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18 Cards in this Set
- Front
- Back
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Mammo findings that are properly followed at 6 months
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-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 |
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Mammo shows bilateral axillary lymphadenopathy. Ddx?
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Lymphoma
Leukemia Lupus Sarcoid RA |
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How do you manage a filling defect on ductogram or a mass in a cyst wall (give ddx on this)?
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Surgical removal.
In cyst w/ mass, DON'T try needle (lose mass w/o cyst fluid as bckground). Ddx: Papilloma Papillary carcinoma Blood clot |
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Indication for ductogram
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Unilateral spontaneous discharge which is clear, bloody, or brown.
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How do you do a ductogram?
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0.1-0.3cc Optiray injected into duct with blunt 31g needle.
Get CC and 90deg ML views. |
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Differential for
mammo finding: SPICULATED MASS |
* Cancer
* Radial Scar, Biopsy Scar * Fat necrosis, Sclerosing adenosis * Abscess, Hematoma * desmoid, granular cell tumor |
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Findings seen in implant rupture
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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. |
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The "classically" benign types of mammographic calcifications
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"popcorn"
secretory Skin calcs Milk of calcium Adenosis - rosettes |
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Breast lesion which shows shadowing on ultrasound. Ddx?
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Fibroadenoma
Granular cell tumor - Radial scar Surgical scar - Fibrosis Fat necrosis Sclerosing adenosis - Diabetic mastopachy Normal breast tissue |
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Mammographic finding: well circumscribed mass. Which ones do you leave alone?
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Intramammary LN
Fibroadenoma with typical calcs Lipoma Hamartoma |
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Mammographic finding: well circumscribed mass. Which ones are "low" prob for cancer?
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simple cyst - done
complex cyst - MUST aspirate (medullary carcinoma often looks cystic) solid mass |
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Unilateral inflammatory changes in breast (skin thickening, prominent trabecular markings). Management?
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Rule out RTX, trauma, lymphatic obstruction.
Tx with abx for 2 weeks. Mastitis will resolve, inflammatory breast CA won't. |
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Breast lesion with fat in it
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hamartoma
lipoma galactocele oil cyst |
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Breast mass with MACROlobulation
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Phylloides
Fibroadenoma Cyst LN |
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Breast mass with ring-like peripheral calcium
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Fibroadenoma
Calcified cyst Oil cyst Fat necrosis |
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Non-mass like enhancement on breast MRI
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Clumped - DCIS, carcinoma, seroma (post-bx)
especially if segmental distr Reticular/Dendritic - involution, inflammatory CA |
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Appearance of post-op seroma on MR
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low on T1, with clumped enhancement extending to nipple
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Ddx for unilateral prominence of trabeculae
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Mastitis
Inflammatory CA axillary mass RTX |
