breast cancer Flashcards
what is the most common basis for lawsuits involving breast CA
delayed diagnosis
what are some factors that inc risk of breast CA
> 65yrs, Bx confirmed atypical hyperplasia, inherited genetic mutations BRCA1,2, mammographically dense breast, 2 or more 1st deg relatives
what are the 2 standard views for mammography
craniocaudal (CC), mediolateral oblique (MLO)
if there is suggestion of a nodule what views would better evaluate
spot compression, for medial- cleavage view, magnification, additional views
according to american college of radiology BI-RADS classification at what lvl do you have a suspicion of malignancy
4A (0-4A,B,C,-6) 0=needs additional imaging 4A=low;B=intermediate;C=moderate concern for malignancy 5=highly suggestive-refer to surgeon 6=known Bx proven malig-axn
in a young pt with inconclusive MMG results with dense breast what imaging modality would you use
Ultrasonography- better differentiates between solid and cystic mass- can guide core needle Bx
what diagnostic test is not recommended for eval of breast mass
MRI- used for staging
IV gadolinium dye- check renal fxn
when would you use a fine needle aspiration Bx
low probability of CA, determine if cyst
when is a core needle Bx used
if you need samples from larger solid breast mass
T/F in the US 12% of women will develop invasive breast CA
true! 1 in 8
what type of noninvasive (in situ) breast carcinoma is treated as a malignancy for potential to develop into invasive CA
DCIS
how does DCIS present
clustered pleomorphic calcifications on MMG, 80% non palpable, ill defined mass on US
how do you treat DCIS
breast conserving therapy c/ radiation, sentinel node Bx, hormone therapy if ER and PR + (Tamoxifen, Arimidex)
what is the most common INVASIVE breast malignancy
ductal- 80%
commonly palpable mass or MMG abnormality
5-10% of all invasive breast malignancies, does not form microcalcifications, more apt to be bilteral
Lobular
