Diagnostic Imaging: Breast
- 4th Edition - April 8, 2026
- Latest edition
- Authors: Jessica W. T. Leung, Nicole S. Winkler
- Language: English
- Hardback ISBN:9 7 8 - 0 - 4 4 3 - 2 8 4 4 7 - 2
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 2 8 4 4 9 - 6
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 2 8 4 4 8 - 9
Covering the entire spectrum of this fast-changing field, the fourth edition of Diagnostic Imaging: Breast is an invaluable, everyday resource for general radiologists and breast… Read more
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Covering the entire spectrum of this fast-changing field, the fourth edition of Diagnostic Imaging: Breast is an invaluable, everyday resource for general radiologists and breast imaging specialists; surgical, medical, and radiation oncologists; pathologists; all health care providers in the breast cancer arena as well as trainees—anyone who requires an easily accessible, highly visual reference in this complex area of imaging. Drs. Jessica W. T. Leung, Nicole S. Winkler, and a team of highly regarded multidisciplinary experts provide up-to-date information in concise yet detailed chapters to help you make informed decisions at the point of care. The text is lavishly illustrated, precisely delineated, and extensively referenced, making it a useful learning tool for readers at all levels of experience as well as a handy reference for daily clinical practice.
- Provides comprehensive, expert information on breast anatomy and normal variants, physical principles of breast MR, techniques for performing image-guided biopsies and preoperative localization, the role of imaging in determining the extent of disease, and principles of breast cancer treatment with surgery, oncoplastics, radiation therapy, and chemotherapy
- Discusses updated and standard imaging protocols, treatment plans, and image-guided and surgical procedures with an eye toward trending topics in frontline breast imaging
- Contains new BI-RADS details across all relevant chapters as well as updated information from the American College of Radiology, American Society of Breast Surgeons, and National Comprehensive Cancer Network on evolving medical, surgical, and radiation treatment of breast cancer patients, along with discussion of ongoing trials and future directions in patient care
- Includes details on 2024 federal screening guidelines that ensure equity and access
- Features more than 4,000+ high-quality print images, illustrations, and videos (with an additional 5,000+ images in the complimentary eBook) to help evaluate breast symptoms, such as palpable lumps, nipple discharge, and axillary adenopathy
- Uses a bulleted, image-rich layout with short chapters designed for quick access to critical content on terminology, characteristics seen in various imaging studies on the same anatomic location, differential diagnoses, pathological and clinical issues to consider, and more
- Provides a diagnostic checklist and updated references with each chapter
- Includes an eBook that allows you access to everything in the print version as well as new text, new videos, and thousands of additional images and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud
General radiologists at all levels of expertise and experience
SECTION 1: ANATOMY AND NORMAL VARIANTS
ANATOMY
Breast Overview
Embryology and Normal Development
Segmental Anatomy
Nipple-Areolar Complex and Skin
Neurovascular Supply
Lymph Nodes and Lymphatics
Axilla
Pectoralis Muscle and Chest Wall
NORMAL VARIANTS
Axillary Breast Tissue
Muscle and Chest Wall Variants
Sternalis Muscle
SECTION 2: IMAGING
BREAST IMAGING OVERVIEW
Approach to Screening
Screening Mammography
Diagnostic Mammography
Mammography Positioning
Tomosynthesis
Breast Density
Ultrasound
Magnetic Resonance Imaging
Interval Cancers
Missed Cancers
SPECIAL TOPICS IN SCREENING AND DIAGNOSTIC IMAGING
Screening at Age Extremes (< 40, > 70 Years)
Screening in 5th Decade (40-49 Years)
Screening Intervals: Annual vs. Biennial
Screening Ultrasound
Automated Breast Ultrasound
Elastography
Risk Assessment Models
Indications and Management of Genetic Testing
