Breast review

  1. 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
  2. What types of patients should undergo MR screening for breast cancer?
    Lifetime risk of breast cancer greater than 20%
  3. What is the appropriate next imaging test for patients with negative mammograms yet a clinically evident mass?
  4. Which mammographic view depicts the greatest amount of breast tissue?
    MLO view
  5. 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
  6. 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
  7. What are the classic radiographic signs of malignancy?
    1. Spiculated mass

    2. Pleomorphic calcifications
  8. What mammographic view can you obtain if you believe that a lesion is on the skin?
    Tangential view
  9. What are features that can help you to distinguish a mass from an asymmetry?

    • 1. Convex borders
    • 2. Denser towards the center
  10. What is the differential diagnosis for a spiculated mass besides breast carcinoma?
    Fat necrosis

    Surgical scar

    Complex sclerosing lesion (doesn't need history of biopsy)
  11. Image Upload 1
    Duct ectasia
  12. Image Upload 2
    Post-partum woman with palpable lump
    Galactocele with fat fluid level
  13. Image Upload 3
    Radial scar (spiculated with central lucency, no mass like lesion in center)
  14. Image Upload 4
    Hypoechoic mass with tail

    Intraductal papilloma
  15. How can elastography be used to distinguish between benign and malignant masses?
    Malignant masses are harder/more firm - less strain compared with benign masses
  16. 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
  17. What are the most common locations for skin (dermal calcifications)?

    Inframmary fold
  18. What is the definition of a cluster of microcalcifications?
    > 5 calcifications

    Less than 1 cc/cm of volume
Card Set
Breast review
Breast radiology review