Breast Imaging Flashcards
When is breast imaging needed?
Symptomatic patients: Lumps Bloody nipple discharge Skin tethering Signs of inflammation
What is the 1st line breast imaging tool in a patient under 40?
Ultrasound
More dense breasts, mostly fibroglandular tissue
What is the 1st line breast imaging tool in a patient over 40?
Mammography +/- ultrasound
More fatty breasts
Mammography is a type of XRAY. True/False?
True
Low-dose XRAY that maximises contrast between breast tissue with minimal radiation
List they types of mammography
Normal mammogram
Tomosynthesis 3D mammogram to show density
Constrast-enhanced mammogram using IV iodine
What are the 2 main views/planes in which a mammogram is taken?
Mediolateral oblique
Craniocaudal
How does the distribution of benign lesions differ to malignant lesions on mammogram?
Benign: scattered or diffuse
Malignant: clustered or segmental
Why can ultrasound be helpful following a mammogram?
Characterises findings - differentiates cysts from solid lesions
Describe the appearance of benign nodules on breast ultrasound
Circumscribed
Wider than tall
Homogeneous
Often multiple
Describe the appearance of malignant nodules on breast ultrasound
Poorly circumscribed
Taller than wide
Heterogeneous
Often single
What is ultrasound elastography?
Ultrasound with “palpation” - assess whether a lesion is soft or hard
Why is MRI sometimes used for imaging breasts?
Good intrinsic tissue contrast
No ionising radiation
Accuracy independent of tissue density (mammogram less sensitive in dense breasts)
List indications of using MRI for imaging breasts
Muscle involvement
FHx screening e.g. BRCA
After neoadjuvant chemotherapy
What imaging is appropriate in locally advanced or recurrent breast cancer to check for metastases?
CT chest abdo pelvis
List the commonest sites of breast cancer metastases
Lymph nodes Liver Lung Bone Brain
