Mamm

Question 1

What findings can get a BI-RADS 3? (6)

Answer 1

• noncalcified circumscribed solid mass
• focal asymmetry
• solitary grp of punctate calcifications
• typical fibroadenoma
• isolated complicated cyst
• clustered microcysts

Question 2

What is the recommendation for BI-RADS 3?

Answer 2

• unilat short term 6mo fu
• if stable, bilat 12 mo fu (from time of screening)
• if stable, another 24 mo fu (from time of screening)

Question 3

BI-RADS 3 lesion –> followed for 2 years –> stable –> then what?

Answer 3

categorized as BI-RADS 2 –> back to routine screening

Question 4

BI-RADS 3 –> likelihood of cancer (%)?

Answer 4

<2%

Question 5

BI-RADS 3 –> what category is it?

Answer 5

probably benign

Question 6

BI-RADS 4 –> what category is it?

Answer 6

suspicious

Question 7

What is the recommendation for BI-RADS 4?

Answer 7

biopsy should be considered

Question 8

BI-RADS 4 –> likelihood of cancer (%)?

Answer 8

2-95%

Question 9

what are the subcategories of BI-RADS 4? What are their % likelihood of cancer?

Answer 9

• 4A: low suspicion for malignancy (2-10%)
• 4B: mod (10-50%)
• 4C: high (50-95%)

Question 10

What findings can get a BI-RADS 4A? (3)

Answer 10

• partially circumscribed mass, suggestive of (atypical) fibroadenoma
• palpable, solitary, complex cystic and solid cyst
• probable abscess

Question 11

What findings can get a BI-RADS 4B? (3)

Answer 11

• grp amorphous or fine pleomorphic calcifications

- nondescript solid mass w indistinct margins

Question 12

What findings can get a BI-RADS 4C? (2)

Answer 12

• new grp of fine linear calcifications

- new indistinct, irregular solitary mass

Question 13

What category is BI-RADS 5?

Answer 13

highly suggestive of malignancy

Question 14

BI-RADS 5 –> % likelihood of cancer?

Answer 14

> 95%

Question 15

What findings can get a BI-RADS 5? (3)

Answer 15

• spiculated, irregular high density mass
• segmental or linear arrangement of fine linear calcifications
• irregular spiculated mass w assoc pleomorphic calcifications

Question 16

80F –> screening –> new circumscribed mass –> ddx? (3)

Answer 16

since new –> most likely malignancy:

• mucinous CA
• papillary
• medullary

Question 17

inflammatory breast cancer –> histologic pathognomonic finding?

Answer 17

dermal lymphatic invasion

Question 18

DCIS –> classic MRI pattern of enhancement?

Answer 18

clumped non-mass enhancement in ductal distribution

Question 19

fibrocystic change –> MRI pattern of enhancement?

Answer 19

diffuse stippled background enhancement

Question 20

core needle bx –> LCIS –> next step?

Answer 20

surgical excision

Question 21

male –> palpable breast mass –> most likely dx?

Answer 21

gynecomastia

Question 22

diabetic mastopathy –> classic sonographic findings

Answer 22

irreg hypoechoic mass –> marked posterior acoustic shadowing

Question 23

pseudoangiomatous stromal hyperplasia –> what is it? etiology?

Answer 23

benign stromal overgrowth derived from possible hormonal etiology

Question 24

BI-RADS 3 category lesion –> next step would be bx in what situation?

Answer 24

patient not able to comply with followup

Question 25

breast MRI --> kinetic curve enhancement pattern --> which has highest PPV for CA?

Answer 25

wash out

Question 26

ruptured implant --> MRI noncontrast or MRI with/wo?

Answer 26

noncontrast

Question 27

last 6mo of residency --> how many mammo studies needed?

Answer 27

240

Question 28

what are the 3 types of kinetic curves for breast MRI? what is their significance?

Answer 28

I persistent: benign II plateau: concerning for malig III washout: strongly suggestive of malignancy

Question 29

MQSA --> phantom testing --> how often?

Answer 29

wkly

Question 30

MQSA) requirements state that a facility must send each patient a summary of the mammography report within how many days?

Answer 30

30day

Question 31

Approximately what percentage of breast cancers occur in men?

Answer 31

1%

Question 32

invasive lobular CA --> accounts for 20% of all breast CA cases --> T/F?

Answer 32

F 10%

Question 33

invasive lobular CA --> typical US appearance --> ill-defined hypoechoic mass --> T/F?

Answer 33

T