radiology of breast

Question 1

Gold standard screening test
for breast diseases?

Answer 1

mammography

Question 2

during which test a total of 4 images in two planes (craniocaudal-CC and mediolateral oblique-MLO graphs) are taken?

Answer 2

mammography

Question 3

mammography is considered a type of which radiograph?

Answer 3

x-ray

Question 4

what are the 2 main positions of breast taken in mammography?

Answer 4

craniocaudal view (CC)

mediolateral oblique view (MLO)

Question 5

how is a mammography performed?

Answer 5

Breast are fully compressed in order to get more detailed and clear images, also compression decreases radiation dose

Question 6

why is compression imp in mammography?

Answer 6

• Movement is restricted [which allows for a high-quality image]
• Tissue homogeneity is provided.
• Lesion borders are seen more clearly.
• Tissue thickness decreases and consequently:
  - The radiation dose
  received by the patient
  is reduced.
  - The radiation scattered
  is reduced.

Question 7

what is the purpose of BI-RADS(Breast Imaging-Reporting and Data System): ?

Answer 7

Purpose; to standardize evaluation of findings reporting suggestions,
MG
US
MRI
+to create better communication about the findings and treatment accordingly is possible between radiologists and between radiologists and clinicians

Question 8

when is a biopsy is required according the BIRADS scale?

Answer 8

in BIRADS 4 and 5

Question 9

according the the BIRADS scale, when is a follow-up enough?

Answer 9

in BIRADS 0-3

Question 10

BREAST DENSITY CLASSIFICATION (BI-RADS)
?

Answer 10

A: the breasts are almost entirely fatty

B:there are scattered areas of fibroglandular density

C: the breasts are heterogeneously dense, which may obscure small masses

D: the breasts are extremely dense, which lowers the sensitivity of mammography

Question 11

how do breast tm form?

Answer 11

calcifications and microcalcifications:
BENIGN:
-Diffuse
-Regional
Suspicious:
-Clustered(maybe in a
lobule)
Malignant:
- Linear(deposits in a duct.)
-Segmental(suggests deposits in a duct
&their branches)

Question 12

***at what age is it appropriate to start mammography screening?

Answer 12

Screening starts at age 40 and repeated annually for women without any risks or symptoms

Question 13

*you are presented with a patient under the age of 40 that has a risk of breast neoplasm; what is the first test you’ll perform?

Answer 13

Under the age of 40/or pregnant/lactating patients who are symptomatic
▼
First ULTRASONOGRAPHY

Question 14

**disadvantages of MRI for breast imaging?

Answer 14

Not reliable to differentiate the microcalcifications [seen on MG]

Question 15

advantages of MRI for breast imaging?

Answer 15

-characterization of lesions
-discrimination between benign and malignant breast lesions
-preoperative staging
-tumor size estimation
-detection of the invasive component in DCIS lesions
-detection of additional tumor foci in the ipsilateral and contralateral breast
-to document response in patients treated with neoadjuvant chemotherapy
-screening in high-risk patients
-detection of additional occult cancer foci
-Evaluation of breast implants

Question 16

**what is the examination done on >20yrs of age for breast cancer ?

Answer 16

+Self examination
Over 20 years old, once a month

+Medical physical examination
Over 20 years old, every 2 years
Over 40 years old, once a year

Question 17

**what are the indications for screening for breast neoplasm

Answer 17

• After the age of 40, once a year, mammography (ACR*:ABCD breast density scale)
  
  • For Type C and D dens breasts, US should be added.
  • In high risk group special protocols (mammography +/- ultrasonography +/- MRI)

Question 18

**what are the indications for examination for breast tm in symptomatic pts?

Answer 18

+Before the age 40, physical examination and first ultrasonography (mammography or MRI, if necessary)
+After the age 40, physical examination and first mammography (ultrasonography and/or MRI, if necessary)