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Flashcards in Mammo Deck (83):
1

Level 1 axillary lymph node

lateral to pec minor

2

level 2 ax node

under pec minor

3

level 3 ax node

medial and above pec minor

4

rotter node

between pec minor and major

5

What is the best time to image breasts

follicular phase day 7-14

6

When is a LMO view obtained? 2

kyphosis/pectus excavatum or avoid pacer/line

7

How many cancer diagnoses should be made per 1000 mammos?

3-8

8

What should PPV be?

4%

9

Shape on mammo

ROI round oval irregular

10

Margin on mammo

circumscribed
obscured
microlobulated
indistinct
spiculated

11

Margin on US

circumscribed
angulated
microlobulated
indistinct
spiculated

12

5 things to describe mass on US

shape
margin
posterior features
echo pattern
orientation

13

Background parenchymal enhancement is based off of what on MRI?

1st post contrast sequence

14

What three categories are there for lesion analsysi on MRI?

foci, mass, non mass like enhancement

15

Margin on MRI

circumscribed irregular spiculated

16

What are the four internal enhancement patterns on MRI?

homogeneous
heterogeneous
rim
dark internal septation

17

What are the 7 types of non mass like enhancement on MRI?

focal
linear
linear branching
segmental
regional
multiple regional

18

clustered ring enhancement on MRI=

DCIS or IDC

19

What are the five distributions of calcifications?

segmental
linear
grouped
regional
scattered

20

cigar shaped w/ lucent center-

secretory calcs

21

calcs 10-20 years after menopause=

secretory calcs

22

massive eggshell calcs=

liponecrosis macrocystica

23

How is milk of calcium seen on biopsy?

polarized light for birefringence

24

4 ddx for amorphous calcs

fibrocystic change
sclerosing adenosis
columnar cell change
DCIS low grade

25

4 ddx coarse heterogeneous calcs

fibroadenoma
papilloma
fibrocystic change
DCIS low intermediate grade

26

4 ddx fine pleomorphic calcs

fibroadnoma
papilloma
fibrocystic change
DCIS

27

What is the puff of smoke sign in mammo

central calcs in mass

28

A ton of oil cysts=

steatocystoma multiplex

29

PASH f/u recommendation?

1 year

30

fibroadenoma characteristics on MRI?

T2 bright with type 1 enhancement

31

what IDC type is associated with radial scar?

tubular

32

What does ILC look like on US?

shadowing without a discrete mass

33

shrinking breast=

ILC

34

dark star ddx 4

lobular carcinoma, radial scar, surgical scar, IDC NOS

35

What is breast pagets associated with?

high grade DCIS

36

Radial scar is a/w what three things?

DCIS, IDC, tubular carcinoma

37

What is the most common benign cause of nipple discharge in a postmenopausal woman?

ductal ectasia

38

What is the most common benign cause of nipple discharge in a premenopausal woman?

fibrocystic change

39

AD + calcs=

IDC and DCIS

40

AD without calc=

ILC

41

normal lymph node cortical thickness?

less than 2.3-3mm

42

dense calcs in lymph node=

gold therapy

43

snow storm node=

silicone infiltration or gel bleed

44

What is diffuse glandular gynecomastia seen in?

men with estrogen therapy

45

What is the second most common palpable mass in a man?

lipoma

46

What is the most common type of male breast cancer?

IDC NOS

47

step ladder on US

intracapsular rupture

48

linguine sign on MRI

intracapsular rupture

49

What is the local recurrence rate when treated with breast conserving therapy?

6-8%

50

What is the peak time for breast cancer recurrence?

4 years

51

Without radiation, what is rate of local recurence?

35%

52

Benign calcs are seen when after treatment?

2 years (opposed to 4 for cancer recurrence)

53

red plaques/skin nodules 6 years after radiation=

secondary angiosarcoma

54

T1

<2cm

55

T2

2-5 cm

56

T3

>5cm

57

T4

skin involvement, chest wall fixation, inflammatory

PAGETS is NOT T4

58

What are the five contraindications for breast conservation?

inflammatory
large cancer size relative to breast
multicentric disease
prior radiation to same breast
contraindication to radiation treatment

59

Risk of cancer in Type 1 curve

6%

60

Risk of cancer in Type 2 curve

7-28%

61

Risk of cancer in Type 3 Curve

29%+

62

What two tumors are T2 bright?

colloid cancer or mucinous cancer

63

If patient with known breast CA, how often contralateral cancer found by mammo?

0.1-2%

64

If patient with known breast CA, how often contralateral cancer found by MRI?

3-5%

65

At what radiation dose will child later need screening MRI?

20Gy

66

At what age does child with high chest radiation get screening MRI?

age 25 or 8 years post exposure whichever is later

67

What are the four features of Cowden Syndrome?

breast CAn, follicular thyroid cancer, endometrial cancer, lhermitte duclos

68

QC localization and accuracy test performed

daily

69

What is the required resolution of line pairs?

13 in anode cathode direction, 11 in left right direction

70

What must be seen to pass image quality?

4 fibers, 3 microcalc clusters, 3 masses, acceptable artifacts

71

What are the characteristics of the dose phantom?

4.2 cm thick, 50% glandularity, 3 mGy per image

72

Typical patient phantom dose one view, two view?

2 mgy, 4 mgy

73

Typical compressed breast is how thick and what percent glandular?

6cm, 15-20%

74

processor QC

daily

75

darkroom cleanliness

daily

76

viewbox conditions

weekly

77

phantom evaluation

weekly

78

repeat analysis

quarterly

79

compression test

semi annually

80

darkroom fog

semi annually

81

screen film contrast

semi annually

82

How is flaring fixed on mri?

put pad between breast and coil

83

How is heterogeneous fat satting fixed?

shimming