Misc Flashcards
What clinical history most likely accounts for the imaging findings shown?
Bilateral reduction mammoplasty
Inflamed cyst
MR: T2-hyperintense, oval or round mass; slow, persistent, uniformly thin rim (not nodular or irregular) enhancement
mucinous carcinoma/colloid carcinoma
-subtype of IDC
MR: Characteristic high-signal T2/STIR due to high mucin content; avid, slow rim enhancement
Paget disease of the left breast. Left areolar thickening.
Paget is DCIS of the nipple. Stage 0
True or false, discharge associated with breast cancer usually arises from a single duct
true.
Benign nipple discharge usually arises from multiple ducts, whereas nipple
discharge from a papilloma or DCIS usually occurs from a single duct.
Most common mass producing bloody nipple discharge:
benign intraductal papilloma
When is nipple discharge concerning?
Nipple discharge is of particular concern if it is spontaneous and from a
single duct, or if the discharge is clear or bloody.
Which of the following risk factors places a patient at highest risk for developing breast cancer?
A. Moderate/florid ductal hyperplasia
B. Lobular carcinoma in situ
C. Sclerosing adenosis
D. Atypical ductal hyperplasia
B. Lobular carcinoma in situ.
High risk for breast cancer with lobular carcinoma insitu( 8-10X
increase)
Ductal hyperplasia, sclerosing adenosis and typical ductal hyperplasia have a moderate increased risk
What percentage of breast cancers occur in men?
1%
mean age of presentation of phyllodes
40 -50 years old. Phyllodes tumors typically occur 10-20 years later than
fibroadenomas
if you see an MRI finding on MRI for the extent of the disease and see a new lesion, next step?
go to mammo or US and look for the lesion there and then biopsy it using either of those modalities
if you get a benign path result for a BI-RADS cat 5 lesion, what is the next step?
surgical excision. BI RADS 5 means you are really sure it is cancer despite the path results and it should be taken out
surgically excise what lesions?
DCIS, LCIS, anything with atypia in the name
NF1
NF-1 in an 80-yearold woman with multiple superficial neurofibromas over her torso. Right and left MLO mammograms (a) and left craniocaudal mammogram (b) show numerous dense, circumscribed ovoid masses surrounded by lucent halos of air in the axillae (arrowheads in a) and breasts (arrows in b), findings that represent cutaneous neurofibromas.
Mixed connective tissue disease characterized by limited systemic sclerosis, severe Raynaud phenomenon, and dermatomyositis in a 37-year-old woman.
complicated cyst
30% chance of malignancy
BUT…in this case on mammo there was egg shell/rim calcifications. So this was a case of fat necrosis which can mimic malignancy
how thick does the breast has to be for stereotactic biopsy?
3 cm thickness (minimum)
how deep does the lesion have to be for a stereotactic biopsy?
at least 1 cm
male with breast tenderness
gynecomastia
NF1
breast feeding woman with new palp
lactating adenoma
notice the internal vascularity. in contrast, a galactocele will not have internal flow
next step for breast abscess
aspiration and antibiotics
bi-rads for an abscess
bi-rads 2
what is a granular cell tumor
rare tumor of neural origin
typically benign
in pre-menopausal women
when deep may adhere to pectoralis fascia (commonly seen in the retroglandular fat)
if there are suspicious calcs ans associated increased density, what is the next step?
go to ultrasound to look for the invasive mass lesion –> US biopsy
calcs in the duct are typically not invasive (confined to the duct)
what are the predominant type of xrays generated in mammography?
characteristic radiation
US of intracapsular rupture (step ladder sign)
normal US appearance of an implant
what factors cause decreased breast density?
vitamin D and calcium intake, Danazol, age, weight gain
