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Stereotactic breast biopsy

Breast biopsy is performed whenever it becomes necessary to characterize a breast lesion. This consists of the withdrawal and collection of cells (cytologic exam) or tissue fragments (histologic exam) and in the anatomical-pathological analysis of the sample tissue. There are many different wa...

Stereotactic mammotome

Stereotactic mammotome is method of biopsing breast lesions, particularly if they are occult on ultrasound. A vacuum-assisted core biopsy (VACB)-stereotactic breast biopsy is performed as a diagnostic approach when mammography shows irregularities with micro-calcifications, parenchymal distorti...

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...

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 any chronically lymphedematous region due to any cause2. The inciden...

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. Pathology Squ...

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.

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...

Supraclavicular lymph nodes

The supraclavicular lymph 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 system. They oversee the transport of lymph fr...

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...

Suspicious breast calcifications

Suspicious breast calcifications are calcifications within the breast that are not benign. These calcification need further work up and biopsy. The BI-RADS lexicon includes four descriptors of suspicious calcification morphology on mammography: amorphous coarse heterogeneous fine pleomorphic...

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 ...

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...

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...

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...

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...

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. ...

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...

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 ...

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...

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 ...

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...

Triple receptor negative breast cancer

Triple receptor-negative (TRN) breast cancer 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 growth factor receptor 2 (HER2/neu) Ep...

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 ...

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...

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. Pathology On gross patholo...

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...

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 ...

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...

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 the stromal fibrosis, or both processes lead to the formation of cysts, disabling the drainage of the terminal ducts of the lobules. I...

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, such as: BIRADS ...

Unilateral axillary lymphadenopathy (differential)

Unilateral axillary lymphadenopathy while being more concerning than bilateral axillary lymphadenopathy can still arise from a various benign as well as malignant causes. Benign mastitis other regional infective causes tuberculosis ipsilateral arm infection, e.g. cellulitis silicone induce...

Vascular calcification in breast

Vascular calcifications in the breast are calcifications associated with blood vessels. Epidemiology They are most often seen in post menopausal women with arteriosclerotic heart disease. Pathology Results due to calcified atherosclerotic plaques in the arterial walls. Associations coro...

Well-defined breast cancers (differential)

Certain well-defined breast cancers tend 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 spiculation ...

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...

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 ...

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