Imaging and Analysis Flashcards
What is mammography
What images typically get seen
The gold standard imaging for breasts, widely used in breast imaging and breast screening program across the world
Craniocaudal (top to bottom)
Mediolateral view (side to side)
What additional views can be requested (5)
Coned views- small spot, firm Magnification view- calcifications True lateral- dont tilt Extended CC- specific to certain side Eclund views- Push implants back to breast
Why is mammography generally reserved for the over 40’s
Younger breast shave more glandular tissues that can be negatively impacted by radiation
What are the benefits of ultrasound
How does a benign lesion appear on an ultrasound
Differentiates solid from cystic
Lack of radiation
Smooth oval shaped outline with acoustic enhancement
How do malignant lesions appear on ultrasound?
Why would you do an MRI scan in a breast pathology
Irregular, interrupting shaped architecture and have an acoustic shadow
Recurrent disease is present, if woman has implants, if there is an intermediate lesion following triple assessment or screening high risk woman
Why wouldnt you use MRI
What is sentinel node sampling?
Poor specificity, claustrophobic noisy expensive.
A procedure carried out to decide if it has spread to the nearest lymph nodes
How is sentinel node biopsy carried out
A peritumoral injection of 99m Tc sulphur colloid possibly with blue dye. A single lymph node is removed and is 97% accurate
What is triple asessment
How is FNA cytology carried out
A combination of clinical examination, imaging and FNA cytology. It is by far the beast way of identyfying breast cancer
Feel or guided image. During a mammogram a needle can be released to biopsy the breast. A computer assesses the tilt required
What is Brevera
Who receives mammography
How successful is it?
New biopsy tool which uses suction when collecting samples. It has a built in x-ray to check the quality of samples and reduce the extent of the procedures
Woman aged between 50-70 are invited every 3 years
Detect 5 cancers per 1000 and the uptake is around 84%. Recall is around 5-10%
What is cytology?
What type of cytological intervention do woman with suspicious masses receive?
What are the indications that woman should recieve cytological intervention
The study of individual cells
Core biopsy (FNA and lymph node screening)
Diffuse thickening, a solid or cytic mass, nipple discharge, eczematous skin around the nipple.
What does a benign cytology result look like
low moderate cellularity of a cohesive group of cells. The cells are uniform, flat sheets with bipolar nuclei in the background
What does a malignant cytology score look like
Loss of cohesion between cells/ crowding of cells
enlarged nuclei
absence of bipolar nuclei
What is cytologies scorimg system
C1- Unsatisfactory C2-Benign C3-Atypia C4-Suspicious C5- Malignant
What is the management of cysts?
Drained by FNA, fluid is typically discarded unless it is shown to be blood stained or there is a residual mass present.
What are the complications of FNA
Pain, heamatoma, fainting, infection, pneumothorax
