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Radiology > Breast > Flashcards

Breast Flashcards

1
Q

Bilateral Increased Breast Density

A

1) Pregnancy/Lactation
2) Exogenous Estrogen
3) Weight Loss
4) CHF/CKD/Liver Dz
5) Lymphedema (axillary dissection)
6) Meds (antipsychotics)
7) Cancer
8) Pituitary Prolactinoma

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2
Q

Trabecular & Skin Thickening

A

1) Cancer
- Diffuse invasive carcinoma
- Inflammatory carcinoma
2) Lymphedema (axillary dissection)
3) Radiation Rx
4) Mastitis
5) Generalized Edema
- CHF
- CKD
- Cirrhosis

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3
Q

Spiculated Masses

A 
Malignant
- IDC
- ILC
- Tubular carcinoma
Benign
- Post Bx scar
- Radial scar
- Sclerosing adenosis
- Atypical fat necrosis
- Atypical FCC
- Desmoid tumor
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4
Q

Rounded Masses

A 
Malignant
- IDC
- Medullary carcinoma
- Papillary carcinoma
- Mucinous carcinoma
- Intracystic carcinoma
- Adenoid cystic carcinoma
- Mets (breast, lymphoma, melanoma)
Benign
- Cyst
- Fibroadenoma
- Phyllodes tumor
- Papilloma
- Sebaceous cyst
- Epidermoid inclusion cyst
- Lactating adenoma
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5
Q

Indistinct Masses

A 
Malignant
- IDC
- ILC
- Lymphoma
- SCC
- Sarcoma
Benign
- PASH
- Focal fibrosis
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6
Q

Fat-Containing Masses

A 
Malignant
- Liposarcoma
Benign
- Intramammary LN
- Galactocele
- Hamartoma
- Lipoms
- Oil cyst/Fat necrosis
- Fat lobule
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7
Q

Fluid-Containing Masses

A 
Malignant
- Necrotic cancer
- Intracystic carcinoma
Benign
- Cyst
- Abscess
- Hematoma
- Galactocele
- Seroma
- Sebaceous & Epidermoid cysts
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8
Q

Amorphous Calcifications

A

1) FCC (most likely)
2) Sclerosing Adenosis
3) Papilloma
4) Fibroadenoma
5) ADH/ALH
6) DCIS (low-grade)

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9
Q

Coarse Heterogeneous Calcifications

A

1) FA
2) Papilloma
3) Fat necrosis
4) FCC
5) DCIS (low to intermediate grade)

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10
Q

Fine Pleiomorphic Calcifications

A

1) FCC
2) DCIS (high-grade)
3) FA (less likely)
4) Papilloma (less likely)

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11
Q

Fine Linear/Linear Branching Calcifications

A

1) High-Grade DCIS

2) Atypical Secretory Calcifications

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12
Q

Oval, Circumscribed, Hypoechoic US Mass

A

1) FA
2) Phyllodes
3) PASH
4) Lactating Adenoma
5) Medullary carcinoma

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13
Q

Large, Necrotic Mass

A

1) IDC
2) Phyllodes
3) Sarcoma
4) Lymphoma

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14
Q

Subareolar Mass

A

1) Papilloma
2) Paget’s Dz
3) Resolving Seroma/Hematoma Post-Trauma
4) Papillary Carcinoma

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15
Q

Architectural Distortion

A 
Malignant
- ILC
Benign
- Radial scar
- Post Bx/surgery changes
- Fat necrosis
- XRT changes
- FCC
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16
Q

Global Asymmetry

A 
Malignant
- ILC
Benign
- Normal variant
- Diabetic mastopathy
- Post-treatment changes
17
Q

Calcified LNs

A

1) Treated lymphoma
2) Mets (ovarian, mucinous GI)
3) RA Gold Therapy
4) Granulomatous Dz
5) Silicone Granuloma

