Zusammenfassung
Die komplementäre Mammadiagnostik aus klinischer Untersuchung, digitaler Mammografie,
Sonografie und MRT ist Standard. Auf der Basis der digitalen Mammografie mit integrierter
Tomosynthese und CAD wird es möglich sein, diese mit anderen Systemen wie z. B. digitalem
Ultraschall zu kombinieren (Hybridsysteme). In Zukunft werden wir in der Mammadiagnostik
eine Volumenbildgebung haben mit der Fusion von Bildern unterschiedlicher Modalitäten
(einschließlich MRT mit Spektroskopie), um so die interdisziplinäre Therapieentscheidung
zu optimieren.
Abstract
Standard complementary breast diagnosis consists of clinical examination, digital
mammography, sonography and MRI. Using digital mammography with integrated tomosynthesis
and CAD it will be possible to combine these findings with those from other systems
such as digital ultrasound (hybrid systems). In future, therefore, imaging for breast
diagnosis will focus on volume with the fusion of images from different modalities
(including MRI with spectroscopy) to optimize the decision for subsequent therapies.
Schlüsselwörter
klinische Untersuchung - Mammografie - Ultraschall - MRT
Key words
clinical examination - mammography - ultrasound - MRI
Literatur
- 1 Duda V F, Schulz-Wendtland R. Mammadiagnostik – Komplementärer Einsatz aller Verfahren. Berlin,
Heidelberg; Springer-Verlag 2004
- 2
Spratt J A, von Fournier D, Spratt J S, Weber E E.
Decelerating growth and human breast cancer.
Cancer.
1993;
71
2013-2019
- 3
Spratt J A, von Fournier D, Spratt J S, Weber E E.
Mammographic assessment of human breast cancer growth and duration.
Cancer.
1993;
71
2020-2026
- 4
Schulz-Wendtland R, Krämer S, Döinghaus K, Säbel M, Lang N, Bautz W.
Significance of roentgen mammography for breast carcinoma screening.
Röntgenpraxis.
1997;
50
103-109
- 5 Fischer U. ACR BI-RADS™. Stuttgart; Thieme-Verlag 2006
- 6 S3-Leitlinie Brustkrebs-Früherkennung in Deutschland, 1. Aktualisierung 2008. München;
W. Zuckschwerdt-Verlag 2008 http://www.senologie.org
- 7 S3-Leitlinie Diagnostik, Therapie und Nachsorge des Mammakarzinoms, 1. Aktualisierung. München;
W. Zuckschwerdt-Verlag 2008 http://www.senologie.org
- 8 European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis,
Fourth Edition, European Communities,. 2006
- 9
Gerber B.
Umweltfaktoren und Brustkrebsrisiko.
Gynäkologe.
2002;
35
561-569
- 10
Miller M D, Marty M A, Broadwin R. et al .
The association between exposure to environment tobacco smoke and breast cancer: A
review by the California Environmental Protection Agency.
Preventive Medicine.
2007;
44
93-106
- 11
Schatzkin A, Kipnis V.
Could exposure problems give us wrong answers to nutrition and cancer questions?.
J Natl Cancer Inst.
2004;
96
1564-1565
- 12
Tempfer C, Bentz E.
Brustkrebsprävention in der klinischen Praxis – Möglichkeiten und Grenzen.
Geburtsh Frauenheilk.
2006;
66
1134-1142
- 13
Van Gils C H, Peeters P H, Bueno-de-Mesquita H B. et al .
Consumption of vegetables and risk of breast cancer.
JAMA.
2005;
293
183-193
- 14
Willett W C, Hunter D J, Stampfer M J. et al .
Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up.
JAMA.
1992;
268
2037-2044
- 15
Hackshaw A K, Paul E A.
Breast self-examination and death from breast cancer: a meta-analysis.
British Journal of Cancer.
2003;
88
1047-1053
- 16
Saltzstein S L.
Potential limits of physical examination and breast-examination in detecting small
cancers of the breast. An unselected population-based study of 1302 cases.
Cancer.
1984;
54
1443-1446
- 17
Thomas D B, Gao D L, Ray R M. et al .
Randomized trial of breast self-examination in Shanghai: final results.
J Natl Cancer Inst.
