Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Breast Imaging > Flashcards

Breast Imaging Flashcards

1
Q

What makes up the triple assessment of a woman with suspected breast cancer?

A

Clinical
Radiology = mammography, US
Pathology = image guided core biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does breast density impact prognosis?

A

Women with 76-100% density have 4-5x increased risk compared to women with 1-10% density = dense area more predictive than percent dense area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the advantages of mammography?

A

Images whole of both breasts
High sensitivity for DCIS and invasive cancer
Only modality known to reduce population mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the disadvantages of mammography?

A

Uses ionising radiation

Can be uncomfortable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is tomosynthesis?

A

3D mammography = multiple images from different angles, slices reconstructed, blurs overlapping tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is contrast enhanced spectral mammography?

A

Identifies contrast enhancement in the breast after IV injection of iodinated contrast material = breast cancers have increased vascularity so enhance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What images can be taken using contrast enhanced spectral mammography?

A

Low energy image = equivalent to standard 2D DM
High energy image = sensitive to contrast
Subtraction image = only sees lesions that enhance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most important adjunctive imaging modality for breast disease?

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the indications for doing a breast US?

A

Palpable mass, image guided biopsy, breast inflammation, breast problems during pregnancy, work up of mammographically detected lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the advantages of US?

A

No ionising radiation and not uncomfortable for patient
Good sensitivity and specificity for invasive cancer
Can differentiate cystic from solid
Quick if examination tailored to specific area
Cheap and image guided biopsy very easy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the disadvantages of US?

A

Low specificity when used for screening

Low sensitivity for DCIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some advanced US techniques?

A

Strain elastography, shear wave elastography, contrast enhanced US, 3D US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some features of contrast enhanced US?

A

Allows quantitative assessment of perfusion

2D or 3D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some uses of contrast enhanced US?

A

Assessing response to NACT
Axillary node characterisation
Improving BIRADS of solid breast masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does elastography measure?

A

Differences in tissue firmness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What kind of image does conventional elastography provide?

A

A colour map of stiffness superimposed on a grey scale image

17
Q

How are invasive cancers viewed by elastography?

A

Stiffer than benign lesions = area of stiffness produced by a cancer is often larger than grey scale US abnormality

18
Q

What are the appearances of lesions scored 1-3 by strain elastography?

A 
1 = entire area and surrounding area is evenly shaded green 
2 = lesion area has mosaic pattern of green, blue and red
3 = central part of area is blue and peripheral part green
19
Q

What are the appearances of lesions scored 4 and 5 by strain elastography?

A 
4 = entire area is blue (stiff)
5 = both entire area and its surrounding area are blue (stiff)
20
Q

What are the disadvantages of strain elastography?

A

Non-quantitative

Poor reproducibility due to operator difference in producing strain

21
Q

What are the advantages of shear wave elastography?

A

Quantitative and good reproducibility

Improved differentiation of benign from malignant when combined with US

22
Q

What are the features of shear wave elastography?

A

Strain is produced by US probe

Ultrafast sequence catches in real time the propagation of shear waves

23
Q

What is the most sensitive modality for detection of breast cancer?

A

MRI = dynamic contrast enhanced MRI has sensitivity of >95% for invasive cancer

24
Q

What is the most accurate method for sizing and focality assessment of breast cancer?

A

MRI

25
Q

What are the disadvantages of MRI?

A

Widespread use in women planned for wide local excision increases mastectomy rates
Doesn’t decrease positive margins, re-excision or local recurrence

26
Q

What are some uses of MRI?

A

Lobular cancer, mammographically occult cancer, downsizing with neoadjuvant chemotherapy, Paget’s disease of the nipple, implant integrity, screening of very high risk women

27
Q

What are some methods of breast biopsy?

A

FNA, core, vacuum

28
Q

What can the EnCor biopsy equipment be used for?

A

Stereotactic, US and MRI guided biopsy

29
Q

What are the commonest causes of breast lumps by age?

A 
<30 = fibroadenoma
30-50 = cyst
>50 = cancer
30
Q

What is the best modality for assessing breast masses?

A

US

31
Q

When would you do a mammogram for a breast mass?

A

If clinical or US is suspicious

Patient age >40

32
Q

How are abnormal axillary nodes identified?

A

By cortical thickness and shape = usually seen on US

33
Q

How sensitive are core biopsies of abnormal axillary nodes?

A

Identifies 40% of node-positive women pre-operatively

34
Q

How is breast cancer staged?

A

Operable disease = local staging

Locally advanced or recurrent disease = CT chest/abdo/pelvis for metastases

35
Q

What are some common sites for breast metastases?

A

Bones, lungs, pleura, liver, brain

36
Q

Is unilateral nipple discharge from a single duct normal?

A

No = always a concerning symptom

37
Q

What are some causes of single duct nipple discharge?

A

Invasive cancer, DCIS, duct ectasia, papilloma

38
Q

What are some causes of breast abscess/infection?

A

Breast feeding and duct ectasia

39
Q

How are most breast abscesses/infections managed?

A

US guided drainage and antibiotics

Reproduction (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions