Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RRC Cards > Breast > Flashcards

Breast Flashcards

1
Q

what % of DCIS found as calcs on mammo?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when are round calcs not benign?

A

linear/segmental

new

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

% DCIS visible on USS

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

management of atypical ductal hyperplasia

A

excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what kind of papilloma gets excision

A

papilloma w/ atypia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which breast cancer lacks e-cadherin

A

lobular neoplasia (ILC & LCIS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which kind of lobular carcinoma in situ should get excised?

A

pleomorphic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where are cancers found in radial scars?

A

periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

recommendation of radial scar & radial sclerosing lesion

A

scar - f/u image

lesion - excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which is more likely to have LN mets in same size lesion? invasive lobular or ductal carcinoma?

A

invasive lobular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

management of breast pain

A
  • <30 start with US
  • 30-35 image with US or mammogram
    >35 start with mammo - if N no further imaging, if abN do USS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

subtypes of invasive ductal carcinoma

A
  • NOS (not otherwise specified)
  • tubular –> slow grow spiculated
  • medullary –> fast grow smooth
  • mucinous
  • papillary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

‘circumscribed’ subtypes of ductal carcinoma

A

mucinous
medullary
papillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

slow growing subtypes of ductal carcinoma

A

tubular
mucinous
papillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

breast cancer T2 bright

A

mucinous carcinoma

invasive ductal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Compared to invasive ductal carcinoma, invasive lobular carcinoma is more likely to:

A

infiltrative pattern of ILC =

  • tends to be larger at diagnosis
  • present as distortion without or with a mass
  • result in a false negative FNA
  • result in mastectomy

compared with IDC.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common intra-cystic breast carcinoma?

A

Papillary carcinoma aka “encapsulated” carcinoma

- behaves like DCIS unless an invasive component extends outside of cyst wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

An apparent decrease in size of one breast is most typical of:

A

“shrinking breast” - typical of invasive lobular

- affected breast does not compress as well on mammo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

56 yo F dx’ed w/ malignant phyllodes tumor. The next step in staging is sentinel lymph node biopsy? True/False

A

False - Malignant phyllodes tumor behaves like a sarcoma with hematogenous spread rather than lymphatic spread. A chest CT would be more appropriate for staging than axillary sampling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what modifier do you use after neoadj chemo in TNM staging?

A

yTNM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DCIS calcification types & grade

A

fine, linear, fine linear branching (high grade)
fine pleomorphic (high grade)
amorphous (low grade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

why do you get posterior acoustic shadowing in birads5 masses

A

desmoplastic changes in mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

breast mets by subtype

A

luminal A - bone
HER 2+ - brain & liver
Triple negative - brain & viscera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

