Breast imaging Flashcards
standard imaging techniques of the breast
Mammography
USS
advanced imaging techniques of the breast
contrast enhanced mammogram tomosynthesis USS contrast enhanced elastography ABUS MRI
2 views taken on mammography
mediolateral
craniocaudal
how may masses on mammography be defined
well defined
spiculated
irregular
distortion of tissues
where would you see oil cyst calcification
post trauma
where would you see dystrophic calcification
scar tissue
how may ductal CIS appear on mammography
linear/branching
cluster/segmental
pleomorphic size/density
advantages of mammography
images whole breast accessible and inexpensive reproducible screening highly sensitive for cancer and DCIS
disadvantages of mammography
ionising radiation
challenging for low mobility
uncomfortable
indication for mammography
asymptomatic screening 50-70 symptomatic screening >40 or high risk screen >40 response to tx image guidance follow up
reassuring description of masses on USS
anechoic
well defined
wide
hypoechoic
malignant description of masses on USS
tall
ill defined
hypoechoic and heterogenous
advantages of USS
no radiation cheap comfortable good sensitivity and specificity image guided
disadvantages of USS
low specificity for screening
low sensitivity for DCIS
operator dependent
indications for USS
targeted pregnancy follow up monitor systemic tx image guided procedures
what is tomosynthesis
3d technique of images taken in angles in an arc to remove overlap
advantages of tomosynthesis
removes overlapping tissue
lesion outline
disadvantages of tomosynthesis
additional radiation
accessibility
low sensitivity in very dense breasts
indications of tomosynthesis
assessing mammographic abnormalities
screening in some cases
what is CESM
contrast enhanced mammography
two images of low energy and contrast enhanced
advantages of CESM
increased sensitivity and specificity esp for dense breasts
inexpensive
quick
disadvantages of CESM
more radiation
IV contrast
discomfort
what is elastography
measure of tissue stiffness
cancer usually stiffer
what is strain elastography
palpation with USS probe to lead to colour map on USS screen
operator dependent
what is shear wave elastography
strain produced by shear waves in probe
operator dependent but stiffness can be sensitive and specific
can be used to diagnose fibreadenoma
malignant features on CE USS
hyperenhancement with enlarged range or irregular margin
rapid/iso enhancement with penetrating vessels
hyper centre-petal enhancement with perfusion defect
advantages of contrast MRI
best sensitivity
most accurate for sizing
disadvantages of contrast MRI
contraindication
patient tolerance
small foci previously mopped up so over-tx
no increase in +ve margin, reexcision or recurrence
moderately specific
what age and how often are people referred to the national breast screening programme
50-70
3 years
