BRANT: Chapter 20: #Pathologic (Imaging the Diagnostic Patient) Flashcards
This projection is used for magnification views over the MLO projection to evaluate for milk of calcium and for better localization
Lateral projection (ML or LM)
T/F: When microcalcifications are being evaluated, typically magnification views in the CC and true lateral (either ML or LM) projections are performed.
True
These views can be performed if there is suspicion for dermal calcifications
Tangential views
Show lesions deep in posteromedial breast not seen in CC view
Cleavage view
View for localizing lesion seen in one view
90-degree lateral
View that determines lesion seen in one view by seeing how location changes
Rolled views
View that improved visualization of superomedial tissue or used for improved tissue visualization and comfort for women with pectus excavatum, recent sternotomy or prominent pacemaker
Lateromedial oblique (LMO)
Diagnosis
Skin calcifications
Diagnosis
Milk of calcium in breast cysts
Views the can evaluate asymmetries, mammographic findings that do not conform to a radiosense mass and that are only viewed in one project include the following when DBT is not available:
a. True lateral views
b. Rolled CC views
c. Both
d. Neither
c. Both
Diagnosis
Fibroadenoma
29/F with palpable breast mass. What is the recommended initial imaging modality of choice?
Ultrasound
T/F: If the ultrasound identifies a suspicious finding in a young or pregnant patient, a mammogram should be performed to evaluate for extent of disease.
True
Cyclic breast pain is defined by intermittent breast pain that spikes during the ____ phase and is thought to be primarily hormonal in etiology due to its relationship to the menstrual cycle
Luteal
35/F with noncyclical pain. What is the recommended initial imaging modality of choice?
a. Mammography
b. Ultrasound
c. Either
d. No need for imaging evaluation
c. Either
If cyclical pain, no need for imaging evaluation
Pathologic nipple discharge typically presents as the following:
a. Green in color
b. Nonspontaneous
c. Usually arises from multiple ducts
d. Serous
d. Serous
Pathologic nipple discharge presents as serous or bloody in color, spontaneous, unilateral, and arising from a single duct.
Physiologic nipple discharge can be green, yellow, or milky in color, nonspontaneous (only presents with expression), bilateral, and usually arises from multiple ducts.
Most common etiology of pathologic nipple discharge
Intraductal papilloma
42/F with pathologic nipple discharge. What is the recommended initial imaging modality of choice?
a. Mammography
b. Ultrasound
c. Either
d. Neither
a. Mammography
42/F with pathologic nipple discharge have both negative mammographic and sonographic findings. What is the next best step for evaluation?
a. Galactography
b. MRI
c. Either
d. Both
e. NOTA
d. Both
Mastitis is a common complication for breast feeding women, and typically caused by what organism?
Staphylococcus aureus
Typically the modality of choice for initial evaluation for mastitis
Ultrasound
On ultrasound, mastitis is characterized by an area of heterogeneously altered echotexture from the edema within the parenchyma, skin thickening, and increased vascularity.
An abscess typically presents as a palpable mass with overlying erythema and appears sonographically as an irregular, indistinct, heterogeneously hypoechoic collection, sometimes with multiple loculations
54/F presenting with breast erythema, tenderness and skin thickening resembling the outside of an orange. Given antibiotics with no complete resolution. Diagnosis?
Inflammatory breast cancer
56/F presenting with itching, eczema, and ulceration of the nipple. What is the best imaging modality with best accuracy at finding an underlying malignancy?
Breast MRI
Diagnosis: Paget disease (characterized pathologically as invasion of the epidermis of the nipple by malignant cells)
Surgical biopsy for definitive diagnosis
Mammography: initial imaging method but is usually negative
23/M. Diagnosis?
Normal male breast
