What are major risk factors for breast cancer?
1. Personal history of ovarian or breast cancer
2. BRCA1/2 mutation
3. First degree relative with breast cancer
4. Biopsy with atypical ductal hyperplasia
What types of patients should undergo MR screening for breast cancer?
Lifetime risk of breast cancer greater than 20%
What is the appropriate next imaging test for patients with negative mammograms yet a clinically evident mass?
Which mammographic view depicts the greatest amount of breast tissue?
What are the landmarks one should look for on an MLO view to ensure adequacy?
1. Pectoral muscle should be seen to the level of nipple line
2. Inframammary fold should be seen to ensure that inferior portion of breast is seen
What are the landmarks one should look for on a CC view to ensure adequacy?
1. Pectoralis muscle seen centrally (posteriorly)
2. Nipple is in profile
What are the classic radiographic signs of malignancy?
1. Spiculated mass
2. Pleomorphic calcifications
What mammographic view can you obtain if you believe that a lesion is on the skin?
What are features that can help you to distinguish a mass from an asymmetry?
1. Convex borders
2. Denser towards the center
What is the differential diagnosis for a spiculated mass besides breast carcinoma?
Complex sclerosing lesion (doesn't need history of biopsy)
Post-partum woman with palpable lump
Galactocele with fat fluid level
Radial scar (spiculated with central lucency, no mass like lesion in center)
Hypoechoic mass with tail
How can elastography be used to distinguish between benign and malignant masses?
Malignant masses are harder/more firm - less strain compared with benign masses
What is the definition of a circumscribed mass?
At least 75% of the margin is well defined
Remainder should not be irregular, microlobulated or spiculated
What are the most common locations for skin (dermal calcifications)?
What is the definition of a cluster of microcalcifications?
> 5 calcifications
Less than 1 cc/cm of volume
Breast radiology review