast lesion is:
STARFACE
Mnemonic
S: summation shadow
T: tumor (i.e. invasive breast cancer)
A: abscess
R: radial scar
F: fibroadenoma / fat necrosis
A: adenosis (sclerosing)
CE: other causes, hematoma (e.g. postoperative, post biops...
Article
Step-and-shoot tomosynthesis (breast)
Step-and-shoot is a technology of image acquisition in digital breast tomosynthesis characterized by stop scanning at every single angle during images acquisition.
Step-and-shoot technology allows advantages in microcalcifications conspicuity, spatial resolution, signal-to-noise Ratio improveme...
Article
Stepladder sign (disambiguation)
Stepladder sign may refer to:
intracapsular breast implant rupture (ultrasound)
gas-fluid levels in obstructed small bowel (erect abdominal radiograph)
Article
Stepladder sign (intracapsular breast implant rupture)
The stepladder sign is a sonographic sign indicating an intracapsular breast implant rupture. It is considered the most reliable ultrasonographic finding in silicone gel breast implant intracapsular rupture. It is identified as multiple, discontinuous, parallel, linear echoes in the lumen, and i...
Article
Step-oblique mammography
Step-oblique mammography is an accurate technique for determining whether a mammographic finding visible on multiple images on only one projection (but not elucidated using standard additional mammographic projections) represents a summation artifact or a true mass and for precisely localizing t...
Article
Stereotactic breast biopsy
Stereotactic breast biopsy refers to percutaneous sampling of breast tissue using mammographic guidance for targeting.
Indications
It is the biopsy method of choice when the finding of interest is best seen on mammography, such as microcalcifications (most common), architectural distortion, or...
Article
Sternalis muscle
The sternalis muscle is an uncommon anatomic variant of the chest wall musculature and is of uncertain etiology and function. Its importance lies in that it should not be mistaken for a pathological lesion.
Epidemiology
Cadaveric studies have shown that the muscle is present in ~5% (range 1-8...
Article
Stewart-Treves syndrome
Stewart-Treves syndrome refers to an angiosarcoma seen in the setting of lymphedema 1.
It was classically attributed to lymphedemas induced by radical mastectomy to treat breast cancer. Nowadays, we know that it can arise in chronically lymphedematous regions of any cause 2.
The incidence is ...
Article
Subareolar abscess
Subareolar breast abscess are relatively uncommon and tend to occur mostly in young women.
Clinical presentation
Mastalgia, signs of inflammation, lump formation in the subareolar region and nipple discharge. In chronic cases fistula formation and nipple deformity may be seen. Some risk facto...
Article
Subcapsular line sign (intracapsular breast implant rupture)
The subcapsular line sign is a small localized leak from a silicone implant that leads to the formation of a thin layer of silicone between the implant shell and the fibrous capsule. It represents a minimally collapsed intracapsular breast implant rupture. It is best appreciated by MRI.
Article
Supernumerary nipples
Supernumerary nipples are a common minor congenital malformation that consists of accessory nipples.
Supernumerary nipples are located along the embryonic milk lines. Ectopic supernumerary nipples are found beyond the embryonic milk lines. In human beings, the embryonic milk line extends from a...
Article
Supraclavicular lymph nodes
The supraclavicular lymph nodes (often shortened to the supraclavicular nodes) are a paired group of lymph nodes located on each side in the hollow superior to the clavicle, close to the sternoclavicular joint. It is the final common pathway of the lymphatic system as it joins the central venous...
Article
Suspensory ligament of the axilla
The suspensory ligament of the axilla is the inferior extension of the clavipectoral fascia on each side of the thorax.
Gross anatomy
The suspensory ligament of the axilla originates from the inferior border of pectoralis minor, where the 'leaflets' of the clavipectoral fascia have fused again...
Article
Suspicious breast calcifications
Suspicious breast calcifications are calcifications within the breast that have a morphology and/or distribution on mammography indicating a significant probability of malignancy. These merit further workup and biopsy 1.
Radiographic features
Technique
Some calcifications may be more conspicu...
