Breast Imaging Flashcards
(29 cards)
Where do the majority of breast cancers occur?
Outer upper quadrant; this is because there is increased fibroglandular tissue there
Is there a link between breast density and breast cancer?
Yes, those with a high breast density are more likely to get breast cancer
Describe the triple assessment?
Clinical
Radiology; MGM and USS
Path; image guided core biopsy
What pathologies is mammogram highly specific for?
DCIS
Invasive cancer
What can cause calcification within the breast?
Duct ectasia; benign
DCIS; malignant
What is the benefit of contrast enhanced spectral MGM?
Identified contrast enhancement in breast after IV injection of iodinated contrast
Removes breast density and only shows tumour that takes up contrast
What are the indications for an ultrasound?
Palpable lump Work up of MGM detected lesion Image guided biopsy Breast inflammation Breast problems during pregnancy
Is USS good for detecting DCIS?
No; but VERY good for detecting invasive cancer
What is elastography?
Measures stiffness of tissue
Why is elastography helpful in breast cancer?
Invasive cancers are stiff
Benign lesions are mobile
Why are invasive cancers stiff?
Disorganised collagen in stroma
Disorganisation and stiffness of carcinoma is prognostic
Why are lobular carcinomas difficult to detect from mammogram?
Lack of E-cadherin adhesion molecule and therefore instead of forming a solid, single mass they will diffusely spread throughout the lobules
What is the most sensitive imaging modality for detection of breast ca?
MRI
When should MRI be used in the work of of breast cancer?
Unsure of the size of tumour Lobular cancer Cancer that doesn't show up on MGM Discrepancy from USS sizing and clinical examination Paget's disease of nipple Implant integrity Screening in v high risk women Positive axillary node with normal MGM and USS
What are the methods for biopsy of breast ca?
Core biopsy
Vacuum
What is a stereotactic biopsy?
Mammogram directed biopsy
Do papillomas and radial scars need to be removed?
Yes; have malignant potential
In terms of age, describe the commonest causes of breast lump
<30 = fibroadenoma 30-50 = cyst >50 = cancer
What is the best imaging modality for a breast mass?
US
Can tell you if cystic or solid
Stiffness
If under 40; only use mammogram if you suspect cancer
On mammogram, what is a buzzword for a carcinoma?
Spiculate/ stellate mass
How are abnormal axillary nodes detected on USS?
Cortical thickness and shape
Describe the staging process for breast cancer
If operable; only local staging needed
Locally advanced or recurrence; use CT chest, abdo, pelvis to look for mets
Where will breast cancer metastasize to?
Bone Lung Pleura Liver Brain
What indicates worrying nipple discharge?
Unilateral single duct
