Breast Flashcards
Use of breast ultrasounds in assesment
able to differentiate cysts from solid lesions
guide FNAC and core biopsy
assess tumor size and response to therapy
ddx of microcalcifications on mammogram
dcis invasive ca papilloma fibroadenoma fat necrosis
Mx of microcalcifications detected on mammogram
hookwire localization or stereotactic u/s guided biopsy
ddx of spiculated lesions seen on mammogram
invasive cancer 95%
dcis
fat necrosis
fibromatosis
ddx of a circumscribed mass
lipoma
fibroadenoma
abscess
mucinous or medullary carcinoma
describe a core needle
plastic handle , graduated sliding bar, and inner needle
what are the diffent types of bipsies
cnb, fnac, excitional, incisional, hookwire localization and biopsy
what is a core needle used for
take core biopsy of lumps and other masses with or without ultrasound
what info both histological and cytological do u get from a core needle
histology showing if there is lymphovascular infiltration
cytology; whether there is malignancy or not and level of differentiation
allows grading of tumor and talks about estrogen, HER2, progesterone receptors
difference between FNAC and core needle
fnab: thin hollow needle attached to syringe, cnb: larger
adv: fnab: skin doesnt have to be cut and possible to make diagnosis same day while CNB: done with local anes and histological diagnosis
Core needle biopsy may provide a more accurate analysis and diagnosis than fine needle aspiration because tissue is removed, rather than just cells.
what are the levels of birads classification for malignancy
0 incomplete 1 normal 2 unequivocally benign 3prob benign 4 sus malignancy 5 highly sus malignancy 6 proven malignancy
based on birad score how would u manage
1-2: repeat mammogram in 1-2 yrs
3: f/u with imaging in 3-6 mo (radiologist usually suggests alternative imaging)
4-5: biopsy
If the cytology comes back birads 4 or 5 but your mammographic findings suggest malignancy what you you do?
Do an excisional biopsy.