Article
Suture calcification in breast
Suture calcification in breast can be seen after a lumpectomy and/or radiation therapy. It is theorized that tissue damage from radiation therapy delays the resorption of the suture. The residual suture material is thought to act as a nidus for calcification.
Radiographic features
Mammography
...
Article
Synchronous breast cancer
Synchronous breast cancers are two (or more) primary breast cancers that occur in either breast at the same time.
Epidemiology
Up to 10% of all breast cancers may be synchronous (particularly found with the use of breast MRI). The occurrence of bilaterality is greatest with invasive lobular c...
Article
Tabar 5-tier grading system
The Tabar 5-tier grading system is used to classify mammographic lesions. This should not be confused with the Tabar classification of parenchymal patterns in breast imaging. It is a separate but translatable system to the BI-RADS classification system (please note that Tabar grade 3 ≠ BI-RADS 3...
Article
Tamoxifen-induced reversible hepatic steatosis
Tamoxifen is an important anti-estrogen agent used for the treatment of hormone receptor-positive breast cancer and it may induce reversible hepatic steatosis. This is usually transient and may occasionally be associated with hepatic dysfunction. It only rarely leads to cirrhosis 1.
Epidemiolog...
Article
Tangential views
Tangential views are useful to differentiate intracutaneous radiopaque particles in a tattoo from intraparenchymal microcalcifications.
Mammographic findings close to the skin such as masses, microcalcifications, skin dimpling or shaded areas always pose a problem of differential diagnosis.
Va...
Article
Tanner stages of normal breast development
Breast development occurs in two phases, one during fetal life and the second during puberty. In fetal life a rudimentary organ with simple ducts develop under maternal stimulus. During puberty, further complex branching of ducts and glandular tissue forms which is divided into five stages.
Tan...
Article
Tattoo sign (mammogram)
The tattoo sign is a feature given to describe dermal calcifications seen on mammography 1. The basis of this sign is that dermal calcifications maintain fixed relationships to one another that are reproducible with similar projections at different times. This is in contrast to intramammary calc...
Article
Teardrop sign (intracapsular breast implant rupture)
The teardrop sign indicates an uncollapsed intracapsular breast implant rupture and is seen as a small focal invagination of the implant shell caused by a minimal concealed leak of droplets of silicone outside the shell where the two membranes contact each other. It is best appreciated by MRI.
...
Article
Technique of masking
Masking is very important when viewing mammograms, especially with high-density breasts. It helps the adaptation of the eye to the luminance of the mammograms on the viewbox.
The technique of masking allows the comparative study of small areas of both breasts and is a featur...
Article
Tent sign (breast)
The tent sign is a term referring to a characteristic appearance of the posterior edge of the breast parenchyma when a mass (usually an infiltrating lesion) causes its retraction and forms an inverted "V" that resembles the tip of a circus tent.
The detection of a "tent sign" is facilitated by ...
Article
Terminal ductal lobular unit
Each breast lobe is drained by a collecting duct terminating in the nipple. The collecting duct has several branches, which ends in a terminal ductal-lobular unit (TDLU), the basic functional and histopathological unit of the breast. The TDLU is composed of a small segment of the terminal duct a...
Article
Transverse rectus abdominis musculocutaneous flap
Transplantation of a transverse rectus abdominis myocutaneous (TRAM) flap is a commonly used surgical procedure for breast reconstruction following mastectomy.
An autologous myocutaneous flap consisting of abdominal skin, subcutaneous fat, the rectus abdominis muscle, and adjoining vasculature ...
Article
Triangulation
Triangulation is a technique for localizing lesions seen on at least two views on 2D mammography.
Technique
hang the CC, MLO, and 90° lateral films (in that order) on the view box
the nipple on each film must be at the same level
use a ruler and place one end over the lesion on the 90° later...
Article
Triple receptor negative breast cancer
Triple receptor-negative (TRN) breast cancer or triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by a relative absence of immunohistochemical staining for the following hormone receptors/protein:
estrogen receptor (OR)
progesterone receptor (PR)
human epidermal...
Article
Tuberculous mastitis
Tuberculous mastitis is often considered a form of granulomatous mastitis secondary to Mycobacterium tuberculous infection of the breast. Some authors however reserve the term granulomatous mastitis to idiopathic granulomatous mastitis.
