Interventional procedures

Question 1

needle gauge

Answer 1

-the smaller the gauge number the bigger the needle core (opening)/ the bigger the gauge number the smaller the needle core

Question 2

cyst aspiration

Answer 2

-cystic lesions that have thick walls and other suspicious features
-symptom relief
-eliminate mammographic masses
-cytology fluid evaluated only if color is suspicious (if not, discarded in sharps container)

Question 3

abscess drainage

Answer 3

-pt with an infection fluid collection that is not responding to antibiotic treatment (may have to be repeated)

Question 4

fine needle aspiration (FNA)

Answer 4

-local anesthetic applied
-fine needle (18-25 gauge) used to aspirate cell
-cytotechnologist preps sample and places cell on a glass slide (multiple passes may be needed)
-U/S guided FNA done on irregular lymph nodes with thickened cortex
-yields CYTOLOGIC evaluation of CELLS

Question 5

FNA advantages

Answer 5

-less invasive than core biopsy
-local anesthesia may be used
-safe, minimal complications
-usually on lymph nodes breast/axilla
-results in <1-2 hrs

Question 6

FNA disadvantages

Answer 6

-possible false neg. b/c of small sample size
-cytologic eval doesn’t differentiate in situ from invasive cancers
-not used for sampling microcalcifications

Question 7

Ultrasound core biopsy

Answer 7

-US guidance only
-solid lesions with other suspicious features
-lesions near chest wall
-pts with bleeding or clotting disorders where vacuum assistance may be contraindicated (not recommended)

Question 8

US core biopsy technique

Answer 8

-14-16 gauge core biopsy needle in a spring loaded design with a trough
-3-5 passes (US used to guide)

Question 9

core biopsy advantages

Answer 9

-less invasive than open surgical biopsy
-small incision and local anesthetic
-sample volume is sufficient for HISTOLOGIC (tissue) eval

Question 10

core biopsy disadvantages

Answer 10

-risk of bleeding, infection or hematoma
-dense lesions are difficult to sample
-histologic analysis usually req. a min. of 24 hrs

Question 11

vacuum-assisted core biopsy (VAAB
vacuum-assisted breast biopsy (VABB)

Answer 11

-Indications;
-solid lesions with other suspicious features should be biopsied
-7-14 gauge automated sampling system
-after local anesthesia, 1/4 in. skin incision made
-needle enters lesion once, sampling notch is rotated
-common type of image guided biopsy; stereotactic, US, MR, and Tomo

Question 12

Vacuum assisted core biopsy stereotactic guidance used for what?

Answer 12

suspicious calcification

Question 13

vacuum assisted core biopsy advantages

Answer 13

-less invasive than surgical bx, local anesthetic
-greater accuracy sampling dense masses
-vacuum assisted- one needle pass
-small lesions may be completely excised
-HISTOLOGIC (tissue) samples
-less cost

Question 14

vacuum assisted core biopsy disadvantages

Answer 14

-greater risk of bleeding, infection, hematoma, or other complications
-healthy tissue may be compromised

Question 15

clip placement

Answer 15

-can be placed after US, MR, stereotactic, or DBT breast biopsy
-safe, minimal complication

Question 16

why do we do clip placement?

Answer 16

-necessary to place clip during biopsies in order to continue surveillance of the area on images on the pt in years following
-if area needs to be surgically removed, then clip will be removed too

Question 17

post procedure imaging views to verify clip placement

Answer 17

-breast; CC, MLO
-axilla; AT, AP shoulder

Question 18

wire localization (needle localization) indications

Answer 18

-placement of percutaneous needle wire for pre-operative guidance in locating;
-biopsy proven breast cancer or high-risk lesion
-non-palpable breast lesion
-wire guides surgeon to the mass (can be done w/ US or mammo)

Question 19

post procedure mammogram
wire localization

Answer 19

-after wire localization, CC & ML or MLO are taken to assess wire placement
-following localization using a hook wire, pt is taken to surgery
-surgeon removes wire along with surrounding breast tissue

Question 20

specimen radiography

Answer 20

-xray of specimen is taken to assure that the area of interest and/or clip is in the excised tissue
-specimen sent to pathology lab for examination and interpretation

Question 21

seed placement

Answer 21

-wire free breast localization system
-size of a grain of rice
-non-radioactive; magseed SAVI SCOUT
-radioactive; I125 seed

Question 22

post procedure imaging
verify seed placement

Answer 22

-breast; CC, ML
-axilla; AT, AP shoulder

Question 23

OSHA

Answer 23

occupational safety and health administration created in 1970

Question 24

biohazardous waste (medical waste)

Answer 24

waste that has risk of carrying infectious diseases (needles, glass, blades)

Question 25

infectious material

Answer 25

human bodily fluids, blood or unfixed tissue (to the body)

Question 26

universal precautions

Answer 26

an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV, and other bloodborne pathogens