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Radiology Core > Breast > Flashcards

Breast Flashcards

1
Q

Second most common IDC breast cancer subtype?

A

Papillary IDC (after NOS)

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2
Q

What is associated with Paget’s disease of nipple?

A

High grade DCIS

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3
Q

What’s the second most common breast cancer subtype?

A

ILC

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4
Q

Shrinking breast seen in?

A

ILC - the breast is not being compressed that much , but might look normal in size clinically.

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5
Q

Which view ILC is seen better?

A

CC- since it compresses better. Appears as an architectural distortion

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6
Q

ILC buzzwords:

A

Mammo: dark star - shrinking breast.

US: shadowing without a mass.

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7
Q

Most common implants complication?

A

Capsular contracture: due to contraction in the fibrous capsule.

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8
Q

Major risk factor for implant rupture?

A

Age on the implant

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9
Q

Risk of breast cancer in NF-1?

A

Moderate risk.

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10
Q

Salad oil sign

A

Mixing of silicone and saline in a double-lumen intracapsular rupture.

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11
Q

Location of oil cysts in steatocystoma multiplex?

A

Intradermal While in post-traumatic are intra-parenchymal.

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12
Q

What medication can cause focal fibrosis?

A

Hormone replacement therapy.

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13
Q

What’s the rule of multiplicity?

A
  • at least 3 masses (one in each breast).
  • benign margins
  • non palpable
  • no suspicion calcs
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14
Q

Which breast is involved in a seatbelt injury?

A

Driver: left breast

Passenger: right breast

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15
Q

Most common sites for phylloids mets?

A

Lung and bone (it’s hematogenous route).

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16
Q

Thickness of tomo slice?

A

1 mm

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17
Q

Examples of cellular fibroepithelial lesions?

A

Fibroadenoma

Phylloides

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18
Q

What’s picture framing in MRI?

A

Normal pattern of parenchymal enhancement from the periphery to the center.

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19
Q

How does fat necrosis look on MRI?

A

T1 non-FS: hyper similar to normal fat.

T1 FS: hypo with rim enhancement.

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20
Q

Thin, nonenhancing septa in MRI?

A

Fibroadenoma

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21
Q

Types of needle loc systems?

A

Hook wire needle system: needle is removed and wire stays in lesion.

Rigid needle and J wire: both needle and wire remains in lesions while patient awaits surgery.

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22
Q

In needle loc, how far the tip of the needle should be from the lesion?

A

The tip should be 1 to 1.5 cm beyond the lesion.

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23
Q

What’s stroke margin in stereo?

A

The calculated distance between the needle tip and the detector once needle has been fired. Calculated by computer

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24
Q

What’s positive stroke margin?

A

When there’s enough breast tissue beyond the post fired needle tip without traversing the entire breast or hitting the detector.

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25
Q

What’s the maximum dose of 1% lidocaine without epinephrine?

A

4.5 mg/kg not exceeding 300mg

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26
Q

What’s the maximum dose of 1% lidocaine with epinephrine?

A

7 mg/kg not exceeding 500 mg

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27
Q

Pregnant diagnosed with breast cancer, how to treat?

A

Immediate surgery then radiation after delivery. No chemo or radio in first trimester.

28
Q

How to anesthetize nipple Areola complex?

A

Topical lidocaine!

29
Q

What’s the upgrade risk in sclerosing adenosis?

A

Less that 2%, therefore, it goes back to screening.

30
Q

How’s the z-axis generated in stereo?

A

By calculating the parallax shift of the target on the stereotactic images compared with the target location on the scout image.

31
Q

What local anesthetic is administered for skin wheel?

A

Lidocaine 1% buffered with sodium bicarbonate (1:9) m- to reduce burning.

32
Q

What local anesthetic is administered into breast parenchyma?

A

Lidocaine 1% with epinephrine (1:100,000) for hemostasis. Dose is 7mg/kg

33
Q

Cleft like cystic spaces in a well defined mass?

A

Phylloids. A feature that can differentiate it from fibroadenoma

34
Q

What’s the soure to image distance in mammo?

A

50-80 cm

35
Q

how is motion in DBT compared to conventional mammo?

A

May be worse!

36
Q

Can you BIRADS MRI without giving Gad?

A

NO! Gad should be there to BIRADS!

37
Q

Male with clinical exam is consistent with gynecomastia

A

No imaging needed.

38
Q

Male under 25 with suspicion clinical exam?

A

Do US first

39
Q

Male above 25 with suspicion exam?

A

Do Mammo first then US.

40
Q

Can biopsy epidermal inclusion cyst?

A

NO - It’s contraindicated.

41
Q

what’s the typical compression thickness?

A

4-5 cm

42
Q

If a mass is seen on mammo then disappears on C+ mammo

A

eclipse sign - it’s a cyst.

43
Q

What is used for molecular breast imaging?

A

Tc99m-sestamibi

44
Q

If radial scar if >2 cm

A

is called –> Complex sclerosing lesion.

45
Q

Mucocele-like lesions:

A

fibrocystic change with columnar cell change. They are high-risk lesions.

46
Q

What’s the FDA recommendation regarding implant rupture screening?

A

MRI every 3 years.

47
Q

New fluid formed around in implant?

A

Aspirate and send it to r/o implant-associated lymphoma.

48
Q

When to biopsy a fibroadenoma?

A

if size> 2.5 cm or interval growth of > 20%.

49
Q

How long post-radiation changes last?

A

Peaks at 6 months and may last to 18 months.

50
Q

Chest radiation received after the age of 30?

A

Not a high risk for MRI screening

51
Q

When to perform Sentinel lymph node biopsy in DCIS?

A

Only if there’s necrosis or microinvasive disease.

52
Q

Which part of breast can be excluded in MLO?

A

Superior medial breast.

53
Q

Invasive tumors with increased through transmission

A

are 10-24x more likely to be high grade than invasive tumors without this feature.

54
Q

What’s the position of glandular tissue after reduction mammoplasty?

A

INFERIOR redistribution relative to pre op.

55
Q

How frequent localization accuracy is done for sterotactic machine?

A

Annually

56
Q

Pt didn’t show up for mammogram after the initial screening exam, for how long her record should be kept?

A

10 years.

If follow ups available, then records are kept for 5 years.

57
Q

Reduction mammoplasty findings

A
  • Nipple: Superiorly shifted
  • Fibroglandular tissue: Inferiorly shifted
58
Q

Which type of breast cancer is associated with lymphoid infiltration?

A

Medullary carcinoma

59
Q

What’s the name of the artifact?

A

Blurring-ripple artifacts.

  • Seen with breast tomosynthesis.
  • related to the small number of projections acquired at DBT
  • Analogous to volume averaging.
  • Oriented perpendicular to the x-ray tube sweep direction.
  • Corrected with an increasing number of projections, disappearing when the number of projections matches the number of reconstruction sections
60
Q

Examples of truncation artifact in breast tomo?

A
  • Stair-step artifact.
  • Bright-edge artifact.
61
Q

Which mammography QC test is this?

A

Flat Field Test. Done Weekly.

62
Q

Developing asymmetry most likely is?

A

PASH

PASH

PASH

63
Q

Imaging difference between lactating adenoma and a galactocele?

A

LA: Has Doppler vasularity

64
Q

what additional views should be done in case of axillary oil cyst/fat necrosis?

A

Tangential

65
Q
A

Radiology Core (9 decks)

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