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18 Cards in this Set

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Mammo findings that are properly followed at 6 months
-Cluster of calcs if MAG views show they are all round or oval

-Solid NON-palpable mass without calcs which is _round or oval, and has smooth or gently lobulated margins_

- NONpalpable focal asymmetry seen on two views and has concave margins or fat within the lesion

- Odd focal findings
eg. single dilated duct ; architectural distortion @ known bx site w/o dense central mass

- Multiple similar lesions of intermed suspicion
Mammo shows bilateral axillary lymphadenopathy. Ddx?
Lymphoma
Leukemia
Lupus
Sarcoid
RA
How do you manage a filling defect on ductogram or a mass in a cyst wall (give ddx on this)?
Surgical removal.
In cyst w/ mass, DON'T try needle (lose mass w/o cyst fluid as bckground).

Ddx: Papilloma
Papillary carcinoma
Blood clot
Indication for ductogram
Unilateral spontaneous discharge which is clear, bloody, or brown.
How do you do a ductogram?
0.1-0.3cc Optiray injected into duct with blunt 31g needle.

Get CC and 90deg ML views.
Differential for

mammo finding:

SPICULATED MASS
* Cancer
* Radial Scar, Biopsy Scar
* Fat necrosis, Sclerosing adenosis
* Abscess, Hematoma

* desmoid, granular cell tumor
Findings seen in implant rupture
Saline - implant collapses

Silicone-
1) intracapsular - US shows "stepladder", MRI shows "linguine sign"
2) extracapsular - high density on mammo if gel in tissue. Gel seen in LNs. U/S - snowstorm appearance.
The "classically" benign types of mammographic calcifications
"popcorn"
secretory
Skin calcs
Milk of calcium
Adenosis - rosettes
Breast lesion which shows shadowing on ultrasound. Ddx?
Fibroadenoma
Granular cell tumor
-
Radial scar
Surgical scar
-
Fibrosis
Fat necrosis
Sclerosing adenosis
-
Diabetic mastopachy
Normal breast tissue
Mammographic finding: well circumscribed mass. Which ones do you leave alone?
Intramammary LN
Fibroadenoma with typical calcs
Lipoma
Hamartoma
Mammographic finding: well circumscribed mass. Which ones are "low" prob for cancer?
simple cyst - done
complex cyst - MUST aspirate (medullary carcinoma often looks cystic)
solid mass
Unilateral inflammatory changes in breast (skin thickening, prominent trabecular markings). Management?
Rule out RTX, trauma, lymphatic obstruction.

Tx with abx for 2 weeks. Mastitis will resolve, inflammatory breast CA won't.
Breast lesion with fat in it
hamartoma
lipoma
galactocele
oil cyst
Breast mass with MACROlobulation
Phylloides
Fibroadenoma
Cyst
LN
Breast mass with ring-like peripheral calcium
Fibroadenoma
Calcified cyst
Oil cyst
Fat necrosis
Non-mass like enhancement on breast MRI
Clumped - DCIS, carcinoma, seroma (post-bx)
especially if segmental distr

Reticular/Dendritic - involution, inflammatory CA
Appearance of post-op seroma on MR
low on T1, with clumped enhancement extending to nipple
Ddx for unilateral prominence of trabeculae
Mastitis
Inflammatory CA
axillary mass
RTX