Mammo CORE - Sheet1 Flashcards
When I say “The calcifications don’t change configuration on CC and MLO views”
dermal calcifications (“tattoo sign”)
next step for possible skin calcs
tangential views
secretory calcifications: pre or post menopause?
post - don’t call them secretory on a premenopausal
if they show you an ML view of calcifications
think of milk of calcium/tea cupping
3 ways to show DCIS on the exam
(1)suspicious calcifications (fine linear branching or fine pleomorphic), (2) non mass like enhancement on MRI, or (3) multiple intraductal masses on galactography.
what happens with skin thickening and trabecular thickening over time?
improves - otherwise it’s recurrent disease
When I say “shrinking breast,” you say
ILC
When I say “thick coopers ligaments,” you say
edema
When I say “thick fuzzy coopers ligaments - with normal skin,” you say
blur
When I say “dashes but no dots,” you say
Secretory Calcifications
When I say “cigar shaped calcifications,” you say
Secretory Calcifications
When I say “popcorn calcifications,” you say
degenerated fibroadenoma
When I say “breast within a breast,” you say
hamartoma
When I say “fat-fluid level,” you say
galactocele
When I say “rapid growing fibroadenoma,” you say
Phyllodes
When I say “swollen red breast, not responding to antibiotics,” you say
inflammatory breast ca
When I say “ lines radiating to a single point,” you say
Architectural distortion.
When I say “Architectural distortion + Calcifications,” you say
IDC + DCIS
When I say “Architectural distortion without Calcifications,” you say
ILC
When I say “Stepladder Sign,” you say
lntracapsular rupture on US
When I say “Linguine Sign,” you say
lntracapsular rupture on MRI
When I say “Residual Calcs in the Lumpectomy Bed,” you say
local recurrence
When I say “No calcs in the core,” you say
milk of calcium (requires polarized light to be seen)
what’s different about mag views
no grid
BIRADS 3 = what % cancer
< 2% chance of cancer
BIRADS 5 = what % cancer
> 95% chance of cancer
nipple enhancement on MRI - normal?
yes, normal - don’t call it Pagets
which quadrant has most breast cancers?
upper outer (most tissue)
main blood supply?
(60%) is via the internal mammary
main lymphatic drainage?
(97%) is to the axilla
The sternalis muscle can only be seen on
CC view
Most common location for ectopic breast tissue is in the
axilla
best time in cycle for mammogram (and MRI)
follicular phase (days 7-14)
Breast Tenderness is max around day
27-30.
most comprehensive risk model
Tyrer Cuzick (but does not include density)
level of chest radiation as a child that would prompt screening MRI
20 Gy
Are males more likely to get breast cancer if they have BRCA 1 or 2?
BRCA 2
If triple negative status, more likely to have BRCA 1 or 2?
BRCA 1 is more often a triple negative CA
special view to help with kyphosis, pectus excavatum, and to avoid a pacemaker/line
LMO
which calc pattern has highest suspicion for malignancy?
fine pleomorphic
density of surgical scars related to recurrence
Surgical scars should get lighter, if they get denser - think about recurrent cancer.
can you have isolated extracapsular rupture?
nope, always with intra
List types of asymmetries
- asymmetry,
- global asymmetry
- focal asymmetry
- developing asymmetry
Mammo: typically benign vs. suspicious calcifications
Benign: Skin, vascular, popcorn, plasmacell mastitis, fat necrosis, milk of calcium, dystrophic, eggshell, suture
Suspicious: amorphous, coarse heterogenous, fine linear, branching, pleomorphic
https://radiologyassistant.nl/breast/calcifications/differential-of-breast-calcifications
Calcifications: distribution
scattered, regional, grouped/clustered, linear, segmental
IDC subtype associated with radial scar or spiculated mass
required resolution of line pairs is
13 lp/mm in anode-cathode direction and 11 lp/mm in left-right direction
part of the annual survey from FDA
