modalities and procedures Flashcards
pt is having no issues and its been at least one year since her last screening exam and she is 40 or older
screening
pt is complaining of an issue with her breast or her physician feels something
diagnostic
4 imaging exams
dbt
us
mri
sentinel node mapping
xray tube moves in an arc across the breast while multiple projections are taken. images are perpendicular to beam. images are parallel to detector; projections are reconstructed into slices; slices are dependent on breast thickness
dbt
sweep of gantry
arc
the angles in degrees from the negative to positive side; these are the images initially taken. this is where the actual radiation dosage to the patient comes from
projections
the number of images created from the projections to create the 3D mammogram; dependent on how much the breast is compressed in mm; 1mm thick
slices
for CC DBT image set- images are taken from ______ to ______ breast
inferior
superior
for MLO DBT image set- images are taken from _____ to _____ breast
lateral
medial
MQSA = __ mGy per view
DBT= __ mGy one view
3
1.81
uses only 3D slices to create the 2D image; cut patient dose back down to approx half; cuts scan time
synthesized 2D images
adjunct screening exam; automatically scans a woman’s breast capturing multiple images; displays them in 3D; ideal for women with dense breasts
whole breast ultrasound/automated whole breast ultrasound WBUS/ABUS
both breasts are imaged; can have improved tissue contrast of inconclusive masses on other tests; contrast images taken looking for increased uptake
mri
most common malignancy found on breast MRI
gadolinium
_____ is expensive compared to mammo and us with false positive results of benign masses; only effective in 50% of patients with DCIS
MRI
network of lymph nodes to rid the body of toxins and waste and other unwanted materials; its major role is to continually collect excess interstitial fluid and drain it away from the tissues
lymphatic system
tissue swelling from an accumulation of fluid that is unable to drain through the lymph system; commonly found in patients that have many lymph nodes removed during breast cancer treatment
lymphedema
used to check for breast cancer cells spreading/metastasizing
sentinel node mapping
radioactive isotopes and/or a blue dye is injected at the sit of the lesion 2 hours before surgery; during surgery a gamma detector is used to locate the path of drainage from the tumor to the lymph nodes
sentinel node procedure
interventional procedures - 8
informed consent
cyst aspiration
abscess drainage
fine needle aspiration
core biopsy
vacuum assisted biopsy
needle localization/surgical biopsy
specimen radiograph
permission ranted in the knowledge of the possible consequences, typically that which is given by a dr to the patient for treatment with full knowledge of the possible risks and benefits. procedure explanation with risks and benefits and alternatives by provider who performs intervention. tech/nurse responsibility
informed consent
the smaller the needle gauge number, the ____ the needle core (opening)
bigger
where is cytology fluid discarded?
sharps container
indications for certain procedure:
cyst lesions that have thick walls and other suspicious features,
symptom relief,
eliminate masses
cyst aspiration
indications for certain procedure:
a pt with an infection fluid collection that is not responding to antibiotic treatment; may have to be repeated
abscess drainage
indications for certain procedure:
done on irregular lymph nodes with a thickened cortex; yields cytologic evaluation of cells
fine needle aspiration
needle gauge for fine needle aspiration FNA
18-25
advantages of a certain procedure:
less invasive than core biopsy
local anesthesia may be used
safe, minimal complications
usually on lymph nodes in the breast/axilla
results in 1-2 hours
disadvantages of a certain procedure:
multiple passes may be needed,
possible false negative due to small sample size
cytologic evaluation does not differentiate in situ from invasive cancers
not used for sampling microcalcifications
fine needle aspiration FNA
indications for certain procedure:
US guidance only,
solid lesions with other suspicious features,
lesions near chest wall,
pts with bleeding or clotting disorders where vacuum assistance may be contraindicated
US Core Biopsy
needle gauge for US core biopsy
14-16 spring loaded
advantages of a certain procedure:
less invasive than the open surgical biopsy,
requires small incision, and only a local anesthetic,
sample volume is sufficient for histologic evaluation
disadvantages of a certain procedure:
3-5 passes may be needed,
risk of bleeding, infection or hematoma,
dense lesions are difficult to sample
histologic analysis usually requires a min of 24 hours
core biopsy
needle gauge for vacuum assisted core/breast biopsy
7-14
indications for a certain procedure:
solid lesions with other suspicious features should be biopsied
vacuum assisted core/breast biopsy VAAB/VABB
4 most common types of images guided biopsies
stereotactic, US, MR, tomo
an image guided biopsy used for suspicious calcifications
stereotactic guidance vacuum assisted core biopsy
advantages of a certain procedure:
less invasive than surgical biopsy,
local anesthetic,
greater accuracy sampling dense masses,
vacuum assisted-1 needle pass,
small lesions may be completely excised,
histologic samples,
less cost
disadvantages of a certain procedure:
greater risk of bleeding, infection, hematoma or other complications,
healthy tissue may be compromised
vacuum assisted core biopsy
can be placed after US, MR, Stereotactic or DBT breast biopsies
clip placement
to continue surveillance of the area on subsequent images on the patient in years following
clip placement
indications for a certain procedure:
placement of a percutaneous needle wire for pre-op guidance in locating biopsy proven breast cancer or high risk lesions or non palpable lesions
wire localization/ needle localization
wire free breast localization system; size of a grain of rice; non radioactive
seed placement
waste that has the risk of carrying infection diseases (needles, glass, blades)
biohazardous waste
human bodily fluids, blood wet/dry, or unfixed tissue
infectious materials
an approach to infection control to treat all human blood and certain human body fluids as if they were know to be infectious for HIV, HBV and other bloodborne pathogens
universal precautions
written to outline the protective measures to be taken to eliminate or minimize employee exposures
exposure control plan
