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Early Detection of Breast Cancer: Large-section and Subgross Thick-section Histologic Correlation with Mammographic Appearances¹

¹ From the Department of mammography (L.T.) and Department of Pathology and Clinical Cytology (T.T.). Central Hospital, 79182 Falun, Sweden; and Department of Diagnostic Radiology, University of Turku, Finland (P.B.D.), Received April 4, 2007; revision requested April 20 and received May 24; accepted May 30. All authors have no financial relationships to disclose. Address correspondence to L.T. (e-mail: laszlo.tabar{at}mammographyed.com)

Early detection of breast cancer with high-quality mammographic screening and treatment at an early stage has succeeded in lowering the death rate from breast cancer by nearly 50% among women who have attended screening regularly. The challenge of successful screening should be met with a commitment to master the complexities of image production, the variations in normal breast anatomy, the heterogeneity of breast diseases, and the progressive nature of breast cancer. In the authors’ experience, competence in breast image interpretation can be best achieved by direct comparison of mammographic, ultrasonographic and magnetic resonance images with large-section histologic and subgross, thick-section (three-dimensional) histologic images of large, contiguous tissue samples that contain the lesions. This article provides an overview of the variants of normal breast anatomy and a systematic viewing technique to find breast cancer at its earliest detectable phase. Comparison of the mammographic findings with large-section and subgross histologic images facilitates understanding of the pathophysiologic processes that underlie the imaging findings. These comparisons will enable the radiologist to better differentiate normal from pathologic appearances, improving both the sensitivity and specificity of mammographic interpretation. Early detection is best achieved by special training of both radiologists and radiology technologists in breast imaging, ideally by subspecialization. (Full text and figures for this article are available in the print issue only.)

© RSNA, 2007

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