الفهرس 
Anatomy of the Breast
Lymphatic drainage of the breastOnly 14 pages are availabe for public view
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Abstract
Breast cancer is most common cause of cancer deaths among
women worldwide. Despite the improvement in the detection of
breast cancer with the widespread application of mammography and
ultrasound, some breast lesions still remain difficult to diagnose and
characterize, especially in dense fibroglandular breasts and in
differentiating post-operative changes from recurrent masses.
The sensitivity of breast MRI for the detection of cancer is the
greatest of all imaging techniques especially when the findings of
conventional imaging are inconclusive. MRI can be used as a
problem-solving modality, it is also better at identifying the true
extent of cancer and help in cancer staging when multifocal disease
or ductal carcinoma in situ is present. However its reported
specificity is variable.
Consequently, there has been considerable interest in the
development of adjunct MR imaging methods to improve the
specificity of dynamic contrast-enhanced breast MR imaging.
Diffusion-weighted breast imaging is being investigated for its
potential to improve breast disease diagnosis. It is desirable that a
diagnostic test in the breast should either rule in or rule out
malignancy. The application of additional DWI to MRI protocols is
fast and does not require further preparations.
In this study we attempted to investigate the validity of DWI
and ADC measurements in differentiating benign and malignant breast lesions and further correlation of the study results with
histopathological data and/ or follow up.
The study included 40 patients. All patients underwent
contrast enhanced-MRI, DWI and ADC values measurements with
documentation of findings.
We found that DWI and ADC measurement increased the
specificity of the breast MRI in characterization of different breast
lesions and was of great help in differentiating between posttherapeutic
changes from recurrent breast cancers. It also can reduce
the number of false-positive results and associated unnecessary
biopsies.
The calculated ADC value is clearly affected by the scanning
parameters used for DWI. That is the reason for the different cut off
values found for the discrimination of the malignant from benign
lesions among different studies. So, all MRI centres should
determine their own cut off values according to the DWI sequence
used for breast imaging.