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32 Cards in this Set
- Front
- Back
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diagnostic methods in mammology - history
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• A.Salmon 1913: X-ray detection of the calcification
• Kleinschmidt 1927 – 1st MG • R.Blaha 1937 – X-ray differentiation of the benign and ca lesions of the breast |
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in what time did genetic examination start
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1980-90
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% of breast cancer that is
1) non-genetic 2) hereditary |
1) 90%
2) 10% |
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risk of ca mammae whan having BRCA1 or BRCA 2
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85%
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risk of ca mammae in normal population
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10%
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2 most common genes related to ca mammae
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• BRCA1 – 52% (families)
• BRCA2 – 32% (families) |
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cancers related to BCRA1
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• Breast cancer 85%
• Meta deposits 60% • Ovarian ca 60% • Colorectal ca 4% • Prostate ca 3% |
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cancers related to BCRA2
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• Breast ca 85%
• Meta deposits 60% • Overian ca 20% • Gall bladder ca RR 5 • Ca pancreas RR 3,5 • Ca gastric RR 2,5 • Ca prostate RR 4,5 • Colorectal Ca RR 4 • Male breat ca 6% |
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Syndromes related to risk of ca mamma
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- LiFraumeni sy
- Ataxia telangiectatica - Peutz-Jeghers - Cowden sy - Lynch sy |
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tumor markers - female
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CA125, CEA, CA 15-3
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tumor markers - male
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CEA, CA 19-9, PSA
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invasive diagnostic methods
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• Fine-needle cytology (routine examination)
• Core cut biopsy • Vakuum biopsy • Peroperative x-ray control • Peroperative biopsy • SNB – frozen section (at least one LN from axilla → differ between real metastasis and micrometastasis) o Axillary section → take the 2 first of the 3 levels of LN |
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highers incidence of breats cancer at age
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45, and increasing until 65
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Screening mammography (SMG)
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• For asymptomatic women 45-75 years
• Every 24 months • Event. + US • In czech republic only 50% regularly scanned • Target: get the preinvasive forms of the tumor within the 1st stage of the disease |
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2 views used in mammography
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o mediolateral
o craniocaudal |
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TABAR classification (5 stages) of mammogram
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1. middle-dense, fibrogranular
2. lipid involusion (absolutely wo/mammary gland) 3. low dense, residual gland 4. dense breast (difficult to diagnose cancer) 5. high density breast (even more difficult to diagnose ca) ---------- I : balanced proportion of all components of breast tissue with a slight predominance of fibrous tissue II : predominance of fat tissue (fat breast) III : predominance of fat tissue with retroareolar residual fibrous tissue IV : predominantly nodular densities V : predominantly fibrous tissue (dense breast) |
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mammogram is used for
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both breast and axilla
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most common benign lesion
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fibroadenoma
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treatment of fibroadenoma
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do not operate if it is not too painful for the patient → it often comes back after 1-2 years
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benign lesions seen on mammography
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- fibroadenoma
- benign micorcalcification - fibroadenolipoma - lipoma - cysts |
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LN MG
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• Meta deposits
• Primary lymphoma • Inflammation |
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Types of biopsies
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• Fine-needle biopsy (FNB)
• Core-cut biopsie (CCB) |
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important receptors
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Estrogen, progesteron & HER2
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use of MRI
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• used for multifocal ILC (cancer)
• plastic surgery implants - dislocation |
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precancerosis MG
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- atypical ductal hyperplasia
- atypical lobar hyperplasia - cystosarcoma phyloides - giant fibroadenoma |
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"safe edges"
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2mm from edges of tumor
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CA125
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- ovarian cancer
- endometrial cancer - fallopian tube cancer - lung cancer, breast cancer - gastrointestinal cancer - endometriosis |
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CEA (Carcinoembryonic antigen)
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- colorectal carcinoma
- gastric carcinoma - pancreatic carcinoma - lung carcinoma - breast carcinoma - medullary thyroid carcinoma |
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CA 15-3
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invasive breast cancer
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CA 19-9
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- pancreatic cancer (!!!)
- colon cancer - hepatocellular carcinoma - gallstones, cirrhosis, pancreatitis, and cholecystitis |
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PSA
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- prostate spesific antigen
- may indicate prostate cancer, prostatitis, enlarged prostate |
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classifications for parenchymal patterns in breast imaging
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1) Wolfe: four parenchymal patterns (N1, P1, P2 and DY) according to the distribution of fat and the prominence of the ducts
2) Boyds: based on mammographic density percentage given by radiologists and divided into six categories of unequal intervals 3) Tabar: based on an histologic-mammographic correlation with a three-dimensional, subgross (thick-slice) technique, and on the relative proportion of four “building blocks” (nodular denisties, linear densities, homogeneous fibrous tissue, radiolucent fat tissue) |
