Cara's Mammo cards Flashcards

1
Q

When I say “The calcifications don t change configuration on CC and MLO views”

A

dermal calcifications (“tattoo sign”)

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2
Q

next step for possible skin calcs

A

tangential views

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3
Q

secretory calcifications: pre or post menopause?

A

post - don t call them secretory on a premenopausal

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4
Q

if they show you an ML view of calcifications

A

think of milk of calcium/tea cupping

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5
Q

what happens with skin thickening and trabecular thickening over time?

A

improves - otherwise it s recurrent disease

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6
Q

When I say “shrinking breast,” you say

A

ILC

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7
Q

When I say “thick coopers ligaments,” you say

A

edema

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8
Q

When I say “thick fuzzy coopers ligaments - with normal skin,” you say

A

blur

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9
Q

When I say “dashes but no dots,” you say

A

Secretory Calcifications

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10
Q

When I say “cigar shaped calcifications,” you say

A

Secretory Calcifications

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11
Q

When I say “popcorn calcifications,” you say

A

degenerated fibroadenoma

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12
Q

When I say “breast within a breast,” you say

A

hamartoma

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13
Q

When I say “fat-fluid level,” you say

A

galactocele

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14
Q

When I say “rapid growing fibroadenoma,” you say

A

Phyllodes

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15
Q

When I say “swollen red breast, not responding to antibiotics,” you say

A

inflammatory breast ca

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16
Q

When I say “ lines radiating to a single point,” you say

A

Architectural distortion.

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17
Q

When I say “Architectural distortion + Calcifications,” you say

A

IDC + DCIS

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18
Q

When I say “Architectural distortion without Calcifications,” you say

A

ILC/radial scar

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19
Q

When I say “Stepladder Sign,” you say

A

lntracapsular rupture on US

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20
Q

When I say “Linguine Sign,” you say

A

lntracapsular rupture on MRI

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21
Q

When I say “Residual Calcs in the Lumpectomy Bed,” you say

A

local recurrence

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22
Q

When I say “No calcs in the core,” you say

A

milk of calcium (requires polarized light to be seen)

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23
Q

what s different about mag views

What is the cost of mag view?

A

no grid, smaller focal spot (0.1 mm), air gap

Cost of mag view is increased radiation.

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24
Q

nipple enhancement on MRI - normal?

A

yes, normal - don t call it Pagets

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25
Q

which quadrant has most breast cancers?

A

upper outer (most tissue)

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26
Q

main blood supply to the breast?

A

(60%) is via the internal mammary

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27
Q

The sternalis muscle can only be seen on which view on Mamms

A

CC view

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28
Q

Most common location for ectopic breast tissue is in the

A

axilla

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29
Q

best time in cycle for mammogram (and MRI)

A

follicular phase (days 7-14)

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30
Q

Breast Tenderness is max around day

A

27-30.

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31
Q

most comprehensive risk model

A

Tyrer Cuzick (but does not include density)

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32
Q

level of chest radiation as a child that would prompt screening MRI

A

20 Gy

33
Q

Are males more likely to get breast cancer if they have BRCA 1 or 2?

A

BRCA 2

34
Q

If triple negative status, more likely to have BRCA 1 or 2?

A

BRCA 1 is more often a triple negative CA

35
Q

Mammo: special view to help with kyphosis, pectus excavatum, and to avoid a pacemaker/line

A

LMO

36
Q

which mammo calc pattern has highest suspicion for malignancy?

A

fine pleomorphic (branching)

37
Q

density of surgical scars related to breast cancer recurrence

A

Surgical scars should get lighter, if they get denser - think about recurrent cancer.

38
Q

can you have isolated extracapsular rupture?

A

nope, always with intra

39
Q

The number one risk factor for implant rupture is

A

the age of the implant

40
Q

affect of Tamoxifen on parenchymal uptake?

A

Tamoxifen causes a decrease in parenchymal uptake, then a rebound.

41
Q

Breast MRI: which cancer is T2 bright?

A

colloid and mucinous cancer

42
Q

axillary lymph node levels: level 1 - 3

Rotter node

A

Level 1: lateral to pec minor

2: beneath pec minor
3: medial to pec minor

Rotter node: between pec major and minor

43
Q

most cancers start in the

A

TDLU

44
Q

should you biopsy a prepubescent breast?