BRCA1 and BRCA2 Mutation Carriers
Screening MR
Abbreviated Breast MR
Diffusion-Weighted Imaging (MR)
MR Spectroscopy
CAD and Double Reading: Mammography and Tomosynthesis
Contrast-Enhanced Mammography Overview
Contrast-Enhanced Mammography Lexicon and Usage
Contrast-Enhanced Mammography-Directed Core Needle Biopsy
Molecular Breast Imaging (MBI and BSGI)
Dedicated Breast PET (PEM)
PET/CT
SECTION 3: INTERPRETIVE CRITERIA
Approach to Lexicons of Breast Imaging
Mammography BI-RADS Lexicon and Usage
Probably Benign Lesions
Ultrasound BI-RADS Lexicon and Usage
MR BI-RADS Lexicon and Usage
Molecular Breast Imaging Lexicon (Includes BSGI)
Breast PET Lexicon and Usage
SECTION 4: LESION IMAGING CHARACTERISTICS
MASSES
Circumscribed and Obscured Margins
Fat-Containing Mass
High-Density Mass
Indistinct Margins
Intramammary Lymph Node
Microlobulated Margins
Spiculated Margins
CALCIFICATIONS, TYPICALLY BENIGN
Typically Benign Calcifications
Round Calcifications
Layering Calcifications
CALCIFICATIONS, NOT TYPICALLY BENIGN
Amorphous Calcifications
Coarse Heterogeneous Calcifications
Fine Pleomorphic Calcifications
Fine Linear Calcifications
CALCIFICATION DISTRIBUTION
Diffuse Distribution of Calcifications
Grouped Distribution of Calcifications
Regional Distribution of Calcifications
Linear Distribution of Calcifications
Segmental Distribution of Calcifications
ADDITIONAL FINDINGS
Architectural Distortion
Asymmetries
Developing Asymmetry
Duct Ectasia
Multiple Bilateral Similar Findings
One-View-Only Findings
Solitary Dilated Duct
Trabecular Thickening, Edema
ULTRASOUND LESION CHARACTERISTICS
Non-Mass Lesion (US)
Calcifications (US)
Clustered Microcysts (US)
Complex Cystic and Solid Masses (US)
Complicated Cyst With Debris (US)
Cyst, Simple (US)
Echogenicity: Anechoic (US)
Echogenicity: Hyperechoic (US)
Echogenicity: Hypoechoic (US)
Echogenicity: Isoechoic (US)
Echogenic Rim (US)
Echogenicity: Heterogeneous/Mixed (US)
Intraductal Mass (US)
Lesion Orientation (US)
Margins, Not Circumscribed (US)
Posterior Features (US)
MR FINDINGS
Background Parenchymal Enhancement (MR)
Kinetic Assessment (MR)
T2 Hyperintensity (MR)
Dark Internal Septations (MR)
Mass (MR)
Focal Area, Regional, and Diffuse Enhancement (MR)
Clumped and Clustered Ring Enhancement (MR)
Linear Enhancement (MR)
Segmental Enhancement (MR)
Rim Enhancement (MR)
SECTION 5: HISTOPATHOLOGIC DIAGNOSES
Pathology Methods
Approach to Histopathologic Diagnoses
Imaging-Histopathologic Discordance
BENIGN LESIONS
Adenosis, Sclerosing Adenosis, Microglandular Adenosis
Apocrine Metaplasia
Columnar Cell Lesions
Cyst, Ruptured/Inflamed
Fat Necrosis, Oil Cyst
Fibroadenoma
Fibroadenomatoid Change
Fibrocystic Change
Fibrosis
Hamartoma (Fibroadenolipoma)
Hematoma
Lipoma and Angiolipoma
Papilloma, Benign
PASH
Radial Scar, Benign Sclerosing Lesions
Tubular Adenoma and Nipple Adenoma
RISK LESIONS
Atypical Ductal Hyperplasia
Atypical Lobular Hyperplasia
Atypical Papilloma
Flat Epithelial Atypia
Lobular Carcinoma In Situ, Classic
Lobular Carcinoma In Situ, Pleomorphic
Mucocele-Like Lesions
LOCALLY AGGRESSIVE LESIONS
Fibromatosis
Granular Cell Tumor
Myoepithelial Neoplasms
Myofibroblastoma
Phyllodes Tumor: Benign
Phyllodes Tumor: Borderline and Malignant
MALIGNANT LESIONS
Adenoid Cystic Carcinoma
Apocrine Carcinoma
DCIS, General
DCIS, Low Grade
DCIS, Intermediate Grade
DCIS, High Grade
DCIS, Micropapillary 702 Encapsulated Papillary Carcinoma
HER2-Positive Cancer
Invasive Ductal Carcinoma NST, Grade 1, 2, 3
Invasive Lobular Carcinoma, Classic
Invasive Lobular Carcinoma, Pleomorphic
Invasive Micropapillary Carcinoma
Luminal A and B Cancers
Lymphoma, Primary Breast
Anaplastic Large Cell Lymphoma
Medullary Carcinoma
Metaplastic Carcinoma
Mixed Invasive Ductal and Lobular Carcinoma
Mucinous Carcinoma
Papillary Carcinoma, Invasive
Sarcomas
Triple-Negative and Basal-Like Breast Cancer
Tubular and Tubulolobular Carcinoma
SECTION 6: SIGNS AND SYMPTOMS
Approach to Signs and Symptoms of Disease
NIPPLE
Nipple Discharge
Nipple Retraction and Inversion
Paget Disease of Nipple
SKIN
Epidermoid Cyst
Erythema
Sebaceous Cyst
Skin Lesions, Other
Skin Retraction
Skin Thickening
AXILLA
Axillary Adenopathy
