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Repro > Breast Imaging > Flashcards

Breast Imaging Flashcards

1
Q

Patients with high % breast density have lower/higher risk than patients very low % breast density. Breast cancer is also easier/harder to detect in dense breasts.

A

higher risk, harder to detect

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2
Q

What two views are used in mammography?

A

Mediolateral oblique and craniocaudal views

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3
Q

4 micro-calcification signs in mammography that are benign

A

vascular calcification,
oil cyst eggshell calcification, (often after injury)
plasma cell mastitis: long, bilateral, pointing to nipple,
dystrophic calcification in scar

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4
Q

3 micro-calcification signs in mammography that indicate DCIS

A

linear or branching micro calcifications,
clusters or segmental,
pleomorphic size and density

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5
Q

Mammography pros (3)

A

images whole breast,
high sensitivity for DCIS & invasive,
accessible

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6
Q

Mammography cons (4)

A

ionising radiation,
breast pain/discomfort,
challenging if limited mobility,
bad for dense breasts

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7
Q

Indications for mammography (6)

A

screening (50-70yrs),
higher risk screening >40,
symptomatic assessment >40,
monitoring response to systemic treatment,
follow up,
image guided techniques e.g. biopsy/localisation

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8
Q

Patients who had surgery for breast cancer will receive annual mammograms for approx. how long after?

A

3-5yrs

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9
Q

Grey-scale USS uses?

A

breast or axilla

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10
Q

USS benign signs

A

wide,
well-defined,
anechoic (black) - cysts,
hypo echoic

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11
Q

USS malignant signs

A

tall,
ill-defined,
hypo echoic,
heterogeneous (dark/mixed)

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12
Q

Treatment for cyst?

A

aspiration

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13
Q

Grey-scale USS pros (3)

A

no radiation,
comfortable,
good sensitivity and specificity for invasive

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14
Q

Grey-scale USS cons (2)

A

low specificity in screening,

low sensitivity for DCIS

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15
Q

Grey-scale USS indications (5)

A

assess clinical/mammographic abnormality,
during pregnancy,
monitoring response to systemic treatment,
follow-up for cancers not visible in mammography,
image-guided procedures

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16
Q

Both mammography and USS are useful for guiding biopsy/VAE and localisation. USS also has use for what other image-guided procedure?

A

aspiration of cyst or abscess

17
Q

What is tomosynthesis?

A

Pseudo 3D technique by taking images at diff. angles in arc then reconstructing int multiple slices

18
Q

Tomosynthesis pros? (2)

A

removes overlapping tissue,

lesion outline

19
Q

Tomosynthesis cons? (3)

A

more radiation,
accessibility,
low sensitivity in v. dense breasts

20
Q

Tomosynthesis indications? (3)

A

assessing mammography abnormalities,
screening sometimes in denser breasts,
not really used in follow up

21
Q

What is Contrast Enhanced Spectral Mammography (CESM)?

A

IV contrast given and two images made - one normal mammography and one that shows enhanced bits

22
Q

Why are mammographies usually only used in older women?

A

Because visibility not as good in younger breasts

23
Q

CESM pros (2)

A

good sensitivity and specificity for dense breasts,

shows tumour blood supply

24
Q

CESM cons (3)

A

radiation,
contrast use,
breast pain/discomfort

25
Q

USS technique strain elastography measures what and how?

A

measures tissue stiffness - cancer tissues stiffer - by palpation with ultrasound

26
Q

What is shear wave elastography?

A

ultra fast sequence to test tissue elasticity

27
Q

Shear wave indications? (2)

A

adjuvant to grey-sale USS,

diagnosis of fibroadenomas (25-40yrs)

28
Q

Contrast-enhanced USS (CE-US) indications? (3)

A

assessing response to chemo,
axillary node characterisation,
improving BIRADS classification of solid lesions

29
Q

What is the name of the classification system used for assessment of breast lesion in USS, mammography and MRI?

A

BI-RADS

30
Q

CE-US malignant features? (3)

A

hyper-enhanced,
irreegular margin,
rapid-iso-enhancement with penetrating vessels

31
Q

Automated breast USS (ABUS) is a new technique that is particularly useful for women with?

A

dense breasts

32
Q

Contrast-enhanced MRI contrast and patient position?

A

IV gadolinium,

lie prone

33
Q

MRI pros (1)

A

most sensitivity for all

34
Q

MRI cons (2)

A 
moderate specificity (more mastectomies), 
may pick up parts that would've been treated by RT
35
Q

MRI is particularly useful for which type of breast carcinoma and why?

A

lobular because usually multi-focal and multi-central

36
Q

MRI indications (3)

A

for monitoring neoadjuvant chemotherapy,
to figure out discrepancy between USS and mammogram or imaging and palpation,
mammographically occult lesions

Repro (49 decks)

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