 Good afternoon, everyone. My topic of presentation is the correlation of the mammography and with the MRI in the evaluation of the breast pathologies. My name is Dr. Anandesh. I'm a GMC. GMC. As we know this cancer has ranked number one cancer among the breast female female female females with the age of just with as a rate 25 per one like women's and mortality 12 per one like months and mobility to incidence ratio was found to be high there is 66 in the ruler and it in the There are multiple health awareness and programs and a lot of breast cancer screen programs. They are implemented in the in our country that is a main objective end of the study is to characterize the various best lesions using the different the MRI sequences. The difference between the breast benign and malignant malignant lesions are with the help of the contrast enhancement cause to evaluate the accuracy and efficiency of the MRI in the evaluation of the best pathologies. And then this is study is conducted in the GMC Nagpur in the source of study source of cases of the surgery under the patient there is oncology patients. The sample size 32 patients with the lump and pain in the breast. And then the replenish, replenish traction and high screen patient are included in the study. The patient with the MRI in computer devices, then costable patient, then a lot of patients who lost their follow-up, then play with them and elected humans are excluded from the study. The patient. The protocol for the mammography, the patient with the patients related with the mammography with the help of the CCC view that is craniocodal and middle lateral obdicate is MLA. The CC view is in this patient is patient is a stand upright in front of the machine and the best is positioning the sandwich sequence. Technique that is animal position that the X-ray to be so angle with the in the 40 to 60 that in this study we have used a 30 degree angulations with the horizontal and patient X-ray to be parallel to the in the previous measure in the axilla. The protocol for the MRI machine the patient and the patient's position is lying down position, the prone position with the breast hanging freely in the coil apertures and the program is placed in the center of the coil. The T1 T2 vitre sequences and T1 fat study measures, then T2 spare images, T2 core images, then different division vitre imaging, then T1 contrast image that is a transverse core and SAG imaging article. Let's come to the observations of the mass studies. And the most of the patients are the female that is 31 patients constitute 96% of the study. In this study then age distribution most of the patients are we are in the 41 to 50 years of the age that is constitute 37% patient that is 12 patients. The clinical presentation most of the patient are presented with the lump in breast, followed by the patient breast. This is pathology universities. And the most common pathologies are the male unit one, that is 15 patient because to 46% then followed by B9 it is 31%. The laterally most patients are most patient presented with the lesion in the right breast and gamma that is eight patients. Out of the male unit patients. And at the cost of 53% of all male unit patients, male unit lesion with the patients. The location most most most of the patients of the male unit lesions are lesions are detected in the outer and outer quadrants that is six patients that is constitute 40% of the male unit breast tumors. And then FNSE detection on the FNSE and histopathology. Most of the male unit patient detected on the FNSE test, that is 13 patients that out of 15 patients are detected on the FNSE and two of them are the indeterminate or the negative patients. Then the fibrodenoma are also detected on the FNSE, five out of five patients, the fibrocystic adenovibrosity diseases. FNSE composite in the one patient and negative on the two patients. FNSE and lipoma are also detected on the FNSE detection. MRI enhancement types, there are three types, there is no enhancement that mass like or non mass like. Mass like enhancement are the most common pattern on the enhancement that is 86, 43% of the cases, up to 32 patients. Then type of the mass like enhancement, there are three type of, there are non enhancement that the homogenous enhancement, and there are heterogeneous enhancement and remanagement. So the malignant lesions, malignant breast tumors are heterogeneous type of enhancement. Then three of the patients, 20% out of 15 patients that they are homogeneously enhancing and the fibrodenoma, there are also heterogeneous and homogenous enhancement. In our study, the heterogeneous are the most common type of enhancement pattern in the malignant tumors and heterogeneous enhancement may also present in the 40% of the fibrodenoma. In the 40% of the curves, the most type three, the most commonly seen malignant lesions, that is 80% of the patients out of 15 patients, that is 12 patients. In our study, 12 out of 15 patients with the malignant tumors