Imaging the breast Flashcards
What condition might microcalcifications in the breast indicate?
Ductal carcinoma in situ
How does fat necrosis present in mammography?
Abnormal mass or calcifications in the breast
Which is the only imaging modality that can detect microcalcifications?
Mammogram
What is the modality of imaging used in patients presenting with a breast lump over the age of 40?
Mammogram
What is the modality of imaging used in patients presenting with a breast lump under the age of 40?
Ultrasound
What is mammography?
A low dose xray designed specifically to maximise contrast between the breast tissues
Which form of mammography is most useful in dense breasts or in younger women?
Digital mammography
What are the indications for mammography?
Screening in asymptomatic women
All women with a palpable mass over 40y to exclude or confirm malignancy & assess normality of contralateral breast
What are the two views from which a mammogram is normally taken?
Mediolateral
Craniocaudal
How can a mediolateral mammogram be differentiated from a craniocaudal mammogram?
Can see the pec major in the image of ML
What view has this mammogram been taken from?
Craniocaudal
What are the classifications of BIRADs for breast density?
- a: nearly all fat
- b: scattered fibroglandular densities (25-50%)
- c: heterogeneously dense (51-75% glandular)
- d: extremely dense (> 75% glandular)
How would this breast be classified on BIRADs?
D: the breast tissue is completely dense and it would be difficult to spot a malignancy
What are the features of malignant calcification on mammogram?
Clustered or segmental
Rhomboid forms
Linear/branching/Y shaped forms
What are the indications for ultrasound of the breast?
Palpable lesions in women <40
Nipple discharge
Breast implants
Inflammatory conditions e.g. abcess
Evaluation of response to chemotherapy
What is this ultrasound showing and why?
Fluid filled (black)
Round shape
Clear edges
What are the features of a benign solid nodule on ultrasound?
Circumscribed
“Wider than Tall”
Homogeneous/uniform
Peripheral/no vascularity
Often Multiple
What are the features of a malignant solid nodule on ultrasound?
Poorly Circumscribed
Hypoechoic
Heterogeneous
“Taller than wide”
Spiculate
Oedema/peritumoral fat
Is this lesion likely to be benign or malignant?
Malignant
Is this lesion likely to be benign or malignant?
Benign
