Cara's Mammo cards Flashcards

(79 cards)

1
Q

When I say “The calcifications don t change configuration on CC and MLO views”

A

dermal calcifications (“tattoo sign”)

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2
Q

next step for possible skin calcs

A

tangential views

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3
Q

secretory calcifications: pre or post menopause?

A

post - don t call them secretory on a premenopausal

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4
Q

if they show you an ML view of calcifications

A

think of milk of calcium/tea cupping

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5
Q

what happens with skin thickening and trabecular thickening over time?

A

improves - otherwise it s recurrent disease

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6
Q

When I say “shrinking breast,” you say

A

ILC

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7
Q

When I say “thick coopers ligaments,” you say

A

edema

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8
Q

When I say “thick fuzzy coopers ligaments - with normal skin,” you say

A

blur

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9
Q

When I say “dashes but no dots,” you say

A

Secretory Calcifications

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10
Q

When I say “cigar shaped calcifications,” you say

A

Secretory Calcifications

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11
Q

When I say “popcorn calcifications,” you say

A

degenerated fibroadenoma

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12
Q

When I say “breast within a breast,” you say

A

hamartoma

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13
Q

When I say “fat-fluid level,” you say

A

galactocele

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14
Q

When I say “rapid growing fibroadenoma,” you say

A

Phyllodes

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15
Q

When I say “swollen red breast, not responding to antibiotics,” you say

A

inflammatory breast ca

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16
Q

When I say “ lines radiating to a single point,” you say

A

Architectural distortion.

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17
Q

When I say “Architectural distortion + Calcifications,” you say

A

IDC + DCIS

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18
Q

When I say “Architectural distortion without Calcifications,” you say

A

ILC/radial scar

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19
Q

When I say “Stepladder Sign,” you say

A

lntracapsular rupture on US

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20
Q

When I say “Linguine Sign,” you say

A

lntracapsular rupture on MRI

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21
Q

When I say “Residual Calcs in the Lumpectomy Bed,” you say

A

local recurrence

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22
Q

When I say “No calcs in the core,” you say

A

milk of calcium (requires polarized light to be seen)

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23
Q

what s different about mag views

What is the cost of mag view?

A

no grid, smaller focal spot (0.1 mm), air gap

Cost of mag view is increased radiation.

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24
Q

nipple enhancement on MRI - normal?

