Breast imaging Flashcards
What must we remove in BRCA gene?
Breast AND ovaries
What are predisposing factors for breast cancer
- family history (genetics)
- hormonal treatment
- previous breast surgeries, malignancies
3 imaging modalities used in breast imaging
- Mammography
- US
- MRI (see occult tumors AFTER US or mammo, not as a first screening choice)
Changes to breast tissue during life
Breast tissue is very dependant on hormone levels. In young women, the tissue will be mostly glandular - but after 40 years old, it will be mostly fatty tissue
What are CT and PET-CT good for in breast imaging?
To detect metastasis, to do staging of the cancer, to check out lymph nodes
Why is there a higher risk of getting to the point of a carcinoma in dense breasts ?
Because it’s harder to detect lesions in mammography in dense breasts
How can we know if MLO photo?
Because we can see the pectoralis muscle
What are the 2 mammography views?
MLO (mediolateral oblique) and CC (craniocaudal)
What is BIRADS ?
A system of classification of breast tissue composition - from A to D
What is the Tabar classification?
A hungarian classification of breast tissue classification - from T1 to T5
What are the physical examination signs of breast cancer?
- Asymmetric density
- Microcalcification
- Architectural distortion
Where are most of the breast cancers located?
Upper outer quadrant - 50%
What are 3 physical signs of malignancy in breast cancer?
Which are the most / least worrisome calcifications in breast cancer?
- Macrocalcification is almost always benign
- Clustered polymorph calcifications are the most alarming ones
What are examples of benign calcifications?
- Popcorn (fibroadenoma)
- Eggshell / oil cyst
What are some alarming calcification types?
What probe is used in breast US?
High frequency linear transducer (8-18MHz)
One advantage of breast US?
Can tell the difference between a cyst and a solid mass
Pattern of breast cancer on enhanced MRI?
Malignancy has a “wash-out” pattern
What sampling method do we use for which BIRAD?
- BIRAD3 : can use FNAB
- BIRAD4 : have to do a core biopsy
What is the modality used for screening breasts in symptomatic / asymptomatic patients?
- Asymptomatic : mammography
- Symptomatic : depends on age (US if young etc)
Screening in patients with BRCA mutation
annual screening breast MRI as early as age 25 years, and the addition of
annual screening mammography or digital breast tomosynthesis starting at age 30 years
