A Brief Overview of the WHO Classification of Breast Tumors, 4th Edition, Focusing on Issues and Updates from the 3rd Edition. Infiltrating ductal carcinoma of breast presenting as areolar dermal lesion. Analysis of sonographic features for the differentiation of benign and malignant breast tumors of different sizes. Unusual breast cancers: useful clues to expanding the differential diagnosis. Wash-out or plateau kinetic curves (76-91%) Ring enhancement with centripetal progression, or non-mass enhancement (NME)Įarly wash-in: higher initial enhancement ratio (IER) This feature correlates with the tumor grade 5. Posterior acoustic shadowing: 71% in grade 1ĭuctal extension may be seen: represents extension of the mass into the surrounding parenchymaĮlastography depicts increased stiffness of the mass and the surrounding tissue. Microcalcifications: 34% in grade 1 and 37% in grade 3 5 Spiculated and hyperdense: 41% in grade 1 and 26% in grade 3Ĭircumscribed: more commonly grade 3 (36%) Irregular mass with or without calcifications This grading system is based on the following criteria 6:ġ point: >75% of the tumor (majority of tumor)ģ-5 points: grade 1 or well-differentiated tumorĦ-7 points: grade 2 or moderately-differentiated tumorĨ-9 points: grade 3 or poorly-differentiated tumor The Nottingham combined histologic grade system, also called the modified Scarff-Bloom-Richardson grading system, is recommended by the College of American Pathologists. ![]() Often presents as a large palpable, immobile mass.
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