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RDS Test 2 > B8.033 Prework 1: Introduction to Breast Imaging > Flashcards

B8.033 Prework 1: Introduction to Breast Imaging Flashcards

1
Q

most common cancer among women in the US

A
  1. breast
  2. lung
  3. colorectal
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2
Q

leading cause of cancer death among women in the US

A
  1. lung
  2. breast
  3. colorectal
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3
Q

breast cancer stats

A

1 in 8 women in the US will get it in their lifetime

annual screening mammography has proven to significantly reduce breast cancer mortality

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4
Q

risk factors for BC

A 
age and gender
genetic mutation (BRCA1, BRCA2)
family history
breast density
hx of breast cancer
early menarche/late menopause/HRT use
lower parity/higher age at first birth
obesity, alcohol, smoking
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5
Q

types of breast densities

A

mostly fatty
scattered density
consistent density
extremely dense

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6
Q

mostly fatty breast

A

breasts are made up of mostly fat and contain little fibrous and glandular tissue
mammogram would likely show anything that was abnormal

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7
Q

scattered density breast

A

breasts have quite a bit of fat, but there are a few areas of fibrous and glandular tissue

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8
Q

consistent density breast

A

many areas of fibrous and glandular tissue that are evenly distributed through the breasts
make it hard to see small masses in the breast

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9
Q

extremely dense breast

A

breasts have a lot of fibrous and glandular tissue

may make it hard to see a cancer on a mammogram because the cancer can blend in with the normal tissue

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10
Q

breast density and cancer risk

A

dense breasts 6x more likely to develop cancer
AND
harder for mammograms to detect breast cancer

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11
Q

screening imaging modalities

A

mammography
MRI
US

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12
Q

diagnostic imaging modalities

A

mammography
targeted US
MRI
ductography

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13
Q

image guided tissue sampling and surgical localization procedures

A

US guided biopsy
stereotactic guided biopsy
MRI guided biopsy
pre-operative wire/radioactive seed localization

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14
Q

what is BIRADS

A

breast imaging reporting and data system

standardized way to describe and report breast imaging findings, results, and recommendations

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15
Q

BIRAD 0

A

incomplete

needs further imaging

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16
Q

BIRAD 1

A

category: negative
management: routine screening
likelihood of cancer: essentially 0%

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17
Q

BIRAD 2

A

category: benign
management: routine screening
likelihood of cancer: essentially 0%

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18
Q

BIRAD 3

A

category: probably benign
management: short interval follow up
likelihood of cancer: 0-2%

19
Q

BIRAD 4

A

category: suspicious
management: tissue diagnosis
likelihood of cancer: 2-95%

20
Q

BIRAD 5

A

category: highly suggestive of malignancy
management: tissue diagnosis
likelihood of cancer: >95%

21
Q

BIRAD 6

A

category: known biopsy proven
management: surgical excision when clinical appropriate
likelihood of cancer: na

22
Q

breast cancer screening

A

in a female patient who is asymptomatic

23
Q

recommendations for annual screening mammography

A 
age 40 and older
-women at average risk
younger than age 40
-BRCA
-women with mothers or sisters with pre-menopausal breast cancer
-women with 20% or greater lifetime risk
-women with history of radiation between 10 and 30
-women with biopsy proven cancer
24
Q

when should you not screen for breast cancer

A

life expectancy < 5-7 years

when abnormal results would not be acted on

25
Q

techniques for screening mammography

A 
2 standard view of each breast:
-CC and MLO
-additional views for patients with implants
compression paddle and detector
increasing use of digital tomosynthesis
low dose xray
26
Q

primary goal of BC screening

A

detect masses, calcifications, asymmetry, and architectural distortion

27
Q

what is tomosynthesis

A 
3D mammography
tube moves in a 15 deg arc
15 low dose images are acquired
-1 at each degree
images are reconstructed into 1 mm slices
28
Q

why is there a need for tomosynthesis

A

tissue superimposition hides pathologies in 2D

tissue superimposition mimics pathologies in 2D

29
Q

additional views needed in patients with implants

A

implant displaced MLO and CC

30
Q

MLO

A

medial lateral oblique

31
Q

CC

A

craniocaudal

32
Q

recommendations for screening MRI

A

proven carriers of BRCA
untested first degree relatives of proven BRCA
women with 20% or greater lifetime risk
women with history of chest irradiation
women with newly diagnosed breast cancer and normal contralateral breast on mammography and physical exam

33
Q

recommendations for screening ultrasound

A

may be considered in high risk women who can not undergo MRI

women with dense breast tissue (maybe)

34
Q

who gets a diagnostic evaluation for breast cancer

A 
symptomatic patients
abnormal clinical breast exam
abnormal screening exam
patients with history of breast conservation therapy for prior breast malignancy
symptomatic male patients
silicone implant rupture
35
Q

additional mammography views for diagnosis

A

spot compression
spot magnification
lateral
tangential
utilize metallic BB markers to localize palpable areas of concern
start with standard views in male patients
digital tomosynthesis

36
Q

indications for a targeted ultrasound eval

A

further characterize an abnormal finding on mammography or MRI
prepare for image guided biopsy
first line imaging modality for patients < 30
first line imagine modality for palpable mass in patients with prior mastectomy

37
Q

features of breast MRI for screening

A

sensitive, but high false positive rate

38
Q

indications for breast MRI

A 
new diagnosis of breast cancer
-extent of disease
-screen contralateral breast
high risk annual screening
evaluate response to neoadjuvant chemo
scar versus recurrence
positive margins after lumpectomy
axillary metastases with unknown primary
silicone implant rupture
39
Q

when do you use image guided tissue sampling and surgical localization procedures

A

if a breast finding has >2% chance of malignancy based on imaging characteristics

40
Q

options for image guided tissue sampling and surgical localization

A

US guided
stereotactic guided
MRI guided

41
Q

description of image guided tissue sampling and surgical localization procedures

A

minimally invasive, outpatient, local anesthesia only
always place a tissue marker at the site of biopsy and obtain post procedure 2 view mammogram
preoperative wire/radioactive seed localization

42
Q

US guided procedures

A

fast, cheap, more comfortably for the patient (no compression), real time imaging
core needle biopsy
cyst aspiration
fine needle aspiration of abnormal lymph nodes

43
Q

stereotactic guided biopsy

A

superior to US and MRI for sampling of calcifications
prone stereotactic breast biopsy table
utilizes mammography with compression for targeting

RDS Test 2 (24 decks)

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