Post on 22-Nov-2014
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Breast Cancer Diagnostic Imaging in
Dharmais Cancer Hospital
KardinahDept.Radiology Diagnostic Dharmais Cancer Hospital/National Cancer Center
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Breast Cervix Uteri Bronchus and Lung
Pharynx Colorectum Lymph Nodes
Leukemia Ovary Thyroid Gland
Hepar Oral Cavity Skin Soft Tissue
Top 13
Data Hospital Base 2005-2007RS.Kanker Dharmais
Imaging Modalities
Modalities
• Mammography
• Breast Ultrasound
• Breast MR
• Nuclear Medicine
• Guided Biopsy
Cancer Phase
• Screening
• Diagnosis – Primary Tumor
– Axillary Nodes
• Staging
• Restaging
• Response Evaluation
Level Diagnostic
Basic CBE
Limited Diagnostic Breast Ultrasound
Enhanced Diagnostic Mammography+SpecimenMammography
Maximal PET scan, MIBI scan,Breast MRIMammographic double reading
Guideline implementation for breast healthcare in low- and middle-income countries: diagnosis resource allocation.
Breast Health Global Initiative (BHGI)
DiagnosisPrimary tumor
• Mammography
• Breast Ultrasound
• Breast MR
• MIBI scan
Axillary nodes
• AxillaryUltrasound
• Sentinel node lympho-
scintigraphy
Histology
1 .Normal 2.Benign 5. Malignant3.Suspicious Benign4.Suspicious Malignant
Breast Imaging Reporting and Data System
Early Detection
• Clinical Breast Examination
• Pilot Project in 7 Districts
– Training general physicians and midwives
– Supervised by surgeon
–Referral system
Distribusi Diagnosis kelainanpayudara
3.8%
91.3%
1.0%
1.2%
2.6%
CBE+ Mammo
Absent
Normal
Benign
Malignant
Cyst
1139
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(N=2)
CBE +Mammography
(N=15)
Mean 4.3(3 - 5.6)
3.7(1.1 - 5.6)
Phase 1 Result , Research Funding from BHGI
Mammography
Breast Cyst
Axillary Nodes
Lymphnodes
Lymphnode
Sentinel Node
Ultrasound
parasternal
aksilaaksila
Conjunction Imaging
Mammography
• Dense Breast
• Asymmetric density
• Breast Lesion : Cyst or solid lesion, complicated cyst, complex cyst
Ultrasound
• Solid lesion with calcification
• Irregular border
• High risk patient
Early Detection Clinic
• > 35 yr
Mammography
• Normal
• Abnormal
Breast Ultrasound
• <35 yr
Breast Ultrasound
• Normal
• Abnormal
Mammography