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Repro > Breast imaging * > Flashcards

Breast imaging * Flashcards

1
Q

where is the breast base anatomically

A

over 2nd-6th ribs midclavicularly

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2
Q

breast is anterior to what two muscles

A

deep pectoral fascia and low part serrates anterior

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3
Q

when is breast imaging used

A 
lumps
unilateral or blood stained nipple discharge
skin tethering of dimpling 
signs of inflam 
axillary lumps
screening
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4
Q

when should breast imaging not be used

A

pain
tenderness
symmetrical nodularity

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5
Q

when should someone with breast pain be imaged and which ix

A

associated focal/asym modulatory
USS is <40
XRM +/- >40

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6
Q

what is a mammogram

A

low dose x ray designed to specifically maximise contrast between the breast tissues whilst minimising radiation dose

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7
Q

why mammography

A

cost effect
non invasive exam
reproducible
reliably visualises microcalcificaions (<0.5mm)

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8
Q

types of mam

A

film/screen

digital (full field digital mammography FFDM)

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9
Q

what is a digital mam

who is digital mam best in

A

replaces film/screen combination
various image detectors
excellent contrast resolution

better in dense breasts,younger women

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10
Q

advantages of digital imaging

A 
better contrast between dense and non dense tissues
shorter exam 
fewer technical repeats
fewer films
easier image storage and transfer
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11
Q

indications for mam

A

screening
women >40 with palpable mass
to exclude/confirm malignancy and assess contralateral breast

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12
Q

when is a mam not indicated

A

women <40 screening or symptomatic

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13
Q

what should be present in a normal mam

A

skin and pores
fat of low density
glandular tissue of high density
trabeculae - think sharply defined
blood vessels +/- vascular calcifications
lymph nodes
calcifications - arteria, sebaceous glands (polo mints) eggshell curvilinear (oil cysts)

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14
Q

what are some normal calcifications seen on a mam

A

arterial, sebaceous glands (polo mints) eggshell curvilinear (oil cysts)

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15
Q

views for mam

A

mediolateral oblique (MLO)*
craniocaudal (CC)*
extended CC

laterally or medially rotated CC, rolled CCs
true laterals 
axillary tail views
localised compression or paddle views
magnification views
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16
Q

MLO

A

best single view
table at 45 degrees off vertical
XR beam perpendicular to long axis breast
quality criteria for adequacy

17
Q

CC

A

table horizontal
nipple in profiles
shows medial and most of lateral tissue not axillary tail

18
Q

paddle view

A

very firm localised compression
less scatter more contrast
demonstration of bodies of mass

19
Q

magnification views

A

for micro calcification
CC and lateral views
x 1.2 -2.0

20
Q

breast density in normal mams

A

20% aged 30 have fatty breasts

40% aged 80 have dense breasts

21
Q

BIRADS parenchymal patterns

A

a. nearly all fat
b. scattered fibroglandular densities (25-50%)
c. heterogeneously dense (51-75% glandular)
d. extremely dense (>75% glandular)

22
Q

features of malignant calcifications

A

clutters or segmental
scattered or diffuse r usually benign

rhomboid forms

linear/branching/Y shaped forms

23
Q

USS indications

A 
characterisation of mamographic findings 
palpable lesions in women <40
nipple discharge 
breast implants or augmentation 
inflam conditions such as abscess
evaluation of response to chemotherapy
24
Q

USS equipment

A

high centre frequency 12-13MHz

linear phased array transuducer

25
Q

cystic lesions

A

cysts - fluid collections
clustered cysts
complex cysts
aspirate

26
Q

solid nodules that are benign

A 
circumscribed
hypo echoic/hyperechoic
wider than they are tall 
homogenous
peripheral/no vascularity 
often multiple
27
Q

solid nodules that are malignant

A 
poorly circumscribed 
hypoechoic
heterogeneous
taller than they are wide
speculate 
oedema/peritumoral fat
28
Q

types of elastography

A

MRI based

USS based

29
Q

USS based elastography

A

sonoelasticity vibration)
single/multi step compression
sheer wave elastography

30
Q

devices for vacuum assisted biopsy

A

mammotome
SUROS
EnCor

31
Q

disadvantages of mam

A

decreased sensitivity in dense breasts so in over 50s

32
Q

advantages of MRI

A

good contrast
no compression
no ionising radiation
accuracy independent of breast density

33
Q

MRI contraindications

A

cardiac pacemakers, cochlear implants, ferromagnetic aneurysm clips, renal impairment
pregnancy, lactation

34
Q

MRI indications

A 
implants 
diagnosis of malig dx
staging
residual disease
response assessment - chemo
recurrent disease
screening
35
Q

MRI indications for screening

A

high risk groups:
previous irradicaition
BRCA 1, 2, TP53 mutation
personal history of breast cancer

Repro (56 decks)

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