Breast Interventions

Question 1

discordant vs concordant

Answer 1

concordant: pathology matches radiology
discordant: further workup required (another biopsy)

Question 2

US biopsy

Answer 2

core needle biopsy; spring loaded 14 gauge needle

Question 3

US biopsy techniques

Answer 3

keep biopsy device parallel to chest wall; shallow angle of obliquity

lateral approach to lesion

titanium tissue marker placed post procedure

Question 4

US cyst techniques

Answer 4

standard syringe 20 or 18 gauge to aspirate target cyst

send for cytology if bloody or clear

green/gray/yellow/cloudy may be discarded

Question 5

stereotactic biopsy techniques

Answer 5

prone (less vasovagal syncope)/upright

breast immobilized in compression during entire procedure

needle path calculated by computer

vacuum assisted 11 gauge biopsy needle used; biopsy clip placed

Question 6

MR guided biopsy

Answer 6

requires IV gadolinium; lesion must be targeted before contrast washes out or lesion obscured

grid coordinate method used

lateral approach preferred

Question 7

wire localization

Answer 7

preoperative localization of lesion prior to excisional biopsy/lumpectomy

shortes approach to lesion with appropriate wire length (5,7, 9 cm)

radiographcs obtained to confirm target lesion/hook wire are within specimen