18
Q

Single Dilated Duct/Bloody Nipple Discharge

A

1) Ductal Ectasia
2) Papilloma
3) Malignancy
- DCIS
- IDC
- Papillary carcinoma

19
Q

Masses Associated w/ Implants

A

1) Breast Cancer
2) Silicone Granuloma
3) BIA-ALCL

20
Q

Subtypes of IDC

A

1) IDC-NOS
2) Tubular
3) Medullary
4) Mucinous
5) Papillary

21
Q

Subtypes of DCIS

A

1) Comedo
2) Solid
3) Cribiform
4) Micropapillary

22
Q

Etiology of Gynecomastia

A

1) Absolute Inc in Estrogen (tumors)
- Germ cell tumor
- HCC
- Pituitary tumor
- Adrenal cortical tumor
2) Absolute Inc in Estrogen (Rx)
- Prostate Ca
- Baldness
3) Absolute Inc in Estrogen (inc precursors)
- Cirrhosis
- Hyperthyroidism
2) Relative Increase in Estrogen
- Testicular failure/atrophy
- Klinefelter syndrome
- Refeeding after malnutrition
3) Drugs/Meds
- Spironolactone
- Propecia
- Dilantin
- Marijuana

23
Q

Male Breast Masses

A

1) Benign
- Lipoma (most common)
- Gynecomastia (most common reason for imaging)
- Pseudogynecomastia
- Epidermoid inclusion cyst
- papilloma
- Diabetic mastopathy
- Leiomyoma
- Granular cell tumor
2) Malignant
- IDC
- Mets
- Lymphoma
- Sarcoma

24
Q

Pregnancy-Related Masses

A

1) Benign (vast majority)
- Lactating adenoma
- Galactocele
- FA
- Mastitis
2) Pregnancy-Related Malignancy (< 1yr)

25
Q

Breast Masses in Young Pts (< 30yo)

A

1) Benign
- FA
- Phyllodes
- Granular cell tumor
- Lactating adenoma
- FCC
- Hamartoma
- Juvenile hypertrophy
- Juvenile papillomatosis
2) Malignancies
- Malignant Phyllodes (most common)
- Mets
- Lymphoma/Leukemia
- Angiosarcoma

26
Q

Recurrence/Residual Disease Trivia

A

1) Local recurrence risk 6-8% after BCS + XRT
- Risk inc to 35% w/o XRT
- Peak incidence 4yr post-Tx
2) RFs for Recurrent Dz
- Young pt
- Positive surgical margins
- Lymphovascular invasion
- Multicentric
3) Calcifications
- Residual calcs associated w/ 60% recurrence rate
- New calcs benign immediately post-op
- Recurrence calcs occur few years post-Tx
4) Tissue Flap Recurrence
- Residual superficial breast
- Along scar line
- Axilla
- Will not recur along flap

27
Q

Nipple Discharge

A 
Bloody, Spontaneous Discharge
- Multiple ducts --> benign
- Single duct --> papilloma vs. cancer
Milky Discharge --> pituitary adenoma
Ductal Ectasia --> discharge in post-menopause
28
Q

Major Duct Lesions

A

1) Ductal Ectasia
2) Papilloma
3) Papillary Carcinoma

29
Q

Terminal Duct Lesions

A

1) DCIS
2) IDC
3) ADH
4) Ductal Adenoma
5) Radial Scar
6) Tubular Carcinoma
7) Medullary Carcinoma
8) Mucinous Carcinoma
9) SCC
10) Adenoid Cystic Carcinoma

30
Q

Lobule Lesions

A

1) FA
2) Lactating Adenoma
3) Cyst
4) Sclerosing Adenosis
5) Galactocele
6) Juvenile Papillomatosis
7) ILC
8) LCIS
9) Juvenile Fibroadenoma
10) Lobular Neoplasia

31
Q

Stromal Lesions

A

1) Fat Necrosis
2) Lipoma
3) Hamartoma
4) Fibrosis
6) PASH
7) Abscess
8) Mets
9) Diabetic Mastopathy
10) Desmoid
11) Lymphoma
12) Phyllodes

Radiology (15 decks)

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