Axillary Nodal Calcification
Metastatic Node, Unknown Primary
BREAST
Pain
Palpable Lump or Thickening
VASCULAR ENTITIES
Benign Lesions of Vascular Origin
Mondor Disease
SECTION 7: SPECIAL TOPICS HORMONAL CHANGES
Hormonal Supplementation
Hormone Blocking: Endocrine Therapy
GENDER REASSIGNMENT
Transgender Patients: Terminology and Normal Appearances
Transgender Patients: Surveillance and Cancer
PREGNANCY
Galactocele
Lactating Adenoma
Lactation
Pregnancy-Associated Breast Cancer
INFECTIONS AND INFLAMMATION
Abscess
Granulomatous Mastitis
Mastitis
Unusual Infections
BREAST MANIFESTATIONS OF SYSTEMIC CONDITIONS
Amyloid
Breast Manifestations of Organ Failure
Collagen Vascular Disease
Diabetic Mastopathy/Lymphocytic Lobulitis
Leukemia
Lymphoma, Secondary
Metastases to Breast
Sarcoid
Weight Fluctuations
TRAUMA
Trauma
MALE BREAST
Gynecomastia
Male, Breast Cancer
Male, Other Neoplasms
ARTIFACTS
Artifacts: Mammography and Tomosynthesis
Artifacts: MR
Artifacts: Nuclear Medicine
Artifacts: Ultrasound
IMAGING SAFETY
Contrast Reactions
Gadolinium Safety
Radiation Dose and Safety: Mammography and Tomosynthesis
SECTION 8: TREATMENT
PRINCIPLES IN TREATMENT
Approach to Breast Cancer
Oncology Overview (Adjuvant and Neoadjuvant)
Pathology Overview: Prognostic and Predictive Features
Radiation Therapy Overview
Staging: Breast
Surgery Overview
FOCUSED ISSUES IN TREATMENT
Approach to Treatment Planning
Breast Cancer in Young Patients (< 40 Years)
Contralateral Breast Cancer
Extensive Intraductal Component
Inflammatory Breast Carcinoma
Internal Mammary Adenopathy
Locally Advanced Breast Cancer
Metastatic Breast Cancer
Multifocal/Multicentric Breast Cancer
Pectoralis Muscle and Chest Wall Invasion
Skin Invasion
Tumor Genomic Testing: e.g., Oncotype DX, MammaPrint
SECTION 9: POSTOPERATIVE AND
POSTTREATMENT IMAGING
Approach to Postoperative Imaging Findings
RESULTS OF BENIGN INTERVENTION
Benign Surgical Biopsy, Postoperative Imaging
Cosmetic Augmentation Injections
Implant, Saline
Implant, Silicone
Implant With Multiple Lumina
Implants and Cancer
Post-Core Biopsy and Clip Placement Imaging
Reduction Mammoplasty, Imaging
Silicone Granuloma
RESULTS FOLLOWING TREATMENT FOR MALIGNANCIES
Accelerated Partial Breast Irradiation
Neoadjuvant Chemotherapy
Positive or Close Margins
Post Breast-Conserving Surgery
Personal History of Breast Cancer Surveillance
Recurrent Breast Carcinoma
Prior Chest Radiation Therapy, Surveillance
Tissue Transfer Reconstruction Imaging
SECTION 10: PROCEDURESIMAGE-GUIDED PROCEDURES
Aspiration
Ductography
Fine-Needle Aspiration Biopsy, Breast
MR-Directed Ultrasound
MR-Guided Vacuum-Assisted Biopsy
Preoperative Lesion Localization, Bracketing
Preoperative Axillary Node Localization
Preoperative Localization, Tomosynthesis
Preoperative Magnetic, Other Nonradioactive Localization
Preoperative Radioactive Seed Localization
Preoperative Wire Localization, Mammography
Preoperative Localization, MR
Preoperative Wire Localization, Ultrasound
Skin Localization
Specimen Imaging
Stereotactic Biopsy, Prone
Stereotactic Biopsy, Upright
Ultrasound-Guided Core Needle Biopsy
Ultrasound-Guided Vacuum-Assisted Biopsy
SURGICAL PROCEDURES
Reduction Mammoplasty, Procedure
Sentinel Lymph Node Biopsy
Targeted Axillary Dissection
Axillary Lymph Node Dissection
Breast-Conserving Surgery
Oncoplastic Techniques
Mastectomy
TRAM and Other Flap Procedures
- Edition: 4
- Latest edition
- Published: April 8, 2026
- Language: English
JL
Jessica W. T. Leung
Jessica W. T. Leung, MD, FACR, FSBI, is Professor of Diagnostic Radiology and Deputy Chair of Breast Imaging at the University of Texas MD Anderson Cancer Center in Houston, Texas.
Affiliations and expertise
Professor of Diagnostic Radiology, Deputy Chair of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USANW
Nicole S. Winkler
Nicole S. Winkler, MD, is Associate Professor with the Department of Radiology and Imaging Sciences at the University of Utah Huntsman Cancer Institute in Salt Lake City, Utah
Affiliations and expertise
Associate Professor, Department of Radiology and Imaging Sciences, University of Utah Huntsman Cancer Institute, Salt Lake City, Utah, USA