Mammo Flashcards
Level 1 axillary lymph node
lateral to pec minor
level 2 ax node
under pec minor
level 3 ax node
medial and above pec minor
rotter node
between pec minor and major
What is the best time to image breasts
follicular phase day 7-14
When is a LMO view obtained? 2
kyphosis/pectus excavatum or avoid pacer/line
How many cancer diagnoses should be made per 1000 mammos?
3-8
What should PPV be?
4%
Shape on mammo
ROI round oval irregular
Margin on mammo
circumscribed obscured microlobulated indistinct spiculated
Margin on US
circumscribed angulated microlobulated indistinct spiculated
5 things to describe mass on US
shape margin posterior features echo pattern orientation
Background parenchymal enhancement is based off of what on MRI?
1st post contrast sequence
What three categories are there for lesion analsysi on MRI?
foci, mass, non mass like enhancement
Margin on MRI
circumscribed irregular spiculated
What are the four internal enhancement patterns on MRI?
homogeneous
heterogeneous
rim
dark internal septation
What are the 7 types of non mass like enhancement on MRI?
focal linear linear branching segmental regional multiple regional
clustered ring enhancement on MRI=
DCIS or IDC
What are the five distributions of calcifications?
segmental linear grouped regional scattered
cigar shaped w/ lucent center-
secretory calcs
calcs 10-20 years after menopause=
secretory calcs
massive eggshell calcs=
liponecrosis macrocystica
How is milk of calcium seen on biopsy?
polarized light for birefringence
4 ddx for amorphous calcs
fibrocystic change
sclerosing adenosis
columnar cell change
DCIS low grade
4 ddx coarse heterogeneous calcs
fibroadenoma
papilloma
fibrocystic change
DCIS low intermediate grade
4 ddx fine pleomorphic calcs
fibroadnoma
papilloma
fibrocystic change
DCIS
What is the puff of smoke sign in mammo
central calcs in mass
A ton of oil cysts=
steatocystoma multiplex
PASH f/u recommendation?
1 year
fibroadenoma characteristics on MRI?
T2 bright with type 1 enhancement
what IDC type is associated with radial scar?
tubular
What does ILC look like on US?
shadowing without a discrete mass
shrinking breast=
ILC
dark star ddx 4
lobular carcinoma, radial scar, surgical scar, IDC NOS
What is breast pagets associated with?
high grade DCIS
Radial scar is a/w what three things?
DCIS, IDC, tubular carcinoma
What is the most common benign cause of nipple discharge in a postmenopausal woman?
ductal ectasia
What is the most common benign cause of nipple discharge in a premenopausal woman?
fibrocystic change
AD + calcs=
IDC and DCIS
AD without calc=
ILC
normal lymph node cortical thickness?
less than 2.3-3mm
dense calcs in lymph node=
gold therapy
snow storm node=
silicone infiltration or gel bleed
What is diffuse glandular gynecomastia seen in?
men with estrogen therapy
What is the second most common palpable mass in a man?
lipoma
What is the most common type of male breast cancer?
IDC NOS
step ladder on US
intracapsular rupture
linguine sign on MRI
intracapsular rupture
What is the local recurrence rate when treated with breast conserving therapy?
6-8%
What is the peak time for breast cancer recurrence?
4 years
Without radiation, what is rate of local recurence?
35%
Benign calcs are seen when after treatment?
2 years (opposed to 4 for cancer recurrence)
red plaques/skin nodules 6 years after radiation=
secondary angiosarcoma
T1
<2cm
T2
2-5 cm
T3
> 5cm
T4
skin involvement, chest wall fixation, inflammatory
PAGETS is NOT T4
What are the five contraindications for breast conservation?
inflammatory large cancer size relative to breast multicentric disease prior radiation to same breast contraindication to radiation treatment
Risk of cancer in Type 1 curve
6%
Risk of cancer in Type 2 curve
7-28%
Risk of cancer in Type 3 Curve
29%+
What two tumors are T2 bright?
colloid cancer or mucinous cancer
If patient with known breast CA, how often contralateral cancer found by mammo?
0.1-2%
If patient with known breast CA, how often contralateral cancer found by MRI?
3-5%
At what radiation dose will child later need screening MRI?
20Gy
At what age does child with high chest radiation get screening MRI?
age 25 or 8 years post exposure whichever is later
What are the four features of Cowden Syndrome?
breast CAn, follicular thyroid cancer, endometrial cancer, lhermitte duclos
QC localization and accuracy test performed
daily
What is the required resolution of line pairs?
13 in anode cathode direction, 11 in left right direction
What must be seen to pass image quality?
4 fibers, 3 microcalc clusters, 3 masses, acceptable artifacts
What are the characteristics of the dose phantom?
4.2 cm thick, 50% glandularity, 3 mGy per image
Typical patient phantom dose one view, two view?
2 mgy, 4 mgy
Typical compressed breast is how thick and what percent glandular?
6cm, 15-20%
processor QC
daily
darkroom cleanliness
daily
viewbox conditions
weekly
phantom evaluation
weekly
repeat analysis
quarterly
compression test
semi annually
darkroom fog
semi annually
screen film contrast
semi annually
How is flaring fixed on mri?
put pad between breast and coil
How is heterogeneous fat satting fixed?
shimming