show type three enhancement curves and the three patients show type two enhancement curves. Methodies measure the malignant lesions show type three curve. The defusion restriction, the most of the patients show the defusion restriction are the malignant breast tumors. Then four of the patient shows and not show the defusion restriction. Then fibrodenoma also not show defusion restriction. The mammographic findings, here there is a malignant type of the breast tumors. Calcific, aggressive pattern of the calcification seen also there is a benign pattern also seen in some of the malignant patients. Nercal distortion mostly seen in the 14 patients and the cemetery also seen in the 8 patients. Fibrodenomas are mostly most of the circumscribed margins. There also there is a micro cystic adhesive, this they show the micro circumscribed margin as shown in the chart. Here come to the cases. Case one is the 66 year old female patient need to come in with the lumbine tenderness in the right breast. There is a high density lesion noted in the right breast parenchyma. We are showing the archital distortion and there is no evident calcification can be noted within. On EVG correlation, there is a relatively well defined hyperpilegion noted in the right breast parenchyma. Not taking internal vascularity, this is taller than milder. Showing the malignant plasticity. On MRI, there is a high, there is a relatively well defined micro lumbine lesion noted in the right breast parenchyma. Which is hypo on P122 weighted images and homogeneously enhancing. On a histopathological examination show ductal carcinomas. On a case two, the 55 years old female come with the lumbine tenderness is one month without any fever. Here is the, there is a large high density lesion noted in the left breast parenchyma. I will write breast parenchyma first normal or the type B type of the breast parenchyma. There is a high density, that is hyperpilegion noted in the large hyperpilegion, well defined hyperpilegion noted in the left breast parenchyma. Not taking internal vascularity, multiple malignant p-chords. On MRI correlation, there is a relatively well defined large lesion noted in the left breast parenchyma. Which appears hypointing on T1, hyperintest on T2 and STUR. Then showing the peripheral contrast, post-contrast enhancement with the solid intramural enhancement model. Which showing some perceptions. Which is a, this is a polyprotein breast disease with a TPR. Let's come to the third case. That is 51 year old female, accomplished with a cyclical pain in the left breast. So under mammography, there is a type C type of the breast parenchyma. Which is obliterating the lesions in the breast parenchyma. But so we have proceeded with the UHC and there is a hyperpilegion noted in the right breast parenchyma. The left breast parenchyma, which is not significantly taking internal vascularity. And there is a, not see any calcified within. On MRI sequences, there is a relatively well defined round-the-world lesion noted in the left breast parenchyma. Which is the hypointing on T1, hyperintest on T2 and STUR. And showing the mild peripheral enhancement on the post-contrast administration. And showing the type 1 enhancement curves. On HP correlation, this lesion is suggestive of fibrocystic disease. That is a benign breast lesion. Let's come to this question. In prospective comparison mammography, sonography and MRI in the patient, in the study underwent, study conducted by the Iran et al. 41 patient underwent physical examination mammography and breast sonography in breast MRI. Before and after administration of the contrast. Administration of each game of therapeutic agents. The MRI agents are able to correctly diagnose 71% cases and at least 23. As compared to mammography. The tumor size is also more accurately depicted with the MRI versus mammography. In present study, MRI was able to correctly diagnose 65% of the cases, and 48 in mammography. MRI is used strictly as complemented to the mammography. Then continue assessment of the MRI. Conscious type of the quantitative assessment of the type of the contrast enhancement, kinetic curves on the breast, dynamic contrast enhance the MRI. Resulting significant higher diagnostic performances. In evaluating the breast malignancy of the lesion. In the dynamic contrast enhance the breast MRI to include multi-phase divided images of pre-contrast, early phase contrast, delayed phase contrast and analysis of the contrast update. Allows the MRI to assess the kinetics of the lesion. The MRI is the most powerful tool to detect the lesion as compared to the conventional imaging. Then breast MRI is also better at monitoring the response to the chemotherapy. And mammography is only imaging study that has been proven in the multiple large animals. Trial to decrease the breast cancer mortality. Breast MRI should not be used instead of mammography. It is strictly the complementary to the other modalities. These are my references. Thank you.