Mammographic features and approach to the sternalis muscle

Demirpolat, Gülen; Oktay, Ayşenur; Bilgen, Işıl Günhan; Isayev, Hasan

doi:10.4261/1305-3825.dir.2733-09.2

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…We are agree with Demirpolat et al (15) that the sternalis muscle should be classified as BI-RADS category II and investigation beyond mammography and US is not indicated when an opacity resembling the sternalis muscle is seen. However, CT or MRI may be performed when there is any doubt.…”

Section: Discussionsupporting

confidence: 38%

The Musculus Sternalis: Ultrasonographic Verification of a Rare but Benign Mammographic Finding

Özbalcı¹,

Saracoglu²

2013

J Breasth Health

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Screening mammography requires high-quality images and experienced radiologists. An improved technique with a systematic approach to patient positioning enables visualization of the deep parts of the breast. The sternalis muscle is occasionally observed in mammograms as a variant of the deep normal structures and may mimic a mass. The sternalis muscle is an uncommon anatomic variant of the chest wall musculature. It is located subcutaneously over the pectoralis muscle and has a parallel course to the sternum. It runs from the infraclavicular area to the caudal aspect of the breast. This inconsistent muscle has varying shapes, contours and sizes and may mimic a mass lesion on the craniocaudal (CC) mammogram. Familiarity with its mammographic appearance and ultrasonographic correlation is essential to avoid confusion with a malignant lesion. In this case report, we describe mammographic and ultrasonographic imaging findings of the sternalis muscle and review the literature. The sternalis muscle is a supernumerary muscle located in the anterior thoracic region, running parallel to the sternum. Different anatomical studies have reported the prevalence of the sternalis muscle to be 1.923.5% (4). It was first shown on mammography by Bradley et al. (5), who described it in six women. Case ReportA forty-eight year old patient was interpreted in our centre for screening mammography. Standard CC and MLO views were obtained and interpreted with previous mammograms. CC mammogram demonstrated a developing density in the medial posterior part of the breast. The density was round in shape and the edges were well defined ( Figure 1). As we interpreted that lesion as a developing density, ultrasound examination was performed. Ultrasonographic views showed approximately 5x35x70 mm muscle tissue over the right pectoralis muscle. The muscle tissue was well

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Section: Discussionsupporting

confidence: 38%

The Musculus Sternalis: Ultrasonographic Verification of a Rare but Benign Mammographic Finding

Özbalcı¹,

Saracoglu²

2013

J Breasth Health

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“…In one such study, the authors found no cases of the sternalis muscle from a review of medical records of 1,580 women who had undergone mammographic imaging, compared with three confirmed cases out of 75 cadavers (4.0%) they examined (Saeed et al, ). Demirpolat et al () reviewed 10 years' worth of records from the mammography unit and reported only 10 cases among 52,930 female patients (0.018%). Bradley et al () evaluated 32,000 women who had received craniocaudal projection mammography screening and reported only four cases of the sternalis muscle (0.0001%).…”

Section: Prevalencementioning

confidence: 99%

Sternalis muscle, what every anatomist and clinician should know

2014

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The sternalis muscle is a well documented but rare muscular variation of the anterior thoracic wall. It lies between the superficial fascia and the pectoral fascia and is found in about 8% of the population. It presents in several morphological variants both unilaterally and bilaterally and has no apparent physiological function. There is still much disagreement about its nerve supply and embryological origin. With the advent of medical imaging and thoracic surgery the clinical importance of this muscle has been re-emphasized. It has been implicated in misdiagnosis of breast masses on routine mammograms owing to its parasternal location and relative unfamiliarity among radiologists. When undetected before any thoracic surgery, it has the potential to interfere with and prolong such procedures. When present and detected preoperatively it can be used as a muscular flap in reconstructive surgeries of the breast and neck. This article will present the sternalis muscle with special emphasis on its morphology, homology, and clinical significance.

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“…Although it is often described as a “rare” variant [ 6 , 7 ], the appearance of M sternalis was documented as early as the 17th century [ 14 ], and its identification as a known anatomic variant is common through the early 20th century [ 10 , 13 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], after which it tends to appear only chiefly in case reports of unusual anatomic features. This may be because M sternalis appears to be of little clinical significance except for those who might encounter it in medical imaging or surgical professions [ 11 , 12 , 13 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…In modern times, M sternalis may be encountered in thoracic surgery or in diagnostic imaging, such as mammography [ 11 , 12 , 13 ], which may account for a slightly higher reported prevalence for this muscle in females than in males. However, most reports of this anatomic variant arise from serendipitous findings, like the one in our teaching lab.…”

Section: Introductionmentioning

confidence: 99%

Exploring Anatomic Variants to Enhance Anatomy Teaching: Musculus Sternalis

et al. 2020

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The opportunity to encounter and appreciate the range of human variation in anatomic structures—and its potential impact on related structures, function, and treatment—is one of the chief benefits of cadaveric dissection for students in clinical preprofessional programs. The dissection lab is also where students can examine unusual anatomic variants that may not be included in their textbooks, lab manuals, or other course materials. For students specializing in physical medicine, awareness and understanding of muscle variants has a practical relevance to their preparations for clinical practice. In a routine dissection of the superficial chest muscles, graduate students in a human gross anatomy class exposed a large, well-developed sternalis muscle. The exposure of this muscle generated many student questions about M sternalis: its prevalence and appearance, its function, its development, and its evolutionary roots. Students used an inquiry protocol to guide their searches through relevant literature to gather this information. Instructors developed a decision tree to assist students in their inquiries, both by helping them to make analytic inferences and by highlighting areas of interest needing further investigation. Answering these questions enriches the understanding and promotes “habits of mind” for exploring musculoskeletal anatomy beyond simple descriptions of function and structure.

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Mammographic features and approach to the sternalis muscle

Cited by 10 publications

References 9 publications

The Musculus Sternalis: Ultrasonographic Verification of a Rare but Benign Mammographic Finding

The Musculus Sternalis: Ultrasonographic Verification of a Rare but Benign Mammographic Finding

Sternalis muscle, what every anatomist and clinician should know

Exploring Anatomic Variants to Enhance Anatomy Teaching: Musculus Sternalis

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