Target Volume Determination 2015

ESTRO Course From Imaging to Margins

StefanDelorme Division ofRadiology

StefanDelorme Division ofRadiology

Outline

Outline

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• Types of breast cancer • Imaging methods and features • Mammography • Ultrasound • CT • MRI • T stages • Nodal drainage and N Stages • Treated breast cancer

• Types of breast cancer • Imaging methods and features • Mammography • Ultrasound • CT • MRI • T stages • Nodal drainage and N Stages • Treated breast cancer

Anatomy and lymph node drainage for breast cancer

Stefan Delorme

StefanDelorme Division ofRadiology

StefanDelorme Division ofRadiology

StefanDelorme Division ofRadiology

Breast cancer: Classification

Breast cancer: Growth patterns • Ductal carcinoma • Intraductal carcinoma in situ • Thin extensions • Microcalcifications • Invasive foci • Solitary • Multifocal • Lobular carcinoma • LCIS • Lobular invasive carcinoma

Growth patterns

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Solitary solid

Criterion

Types

According to origin

- Ductal - Lobular - In situ - Invasive

Interstitial (esp. in LIC)

According to invasiveness

According to differentiation

- G1 Low-grade - G2 Intermediate grade - G3 High-grade - Estrogen receptor + / - - Progesteron receptor + / -

According to receptor status

• Single-cell invasion pattern

• Medullary carcinoma • Smooth lump • Inflammatory carcinoma • Extensive lymphangitic and skin infiltration

According to mutation status

- Her-2-neu positive - Her-2-neu negative

DCIS

Multifocal DIC with extensive intraductal component (EIC)