Invasive And Other Procedures

Question 1

The most common complication of breast implants

Answer 1

Capsular contracture

Question 2

Scar tissue forms around and squeezes the implant causing firmness, discomfort and implant deformation. Found in 4 grades of severity

Answer 2

Capsular contracture

Question 3

Surgery that uses the patient’s own muscular and subcutaneous tissue to reconstruct the breast is called:

Answer 3

Autogenous myocutaneous flap surgery

Question 4

MRI without contrast is the best tool for investigating implant integrity

Answer 4

True

Question 5

Most common reason for performing FNA

Answer 5

To provide material for cytological interpretation

Question 6

Fewer lymph nodes are removed during the sentinel node procedure when compared with the traditional axillary lymph node dissection

Answer 6

True

Question 7

Normal variant confused with implant rupture

Answer 7

Radial fold

Question 8

What mass characteristics evident during mammo are we trying to identify and correlate with ultrasound?

Answer 8

Shape, margin and density

Question 9

The position of subpectoral breast implants is:

Answer 9

Posterior to the pectoralis major muscle and anterior to the pectoralis minor muscle.

Question 10

The presence of a filling defect within the duct during ductography may be consistent with:

Answer 10

Papilloma, intraductal carcinoma or air bubble

Question 11

The performance of cyst aspiration is usually reserved for:

Answer 11

Atypical or complex cysts as well as symptomatic cysts.

Question 12

A compression paddle is used typically to assist in the breast localization procedure

Answer 12

True

Question 13

FDA approved for women 18 and older.
Made with silicone outer shell, filled with saline
Less expensive
Less popular due to less natural feel
Rupture quickly detectable

Answer 13

Saline implants

Question 14

FDA approved for women 22 and older
Silicone outer shell and filled with silicone gel
More expensive
More natural feel
Available on single or double lumen

Answer 14

Silicone (round) implants

Question 15

Most popular type of implant

Answer 15

Single lumen silicone

Question 16

Biggest advantage of an open surgical biopsy as compared to core biopsy methods

Answer 16

Complete removal of most breast lesions

Question 17

Ductography is contraindicated in patients with:

Answer 17

Breast abscess

Question 18

Which procedures are considered mammotomies?

Answer 18

Mammotome, MIBB and ABBI

Question 19

What structure is responsible for the stepladder sign?

Answer 19

The shell of a silicone implant

Question 20

Incisional biopsy may be performed in which situation?

Answer 20

For extremely large lesions

Question 21

The stepladder sign on ultrasound imaging is analogous to which sign on MRI

Answer 21

Linguini sign

Question 22

The appearance of free silicone within a lymph node is consistent with a diagnosis of

Answer 22

Extracapsular rupture

Question 23

Why is needle wire localization preferred over skin localization method?

Answer 23

Skin localization often results in more tissue removal than necessary

Question 24

Which procedure provides the pathologist with the largest tissue sample?

Answer 24

Advanced Breast Biopsy Instrumentation (ABBI)

Question 25

Size of the needle typically used for FNA?

Answer 25

22-25 gauge

Question 26

Normal, intact breast implant characteristics

Answer 26

Radial folds, echo free interior, trilaminar line

Question 27

Procedure performed on patients with single duct discharge and a normal mammo

Answer 27

Ductography/galactography

Question 28

Branch of biology dealing with the structure, function, multiplication, pathology and life history of cells

Answer 28

Cytology

Question 29

During a needle localization procedure using an ultrasound approach, deep lesions are best:

Answer 29

Approached at an angle parallel to the chest wall

Question 30

Most likely sonographic appearance of capsular contracture

Answer 30

A rounded implant that lacks compressibility

Question 31

Following lumpectomy, approximately what percentage of patients develop seromas?

Answer 31

50%

Question 32

On the CC view of a mammo, markers should be placed:

Answer 32

Lateral outer aspect of the breast

Question 33

The purpose of sentinel node mapping is______

Answer 33

To locate the first lymph node in the chain through which the breast drains

Question 34

Breast abscesses are usually found in the:

Answer 34

Retroareolar region

Question 35

What is MULD

Answer 35

Medial Up lateral Down In reference to mammographic views

Question 36

Most common indication for galactography

Answer 36

Single duct discharge and normal mammo

Question 37

When would incisional biopsy be useful?

Answer 37

If the lesion is large and poorly defined

Question 38

Most accurate for intraoperative breast specimen imaging

Answer 38

Specimen mammography and ultrasound

Question 39

Following radiation therapy, a patient may demonstrate ________ for up to 2 years

Answer 39

Skin thickening

Question 40

Axillary lymph node dissection procedure typically removes _________

Answer 40

10-15 lymph nodes

Question 41

A lesion visualized on ultrasound will appear closer to the chest wall than the same lesion found on mammo

Answer 41

True

Question 42

The delivery of treatment prior to surgery in order to shrink the cancer

Answer 42

Neoadjuvant therapy

Question 43

Breast abscess drainage is most successful when the abscess is:

Answer 43

Less than 2.5cm

Question 44

Which region of the breast is the most poorly demonstrated on the MLO mammo projection?

Answer 44

Inferomedial

Question 45

Excessive bleeding Hematoma Infection Pneumothorax Vasovagal reaction No diagnosis due to insufficient or inappropriate samples

Answer 45

Possible post biopsy complications

Question 46

Why is it important to perform routine intraoperative specimen imaging for breast-conserving surgery?

Answer 46

To determine if adequate tumor free margins surround the specimen

Question 47

Preffered biopsy method when there are suspicious calcifications identified on mammo

Answer 47

Stereotactic vacuum assisted biopsy

Question 48

Using the mammographic technique, needle/wire breast localization may be combined with dye injection

Answer 48

True

Question 49

Imaging performed with air injected into the cyst to provide therapeutic benefit or reduced cyst recurrence is called:

Answer 49

Pneumocystography

Question 50

Lymphatic drainage to the intramammary lymph nodes rather than axilla Prior radiation therapy or breast/axillary surgery Enlarged axillary lymph nodes Mets to their axillary lymph nodes Previous mastectomy Large tumors (>5cm) Primary tumor cannot be identified Multicentric breast tumors

Answer 50

Contraindications of the sentinel lymph node biopsy procedure

Question 51

Patients who present with greenish nipple discharge often have:

Answer 51

Fibrocystic disease

Question 52

46 y/o patient with breast implants presents with suspected breast carcinoma. The best diagnostic modality to image this would be:

Answer 52

Contrast enhanced MRI

Question 53

The snowstorm sign is also referred to as

Answer 53

Echogenic noise