Breast Imaging Flashcards Preview

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Flashcards in Breast Imaging Deck (29)
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1
Q

Where do the majority of breast cancers occur?

A

Outer upper quadrant; this is because there is increased fibroglandular tissue there

2
Q

Is there a link between breast density and breast cancer?

A

Yes, those with a high breast density are more likely to get breast cancer

3
Q

Describe the triple assessment?

A

Clinical
Radiology; MGM and USS
Path; image guided core biopsy

4
Q

What pathologies is mammogram highly specific for?

A

DCIS

Invasive cancer

5
Q

What can cause calcification within the breast?

A

Duct ectasia; benign

DCIS; malignant

6
Q

What is the benefit of contrast enhanced spectral MGM?

A

Identified contrast enhancement in breast after IV injection of iodinated contrast
Removes breast density and only shows tumour that takes up contrast

7
Q

What are the indications for an ultrasound?

A
Palpable lump
Work up of MGM detected lesion 
Image guided biopsy 
Breast inflammation 
Breast problems during pregnancy
8
Q

Is USS good for detecting DCIS?

A

No; but VERY good for detecting invasive cancer

9
Q

What is elastography?

A

Measures stiffness of tissue

10
Q

Why is elastography helpful in breast cancer?

A

Invasive cancers are stiff

Benign lesions are mobile

11
Q

Why are invasive cancers stiff?

A

Disorganised collagen in stroma

Disorganisation and stiffness of carcinoma is prognostic

12
Q

Why are lobular carcinomas difficult to detect from mammogram?

A

Lack of E-cadherin adhesion molecule and therefore instead of forming a solid, single mass they will diffusely spread throughout the lobules

13
Q

What is the most sensitive imaging modality for detection of breast ca?

A

MRI

14
Q

When should MRI be used in the work of of breast cancer?

A
Unsure of the size of tumour
Lobular cancer
Cancer that doesn't show up on MGM 
Discrepancy
from USS sizing and clinical examination 
Paget's disease of nipple
Implant integrity 
Screening in v high risk women 
Positive axillary node with normal MGM and USS
15
Q

What are the methods for biopsy of breast ca?

A

Core biopsy

Vacuum

16
Q

What is a stereotactic biopsy?

A

Mammogram directed biopsy

17
Q

Do papillomas and radial scars need to be removed?

A

Yes; have malignant potential

18
Q

In terms of age, describe the commonest causes of breast lump

A
<30 = fibroadenoma
30-50 = cyst 
>50 = cancer
19
Q

What is the best imaging modality for a breast mass?

A

US
Can tell you if cystic or solid
Stiffness
If under 40; only use mammogram if you suspect cancer

20
Q

On mammogram, what is a buzzword for a carcinoma?

A

Spiculate/ stellate mass

21
Q

How are abnormal axillary nodes detected on USS?

A

Cortical thickness and shape

22
Q

Describe the staging process for breast cancer

A

If operable; only local staging needed

Locally advanced or recurrence; use CT chest, abdo, pelvis to look for mets

23
Q

Where will breast cancer metastasize to?

A
Bone
Lung
Pleura
Liver
Brain
24
Q

What indicates worrying nipple discharge?

A

Unilateral single duct

25
Q

What can cause a unilateral single duct nipple discharge?

A

Invasive carcinoma
DCIS
Duct ectasia
Paget’s disease of the nipple

26
Q

How are breast abscesses/ infections managed?

A

US guided drainage and antibiotics

27
Q

Describe the normal screening programme

A

Mammography in women aged 50-70

Mammogram every 3 years

28
Q

What is the screening programme for women with a moderate family history of breast cancer?

A

Annual mammography from age 40

29
Q

What is the screening programme for women who are at very high risk for breast cancer (BRCA)

A

Annual MRI and mammogram from 30-35 years

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