Interventional Procedures

Question 1

BIRAD system

Answer 1

Breast Imaging And Reporting System And Data is a standardized mammography reporting system that can be used as a coding and assessment system

Question 2

Capsular contracture or firm rigidity to the breast…

Answer 2

is a complication implant augmentation. It is often the body’s normal response to the presence of a foreign object. Fibrous capsule forms around the implant. Ultrasound and MRI are proven adjunctive evaluation tools.

Question 3

Cyst aspiration

Answer 3

The removal of the content of a cyst. Performed to relieve pain or to assess the cyst’s contents. Often performed under ultrasound guidance.

Question 4

Stereotactic Breast Localization:

Answer 4

A method used to biopsy non-palpable lesions. Images taken at different angles to triangulate the exact coordinates of a lesion. A computer calculates the lesion’s location. Lesions can be biopsied after localization or the stern-localization can be a prelude to an FNAB or core biopsy.

Question 5

Types of stereotactic Units:

Answer 5

Add-on Units attach to a regular mammography unit and with the patient seated.
Dedicated Prone Unit - patient lays prone with arm and breast protruding through the table opening. Most prone table allow for 360 degree tube rotation.

Question 6

Preoperative localization

Answer 6

A prelude to a surgical biopsy and can be used if stereo localization is not available. Performed under mammography, ultrasound or MR guidance.

• The radiologist inserts a long needle with a hooked wire into the breast-beyond lesion
• The needle is withdrawn leaving the hooked wire in place.
• The hooked end of the wire holds the wire within the breast tissue.

Question 7

Types of breast biopsies:

Answer 7

Fine needle aspiration biopsy (FNAB): removes cell samples. The procedure uses a 22 to 25-gauge needle and is generally recommend that the cytotechnologist evaluate the removed sample before the patient leaves the department.
Minimal Invasive Biopsy: removes tissue samples and can include
*Core Needle Biopsy (CNB) using a large-core needle with a special cutting edge (11-16) to remove core samples.
Vacuum Biopsy sometimes uses a local anesthetic and can be performed with mammography, ultrasound or MR guidance.
Large core biopsy removes a larger volume of tissue then a core biopsy and is not commonly used
Open surgical biopsy
Radio frequency biopsy
Lymph Node biopsy

Question 8

Modality Base Biopsy

Answer 8

Mammography
Ultrasound Guided
MR guided

Question 9

Using the BIRAD system, what category of lesion is usually referred for biopsy?

Answer 9

BIRAD 4 and above

Question 10

What is the name given to the procedure whereby the contents of a cyst are removed?

Answer 10

a method of removing fluid from a cyst using a needle. Aspiration is often done under ultrasound guidance.

Question 11

Name the the technique used to triangulate a lesion within the breast and calculate it’s location in three dimensions

Answer 11

Sterotactic

Question 12

What is the needle gauge range commonly used for FNAB?

Answer 12

22-25

Question 13

The lowest false negative rate is obtained using which biopsy technique, open, core, or FNAB

Answer 13

Open

Question 14

Which modality will best biopsy breast calcifications?

Answer 14

Mammography

Question 15

Give two reasons for imaging the specimen .

Answer 15

To ensure the lesions was removed and to ensure the margins are clear

Question 16

Give one use of the ductogram

Answer 16

To evaluate nipple discharge, to evaluate filling defects, irregularities, duct expansions or duct defects.

Question 17

Methods used to definitively classify a lesion include:

1. cytological analysis
2. mammography
3. histological analysis

Answer 17

Cytological analysis and histological analysis.

Question 18

Process by which the breast size is increased using implants is called:

Answer 18

Augmentation mammoplasty

Question 19

A surgical procedure done at the request of the patient to lift the breast and improve firmness is considered

Answer 19

Augmentation

Question 20

A technique performed to evaluate suspicious nipple discharge is called;

Answer 20

Ductography

Question 21

Which of the following biopsy techniques is the most accurate?

Answer 21

Open surgical has the lowest false-negative rate but also the highest complication rate.

Question 22

Which biopsy method removes very small sections of tissue samples for analysis?

1. Core biopsy
2. FNB
3. Ductal lavage
4. Ductography

Answer 22

Core biopsy
FNB and ductal lavage are methods of obtaining cellular material, ductography is a technique used to evaluate the large ducts.

Question 23

An analysis of cell samples taken from the breast is referred to as:

Answer 23

Histological analysis

Question 24

Which procedure is considered a safer replacement for the lamp node biopsy?

Answer 24

Sentinel node biopsy- minimally invasive where only one to four axillary nodes in the chain draining from the breast are removed.

Question 25

If a lesion is seen only on the MR image of the breast, which of the following can be used to biopsy the lesion:

Answer 25

MR guided core biopsy

Question 26

A minimal invasive procedure used to remove a nonpalpable lesion t determine its benign or malignant nature:

Answer 26

Stereotactic - if the lesion is non palpable it would first have to be located before biopsy or aspiration