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15 Cards in this Set
- Front
- Back
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What are the current recommendations for breast cancer screening from the ACS?
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Baseline mammogram at age 40: annually after 40. No fixed end point; based on health of patient.
Clinical Breast Exam (CBE): age 20 - every 3 years, age 40 - annually. Self Breast Exam: monthly after age 20 |
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What are high risk patients and what kind of screening do they get?
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>20% lifetime risk (BRCA mutation or strong family history)
Recommend MRI + mammogram annually |
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How does mammography change with age?
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Decreasing limitations
Increasing effectiveness |
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What coding is used for mammograms?
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BI-RADS
Breast imaging reporting and data system Higher number = worse |
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What is US used for?
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Targeted evaluation of a mass on mammogram or palpable lump
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What 2 views are used for mammography?
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CC: cranial caudal
MLO: medial-lateral oblique |
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What happens after calcifications or mass/asymmetric densities?
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Calcification - spot magnification
Mass or asymmetric density - spot compression |
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What do malignant calcifications look like?
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Pleomorphic
Fine Linear Branching Clustered Linear (ductal) distribution |
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What do benign calcifications look like?
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Vascular
Lucent center Eggshell or rim calcification Coarse Large, rod-like Milk of calcium Diffuse |
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What does milk of calcium look like from different views?
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Appears smudgy on CC, but layers out on MLO
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What characteristics of masses indicate that they're benign?
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Mammogram:
Circumscribed margins Round Oval Low density Ultrasound: Oval Anechoic (black) Posterior enhancement |
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What characteristics of masses indicate they they're malignant?
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Mammogram:
Spiculated margins Irregular Microlobulated High density Ultrasound: Hypoechoic (gray) Posterior shaddowing Taller than wide |
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Explain posterior acoustic changes on ultrasound.
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Fluid-filled cysts have good transmission of sound, so the area behind the cyst is brighter.
Solid lesions absorb or deflect sound, so the area behind the solid lesion is darker. |
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What technique is used to evaluation integrity of implants?
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MRI
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Recommendations for breast MRI
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Screening high risk patients
Dense breast tissue Evaluate extent of disease in a patient with known cancer/contralateral breast Evaluate implant integrity |