A

no, it can affect breast development

45
Q

peak age for breast pain/cyst formation

A

perimenopause - 50s

46
Q

name the 5 high risk lesions

A

ADH, ALD, LCIS, Radial Scar, Papilloma

47
Q
  1. BRCA 1 chromosome
  2. BRCA 2 chromosome
  3. Triple negative cancers more often have which BRCA?
  4. Males w/ breast cancer more often have which BRCA?
A
  1. 17
  2. 13
  3. Triple negative: BRCA 1
  4. Males: BRCA 2
48
Q

4 non-BRCA syndromes associated with breast ca

A

Li Fraumeni, Cowden, Bannayan-Riley Ruvalcaba, NF-1

49
Q

oldest and most validated breast cancer risk model

A

Gail - doesn t use genetics

50
Q

things that increase your estrogen exposure, do what to your breast ca risk?

A

increase it (Early Menstruation, Late Menopause, late age of first pregnancy I or no kids, being fat, Being a Drunk, hormone Replacement (with estrogen))

51
Q

all current risk models under or overestimate risk?

A

underestimate life-time risk

52
Q

when do you start screening kids who get 20 Gy of chest radiation

A

age 25 or 8 years after exposure (whichever is longer)

53
Q

what drugs reduce breast cancer incidence of ER/PR

A

Tamoxifen and Raloxifenc (SERMs)

54
Q

BIRADS: multiple bilateral well circumscribed similar appearing masses

A

2 - don t even ultrasound, unless one is palpable

55
Q

BIRADS: multiple foci on MRI

A

2 (I guess you can think of it as Background parenchymal enhancement..)

56
Q

3 artifacts that cause calcifications on mammo

A

deodorant, zinc oxide, metallic fragements

57
Q

treatment for Mondor disease?

A

thrombosed vein - no anticoagulation, just NSAIDS

58
Q

most common invasive breast cancer

A

IDC - 80-85%

59
Q

most common subtype of IDC

A

NOS - 65%

60
Q

IDC subtypes (besides NOS, 4)

A

tubular, mucinous, medullary, papillary

61
Q
  1. IDC subtype associated with radial scar or spiculated mass
  2. 2 IDC subtypes that present as round/oval masses
  3. IDC subtype associated with complex cystic and solid mass
A
  1. Tubular
  2. mucinous and medullary
  3. Papillary
62
Q

multifocal vs. multicentric breast cancer

A

multifocal = multiple primaries, same quadrant; multicentric = multiple primaries different quadrants

63
Q

which type of DCIS histology is more aggressive?

A

comedo type

64
Q

when I say “shadowing without a mass on ultrasound”, you say

A

ILC

65
Q

Breast Pagets is associated with

A

high grade DCIS

66
Q

3 patterns of gynecomastia

A

nodular, dendritic, diffuse glandular

67
Q

should trans guys who get boobs from hormone therapy be screened?

A

no, not high enough risk

68
Q

Breast MRI: how to tell apart normal radial folds vs. linguine sign?

A

radial folds - all lines connect to periphery of implant

69
Q

timing of breast MRI kinetics

A

initial upslope occurs over 2 min, then washout 2-6 min-ish

70
Q

grading breast MRI kinetics washout

A

continued rise (type 1), plateau (type 2), rapid washout (type 3)

71
Q

mammo recall rate should be less than

A

10% (target range of 5-7%)

72
Q

Mammo: required resolution of line pairs is

A

13 lp/mm in anode-cathode direction and 11 lp/mm in left-right direction

73
Q

describe the mammo dose phantom

A

50% glandularity, 4.2 cm thick

74
Q

Mammo typical patient doses

A

2 mGy per view - but no limits! that s just for the phantom

75
Q

dose limit for mammo phantom

A

3 mGy/view

76
Q

typical patient breast compression and glandularity

A

6 cm, 15-20% glandularity

77
Q

Mammo: target range for cancers/1000 screened

A

3-8 people with cancer

78
Q

Mammo: target range for PPV for biopsy recs

A

15-35%

79
Q

Cowden Syndrome

A

breast cancer, bowel hamartoma, follicular thyroid, Lhermitte Duclos (brain hamartoma)