Breast Cancer Diagnostic Imaging

in
Dharmais Cancer Hospital

Kardinah
Dept.Radiology Diagnostic
Dharmais Cancer Hospital/National Cancer Center
 Data Hospital Base 2005-2007
RS.Kanker Dharmais
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Breast Cervix Uteri Bronchus Pharynx Colorectum Lymph Leukemia Ovary Thyroid Hepar Oral Cavity Skin Soft Tissue
and Lung Nodes Gland
 Imaging Modalities
Modalities Cancer Phase
• Mammography • Screening
• Breast Ultrasound • Diagnosis
• Breast MR – Primary Tumor
– Axillary Nodes
• Nuclear Medicine
• Staging
• Guided Biopsy • Restaging
• Response Evaluation
Guideline implementation for breast healthcare in low- and middle-income
countries: diagnosis resource allocation.

Level Diagnostic
Basic CBE
Limited Diagnostic Breast Ultrasound
Enhanced Diagnostic Mammography+Specimen
Mammography
Maximal PET scan, MIBI scan,Breast MRI
Mammographic double reading

Breast Health Global Initiative (BHGI)

 Diagnosis
Primary tumor Axillary nodes

• Mammography • Axillary
• Breast Ultrasound
Ultrasound • Sentinel node
• Breast MR lympho-
• MIBI scan scintigraphy
 Histology

Breast Imaging Reporting and Data System

1 .Normal 2.Benign 3.Suspicious Benign 5. Malignant
4.Suspicious Malignant
 Early Detection
• Clinical Breast Examination
• Pilot Project in 7 Districts
– Training general physicians and midwives
– Supervised by surgeon
– Referral system
Distribusi Diagnosis kelainanpayudara

CBE+ Mammo
2.6%
Absent
1.2% 3.8%
Normal
1.0%
Benign

1139 Malignant

Cyst
91.3%

Phase 1 Result , Research Funding from BHGI

Mobile Unit Mammography

Phase 1 Result , Research Funding from BHGI

 Malignant Findings

Phase 1 Result , Research Funding from BHGI

 Tumor size

Size (cm) CBE CBE +

(N=2) Mammography
(N=15)

Mean 4.3 3.7

(3 - 5.6) (1.1 - 5.6)

Phase 1 Result , Research Funding from BHGI

Mammography
Breast Cyst
Axillary Nodes
Lymphnodes
Lymphnode
Sentinel Node
Ultrasound
aksila aksila

parasternal
 Conjunction Imaging

Mammography Ultrasound

• Dense Breast • Solid lesion with

• Asymmetric density calcification
• Breast Lesion : Cyst or • Irregular border
solid • High risk patient
lesion, complicated
cyst, complex cyst
 Early Detection Clinic
• > 35 yr • <35 yr

Mammography Breast Ultrasound

• Normal • Normal
• Abnormal • Abnormal

Breast Ultrasound Mammography