Invasive And Other Procedures Flashcards
The most common complication of breast implants
Capsular contracture
Scar tissue forms around and squeezes the implant causing firmness, discomfort and implant deformation. Found in 4 grades of severity
Capsular contracture
Surgery that uses the patient’s own muscular and subcutaneous tissue to reconstruct the breast is called:
Autogenous myocutaneous flap surgery
MRI without contrast is the best tool for investigating implant integrity
True
Most common reason for performing FNA
To provide material for cytological interpretation
Fewer lymph nodes are removed during the sentinel node procedure when compared with the traditional axillary lymph node dissection
True
Normal variant confused with implant rupture
Radial fold
What mass characteristics evident during mammo are we trying to identify and correlate with ultrasound?
Shape, margin and density
The position of subpectoral breast implants is:
Posterior to the pectoralis major muscle and anterior to the pectoralis minor muscle.
The presence of a filling defect within the duct during ductography may be consistent with:
Papilloma, intraductal carcinoma or air bubble
The performance of cyst aspiration is usually reserved for:
Atypical or complex cysts as well as symptomatic cysts.
A compression paddle is used typically to assist in the breast localization procedure
True
FDA approved for women 18 and older.
Made with silicone outer shell, filled with saline
Less expensive
Less popular due to less natural feel
Rupture quickly detectable
Saline implants
FDA approved for women 22 and older
Silicone outer shell and filled with silicone gel
More expensive
More natural feel
Available on single or double lumen
Silicone (round) implants
Most popular type of implant
Single lumen silicone
Biggest advantage of an open surgical biopsy as compared to core biopsy methods
Complete removal of most breast lesions
Ductography is contraindicated in patients with:
Breast abscess
Which procedures are considered mammotomies?
Mammotome, MIBB and ABBI
What structure is responsible for the stepladder sign?
The shell of a silicone implant
Incisional biopsy may be performed in which situation?
For extremely large lesions
The stepladder sign on ultrasound imaging is analogous to which sign on MRI
Linguini sign
The appearance of free silicone within a lymph node is consistent with a diagnosis of
Extracapsular rupture
Why is needle wire localization preferred over skin localization method?
Skin localization often results in more tissue removal than necessary
Which procedure provides the pathologist with the largest tissue sample?
Advanced Breast Biopsy Instrumentation (ABBI)
Size of the needle typically used for FNA?
22-25 gauge
Normal, intact breast implant characteristics
Radial folds, echo free interior, trilaminar line
Procedure performed on patients with single duct discharge and a normal mammo
Ductography/galactography
Branch of biology dealing with the structure, function, multiplication, pathology and life history of cells
Cytology
During a needle localization procedure using an ultrasound approach, deep lesions are best:
Approached at an angle parallel to the chest wall
Most likely sonographic appearance of capsular contracture
A rounded implant that lacks compressibility
Following lumpectomy, approximately what percentage of patients develop seromas?
50%
On the CC view of a mammo, markers should be placed:
Lateral outer aspect of the breast
The purpose of sentinel node mapping is______
To locate the first lymph node in the chain through which the breast drains
Breast abscesses are usually found in the:
Retroareolar region
What is MULD
Medial Up lateral Down
In reference to mammographic views
Most common indication for galactography
Single duct discharge and normal mammo
When would incisional biopsy be useful?
If the lesion is large and poorly defined
Most accurate for intraoperative breast specimen imaging
Specimen mammography and ultrasound
Following radiation therapy, a patient may demonstrate ________ for up to 2 years
Skin thickening
Axillary lymph node dissection procedure typically removes _________
10-15 lymph nodes
A lesion visualized on ultrasound will appear closer to the chest wall than the same lesion found on mammo
True
The delivery of treatment prior to surgery in order to shrink the cancer
Neoadjuvant therapy
Breast abscess drainage is most successful when the abscess is:
Less than 2.5cm
Which region of the breast is the most poorly demonstrated on the MLO mammo projection?
Inferomedial
Excessive bleeding
Hematoma
Infection
Pneumothorax
Vasovagal reaction
No diagnosis due to insufficient or inappropriate samples
Possible post biopsy complications
Why is it important to perform routine intraoperative specimen imaging for breast-conserving surgery?
To determine if adequate tumor free margins surround the specimen
Preffered biopsy method when there are suspicious calcifications identified on mammo
Stereotactic vacuum assisted biopsy
Using the mammographic technique, needle/wire breast localization may be combined with dye injection
True
Imaging performed with air injected into the cyst to provide therapeutic benefit or reduced cyst recurrence is called:
Pneumocystography
Lymphatic drainage to the intramammary lymph nodes rather than axilla
Prior radiation therapy or breast/axillary surgery
Enlarged axillary lymph nodes
Mets to their axillary lymph nodes
Previous mastectomy
Large tumors (>5cm)
Primary tumor cannot be identified
Multicentric breast tumors
Contraindications of the sentinel lymph node biopsy procedure
Patients who present with greenish nipple discharge often have:
Fibrocystic disease
46 y/o patient with breast implants presents with suspected breast carcinoma. The best diagnostic modality to image this would be:
Contrast enhanced MRI
The snowstorm sign is also referred to as
Echogenic noise
