Benign Vs. Malignant

Question 1

What does category 0 mean in the BI-RADS assessment?

Answer 1

Need additional imaging evaluation

Question 2

What does category 1 mean in the BI-RADS assessment?

Answer 2

Negative

Question 3

What does category 2 mean in the BI-RADS assessment?

Answer 3

Benign

Question 4

What does category 3 mean in the BI-RADS assessment?

Answer 4

Probably benign

Question 5

What does category 4 mean in the BI-RADS assessment?

Answer 5

Suspicious

Question 6

What does category 4A mean in the BI-RADS assessment?

Answer 6

Low suspicion for malignancy

Question 7

What does category 4B mean in the BI-RADS assessment?

Answer 7

Moderate suspicion for malignancy

Question 8

What does category 4C mean in the BI-RADS assessment?

Answer 8

High suspicion for malignancy

Question 9

What does category 5 mean in the BI-RADS assessment?

Answer 9

Highly suggestive of malignancy

Question 10

What does category 6 mean in the BI-RADS assessment?

Answer 10

Known biopsy proven malignancy

Question 11

What echogenicity are typically benign lesions?

Answer 11

Hyperechoic

Question 12

What echogenicity are typically benign lesions?

Answer 12

Hypoechoic

Question 13

Lesions that are wider than tall are normally, what?

Answer 13

Benign

Question 14

Lesions that are taller than wide are normally, what?

Answer 14

Malignant

Question 15

What is not a good indicator of malignancy?

Answer 15

Size

Question 16

Smooth contour of a lesions is more commonly seen in what kind of lesion?

Answer 16

Benign
- can have gentle bilobe or trilobe appearance

Question 17

Angular margins of a lesions is more commonly seen in what kind of lesion?

Answer 17

Malignant

Question 18

What are angular margins a result of?

Answer 18

Tumour invasion into and through the base of Cooper’s ligaments

Question 19

What is straightening of Cooper’s ligaments is considered a sign of?

Answer 19

Malignancy

Question 20

What does the appearance of Straightening of Cooper’s ligaments look like?

Answer 20

Moth eaten appearance

Question 21

What can microlobulations be a sign of?

Answer 21

Malignancy

Question 22

What is the highest positive predictive value for malignant characteristic?

Answer 22

Presence of spiculations

Question 23

Spiculated margins are more common who what kind of cancers?

Answer 23

Low grade

Question 24

Angular margins are more common who what kind of cancers?

Answer 24

High grade
- has superior sensitivity

Question 25

Shadowing is more common who what kind of cancers?

Answer 25

Low grade

Question 26

Enhancement is more common who what kind of cancers?

Answer 26

High grade

Question 27

Hypovascularity is typically in what kind of lesion?

Answer 27

Benign

Question 28

Hypervascularity is typically in what kind of lesion?

Answer 28

Malignant

Question 29

What is the vessel % Related To Tumour Volume in benign lesions?

Answer 29

1%

Question 30

What is the vessel % Related To Tumour Volume in malignant lesions?

Answer 30

25% - or more

Question 31

How many intratumoral vessels are in benign lesions?

Answer 31

None

Question 32

How many intratumoral vessels are in malignant lesions?

Answer 32

5 or more

Question 33

How many peripheral vessels are in benign lesions?

Answer 33

Scarce or few

Question 34

How many peripheral vessels are in malignant lesions?

Answer 34

Numerous

Question 35

How many tortuous vessels are in benign lesions?

Answer 35

Rare

Question 36

How many tortuous vessels are in malignant lesions?

Answer 36

Multiple

Question 37

How many shunts are in benign lesions?

Answer 37

None

Question 38

How many shunts are in malignant lesions?

Answer 38

Multiple

Question 39

Where do benign lesions tend to remain?

Answer 39

Within a single plane of breast tissue

Question 40

Where do malignant lesions tend to remain?

Answer 40

They often cross tissue planes

Question 41

What are 2 examples of tumour extension into the duct system?

Answer 41

1. Duct extension 2. Branch pattern

Question 42

Duct extension

Answer 42

Projections from the surface of the tumour extends into a single duct towards the nipple

Question 43

Branch pattern

Answer 43

Extension from the tumour into smaller ducts leading away from the nipple

Question 44

What does specular calcifications within a mass often suggest?

Answer 44

Malignancy - often DCIS

Question 45

What does it mean if breast calcifications are more diffuse?

Answer 45

Suggestive of being benign

Question 46

What does it mean if breast calcifications are more segmentally distributed or linearly distributed?

Answer 46

More suspicious for ductal carcinoma in situ

Question 47

What do cluster calcification mean?

Answer 47

Indeterminate

Question 48

What are 6 benign calcification examples?

Answer 48

1. Popcorn calcification 2. Milk of calcium - tea cup appearance 3. Plasma cell mastitis - large rod-like calcifications 4. Eggshell - rim calcifications 5. Suture -linear or tubular 6. Dystrophic - lava shaped, greater than 0.5mm

Question 49

What are 2 malignant calcification examples?

Answer 49

1. Fine linear/fine linear branching 2. Fine pleomorphic - less than 0.5mm

Question 50

What are 2 indeterminate calcification examples?

Answer 50

1. Amorphous - without a clearly defined shape 2. Coarse heterogenous - larger than 0.5mm

Question 51

What type of calcification is more suspicious for malignancy?

Answer 51

Microcalcifications - comapred to macrocalcifications

Question 52

What kind of lesion exhibit a degree of mobility and/or compressibility?

Answer 52

Benign

Question 53

What kind of masses often feel firm with little to no mobility?

Answer 53

Malignant

Question 54

What are 5 benign solid mass characteristics?

Answer 54

1. Absence of malignant findings 2. Uniform echogenicity (marked hyperechogenicity) 3. Ellipsoid shape 4. Fewer than 4 gentle lobulations (macolobulations) 5. Thin echogenic capsule

Question 55

What are 9 malignant solid mass characteristics?

Answer 55

1. Angular margins 2. Microlobulations 3. Marked hypoechogenicity 4. Spiculations and/or thick echogenic halo 5. Shadowing, punctate calcifications 6. Duct extension - extending towards the nipple 7. Branch pattern - extending away from the nipple 8. Taller than wide 9. Disruption of tissue planes