Mammo Cara flashcards

1
Q

When I say “The calcifications don t change configuration on CC and MLO views”

A

dermal calcifications (“tattoo sign”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

next step for possible skin calcs

A

tangential views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

secretory calcifications: pre or post menopause?

A

post - don t call them secretory on a premenopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if they show you an ML view of calcifications

A

think of milk of calcium/tea cupping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 ways to show DCIS on the exam

A

(1)suspicious calcifications (fine linear branching or fine pleomorphic), (2) non mass like enhancement on MRI, or (3) multiple intraductal masses on galactography.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what happens with skin thickening and trabecular thickening over time?

A

improves - otherwise it s recurrent disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When I say “shrinking breast,” you say

A

ILC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When I say “thick coopers ligaments,” you say

A

edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When I say “thick fuzzy coopers ligaments - with normal skin,” you say

A

blur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When I say “dashes but no dots,” you say

A

Secretory Calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When I say “cigar shaped calcifications,” you say

A

Secretory Calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When I say “popcorn calcifications,” you say

A

degenerated fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When I say “breast within a breast,” you say

A

hamartoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When I say “fat-fluid level,” you say

A

galactocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When I say “rapid growing fibroadenoma,” you say

A

Phyllodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When I say “swollen red breast, not responding to antibiotics,” you say

A

inflammatory breast ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When I say “ lines radiating to a single point,” you say

A

Architectural distortion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When I say “Architectural distortion + Calcifications,” you say

A

IDC + DCIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When I say “Architectural distortion without Calcifications,” you say

A

ILC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When I say “Stepladder Sign,” you say

A

lntracapsular rupture on US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When I say “Linguine Sign,” you say

A

lntracapsular rupture on MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When I say “Residual Calcs in the Lumpectomy Bed,” you say

A

local recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When I say “No calcs in the core,” you say

A

milk of calcium (requires polarized light to be seen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what s different about mag views

A

no grid, smaller focal spot (0.1 mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

BIRADS 3 = what % cancer

A

< 2% chance of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

BIRADS 5 = what % cancer

A

> 95% chance of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

nipple enhancement on MRI - normal?

A

yes, normal - don t call it Pagets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

which quadrant has most breast cancers?

A

upper outer (most tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

main blood supply to the breast?

A

(60%) is via the internal mammary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

main lymphatic drainage of the breast?

A

(97%) is to the axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The sternalis muscle can only be seen on

A

CC view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Most common location for ectopic breast tissue is in the

A

axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

best time in cycle for mammogram (and MRI)

A

follicular phase (days 7-14)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Breast Tenderness is max around day

A

27-30.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

most comprehensive risk model

A

Tyrer Cuzick (but does not include density)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

level of chest radiation as a child that would prompt screening MRI

A

20 Gy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Are males more likely to get breast cancer if they have BRCA 1 or 2?

A

BRCA 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

If triple negative status, more likely to have BRCA 1 or 2?

A

BRCA 1 is more often a triple negative CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Mammo: special view to help with kyphosis, pectus excavatum, and to avoid a pacemaker/line

A

LMO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

which mammo calc pattern has highest suspicion for malignancy?

A

fine pleomorphic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

density of surgical scars related to breast cancer recurrence

A

Surgical scars should get lighter, if they get denser - think about recurrent cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

can you have isolated extracapsular rupture?

A

nope, always with intra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The number one risk factor for implant rupture is

A

the age of the implant

44
Q

affect of Tamoxifen on parenchymal uptake?

A

Tamoxifen causes a decrease in parenchymal uptake, then a rebound.

45
Q

Breast MRI: which cancer is T2 bright?

A

colloid and mucinous cancer

46
Q

axillary lymph node levels: level 1

A

lateral to pec minor

47
Q

axillary lymph node levels: level 2

A

under pec minor

48
Q

axillary lymph node levels: level 3

A

medial to pec minor

49
Q

axillary lymph node levels: rotter node

A

between pec major and minor

50
Q

most cancers start in the

A

TDLU

51
Q

should you biopsy a prepubescent breast?

A

no, it can affect breast development

52
Q

peak time for breast pain/cyst formation

A

perimenopause - 50s

53
Q

name the 5 high risk lesions

A

ADH, ALD, LCIS, Radial Scar, Papilloma

54
Q

BRCA 1 chromosome

A

17 - more common than BRCA 2

55
Q

BRCA 2 chromosome

A

13

56
Q

4 non-BRCA syndromes associated with breast ca

A

Li Fraumeni, Cowden, Bannayan-Riley Ruvalcaba, NF-1

57
Q

oldest and most validated breast cancer risk model

A

Gail - doesn t use genetics

58
Q

things that increase your estrogen exposure, do what to your breast ca risk?

A

increase it (Early Menstruation, Late Menopause, late age of first pregnancy I or no kids, being fat, Being a Drunk, hormone Replacement (with estrogen))

59
Q

all current risk models under or overestimate risk?

