Sign 1 basically describes the response of normal, nonstimulated breast parenchyma to intravenous contrast administration. It can also be seen in scar tissue that is more than 6 months old. Basically this sign is a very strong indicator of a benign condition (adenosis, fibrous fibroadenoma, scar, fat necrosis, etc.). It should be noted, however, that this sign may also occur in malignant lesions following a technically flawed or inadequate contrast injection or if the patient has received chemotherapy in the recent past (i.e., weeks or months before the examination). It should be easy to identify these mitigating factors, however, and therefore sign 1 is considered a very strong indicator of benignancy.
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