BREAST DDx:

Question 1

DDx for amorphous Ca++:

Answer 1

Fibrocystic change (most likely)
sclerosing adenosis
DCIS (low grade)

Question 2

DDx course heterogeneous Ca++:

Answer 2

Fibroadenoma
Papilloma
Fibrocystic change
DCIS (low-intermediate grade)

Question 3

DDx fine pleomorphic Ca++:

Answer 3

Fibroadenoma (less likely)
Papilloma (less likely)
Fibrocystic change
DCIS (high grade)

Question 4

Dark star - distortion without a central mass DDx:

Answer 4

lobular carcinoma
Radial Scar
Surgical scar
IDC NOS

Question 5

• malignant characteristics on US:

SHAME BS CD

Answer 5

Spiculation, 
Height > Width, 
Angular margins, 
Microlobulations, 
Echogenicity (hypo), 
Branch pattern, 
Shadowing, 
Calcification, 
Duct extension

Question 6

benign characteristics on US: \

CHEW

Answer 6

Capsulated (thin, complete),
Hyperechoic,
Ellipsoid (width > height),
Well circumscribed lobulations.

Question 7

Sub types of DCIS:

Answer 7

Comedo

Non-comedo:

• Cribiform
• Micropapillary
• Papillary
• Solid

Lobular carcinoma in situ is its own In situ form.

Question 8

Sub types of Invasive Ductal Carcinoma:

Answer 8

Non special type

Tubular:
- small spiculated mass

Mucinous colloid:

• low density circumscribed mass.
• T2 bright

Medullary:

• younger women, BRCA 1
• Locally aggressive, but better prognosis than NOS.
• tripple negative.

Papillary:
- intraductal

Question 9

Complex cyst in lactating woman:

Answer 9

• Galactocele
• Abscess –> follow up post treatment to ensure not cancer
• Fibroadenoma
• Haematoma
• Lactating adenoma
• Fibrocystic change

Question 10

Course Ca++ in partially circumscribed mass:

Answer 10

Degenerating fibroadenoma
Fat necrosis
Oil cyst
Haematoma
Previous abscess.

Question 11

Fatty Breast Lesion:

Answer 11

Hamartoma / fibroadenolipoma = breast in breast
Lipoma
Galactocele
Fat necrosis.

Question 12

Well circumscribed Mass in pre menopausal woman:

Answer 12

Fibroadenoma
Cyst
Intra mammary node
Breast carcinoma
Papilloma.

Question 13

Axillary lymphadenopathy:

Answer 13

Breast cancer with nodal spread
Lymphoma
Reactive lymphadenopathy
Metastatic disease from remote primary
Connective tissue and granulomatous disease
Castleman disease

Question 14

Mass with central lucency:

Answer 14

Radial scar
Invasive ductal carcinoma
TUbular carcinoma

Fat necrosis
Post surgical scar.

Question 15

Well circumscribed solid breast mass:

Answer 15

Fibroadenoma
Intra mammary node
Hamartoma / fibroadenolipoma
Circumscribed carcinoma
Papilloma

Question 16

Well circumscribed cystic breast mass:

Answer 16

Papilloma / papillary carcinoma
Seroma
Cyst with debris
Haematoma
Abscess.

Question 17

Ductal Mass:

Answer 17

Intraductal papilloma
Intra cystic papillary carcinoma
DCIS
Dilated duct with debris.

Question 18

Bilateral skin thickening:

Answer 18

Congestive heart failure
SVC obstruction
Bilateral lymphoedema
Psoriasis
Renal failure and over load.

Question 19

Breast lesion in a man:

Answer 19

Gynaecomastia
Breat cancer
Lipoma
haematoma
Abscess
Metastasis

Question 20

Well circumscribed breast cancer:

Answer 20

Invasive Ductal carcinoma not other wise specified
Mucinous colloid  carcinoma
Medullary carcinoma
Papillary carcinoma
DCIS

Question 21

Breast Lesion with nipple discharge:

Answer 21

Intraductal papilloma
Mammary duct ectasia
Breast carcinoma (Ductal or papillary)
Fibrocystic change
Galactorrhea

Question 22

Unilateral nipple / skin changes:

Answer 22

Paget disease of nipple
Mastitis
Inflammatory breast carcinoma
Nipple adenoma

Question 23

Large breast mass:

Answer 23

Phyllodes tumour:

• dense circumscribed mass, hypoechoic
• No Ca++
• Cannot reliably differentiate from fibroadenoma
• suspected with a Hx of rapidly growing circumscribed mass.

Fibroadenoma

Circumscribed breast cancer.

Question 24

Complex cystic mas on US:

Answer 24

Abscess
Haematoma
Cystic neoplasm
Fat necrosis
Cyst with debris

Question 25

Multiple subcutaneous lesions:

Answer 25

NF 1

Multiple subcutaneous neurofibromas, peri areolar.