Tuberculous mastitis can mimic many other pathologies in ...
Article
Tuberous breasts
Tuberous breasts are congenital deformities of breast. They are defined by reduced parenchymal volume and herniation of breast tissue through the nipple-areola complex.
Epidemiology
The exact incidence is not clear. However, it is a common cause of patients presenting with breast asymmetry. Pr...
Article
Tubular adenoma of the breast
Tubular adenomas (TA) of the breast, also known as pure adenoma of the breast, are a rare benign breast lesion. It is a type of adenomatous breast lesion.
Epidemiology
They are typically found in young women and are usually palpated by the patient or her physician.
TA are rare tumors of the b...
Article
Tubular carcinoma of the breast
Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma (IDC).
Epidemiology
These account for ~1% of breast cancers. The peak age at presentation may be comparatively younger than with other types of breast cancer 7.
Clinical presentation
The vast majority of tubular carci...
Article
Tubulolobular carcinoma of the breast
A tubulolobular carcinoma (TLC) of the breast is considered a subtype of breast cancer that features of both invasive lobular carcinoma and tubular carcinoma of the breast. It therefore exhibits features of both ductal and lobular differentiation. Multifocality, muticentricity and percentage of ...
Article
Tucked CC views
In the standard CC views posterior tissue may be excluded from the field of view, due to the anatomical attachment to the chest wall restricting mobility of breast tissues. The tucks CC views are useful to depict lesions deep in the posterior portion of the breast, located between 10 and 2 o'clo...
Article
Ultrasound elastography
Ultrasound elastography, also called as sono-elastography, is a modern evolutionary method of sonographic imaging. Techniques include shear wave elastography (also known as transient elastography) and strain elastography (also known as static or compression elastography). These techniques utiliz...
Article
Ultrasound evaluation of breast cysts
Ultrasound evaluation of breast cysts is the modality of choice. Obstruction of the ducts, often appearing as the result of epithelial hyperplastic processes or stromal fibrosis, or both processes lead to the formation of cysts, disabling the drainage of the terminal ducts of the lobules.
In al...
Article
Ultrasound guided breast biopsy
Ultrasound-guided percutaneous breast biopsy is a widely used technique for an accurate histopathological assessment of suspected breast pathology. It is a fast, safe and economical procedure.
Indications
Ultrasound guidance is limited to lesions visible on ultrasound study. The biopsy is gene...
Article
Unilateral axillary lymphadenopathy (differential)
Unilateral axillary lymphadenopathy while being more concerning than bilateral axillary lymphadenopathy can still arise from a variety of benign, as well as malignant, causes.
Benign
mastitis
other regional infective causes
tuberculosis
ipsilateral arm infection, e.g. cellulitis
silicone i...
Article
Vascular calcification in breast
Vascular calcifications in the breast are calcifications associated with blood vessels.
Epidemiology
They are most often seen in postmenopausal women with arteriosclerotic heart disease.
Pathology
Results due to calcified atherosclerotic plaques in the arterial walls.
Associations
coron...
Article
Well-defined breast cancers (differential)
Certain well-defined breast cancers tend to lack the characteristic spiculation and can give false reassurance of more benign entities on both ultrasound and mammography. These include:
certain high grade invasive ductal carcinomas: not enough time for a desmoplastic reaction to form spiculatio...
Article
WHO classification of tumors of the breast
The World Health Organization classification of tumors of the breast is the most widely used pathologic classification system for such disorders. The current revision, part of the 4th edition of the WHO series, was published in 2012 and is reflected in the article below 1.
Classification
Epith...
Article
XCCL view
An XCCL view is a supplementary mammographic view. It is a type of exaggerated cranio-caudal view. It is particularly good for imaging the lateral aspect of the breast.
It is often done when a lesion is suspected on a MLO view but cannot be seen on the CC view. In this view, the lateral aspect...
Article
XCCM view
An XCCM view is a supplementary mammographic view. It is a type of exaggerated cranio-caudal view. It is particularly good for imaging the medial portion of the breast. In this view, the medial portion of the breast is placed forward. A negative 15° tube tilt is suggested.
An optimal XCCM view ...