Breast imaging

Question 1

What is the triple assessment

Answer 1

clinical: history and examination
radiological
pathology

Question 2

What is a mammogram

Answer 2

low energy x-rays showing contrast between soft tissue and fat in the breast

Question 3

what views are taken in a mammogram

Answer 3

cranial caudal views

oblique

Question 4

How does fibroglandular tissue appear on mammogram

Answer 4

white

Question 5

how does fat appear on mammogram

Answer 5

black

Question 6

if there is cancer in the fatty area if the breast it is harder/easier to see on a mammogram

Answer 6

easier

Question 7

breast density increases/decreases with advancing age

Answer 7

decreases

Question 8

you have a higher risk of breast cancer if you have lower/greater breast tissue density

Answer 8

greater

Question 9

which imaging technique is used for breast screening

Answer 9

mammogram

Question 10

mammogram has a high sensitivity for what?

Answer 10

DCIS

invasive carcinoma

Question 11

what are disadvantages to mammogram

Answer 11

ionising radiation exposure

uncomfortable

Question 12

what is tomosynthesis

Answer 12

3D mammography with multiple images from different angles of the breast

Question 13

which imaging technique is the best for symptomatic women especially with a lump

Answer 13

ultrasound

Question 14

indications for a breast ultrasound

Answer 14

lump/symptomatic 
mammographically detected lesion 
palpable mass in clinic 
breast inflammation 
aspiration of abscess 
breast problems during pregnancy

Question 15

advantages to ultrasound

Answer 15

no ionising radiation
comfortable
can differentiate between cyst and solid
cheap

Question 16

USS can detect DCIS, true or false

Answer 16

false

Question 17

what do strain elastography and shear wave elastography measure

Answer 17

stiffness of tissue

Question 18

which type of breast cancer is harder to diagnose on imaging

Answer 18

lobular

Question 19

which imaging technique is the most sensitive modality for detecting breast cancer

Answer 19

MRI

Question 20

which imaging modality is the best for sizing a tumour

Answer 20

MRI

Question 21

indications for MRI

Answer 21

unsure about size of breast 
Paget's disease of the nipple 
neoadjuvant chemo 
lumps in armpit 
intracapsular rupture of implants

Question 22

what is the commonest breast lump seen in <30 year olds

Answer 22

fibroadenoma

Question 23

what is the commonest breast lump seen in 30-50 year olds

Answer 23

cyst

Question 24

what is the commonest breast lump in >50 year olds

Answer 24

breast cancer

Question 25

what hormone must be present for breast cysts to develop

Answer 25

oestrogen

Question 26

in an axillary ultrasound, cortical thickness of __ would indicate a biopsy is needed

Answer 26

> 3mm