2002;
94
1445-1457
- 18
Qualitätssicherungsvereinbarung nach Abs. 2 SGB V zur kurativen Mammographie.
Deutsches Ärzteblatt.
2006;
51 – 52
3504-3514
- 19
Nimmo L J, Alston L A, McFadyen A K.
The influence on technical recall in the UK Breast Screening Programme: are pain,
compression force, and compressed breast thickness contributing factors?.
Clinical Radiology.
2007;
62
439-446
- 20
Martin K E, Helvie M A, Zhou C. et al .
Mammographic density measured with quantitative computer-aided method: comparison
with radiologists estimates and BI-RADS categories.
Radiology.
2006;
240
656-665
- 21
Carney P A, Miglioretti D L, Yankaskas B C. et al .
Individual and combined effects of age, breast density, and hormone replacement therapy
use on the accuracy of screening mammography.
Ann Intern Med.
2003;
138
168-175
- 22
Jung H.
Assessment of usefulness and risk of mammography screening with exclusive attention
to radiation risk.
Radiologe.
2001;
41
385-395
- 23 KVB – Kassenärztliche Vereinigung Bayerns .Merkblatt vom 16. 12. 2002.
- 24
Cowen A R, Launders J H, Jadav M. et al .
Visibility of microcalcifications in computed and screen-film mammography.
Phys Med Biol.
1997;
42
1533-1548
- 25 Tabar L, Dean P B. Teaching Atlas of Mammography. Stuttgart; Thime-Verlag 2001
- 26
Schulz-Wendtland R, Becker N, Bock K, Anders K, Bautz W.
Mammography screening.
Radiologe.
2007;
47
359-369
- 27
Pisano E D, Gatsonis C, Hendrick E. et al .
Diagnostic performance of digital versus film mammography for breast-cancer screening.
N Engl J Med.
2005;
353
1773-1783
- 28
Schulz-Wendtland R, Hermann K P, Bautz W.
Clinical results of digital mammography.
Radiologe.
2005;
45
255-263
- 29
Schulz-Wendtland R, Hermann K P, Wacker T, Bautz W.
Aktueller Stand und weitere Perspektiven in der digitalen Mammographie.
Radiologe.
2008;
48
324-334
- 30 S1-Leitlinie Mammasonographie, www.senologie.org. 2001
- 31
Madjar H, Ohlinger R, Schulz-Wendtland R.
BI-RADS-Analogue DEGUM Criteria for Findings in Breast Ultrasound – Consensus of the
DEGUM Committee on Breast Ultrasound.
Ultraschall Med.
2006;
27
374-379
- 32
Perry M N. et al .
Quality assurance in the diagnosis of breast disease (EUSOMA Working Party).
European Journal of Cancer.
2001;
37
159-172
- 33
Berg W A, Blume J D, Cormack J B. et al .
Lesion detection and characterization in a breast US phantom: results of the ACRIN
6666 Investigators.
Radiology.
2006;
239
693-702
- 34
Fasching P, Schulz-Wendtland R, Beckmann M W. et al .
Staging von Mammakarzinomen BI-RADS™ 4/5: Hohe Brustdrüsendichte (Dichte 3 und 4)
beeinträchtigt Größeneinschätzung (n = 434).
EJR.
2006;
60
398-404
- 35
Schulz-Wendtland R, Bock K, Aichinger U. et al .
13 MHz versus 7,5 MHz in der Mammasonographie – Ergebnisse einer prospektiven Multicenterstudie
(n = 819).
Ultraschall in der Medizin.
2005;
26
209-215
- 36
Lell M, Wenkel E, Schulz-Wendtland R. et al .
3-D Ultrasound in high speed core cut biopsy of breast lesions.
Ultraschall in der Medizin.
2004;
25
126-130
- 37
Cho N, Moon W K, Chan J H. et al .
Differentiating benign from malignant solid breast masses (n = 150).
Radiology.
2006;
240
26-32
- 38
Weismann C, Hergan K.
Aktueller Stand der 3D-/4D‐Volumensonographie der Mamma.
Ultraschall in der Medizin.
2007;
28
273-282
- 39
Sahiner B, Chan H P, Roubidoux M A. et al .
Malignant and benign breast masses on 3D US volumetric images (n = 101).
Radiology.
2007;
242
716-724
- 40
Chang R F, Huang S F, Moon W K. et al .
