Lecture 81 Flashcards

1
Q

4 modalities used to dx BC?

A

Clinical breast exam
Mammography
Breast Ultrasound
Breast MRI

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2
Q

only screening method that has decreased mortality?

A

mammography

Mortality from breast cancer is decreased by 20-40% in women who are screened

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3
Q

at what age do screening mammographies begin?

for whom are there exceptions, and what are they?

A

asymptomatic 40 yo women

If family history in first degree relative - Begin 5-10 years prior to age of first degree relative (not before age 25)

If personal or family history of BRCA 1 or BRCA 2 gene mutations

After chest radiation for lymphoma for example- Begin 8 years after treatment (not before age 25)

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4
Q

what are the two views of the standard screening mammography?

A

Medio-lateral Oblique (MLO)

Craniocaudal (CC)

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5
Q

a 30 yo patient presents with a breast lump, how should you proceed with diagnostics?

A

30yo = Diagnostic mammography + Ultrasound if indicated

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6
Q

what is the classic mammographic appearance of invasive ductal carcinoma ?

DCIS?

A

Spiculated mass

DCIS: Pleomorphic microcalcifications

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7
Q

what special imaging method is best for dense breast tissue?

A

Tomosynthesis

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8
Q

Limitations of mammography sensitivity ?

what is the sensitivity of mammography for breast cancer?

A

Sensitivity = 40 to 80%

dense breast

Some cancers are occult

Poor quality interpretation

Poor quality of the mammography

lack of comparison studies

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9
Q

Indications for breast ultrasound

first line study for whom?

A

first line :

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10
Q

Indications for breast MRI

A

Screening of high risk patients/Diagnostic exam

Newly diagnosed or history of breast cancer – evaluating for extent of disease

Breast implant rupture

Axillary metastatic adenopathy of unknown primary

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11
Q

who should be screened with Breast MRI?

A

BRCA 1 or BRCA 2 gene mutation carrier

1st degree relative with BRCA 1 or BRCA 2 – even if patient has not been tested

History of radiation to the chest between ages 10-30

Certain syndromes – Cowden, Li-Fraumeni

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12
Q

what is the most sensitivity test for breast cancer identification?

A

MRI

but this is never the first line exam

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13
Q

Indications for breast MRI

A

Screening of high risk patients/

Diagnostic exam

Newly diagnosed or history of breast cancer – evaluating for extent of disease

Breast implant rupture

Axillary metastatic adenopathy of unknown primary

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14
Q

who should be high risk patients and therefore what exam should they get ?

A

Breast MRI — after mammography and US

BRCA 1 or BRCA 2 gene mutation carrier

1st degree relative with BRCA 1 or BRCA 2 – even if patient has not been tested

History of radiation to the chest between ages 10-30

Certain syndromes – Cowden, Li-Fraumeni

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15
Q

if a lesion is visible only on mammography but no US what type of interventional bx is obtained?

A

Stereotactic bx

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