A

yes, normal - don t call it Pagets

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25
which quadrant has most breast cancers?
upper outer (most tissue)
26
main blood supply to the breast?
(60%) is via the internal mammary
27
The sternalis muscle can only be seen on which view on Mamms
CC view
28
Most common location for ectopic breast tissue is in the
axilla
29
best time in cycle for mammogram (and MRI)
follicular phase (days 7-14)
30
Breast Tenderness is max around day
27-30.
31
most comprehensive risk model
Tyrer Cuzick (but does not include density)
32
level of chest radiation as a child that would prompt screening MRI
20 Gy
33
Are males more likely to get breast cancer if they have BRCA 1 or 2?
BRCA 2
34
If triple negative status, more likely to have BRCA 1 or 2?
BRCA 1 is more often a triple negative CA
35
Mammo: special view to help with kyphosis, pectus excavatum, and to avoid a pacemaker/line
LMO
36
which mammo calc pattern has highest suspicion for malignancy?
fine pleomorphic (branching)
37
density of surgical scars related to breast cancer recurrence
Surgical scars should get lighter, if they get denser - think about recurrent cancer.
38
can you have isolated extracapsular rupture?
nope, always with intra
39
The number one risk factor for implant rupture is
the age of the implant
40
affect of Tamoxifen on parenchymal uptake?
Tamoxifen causes a decrease in parenchymal uptake, then a rebound.
41
Breast MRI: which cancer is T2 bright?
colloid and mucinous cancer
42
axillary lymph node levels: level 1 - 3 Rotter node
Level 1: lateral to pec minor 2: beneath pec minor 3: medial to pec minor Rotter node: between pec major and minor
43
most cancers start in the
TDLU
44
should you biopsy a prepubescent breast?
no, it can affect breast development
45
peak age for breast pain/cyst formation
perimenopause - 50s
46
name the 5 high risk lesions
ADH, ALD, LCIS, Radial Scar, Papilloma
47
1. BRCA 1 chromosome 2. BRCA 2 chromosome 3. Triple negative cancers more often have which BRCA? 4. Males w/ breast cancer more often have which BRCA?
1. 17 2. 13 3. Triple negative: BRCA 1 4. Males: BRCA 2
48
4 non-BRCA syndromes associated with breast ca
Li Fraumeni, Cowden, Bannayan-Riley Ruvalcaba, NF-1
49
oldest and most validated breast cancer risk model
Gail - doesn t use genetics
50
things that increase your estrogen exposure, do what to your breast ca risk?
increase it (Early Menstruation, Late Menopause, late age of first pregnancy I or no kids, being fat, Being a Drunk, hormone Replacement (with estrogen))
51
all current risk models under or overestimate risk?
underestimate life-time risk
52
when do you start screening kids who get 20 Gy of chest radiation
age 25 or 8 years after exposure (whichever is longer)
53
what drugs reduce breast cancer incidence of ER/PR
Tamoxifen and Raloxifenc (SERMs)
54
BIRADS: multiple bilateral well circumscribed similar appearing masses
2 - don t even ultrasound, unless one is palpable
55
BIRADS: multiple foci on MRI
2 (I guess you can think of it as Background parenchymal enhancement..)
56
3 artifacts that cause calcifications on mammo
deodorant, zinc oxide, metallic fragements
57
treatment for Mondor disease?
thrombosed vein - no anticoagulation, just NSAIDS
58
most common invasive breast cancer
IDC - 80-85%
59
most common subtype of IDC
NOS - 65%
60
IDC subtypes (besides NOS, 4)
tubular, mucinous, medullary, papillary
61
1. IDC subtype associated with radial scar or spiculated mass 2. 2 IDC subtypes that present as round/oval masses 3. IDC subtype associated with complex cystic and solid mass
1. Tubular 2. mucinous and medullary 3. Papillary
62
multifocal vs. multicentric breast cancer
multifocal = multiple primaries, same quadrant; multicentric = multiple primaries different quadrants
63
which type of DCIS histology is more aggressive?
comedo type
64
when I say "shadowing without a mass on ultrasound", you say
ILC
65
Breast Pagets is associated with
high grade DCIS
66
3 patterns of gynecomastia
nodular, dendritic, diffuse glandular
67
should trans guys who get boobs from hormone therapy be screened?
no, not high enough risk
68
Breast MRI: how to tell apart normal radial folds vs. linguine sign?
radial folds - all lines connect to periphery of implant
69
timing of breast MRI kinetics
initial upslope occurs over 2 min, then washout 2-6 min-ish
70
grading breast MRI kinetics washout
continued rise (type 1), plateau (type 2), rapid washout (type 3)
71
mammo recall rate should be less than
10% (target range of 5-7%)
72
Mammo: required resolution of line pairs is
13 lp/mm in anode-cathode direction and 11 lp/mm in left-right direction
73
describe the mammo dose phantom
50% glandularity, 4.2 cm thick
74
Mammo typical patient doses
2 mGy per view - but no limits! that s just for the phantom
75
dose limit for mammo phantom
3 mGy/view
76
typical patient breast compression and glandularity
6 cm, 15-20% glandularity
77
Mammo: target range for cancers/1000 screened
3-8 people with cancer
78
Mammo: target range for PPV for biopsy recs
15-35%
79
Cowden Syndrome
breast cancer, bowel hamartoma, follicular thyroid, Lhermitte Duclos (brain hamartoma)