Solid breast masses: neural network analysis of vascular features at three-dimensional
power Doppler US for benign or malignant classification (n = 221).
Radiology.
2007;
243
56-62
- 41
Martin K E.
Tissue Harmonic Imaging.
Radiology.
2008;
- 42
Thomas A, Fischer T, Frey H. et al .
Real-time elastography – an advanced method of ultrasound: first results in 108 patients
with breast lesions.
Ultrasound Obstet Gynecol.
2006;
28
335-340
- 43
Ricci P, Cantisani V, Pagliara E. et al .
Benigne und maligne Brusttumoren: Aussagekraft des Real-Time kontrastverstärkten Ultraschalls
gegenüber MRT (n = 50).
Ultraschall in der Medizin.
2007;
28
57-62
- 44
Buchberger W, Niehoff A, Obrist P. et al .
Clinically and mammographically occult breast lesions: detection and classification
with high-resolution sonography.
Semin Ultrsound CT MR.
2000;
21
325-336
- 45
Kaplan S S.
Clinical utility of bilateral whole-breast US in the evaluation of women with dense
breast tissue.
Radiology.
2001;
221
641-649
- 46
Kolb T M, Lichy J, Newhouse J H.
Comparison of the performance of screening mammography, physical examination, and
breast US and evaluation of factors that influence them: an analysis of 27, 825 patient
evaluations.
Radiology.
2002;
225
165-175
- 47
Kuhl C.
The current status of breast imaging. Part 1. Choice of technique, image interpretation,
diagnostic accuracy, and transfer to clinical practice.
Radiology.
2007;
244
356-378
- 48
Kuhl C.
Current status of breast MR imaging. Part 2. Clinical applications.
Radiology.
2007;
244
672-691
- 49
AG Mammadiagnostik der Deutschen Röntgengesellschaft .
Empfehlungen zur MR-Mammographie.
RöFo.
2005;
177
474-475
- 50
Schrading S, Kuhl C K.
Mammographic, US, and MR imaging phenotypes of familial breast cancer.
Radiology.
2008;
246
58-70
- 51
Krämer S, Schulz-Wendtland R, Hagedorn K. et al .
Magnetic resonance imaging and its role in the diagnosis of multicentric breast cancer.
Anticancer Res.
1998;
18
2163-2164
- 52
Liberman L.
Breast MR imaging in assessing extent of disease.
Magn Reson Imaging Clin N Am.
2006;
14
339-349
- 53
Lehman C D, Gatsonis C, Kuhl C K. et al .
MRI evaluation of the contralateral breast in women with recently diagnosed breast
cancer.
N Engl J Med.
2007;
356
1295-1303
- 54
Kuhl C K, Schrading S, Bieling H B. et al .
MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study.
Lancet.
2007;
370
485-492
- 55
Kuhl C K.
Breast MR imaging at 3T.
Magn Reson Imaging Clin N Am.
2007;
15
315-320
- 56
Silverstein M J, Lagios M D, Recht A. et al .
Image-detected breast cancer: state of the art diagnosis and treatment.
J Am Coll Surg.
2005;
201
586-597
- 57
Kettritz U, Rotter K, Schulz-Wendtland R. et al .
Stereotactic vacuum-assisted breast biopsy in 2 874 patients.
Cancer.
2004;
100
245-251
- 58
Kaiser W A, Pfleiderer S O, Baltzer P A.
MRI-guided interventions of the breast.
J Magn Res Imaging.
2008;
27
347-355
- 59
Kolb T M, Lichy J, Newhouse J H.
Comparison of the performance of screening mammography, physical examination, and
breast US and evaluation of factors that influence them: an analysis of 27 825 patients
evaluations.
Radiology.
2002;
225
165-175
- 60
Heusinger K, Löhberg C, Schulz-Wendtland R. et al .
Assessment of breast cancer tumor size depends on method, histopathology and tumor
size itself.
Breast Cancer Res Treat.
2005;
94
17-23
Rüdiger Schulz-Wendtland
Universitätsklinikum Erlangen
Radiologisches Institut
Gynäkologische Radiologie
Universitätsstraße 21 – 23
91054 Erlangen
eMail: ruediger.schulz-wendtland@uk-erlangen.de
