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IMAGING OF THE BREAST – TECHNICAL ASPECTS AND CLINICAL IMPLICATION Edited by Laszlo Tabar Imaging of the Breast – Technical Aspects and Clinical Implication Edited by Laszlo Tabar Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Bojan Rafaj Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Imaging of the Breast – Technical Aspects and Clinical Implication, Edited by Laszlo Tabar p. cm. ISBN 978-953-51-0284-7 Contents Preface IX Part 1 New, Innovative Breast Imaging Modalities 1 Chapter 1 Magnetic Resonance Imaging of the Breast Marc Lobbes and Carla Boetes 3 Chapter 2 The Application of Breast MRI on Asian Women (Dense Breast Pattern) Ting Kai Leung 17 Chapter 3 Scintimammography - Molecular Imaging: 99m Tc(V)-DMSA 61 Value and New Perspectives with Vassilios Papantoniou, Pipitsa Valsamaki and Spyridon Tsiouris Chapter 4 Digital Mammography 81 Cherie M. Kuzmiak Chapter 5 Image Quality Requirements for Digital Mammography in Breast Cancer Screening 115 Margarita Chevalier, Fernando Leyton, Maria Nogueira Tavares, Marcio Oliveira, Teogenes A. da Silva and João Emilio Peixoto Chapter 6 Contrast Enhancement in Mammography Imaging Including K Edge Filtering 133 George Zentai Chapter 7 Standards for Electrical Impedance Mammography 159 Marina Korotkova and Alexander Karpov Chapter 8 The Role of Molecular Imaging Technologies in Breast Cancer Diagnosis and Management 179 Anne Rosenberg, Douglas Arthur Kieper, Mark B. Williams, Nathalie Johnson and Leora Lanzkowsky VI Contents Part 2 Chapter 9 Chapter 10 Clinical Implications 197 Suspicious Nipple Discharge Diagnostic Evaluation 199 Yukiko Tokuda and Yoshinori Kodama Radiotherapy After Surgery for Small Breast Cancers of Stellate Appearance 217 Laszlo Tabar, Nadja Lindhe, Amy M.F. Yen, Tony H.H. Chen, Sherry Y.H. Chiu, Jean C.Y. Fann, Sam L.S. Chen, Grace H.M. Wu, Rex C.C. Huang, Judith Offman, Fiona A. Dungey, Wendy Y.Y. Wu, Robert A. Smith and Stephen W. Duffy Preface Early detection of breast cancer combined with targeted therapy offers the best outcome for breast cancer patients. The development of low-dose screen-film mammography made the early detection of breast cancer a reality. This technology was successfully implemented in the population-based screening trials, which proved that the early detection of breast cancer through mammography screening can prevent at least 40% of the deaths from breast cancer in participating women. Additionally, these smaller and less advanced cancers do not need as extensive therapy as the larger, palpable cancers. The heterogeneity of benign and malignant breast diseases has necessitated the development of supplementary imaging methods for their improved detection and differential diagnosis. The optimum preoperative diagnosis and mapping of the full disease extent has become an important prerequisite for adequate management of the disease. This volume deal with a wide range of new technical innovations for improving breast cancer detection, diagnosis and therapy. There is a special focus on improvements in mammographic image quality, image analysis, magnetic resonance imaging of the breast and molecular imaging. A chapter on targeted therapy explores the option of less radical postoperative therapy for women with early, screen-detected breast cancers. Laszlo Tabar, M.D., F.A.C.R. Department of Mammography Falun Central Hospital Falun, Sweden