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Breast Sonography > Indications for Breast Imaging > Flashcards

Indications for Breast Imaging Flashcards

1
Q

What is the gold standard in breast cancer screening?

A

mammography

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2
Q

3 main categories of breast imaging:

A
  1. screening
  2. diagnostic
  3. interventional
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3
Q

When should a normal female get her baseline mammogram?

A

35-40 years

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4
Q

At what age should a woman begin having annual mammograms?

A

40

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5
Q

Women at high risk for breast cancer should have what done every year after 30?

A

mammogram AND MRI

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6
Q

___% of women with breast cancer have no risk factors apart from being female and over 50?

A

70%

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7
Q

When evaluating a palpable mass, women under 30 years should have which performed first, u/s or mammo?

A

u./s first due to breast density

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8
Q

Galactorrhea:

A

milk discharge in a non-pregnant, non-lactating female, bilateral

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9
Q

What causes galactorrhea? (2)

A

medicine or pituitary adenoma

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10
Q

Which pt position best relates to cranio-caudal mammograms?

A

sitting upright

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11
Q

Which pt position relates best to MLO mammograms?

A

posterior oblique.. LPO for right breast, RPO for left breast

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12
Q

High frequency transducers have elevational focus of

A

1-2 cm

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13
Q

Sonographically, fat should appear how on breast exams?

A

medium gray

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14
Q

T/F: Malignancies can change shape with compression?

A

false, they do not change shape

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15
Q

If a mass can be compressed by >30%, it is likely a

A

fatty lesion (lipoma)

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16
Q

Ballottement:

A

alternating compression and release to help demonstrate the mobility of echoes in ducts or cysts

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17
Q

What size stand-off pad is best for evaluating the breast (Specifically the nipple)?

A

1 cm, this raises the elevational focus to 1.5 cm

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18
Q

Radial scanning is used for ___________.

A

Screening

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19
Q

Anti-Radial scanning is used for _____________.

A

documenting pathology

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20
Q

Letters used in labeling refer to

A

depth of mass in tissue A-C

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21
Q

Numbers used in labeling refer to

A

distance from nipple (1-3)

22
Q

Fremitis is

A

the vibration of the chest during speech, or humming. Normal, soft breast tissue will vibrate with color, while malignant masses will not vibrate, and will not have color.

23
Q

How do malignant lesions look on elastography?

A

the harder the lesion, the more blue

24
Q

What is the most important mammogram view?

A

Medial-Lateral Oblique (MLO)

25
Q

Which view is used in mammogram for biopsies?

A

True Lateral View

26
Q

Eklund View in mammogram refers to:

A

tissue pulled forward for compression while implant is left out

27
Q

Name the four classifications of Breast Malignancy:

A
  1. Ductal
  2. Lobular
  3. Stromal
  4. Metastasis
28
Q

Name the nine tumors with ductal origin:

A
  1. Invasive Ductal Carcinoma **
  2. Ductal Carcinoma In Situ
  3. Paget Disease
  4. In Situ Intracystic Papillary Carcinoma
  5. Tubular Carcinoma
  6. Medullary Carcinoma
  7. Colloid AKA Mucinous Carcinoma
  8. Invasive Papillary Carcinoma
  9. Inflammatory AKA Diffuse Carcinoma
29
Q

What is desmoplasia?

A

host response (halo) around tumor, common with scirrhous tumors

30
Q

What is the most common non-invasive breast malignancy?

A

DCIS

31
Q

Describe DCIS:

A

malignant cells form a mass from ductal epithelium, this mass is confined to the duct
*usually asymptomatic

32
Q

Most common form of DCIS

A

Comedo (High Nuclear Grade), agressive, central necrosis

33
Q

Which malignancy is most often associated with Paget’s Disease?

A

DCIS

34
Q

How does DCIS appear on mammogram?

A

clusters of calcifications, linear branch calcifications

35
Q

How does In Situ Intracystic Papillary Carcinoma appear sonographically?

A

thick-walled cyst with a mural nodule, color flow within mass, no posterior shadowing, dilated ducts

36
Q

Which breast malignancy has the worst prognosis?

A

Invasive Ductal Carcinoma (IDC)

37
Q

How does Invasive Ductal Carcinoma occur?

A

maligant cells originate in duct, and then tumor extends oustide of the duct

38
Q

Symptoms of Invasive Ductal Carcinoma (7)

A
  1. papable mass
  2. rigid
  3. firm
  4. nipple discharge
  5. nipple retraction
  6. disrupted skin
39
Q

Which Malignancy is associated with benign radial scar?

A

Tubular Carcinoma

40
Q

How does tubular carcinoma occur?

A

rigid, spiculated lesions originate in duct, invade breast in multicentric, satellite tumors

41
Q

How does tubular carcinoma appear on mammogram?

A

microcalcifications, central density within small spiculated mas (white star), multicentric

42
Q

Which malignancy is most common in Asian and Black women under 50?

A

Medullary carcinoma

43
Q

Symptoms of Medullary Carcinoma:

A

soft, palpable , mobile mass, rapid increase in size, distorted breast contour

44
Q

Sonographic appearance of Medullary Carcinoma

A

-may appear similar to fibroadenoma..round, well defined, lobulations, central necrosis, posterior enhancement, prominent vascularity

45
Q

Symptoms of Colloid Carcinoma

A

smooth, soft, palpable mass in late 50’s

46
Q

How does Colloid Carcinoma appear on mammography?

A

low-density, well defined lobular mass

47
Q

How does Colloid Carcinoma appear sonographically?

A

similar to fibroadenoma, may have microlobulations and posterior enhancement, non-scirrhous

48
Q

Symptoms of Invasive Papillary Carcinoma:

A
  1. bloody nipple discharge
  2. palpable mass
  3. skin dimpling
  4. . nipple retraction
49
Q

Sonographic features of Invasive Papillary Carcinoma

A

nodule formation within dilated ducts, esp papillomas over 1.5 cm, no shadowing

50
Q

Inflammatory Carcinoma AKA

A

Diffuse Carcinoma

51
Q

Which malignancy invades the lymphatics of the skin?

A

Inflammatory Carcinoma

52
Q

Which malignancy may result in Peau de Orange?

A

Inflammatory Carcinoma

Breast Sonography (6 decks)

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