breast ca w/ best outcome

A

ER/PR+, regardless of HER2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
most common invasive breast cancer subtype
luminal A (ER/PgR+)
26
more likely to be multicentric/focal - luminal A or B
luminal B (53%)
27
inflammatory breast carcinoma needs tumor cells where?
dermal lymphatics
28
breast MRI kinetic enhancement curves
type 1 - benign - initial slow uptake and persistent enhancement type 2 - indeterminate - plateau type 3 - malignant - initial fast uptake with washout
29
axillary lymph node levels
level I: lateral to pec minor level II: behind pec minor level III: medial & superior to pec minor
30
LCIS on biopsy - next step
``` sx referral (ALH/cLCIS) excision (pLCIS) ```
31
most common MALE palpable lump
gynecomastia
32
birads for biopsy proven cancer
birads 6
33
PASH
pseudoangiomatous stromal hyperplasia - benign prolif STROMAL lesion consisting of myofibroblasts - responds to hormonal stimulus, usu premenopausal or postmeno on HRT - present as mass or asymmetry, NOT calcs
34
interval breast cancer
clinically detected cancer during interval btwn recommended screenings - can be mammographically occult, missed on prior mammography, or a new mammographic finding - more often in dense breasts - more commonly high grade & triple negative - >50% incr risk of death cf. screen-detected cancer
35
nonpuerperal mastitis and subareolar abscess associated with...
heavy smoking | - results in squamous metaplasia of lactiferous ducts with resulting duct ectasia, stasis, and recurrent infection
36
the goal for recall rate for screening mammography examinations should be less than or equal to...
10% Radiology 2007
37
modality to diagnose saline implant rupture
mammography (+ physical exam) US and MRI not needed
38
multifocal vs multicentric breast cancer
multifocal: disease in the same quadrant or within 5 cm of each other - may be removed by a lumpectomy if breast large enough multicentric: disease in separate quadrants or separated by >5 cm - requires mastectomy
39
modified radical mastectomy involves removal of...
complete breast level I and II axillary nodes (pectoral muscles remain intact)
40
TRAM flap vs DIEP flap
both autologous flaps using abdominal skin, subcutaneous fat & adjoining vasculature (for breast reconstruction post-mastectomy) DIEP: deep inferior epigastric perforator transverse rectus abdominis MYOcutaneous flap: - also uses rectus abdominis muscle deep inferior epigastric perforator flap: - does not use rectus abdominis muscle - fewer complications, faster return to activity Imaging: atrophied rectus abdominis muscle in the reconstructed breast = TRAM
41
contraindications for breast conservation
``` inflammatory cancer large cancer size relative to breast multicentric (multiple quadrants) prior radiation to the same breast contraindication to radiation therapy (collagen vascular disease) ```
42
most common tumour met to breast
melanoma
43
most important predictor of overall survival in breast ca
axillary status
44
breast cancer T staging
T1 = <2cm T2 = 2-5 cm T3 = >5cm T4 = any size with chest wall fixation, skin involvement, or inflammatory breast ca *Paget's is carcinoma in situ of nipple epidermis, NOT T4*
45
mammo findings of extracapsular silicone rupture
silicone granulomas | dense lymph nodes
46
patterns of gynecomastia
early nodular (most common) - flame shaped behind nipple, radiating posterior blending into fat - tender late dendritic (branching tree) - chronic fibrosis & hyalinization; irreversible - usu not tender diffuse glandular - diffuse incr in density (mammo looks like woman's breast) - men receiving estrogen treatment
47
punctate and amorphous high-density foci within axillary node
gold therapy | ipsilateral arm/chest tattoos
48
NPV of combined negative mammography and targeted US for focal breast pain
100%
49
idiopathic granulomatous mastitis
benign noninfective granulomatous inflammation in parous women that mimics malignancy - lobulocentric, noncaseating granulomas painful mass +/- draining sinus 50% resolve spontaneously, most resolve on oral steroids +/- intermittent relapse US: large, ill-defined areas of hypoechogenicity
50
function of BRCA 1 and 2 genes
regulate DNA-damage response and repair in the cell
51
most likely cause for symmetric, regional, heterogeneous non-mass enhancement in the upper outer breast quadrants with persistent enhancement kinetics on MR
normal variant inflow phenomenon - this pattern is most typical during luteal phase of menstrual cycle (days 14-28) - why MR is best performed between days 6-12 of menstrual cycle to decrease background enhancement
52
TNM of inflammatory breast ca
classified as T4d; at least stage IIIB if N3 disease, then stage IIIC: many (>10) axillary LNs, an ipsilateral internal mammary LN with 1 or more positive level I or II axillary LNs, or an ipsilateral supraclavicular LN if distant lymph nodes or organs (M1), then stage IV
53
fine linear or fine linear branching calcs - % likelihood of malignancy
70% BIRADS 4C (>50% to <95%)
54
fine pleomorphic calcs - % likelihood of malignancy
30% BIRADS 4B (>10% to <50%)
55
coarse heterogeneous calcs - % likelihood of malignancy
<15% BIRADS 4B (>10% to <50%)
56
amorphous calcs - % likelihood of malignancy
20% BIRADS 4B (>10% to <50%)
57
HER2/neu positive breast cancer treatment
targeted therapy with trastuzumab (Herceptin) - HER2/neu specific antibody shown to be effective against HER2 positive breast cancer in metastatic, adjuvant, and neoadjuvant settings - relative risk of recurrence is decreased by 50% in early stage breast cancer after treatment with trastuzumab
58
what is the desired cancer detection rate for 1000 screening mammograms?
5
59
which breast MRI sequence is misregistration artifact seen on?
subtraction secondary to motion causing movement of breast tissue between fat suppressed enhanced T1 and fat suppressed unenhanced T1 weighted sequences
60
during an upright stereotactic breast biopsy, when adjusting for depth, which coordinate does not change?
the X coordinate is the only coordinate that does not change when moving the needle to the target on stereotactic upright biopsy the Y changes ever so slightly because the needle is angled slightly the Z has the most significant change as it is the depth and as you dial to the lesion, the Z approaches 0
61
BIRADS for known CLL, bilateral axillary lymphadenopathy, and otherwise negative/normal mammogram
BIRADS 2 report also should indicate presence of lymphadenopathy and known underlying disease e.g. negative or benign followed by “with bilateral axillary lymphadenopathy presumed due to the patient's known lymphoma"
62
when is a focus on breast MRI concerning?
new washout near a cancer
63
Inflammatory breast cancer stage
Stage 3B
64
High risk lesions (5)
``` Radial scar ADH ALH LCIS Papilloma ```
65
Contraindications to breast conservation
``` Inflammatory cancer Large cancer size relative to breast Multi centric Prior radiation to same breast Contraindication to radiation (collagen vascular disease) ```
66
Washout kinetic types & risk of cancer
Type I: persistent, 6% risk Type II: plateau 7-28% Type III: washout =>29%
67
male breast lacks?
- terminal lobules and acini | - cooper's ligaments
68
internal enhancement pattern of NME on MR most predictive of cancer?
clustered ring C+ (87% PPV) clumped 30-40% PPV

RRC Cards (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions