الفهرس 
ANATOMY 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.
Sonomammographically diagnosed BIRADS III and
BIRADS IV lesions are considered indeterminate breast lesions
and imaging dilemmas. This raised the need for other imaging
modalities that would surpass the sensitivity and specificity of
mammography alone or combined mammography and
ultrasonography in the screening and ultimately final diagnosis
of malignancy among patients presenting with such
questionable lesions, hence was the need for breast MR
imaging.
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 repConsequently, there has been considerable interest in the
development of adjunct MR imaging methods to improve the
specificity of conventional MR imaging. Both dynamic
contrast-enhanced breast MR imaging and diffusion-weighted
breast MR imaging are being investigated for their 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 dynamic and DWI to
MRI protocols helps us to achieve such outcome.
In this study we attempted to investigate the validity of
Dynamic post-contrast sequences, DWI and ADC
measurements in differentiating benign and malignant breast
lesions among the study group and further correlation of the
study results with histopathological data following biopsy
and/or surgical excision of those lesions.
The study included 30 patients. All patients underwent
conventional MR imaging, contrast enhanced-MRI, DWI and
ADC values measurements with documentation of findings.
We found that DWI improves the diagnostic accuracy of
the DCE-MRI of the breast. It is a better method for detecting
breast lesions than either T1- or T2-weighted imaging,
however, it is better to be performed in conjunction with
contrast enhanced MRI, which becomes of great help in
differentiating between post therapeutic changes from recurrentorted specificity is breast cancers. It also can reduce the number of false-positive
results and associated unnecessary biopsiesvariable.