Module 1 Facts Flashcards
Men make up ______ of all breast cancer cases
1%
What percentage of women have a breast cancer diagnosis?
12.4%
What is the most important prognostic fact with breast cancer?
If it has spread to the lymph nodes
What is the second most prognostic factor with breast cancer?
size of the tumor. Prognosis is best for tumors under or equal to 1cm.
Tumors greater than _____ are more likely to recur?
5cm
What is the age range for most breast cancer diagnosis?
Increases w age, most occur after 50
What makes someone 72% more likely to have a breast cancer diagnosis?
BRCA1 and BRCA2 genes
The United States Preventative Task Force (USPTF) recommends what for screening?
Biennial screening for patients aged 50-74 for breast cancer
The American College of Radiology (ACR) and Society of Breast Imaging (SBI) both recommend screening starting when?
Annual screening starting at 40 for those at an average risk of breast cancer
Is US an effective screening tool?
No
When performed in addition to mammography, US imaging of the breast has been shown to detect approximately ______ more cancers
40%
What are the best characteristics for US imaging tools?
high resolution large FOV dynamic focusing linear array broad bandwidth
Tranducers in the 10-13.5MHz range can resolve masses ______ or less
0.2mm
Axial resolution improves with __________________, but the depth of _________________.
increasing frequency
penetration decreases
What are 2 ways to improve lateral resolution?
focus
increase frequency
What is the worst measure of image resolution? Why?
Slice thickness (elevational resolution), as it cannot be focused
During the receive phase, what are the degrees of electronic focusing? Increasing these improve?
aperture size # of channels in the transducer # of transducer elements # of scan lines
LR
Contrast resolution improves with increasing transducer __________ and increasing _____________?
Frequency
BW
The majority of breast lesions occur at a depth of ?
3cm or less
Standoff pads should not exceed
1cm
Fat should always appear as what shade of gray
medium
System power should only be set high enough to penetrate to the ?
chest wall
Attenuation occurs at
0.5dB/cm/MHz (1 for return)
What color flow Doppler velocities would indicate malignancy?
25-40cm/s
What color flow Doppler velocities would indicate a benign mass?
<20cm/s
Carcinoma’s have consistent high velocities throughout the mass.
False– they tend to have higher PSV’s and RI’s within the centre of the mass
Benign masses have consistent velocities and RI’s
Most popular way of breast scanning?
Radial (or convergent)
What is echo palpation?
immobilization of a breast mass w two fingers while pressure is applied to the underlying tissues with the US transducer
Benign lesions will ________ during compression, whereas malignant will not
rotate
Zone 1
near nipple
Zone 2
midway within the breast (mammary zone)
Zone 3
periphery of the breast
SA
subareolar
AX
Axillary
A
Anterior third of breast
B
Mid breast
C
Posterior third of breast (chest)
Every image must have a permanent ID label which includes?
Facility name/location, patient’s first and last name, patient ID, and DOB, the exam date, and sonographer’s initials
Speed of sound in soft tissue is? Silicone? Fat?
1540m/s
990 m/s (deeper)
1450 m/s (deeper)
What is the Bayonet sign?
during a needle aspiration the needle appears broken due to the difference in speed of sound between breast tissue and fluid within the cyst (actually helpful because it shows we are within the cyst)
What does THI reduce?
artifacts (speckle and clutter) and side lobes
THI utilizes multiples of the transmission frequency
Disadvantages to CEUS?
Contrast agents are extremely expensive and require an IV injection?
Fremitus technique
AKA vibrational Doppler Imaging (VDI) or sonoelastography.
In theory, the softer components of a normal breast vibrate more than firmer components when vibrational energy is applied. Breast cancers vibrate very little
Shear Wave Elastography:
A technique that visualizes and measures the tissue elasticity
Strain Elastography:
Manual compression with the US transducer
Do 2D or 1.5D linear arrays have dynamic focusing?
Yes, allows for focusing in the elevational (or slice thickness) plane. This improves LR in the near field
What is tomosynthesis?
Allows for a low dose xray system and computer reconstruction to create 3D images of the breast. Ideally it is combined w 2D digital mammo to reduce the radiation dose
A coronal image is a scan plane:
parallel to skin surface
What does the coronal scan plane improve?
The interpreter’s ability to assess the tissues surrounding the tumor. Can also see surface characteristics better
What is the tissue surrounding a tumor called?
Infiltrative zone
Women with dense breasts are ______x more likely to have a missed diagnosis of breast cancer.
4-6
What percentage of women have dense breasts?
43%
What is the accuracy percentage in women w dense breasts?
48%
What is the sensitivity of ABUS when used in conjunction with mammo?
97%
Brachytherapy:
Treatment within or adjacent to cancer tissues
What is the most common treatment for breast cancer?
Radiation therapy (externally) Most common form of treatment of postmastectomy
What are the different kinds of brachytherapy?
Interstitial (aka tube and button): small catheters are inserted into where the cancer was removed from and they deposit radioactive pellets. Less commonly used
Intercavitary (aka balloon catheter): a device put into the lumpectomy site, and for 5days, 2x a day, a radioactive pellet is inserted and then removed. Then the entire device is removed. More common.
Why is brachytherapy better than other methods?
Reduces radiation to the lungs and opposite breast, 1wk treatment time vs 6-7wks, causes no delays w other treatments and it’s an outpatient basis
