Abstracts

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E1679. Multi-Modality Imaging of Breast Emergencies: More Common Than Realized
Authors
  1. Sofya Kalantarova; NYU Winthrop
  2. Irina Rapoport; NYU Winthrop
  3. Marie Surovitsky; North Shore University Hospital
  4. Monica Sheth; NYU Winthrop
  5. Douglas Katz; NYU Winthrop
  6. Elizabeth Morris; Memoral Sloan Kettering Cancer Center
  7. Linda Moy; NYU School of Medicine
Background
Although breast emergencies are infrequently encountered, these acute situations require urgent management, and may be encountered by the general and emergency radiologist. It is important to recognize these clinical signs and imaging appearances for timely diagnosis and treatment. We will review the multi-modality imaging appearances of breast emergencies (including sonography, CT and angiography), and discuss when acute intervention is essential. We will show examples of breast- specific emergencies including traumatic, infectious, malignant, and iatrogenic etiologies, and their potential mimics and pitfalls. These cases will highlight the imaging characteristics of breast disease on the modalities most commonly encountered in the emergency setting, in order to familiarize the general and emergency radiologist with the full spectrum of imaging features. We will also discuss the treatment and follow-up algorithms of acute breast disease, to ensure continuity of care and facilitate timely disease management.

Educational Goals / Teaching Points
Review breast emergencies and the settings where they can occur Recognize clinical and imaging features of breast emergencies and their differential diagnosis Discuss the management for various breast emergencies

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Multimodality review of complications from percutaneous biopsy or trauma: Hematoma/fat necrosis, Pseudoaneurysm and/or arteriovenous fistula, Blunt trauma to the breast; Infections of the breast: Mastitis, Abscess; Malignancy: Inflammatory carcinoma, ED presentations of locally advanced/metastatic breast cancer; Breast lumps presenting to ED: Phylloides tumor, Gynecomastia

Conclusion
Women and men of all ages present to the emergency department with the chief complaint of chest pain. In certain circumstances, evaluation of the patient’s chest pain leads to the discovery of acute breast pathology, or an acute or subacute breast disorder may be evident clinically. Knowledge of the multi-modality imaging appearances of breast emergencies, as well as an understanding of the appropriate treatment for these entities, is essential for emergency department radiologists.