Wolfe described a variety of patterns in the female breast studied by mammography. The pattern can help to identify a woman at a higher risk for breast cancer. The author is from Detroit, Michigan.
Parameters to consider:
(1) age of the patient relative to menopause
(2) amount of fat
(3) densities from connective tissue and epithelial cell (tend to regress with age), referred to as "dysplasia"
(4) prominent ducts
Findings
Pattern
predominantly fat; absence of prominent ducts; no or minimal dysplasia
N1
predominantly fat; prominent ducts in the subareaolar region; ducts <= 25% of breast volume; prominent duct may extend into breast quadrant
P1
prominent ducts in > 25% of breast volume
P2
prominent ducts; extensive dysplasia which may obscure the duct pattern; may appear homogeneous if there is little fat present
DY
prominent ducts with mild to moderate dysplasia in a woman under 40 years of age
QDY
where:
• The "Q" in QDY indicates quasi. The pattern often changes around menopause to P2, P1 or N1.
• Prominent ducts may be cordlike or beaded.
• P2 would contain patterns that do not fit N1, P1 or DY.
Interpretation:
• The N1 pattern is considered normal and has the lowest risk for breast cancer.
• The P1 pattern is low risk for breast cancer.
• The P2 and DY patterns are associated with a higher risk for breast cancer.
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