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37 Cards in this Set
- Front
- Back
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Well-defined mass
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cyst, FA, CA, lymphoma, met, lymph node, papilloma, fibrosis, phyllodes tumor, skin lesion, PASH
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Ill-defined mass
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CA, abscess, hematoma, post-op scar, radial scar, fat necrosis
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Spiculated mass
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CA, fat necrosis, scar, radial scar
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Multiple circumscribed masses
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cysts, FA, lymph nodes, mets, papillomas
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Multiple ill-defined masses
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multifocal or multicentric CA or mets
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Metastasis
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melanoma, sarcomas, lymphoma, lung, GI, other breast
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Giant solid masses
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hamartoma, phyllodes tumor, giant FA, abscess
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High-density
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HRT, inflammatory CA, XRT, mastitis, CHF, obstruction to lymphatic or venous drainage, lactation, weight loss, trauma, estrogen-secreting tumor
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Decreased density
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age, weight gain, tamoxifen
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Fat-containing
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oil cyst, lipoma, galactocele, hamartoma, lymph node, fat necrosis
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Benign calcifications
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skin, vascular, coarse or popcorn-like, secretory, round, lucent-centered, eggshell or rim, milk of calcium, suture, dystrophic
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Malignant calcifications
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pleomorphic, fine linear, branching; distribution – clustered, segmental
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Clustered punctate irregular calcs
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ADH, well-differentiated DCIS, hyperplasia, sclerosing adenosis, FA, early vascular calcs, multiple papillomas, fat necrosis, artifact
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Architectural distortion
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CA, fat necrosis, scar, radial scar
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Nipple retraction
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acquired with age, congenital, tumor, inflammatory
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Trabecular thickening
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edema, lymphatic obstruction, SVC obstruction, mastitis, inflammatory CA, postlumpectomy or postradiation changes, trauma
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Diffuse skin thickening
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edema, lymphatic obstruction, SVC obstruction, diffuse mastitis, inflammatory CA, postsurgical or postradiation changes
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Focal skin thickening
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CA, skin lesions, mastitis, prior trauma or biopsy, fat necrosis, Mondor’s disease
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Skin lesions
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sebaceous cyst, seborrheic keratosis, keloids, NF
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Axillary adenopathy
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CA, lymphoma, leukemia, sarcoid, CVD, inflammation, infection, mets, HIV
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Nodal calcifications
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mets (most common), lymphoma, RA with prior gold injections
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Dense soft tissue calcifications
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silicone granulomas, scleroderma, herbal duct treatment, radiation implant therapy
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Benign on US
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hyperechoic, wider than tall, gentle bilobed or trilobed, thin echogenic pseudocapsule
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Malignant on US
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marked hypoechogenicity, spiculation, angular margins, taller than wide, shadowing, microlobulation, calcifications, branch pattern, duct extension
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Implants
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types – saline or silicone, single or double lumen; location – subglandular or subpectoral; rupture – intracapsular or extracapsular
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Nipple discharge
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papilloma (#1), duct ectasia, intraductal CA, papillomatosis, fibrocystic changes
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Tubular density
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dilated duct, Mondor’s disease
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Male breast enlargement
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gynecomastia (#1), abscess, lipoma, sebaceous cyst, CA
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Gynecomastia
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chronic liver disease, drugs (estrogen, cimetidine, spironolactone, reserpine, marijuana, digitalis, colchicine, HIV meds), tumor (testicular, adrenal, pituitary)
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Stereotactic core biopsy
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compression > 3cm, must see calcs, not too superficial or deep, pt must tolerate lying prone
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Excisional biopsy
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ADH, radial scar, cyst with colid component, possible phylloides or papillary lesion with atypical features, noninvasive CA, incongruency between rad and path
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Neoadjuvant chemotherapy
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>2cm mass or area of calcs, inflammatory CA, axillary nodal mets or distant mets
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MRI
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implant rupture, dense breasts, known multicentric lesions, search for occult primary, assess response to chemotherapy; CA enhances rapidly
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Breast CA risk factors
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age (#1), family hx (1st degree relative) or personal hx (1%/yr for 2nd breast CA), ADH (15%), LCIS (30%), XRT, BRCA gene carrier, early menarche, late menopause, nulliparity, age at 1st pregnancy >30
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Mammo views
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MLO, CC, 90 degree lateral, spot compression, magnification, XCCL, FB, CV, TAN, rolled view, LMO, ID
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Triangulation
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MLO to 90 degree lateral – medial up, lateral down; line up ML, MLO, CC using nipple as horizontal reference point and draw line through lesion
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BI-RADS 3
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cluster of tiny round or oval calcs; noncalcified solid nonpalpable mass with round oval or gently lobular contour and circumscribed margins; nonpalpable focal asymmetric density; miscellaneous focal findings including single dilated duct without associated spontaneous nipple discharge and subtle area of architectural distortion at known biopsy site; multiple similar lesions (either tiny calcs or circumscribed masses) randomly distributed in both breasts
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