A

underestimate life-time risk

60
Q

when do you start screening kids who get 20 Gy of chest radiation

A

age 25 or 8 years after exposure (whichever is longer)

61
Q

what drugs reduce breast cancer incidence of ER/PR

A

Tamoxifen and Raloxifenc (SERMs)

62
Q

BIRADS: multiple bilateral well circumscribed similar appearing masses

A

2 - don t even ultrasound, unless one is palpable

63
Q

BIRADS: multiple foci on MRI

A

2

64
Q

3 things you can BIRADS-3:

A
  1. looks like fibroadenoma, 2. focal asymmetry that becomes less dense on compression, 3. grouped/clustered round calcs
65
Q

Mammo: shapes BIRADS terms

A

round, oval, irregular

66
Q

Mammo: margin BIRADS terms

A

Circumscribed, Microlobulated, Obscured, Indistinct, Spiculated

67
Q

Mammo: density BIRADS terms

A

Fat Density (radiolucent), hypodense, lsodense, hypcrdense

68
Q

Mammo: asymmetries

A

asymmetry, global asymmetry, focal asymmetry, developing asymmetry

69
Q

Mammo: calcifications

A

typically benign vs. suspicious

70
Q

US: shape BIRADS terms

A

Round ,Oval, Irregular

71
Q

US: orientation terms

A

parallel or anti-parallel

72
Q

US: margin BIRADS terms

A

Circumscribed, lndistinct, Angular, Microlobulated, SpicuIated

73
Q

US: echo pattern terms

A

Anechoic, hyperechoic, hypoechoic, lsoechoic, complex cystic and solid, heterogeneous

74
Q

US: posterior features terms

A

None, Enhancement, Shadowing

75
Q

3 artifacts that cause calcifications on mammo

A

deodorant, zinc oxide, metallic fragements

76
Q

Mammo calcifications: distribution

A

scattered, regional, grouped/clustered, linear, segmental

77
Q

Mammo calcifications: benign

A

dermal, vascular, popcorn, secretory, egg-shell, dystrophic, milk of calcium, round

78
Q

Mammo calcifications: suspicious

A

amorphous, coarse heterogeneous, fine pleomorphic, fine linear/linear branching, near a scar/mass/FA

79
Q

treatment for Mondor disease?

A

thrombosed vein - no anticoagulation, just NSAIDS

80
Q

Mammo: 5 classic fat containing lesions?

A

oil cyst/fat necrosis, hamartoma, galactocele, lymph nodes, and Iipoma

81
Q

PASH follow-up rec

A

Pseudoangiomatous Stromal Hyperplasia - 12 month f/u - benign thing with scary sounding name

82
Q

most common invasive breast cancer

A

IDC - 80-85%

83
Q

most common subtype of IDC

A

NOS - 65%

84
Q

IDC subtypes (besides NOS, 4)

A

tubular, mucinous, medullary, papillary

85
Q

IDC subtype associated with radial scar or spiculated mass

A

tubular

86
Q

2 IDC subtypes that present as round/oval masses

A

mucinous and medullary

87
Q

IDC subtype associated with complex cystic and solid mass

A

papillary (older, non-white ladies)

88
Q

multifocal vs. multicentric breast cancer

A

multifocal = multiple primaries, same quadrant; multicentric = multiple primaries different quadrants

89
Q

which type of DCIS histology is more aggressive?

A

comedo type

90
Q

when I say “shadowing without a mass on ultrasound”, you say

A

ILC

91
Q

Breast Pagets is associated with

A

high grade DCIS

92
Q

3 patterns of gynecomastia

A

nodular, dendritic, diffuse glandular

93
Q

should trans guys who get boobs from hormone therapy be screened?

A

no, not high enough risk

94
Q

Breast MRI: how to tell apart normal radial folds vs. linguine sign?

A

radial folds - all lines connect to periphery of implant

95
Q

timing of breast MRI kinetics

A

initial upslope occurs over 2 min, then washout 2-6 min-ish

96
Q

grading breast MRI kinetics upslope

A

slow, medium, rapid

97
Q

grading breast MRI kinetics washout

A

continued rise (type 1), plateau (type 2), rapid washout (type 3)

98
Q

mammo recall rate should be less than

A

10% (target range of 5-7%)

99
Q

Mammo: required resolution of line pairs is

A

13 lp/mm in anode-cathode direction and 11 lp/mm in left-right direction

100
Q

describe the mammo dose phantom

A

50% glandularity, 4.2 cm thick

101
Q

Mammo typical patient doses

A

2 mGy per view - but no limits! that s just for the phantom

102
Q

dose limit for mammo phantom

A

3 mGy/view

103
Q

typical patient breast compression and glandularity

A

6 cm, 15-20% glandularity

104
Q

Mammo: target range for cancers/1000 screened

A

3-8 people with cancer

105
Q

Mammo: target range for PPV for biopsy recs

A

15-35%

106
Q

Cowden Syndrome

A

breast cancer, bowel hamartoma, follicular thyroid, Lhermitte Duclos (brain hamartoma)