CORE Breast

Question 1

when to use US

Answer 1

when a felt lump not seen on mammogram

Question 2

MRi indications include

Answer 2

high risk patients
evaluation of diangosed diseased
chemo response
residual disease
recurrene

occult breast cancer with axillary mets
assessment of breast implants

Question 3

what is the pathogenesis pathway of breast cancer

Answer 3

Normal

Flat epithelial atypia

atypical ductal hyperplasia

DCIS

IDC

Question 4

what is upstaging

Answer 4

cancer i supstaged after excision

an increase from the core biospy

Question 5

what does BRCA1 / BRCA2 mutation cause

Answer 5

increase lifetime risk of breast cancer

80% by 80

Question 6

other risk factors for breast cancner

Answer 6

age, female

1st degree relative
prior chest radiatin
long term estrogen exposure

Question 7

most common subtype of breast cancer is

Answer 7

IDC

Question 8

IDC apperance

Answer 8

felt lump

irregular mass spiculated margins and ax pleomorphic clacifications

Question 9

what are the other types of breast cancer

Answer 9

Tubular

Mucinous

Medullary

encapsulated papillary / solid papillary

adenoid cystic carcinoma

Question 10

mucinous carcinom more common

Answer 10

in old women

Question 11

Medullary carcinoma is found in

Answer 11

younger women with BRCA1 gene mutation

Question 12

Appearanc3e of an encapuslated papillary carcinoma

Answer 12

discharge.
round oval mass.
circumscrbied margins.

US complex cystic solid mass.

Question 13

inflammatroy carcinoma will appear as

Answer 13

skin distortion
edema

mammo - large, dense, trabecular thickening.

Question 14

what is pagets disease of the nipple

Answer 14

DCIS that infiltrates the nipple epidermis

erythema of the nipple

Question 15

non metastatic disease most important prognostic factor

Answer 15

axillary lymph nodes

Question 16

when to do lymph node dissection vs sentinal biopsy

Answer 16

dissection is done if sentinel lymph node is positive

or not identified

Question 17

is Er and Pr a good thing

Answer 17

Yes

longer survival

Question 18

if have HER2 what can you give

Answer 18

trastuzamab - herceptin

Tk inhibitor like lapatinib

Question 19

triple negative is

Answer 19

bad

common with BRCA1 mutation

Question 20

What does BIRADS 0 mean

Answer 20

more imaging required

only used in screening

Question 21

BIRADS 1

Answer 21

normal

Question 22

BIRADS 2

Answer 22

definitely benign

vacsular, bening calc
simple breast csts, inflammatory lymph nodes

Question 23

BIRADS 3

Answer 23

probably benign. Leave no stone untunred to diagnose this

therefore, not used in screening#

circumnscribed solid mass
focal asymmetry
single group punctate calcifications

Question 24

BRIADS 3 f/ u

Answer 24

6 , 12, 24 months

Question 25

BIRADS 4

Answer 25

suspicious biopsy needed 4A-C

Question 26

BIRADS 5

Answer 26

highly likely cancer

Question 27

BIRADS 6

Answer 27

known cancer

Question 28

nipple should be in profile view....

Answer 28

in at least one view

Question 29

what type of breasts have increased risk of cancer

Answer 29

fibroglandular

Question 30

asymmetry vs mass

Answer 30

mass is two views asymmetry is only 1 view

Question 31

margins lexicon

Answer 31

circumscribed microlobulated obscured indistinct sapiculated

Question 32

density lexicon

Answer 32

fat containing low density equal density high density

Question 33

shape lexicon

Answer 33

round oval irregular

Question 34

inversion vs retration of nipple

Answer 34

inversion may be congenital and not necessarily a sign of malignancy

Question 35

causes of trabecular thickening

Answer 35

edema radiation therapy

Question 36

popcorn calc

Answer 36

hyalinising fibroadenoma

Question 37

milk of calcium exists in

Answer 37

CYSTS

Question 38

ROUND CALC ISA

Answer 38

BENIGN

Question 39

RIM calc is from

Answer 39

calc on a sphere. egg shell / lucent centred fat necrosis or a cyst

Question 40

what to do with amorphous calc?

Answer 40

grouped, reginonal or segmental distribution are needing a biopsy as more concerniing otherwise its a benig nfeature

Question 41

coarse heterogenous calc

Answer 41

biopsy as may be malignant

Question 42

pleomorphic has what apperaance

Answer 42

dot and dashes

Question 43

pleomorphic often seen in

Answer 43

DCIS or IDC biopsy needed

Question 44

fine linear

Answer 44

highly concerning birads 5. filling of ducts

Question 45

differential for architectural distoriton

Answer 45

invasive malignancy complex sclerosing lesions/radial scar post-biospy scar fibrocystic change like sclerosing adneitis.

Question 46

all palpable masses are given

Answer 46

US

Question 47

breast fat vs other fat

Answer 47

hypoechoic lipoma, fat necrosis, lymph node hilum: there are hyperechoic

Question 48

small calc better seen on MRI or mammo

Answer 48

mammo

Question 49

breast MRI which sequences are important

Answer 49

both breast at same time pre and post contrast with kinetic acquisitions

Question 50

multicentric cancer results in

Answer 50

mastectomy

Question 51

MRI can be used for what kind of breast implants

Answer 51

silicone saline implants are done by examinaton, mamo and US

Question 52

MRi bunch of grapes on NME internal enhancement pattern

Answer 52

DCIS

Question 53

oil cyst vs lipoma

Answer 53

oil cyst has peripheral calc

Question 54

dark internal septations on MRi are specific for

Answer 54

fibroadenoma