BREAST IMAGING COMPANION
THIRD EDITION
BREAST IMAGING COMPANION
THIRD EDITION
Gilda Cardeosa, MD
Veronica Donovan Sweeney Professor of Breast Imaging
Director of Breast Imaging
Department of Radiology
Virginia Commonwealth University Health System
Medical College of Virginia Hospitals
Richmond, Virginia
Acquisitions Editor: Lisa McAllister
Managing Editor: Kerry Barrett
Project Manager: Rosanne Hallowell
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Third Edition
2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business
530 Walnut Street
Philadelphia, PA 19106
LWW.com
2001 by Lippincott Williams & Wilkins (Second Edition). 1997 by Lippincott-Raven (First Edition).
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopying, or utilizing by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews.
Printed in the United States
Library of Congress Cataloging-in-Publication Data
Cardenosa, Gilda.
Breast imaging companion / Gilda Cardenosa. 3rd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-7817-6491-9
ISBN-10: 0-7817-6491-2
1. BreastCancerDiagnosis. 2. BreastImaging. I. Title.
[DNLM: 1. Breast DiseasesradiographyHandbooks. 2. Mammography Handbooks. WP 39 C266b 2008]
RC280.B8C366 2008
616.99'449075dc22
2007037067
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10 9 8 7 6 5 4 3 2 1
I dedicate the third edition of this book to
The memory of my mother Gilda Paniza Cardeosa (19232003).
Her unwavering determination to give me every possible opportunity against significant odds, brought unique adventures spanning continents and cultures and now a cache of memories few can rival. She was tenacious in her beliefs that there is nothing like the American Dream, and the unalienable rights afforded citizens in this country, and that it could be ours, if we remained true to ourselves and worked hard. She was right.
We made it beyond our wildest imagination; she was quite a lady.
My father Ricardo Cardeosa Barriga
and
Dr. Regina OBrien
CONTENTS
Why another edition of the Breast Imaging Companion? Why an increase in the number of text pages and images, and yet an ongoing struggle to decide what to include and emphasize and what should wait for another book?
For an introductory breast imaging text, are more images and text better, or is struggling to select one or two images as representative of entities and processes that may have marked variability the preferred option, so as not to confuse or overwhelm the reader? I do not know the answer to this; however, I have opted to include as many images as possible with the firm conviction that this is the most helpful to residents, experienced breast imagers, technologists, and other breast health care providers. At this point, I can only hope that the resulting size of the book does not detract from the message or make this book less useful. As in previous editions, I have tried to pack in as much practical common-sense information as possible such that I even use some of the figure legends to introduce material. Imaging modalities, approaches to patient care, and our knowledge of breast diseases have continued to expand rapidly, dictating the need for expanding the text. To illustrate the concepts, I have added images and replaced many of the images used in previous editions, and I assure the reader that these are new images and not repeats from my other books.
The breast imaging story is truly remarkable. Amid controversy, ongoing skepticism, critical shortages in breast imagers, and the lost leader albatross that continually subverts many of our efforts, this specialty pushes forward with far-reaching contributions to the care and management of patients with breast cancer. It is always helpful to acknowledge where we have been and what has been accomplished, and from this to gather the strength and foresight to overcome the challenges we face.
When confronted with technical and quality issues in mammography, the American College of Radiology stepped forward and took a leadership role in proposing, developing, and implementing the first-of-its-kind voluntary accreditation program for mammographic facilities. This heralded the passage of the Mammography Quality Standards Act in 1992. These efforts resulted in marked improvements in the quality of the mammographic studies and established basic continuing medical education requirements for technologists, physicists, and interpreting physicians. Additional voluntary accreditation programs in breast ultrasound, stereotactically and ultrasoundguided breast biopsies, and, more recently, breast magnetic resonance imaging have since been developed.
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